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Articles 811 - 840 of 2525
Full-Text Articles in Medicine and Health Sciences
The Effect Of Allergic Airway Sensitization On The Immune Response To Pulmonary Bacterial Infection., Arthur Harold Totten
The Effect Of Allergic Airway Sensitization On The Immune Response To Pulmonary Bacterial Infection., Arthur Harold Totten
All ETDs from UAB
Asthma is a chronic respiratory disease associated with small airway obstruction and hy-perreactivity. Greater than 300 million people are estimated to live with asthma world-wide, and in the United States (US), estimated cost-of-care is over $50 billion per year. Allergic sensitization and infections have proven to be important in both asthmatic development, as well as recurrent exacerbations. Diversity and number of bacterial species are increased in asthmatics compared to non-asthmatics, and is also predictive of increased incidence of res-piratory infections. Mycoplasma pneumoniae (Mpn) is an atypical bacterial pathogen of the class Mollicutes, which lacks a cell wall and is an …
Analysis Of The Gtp Cyclohydrolase I/Tetrahydrobiopterin Pathway In Glioblastoma Biology, Anh Tran
Analysis Of The Gtp Cyclohydrolase I/Tetrahydrobiopterin Pathway In Glioblastoma Biology, Anh Tran
All ETDs from UAB
Glioblastomas (GBMs) are the most common primary malignant brain tumors in adults and one of the most aggressive cancers with high rates of recurrence and therapeutic resistance. In GBMs, subpopulations of highly tumorigenic cells called brain tumor initiating cells (BTICs) have the unique capacity to promote tumor maintenance, therapeutic resistance, and angiogenesis. Depending on the level, differentiation state, and tumor stage, reactive nitrogen and oxygen species inhibit or increase cancer growth and BTIC maintenance. GTP cyclohydrolase 1 (GCH1) is the rate limiting enzyme in a pathway that can regulate reactive species production but has not been thoroughly investigated in GBM. …
Assessing Barriers And Facilitators To Appropriate Care For Chronic Pain And Prescription Opioid Abuse, Allyson Varley
Assessing Barriers And Facilitators To Appropriate Care For Chronic Pain And Prescription Opioid Abuse, Allyson Varley
All ETDs from UAB
The objective of this study was to understand and assess barriers and facilitators to the uptake of appropriate care for co-occurring chronic noncancer pain (CNCP) and opioid use disorder. Rates of CNCP and opioid overdose have doubled in the past decade. When a patient transitions from appropriate use to misuse, significant changes must be made to their treatment plan. Considering most CNCP is treated with opioids in the primary care setting, primary care providers (PCPs) are potential change agents to remediate the epidemic of opioid abuse. Although studies have explored opioid stewardship, we still lack an understanding of the factors …
Visual, Attentional, And Cognitive Risk Factors For Motor Vehicle Collision Involvement Among Older Adults, Carrie Huisingh
Visual, Attentional, And Cognitive Risk Factors For Motor Vehicle Collision Involvement Among Older Adults, Carrie Huisingh
All ETDs from UAB
Motor vehicle collisions are a major public health problem for older adults in the United States. In 2013, there were 5,671 older adults killed and an estimated 222,000 injured in motor vehicle crashes. After adjusting for miles driven, the risk of crashing increases rapidly after age 70, nearly equal to that of younger drivers whose crash rate is the highest among all age groups. Driving is a highly complex task that relies on a variety of visual and cognitive functions. A large body of work has demonstrated that drivers with visual sensory impairments and/or higher-order visual-cognitive processing deficits, those who …
Global Analysis Of Rpl12 Epistasis Within The Yor1-Δf Biogenesis Network, Mert Icyuz
Global Analysis Of Rpl12 Epistasis Within The Yor1-Δf Biogenesis Network, Mert Icyuz
All ETDs from UAB
In frame deletion of the phenylalanine residue at position 508 of the cystic fibrosis transmembrane conductance regulator (CFTR-ΔF508) results in protein misfolding and degradation, which reduces expression and function at the plasma membrane. The resulting loss of chloride and bicarbonate transport is the molecular basis of cystic fibrosis (CF). The F508-analogous mutation in the yeast oligomycin resistance 1 gene, yor1-ΔF670, has the same molecular consequences, but the phenotypic consequence is reduced resistance to growth inhibition by oligomycin. Comprehensive, systematic and quantitative analysis Yor1-ΔF gene modifiers has been demonstrated as a powerful way to further characterize known and to discover novel …
Prenatal And Postnatal Factors Regulate Food Intake And Body Composition, Minsung Kang
Prenatal And Postnatal Factors Regulate Food Intake And Body Composition, Minsung Kang
All ETDs from UAB
This research sought to identify the effects of prenatal and postnatal factors on systemic metabolism and the regulation of food intake, weight, and body composition. It was found that the manipulation of maternal diets influenced the systemic metabolism of offspring. The offspring of dams fed an isocaloric, low protein diet were significantly smaller and consumed less food than offspring from dams fed a control diet. In the case of the offspring from dams fed a western diet, they were significantly heavier and consumed more food than offspring from dams fed a control diet. In addition, the offspring showed altered glucose …
Exploring Long-Haul Truck Drivers' Cpap Use When Working Over The Road, Kenya D. Kirkendoll
Exploring Long-Haul Truck Drivers' Cpap Use When Working Over The Road, Kenya D. Kirkendoll
All ETDs from UAB
Obstructive sleep apnea (OSA) is a chronic health condition affecting an estimated 13-26% of U.S. adults. The condition is characterized by partial or total airway collapse. It has been associated with increased cardiovascular disease, hypertension, and diabetes mellitus morbidity. Risk factors include middle-age, obesity, male gender, narrowed airway, and smoking. Continuous positive airway pressure (CPAP) is the recommended treatment for OSA. Though it is an effective treatment modality, uptake and adherence to CPAP remains low. With concern for public safety, OSA has received a great amount of attention in the trucking industry. When working over the road, long-haul truck drivers …
Evaluating Fty720 As An Anticancer Agent In Models Of Ovarian Cancer, Kelly Marie Kreitzburg
Evaluating Fty720 As An Anticancer Agent In Models Of Ovarian Cancer, Kelly Marie Kreitzburg
All ETDs from UAB
Despite satisfactory initial responses to frontline therapies that combine tumor debulking with platinum and taxane-based chemotherapies, ovarian cancer remains the principle cause of gynecological malignancies. Drug resistance at relapse contributes to poor outcomes for women diagnosed with advanced disease and underscores the need for novel therapeutic strategies. Compelling data have implicated bioactive sphingolipids and their metabolism in the development and progression of ovarian cancer. Aberrations in sphingolipid metabolism that limit levels of the tumor suppressor lipid ceramide contribute to chemotherapy resistance. This dissertation presents work investigating the anticancer efficacy of the immunomodulatory drug FTY720. The sphingosine analog FTY720 has shown …
Assessment Of Head Asymmetry In Prematurely Born Children During Early Childhood Using 3d Photography, Panagiotis Kyteas
Assessment Of Head Asymmetry In Prematurely Born Children During Early Childhood Using 3d Photography, Panagiotis Kyteas
All ETDs from UAB
The aim of this study is to assess the course of plagiocephaly during early childhood in preterm and fullterm children and determine any differences throughout the given timeframe between the two groups. Materials and Methods: 34 preterm and 34 fullterm children born in the Oulu University Hospital, Finland attended the clinical study at the age of 3 (T1), 6 (T2), (T3) months and 3 years (T4). At each visit, 3D images of the head were obtained using a 3dMD head 5-pod camera system (3dMD, Atlanta, GA). Nine outcome variables including 2D and 3D measurements were calculated. Results: At T1, 26.47% …
An Investigation Of Sla Class Ii As A Xenoantigen, Joseph Ladowski
An Investigation Of Sla Class Ii As A Xenoantigen, Joseph Ladowski
All ETDs from UAB
Xenotransplantation, using genetically-modified pigs as organ donors, is a potential solution to the growing transplant organ shortage. Avoiding antibody-mediated rejection (AMR) is the remaining hurdle to widespread application. The development of a triple glycan knockout pig reduced antibody binding to clinically acceptable levels, allowing for the screening of the history of antibodies to the major histocompatibility complex (MHC). In allotransplantation, the MHC is a group of proteins divided into two classes and anti-MHC antibodies possess the ability to cause both acute and chronic AMR. The pig MHC, the swine leukocyte antigen (SLA), is a hypothesized target of antibodies. This dissertation …
Genetic Influences On Rheumatoid Arthritis In Global Populations, Vincent Albert Laufer
Genetic Influences On Rheumatoid Arthritis In Global Populations, Vincent Albert Laufer
All ETDs from UAB
Rheumatoid arthritis (RA) is a complex disease having numerous genetic and environmental risk factors the interplay of which produces RA pathobiology. While the sheer number of genetic and environmental risk factors complicates understanding of disease biology, understanding has progressed far enough for insight into the most likely mechanisms for the development of the disease. Modern studies of the genetics of RA are massively parallel, enabling researchers to systematically interrogate variants throughout the human genome for associations in genome-wide association studies or GWAS. Such studies have been carried out in European and Asian cohorts many times, and the most recent RA …
The Mechanism Of Tobacco-Induced Decrements In Mucociliary Clearance, Vivian Lin
The Mechanism Of Tobacco-Induced Decrements In Mucociliary Clearance, Vivian Lin
All ETDs from UAB
Chronic obstructive pulmonary disease (COPD), characterized by progressive loss of lung function including mucus obstruction and airway remodeling, is primarily caused by cigarette smoking. This pulmonary phenotype resembles that of cystic fibrosis (CF), which results from genetic mutations in the cystic fibrosis transmembrane conductance regulator (CFTR), an ion channel important in maintaining airway surface hydration and mucus clearance. Cigarette smoke exposure has been found to induce acquired CFTR dysfunction, leading to airway dehydration, abnormal mucin production, and impaired mucus transport. Smoke exposure also induces mucus hypersecretion and ciliary dysfunction; together, these changes result in defective mucus clearance and subsequent muco-obstruction. …
Bone Marrow Transplantation In A Mouse Model Of Cooley’S Anemia, Jonathan Russell Lockhart
Bone Marrow Transplantation In A Mouse Model Of Cooley’S Anemia, Jonathan Russell Lockhart
All ETDs from UAB
β-thalassemia is a group of inherited blood disorders that result in defects in β-globin chain production. Cooley’s anemia (CA), or β-thalassemia major, is the most severe form of the disease and occurs when an individual has mutations in both copies of the adult β-globin gene. Patients with CA fail to make adult hemoglobin, have ineffective erythropoiesis, suffer from severe anemia, and are transfusion dependent for life. Currently, allogeneic bone marrow transplantation (BMT) is the only cure; however, few patients have suitable donors for this procedure that carries a significant risk of morbidity and mortality. To develop new and safer alternatives …
Financial Distress – Causes And Consequences: An Examination Of The Nursing Home Industry, Justin Caleb Lord
Financial Distress – Causes And Consequences: An Examination Of The Nursing Home Industry, Justin Caleb Lord
All ETDs from UAB
Nursing homes operate in a tumultuous and changing environment and are under increasing financial pressure, risk of closure, and financial distress. The issue of financial distress has been explored tangentially within the nursing home industry. This study is the first to validate the Altman Z-Score, a financial distress prediction model, within the nursing home context. The Altman Z-Score model uses multiple discriminate analysis (MDA) to examine multiple financial ratios (liquidity, efficiency, profitability and net worth) simultaneously to predict the likelihood of a firm’s financial distress. After calculating the Z-Score, clustering was used to classify the observations into three groups, distressed, …
Developing Novel And Effective Treatments For Pancreatic Ductal Adenocarcinoma, Aubrey Miller
Developing Novel And Effective Treatments For Pancreatic Ductal Adenocarcinoma, Aubrey Miller
All ETDs from UAB
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor with a 5-year survival rate of 8%. Over 80% of patients are diagnosed with locally advanced or metastatic disease and undergo systemic chemotherapy with gemcitabine. Virtually all patients develop gemcitabine-resistant disease and median survival for these patients is ~6 months. Thus, identification of novel molecular targets and pre-clinical evaluation of therapeutics is essential to improving patient outcome. The bromodomain and extraterminal domain (BET) proteins are important regulators of transcription and have recently become a potentially effective target to treat PDAC. We have shown that the BET inhibitor JQ1 suppressed PDAC tumor …
Hiv Disclosure, Retention In Hiv Care, And Viral Load Suppression : A Study Among New To Hiv Care Patients, Riddhi Modi
Hiv Disclosure, Retention In Hiv Care, And Viral Load Suppression : A Study Among New To Hiv Care Patients, Riddhi Modi
All ETDs from UAB
HIV remains a major ongoing public health problem globally and in the United States (US). Despite the advances in the antiretroviral therapy (ART), new HIV cases continue to occur. Hence, understanding the factors that influence patient’s decision to HIV treatment and prevention is of paramount. HIV disclosure, an important modifiable behavior, is a barrier to linkage and engagement in HIV care. Thus far, studies examining HIV disclosure and its impact on HIV related outcomes, retention in care (RIC) and viral load (VL) suppression among HIV patients newly initiating care are scant. While these studies provide insights on risk factors of …
A Mixed Methods Study Evaluating A Pediatric To Adult Care Transition Program For Sickle Cell Disease, Ardie Vanessa Pack-Mabien
A Mixed Methods Study Evaluating A Pediatric To Adult Care Transition Program For Sickle Cell Disease, Ardie Vanessa Pack-Mabien
All ETDs from UAB
A MIXED METHODS STUDY EVALUATING A PEDIATRIC TO ADULT CARE TRANSITION PROGRAM FOR SICKLE CELL DISEASE ARDIE VANESSA PACK-MABIEN SCHOOL OF NURSING ABSTRACT Sickle cell disease is a potentially life-threatening hereditary hematological disorder. Transition from pediatric to adult care is a challenging process for many adolescents and young adults with sickle cell disease. These challenges involve the adolescent, young adult, family caregiver, health care provider, and health care system. To address the challenges, a limited number of sickle cell centers have developed transition programs to facilitate the transition process. However, research on transition programs is sparse. To address this gap, …
T Cell Immunity Directed Against Novel Anti-Sense Cryptic Epitopes And Its Impact On Hiv Viral Evolution, Binghao Jason Peng
T Cell Immunity Directed Against Novel Anti-Sense Cryptic Epitopes And Its Impact On Hiv Viral Evolution, Binghao Jason Peng
All ETDs from UAB
After nearly four decades of scientific research, a global solution in eradicating the human immunodeficiency virus - 1 (HIV-1) pandemic has still yet to be discovered. The advent of antiretroviral therapies (ART) has significantly decreased the diseases burden for those infected with the virus; however, the access to ART is often limited to those with the financial abilities to afford it. For this reason, finding a way to vaccinate against HIV-1 successfully remains a sought-after pragmatic solution to this worldwide health issue. HIV immunological studies have taught us that increasing the breadth of response to the virus holds significant potential …
Mucus Adhesion As A Therapeutic Target In Cystic Fibrosis, Courtney Fernandez Petty
Mucus Adhesion As A Therapeutic Target In Cystic Fibrosis, Courtney Fernandez Petty
All ETDs from UAB
Cystic fibrosis (CF) is a genetic disease resulting from mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. CFTR is an ion channel responsible for proper movement of chloride and bicarbonate ions across the apical cell surface. Defective CFTR results in an absence of bicarbonate transport, which functions in part to chelate Ca2+, a divalent cation found in abundance in mucin granules in normal conditions; this yields a hyperviscous and adhesive mucus on the respiratory and gastrointestinal tracts of patients with CF. Bronchial mucins are glycosylated proteins with neutral and negative sugars modified by negatively charged sialic and neuraminic …
Transcriptional Changes Underpinning Poor Prognosis And Chemoresistance In Pancreatic Cancer, Ryne Ramaker
Transcriptional Changes Underpinning Poor Prognosis And Chemoresistance In Pancreatic Cancer, Ryne Ramaker
All ETDs from UAB
With a 5-year survival rate of 7% and only marginal improvements in recent dec-ades, pancreatic adenocarcinoma (PDAC) survival statistics present a disheartening chal-lenge. A majority of the high mortality rate associated with PDAC is due to late-stage diagnosis and limited efficacy of the current chemotherapeutic arsenal. This work is largely focused on the ~20% of tumors detected prior to metastasis for which curative surgical resection can be combined with chemotherapy and radiation therapy, increasing the 5 year survival rate to ~25%. Although a subset of these patients who undergo surgi-cal resection experience sustained remission, a majority of patients still relapse …
The Effect Of Novel Antibiotic Compounds On Endodontic Biofilms, Steven Rhodes
The Effect Of Novel Antibiotic Compounds On Endodontic Biofilms, Steven Rhodes
All ETDs from UAB
Purpose: To investigate the effects of three novel experimental antibiotics on monospecies (Enterococcus faecalis) and polymicrobial (mixed) endodontic biofilms. Materials and Methods: Biofilms containing pure Enterococcus faecalis, as well as biofilms derived from mixed bacterial samples aspirated from inside the pulp spaces of necrotic human teeth, were grown onto slices of human dental in vitro. Biofilm formation capability was verified with SEM. The treatment groups consisted of 3 novel experimental antibiotics. 8.25% sodium hypochlorite and sterile saline were used as the controls. The biofilms were investigated with live/dead fluorochrome staining and confocal laser scanning microscopy. Results: The full strength sodium …
The Effects Of Ketamine And Other Rapid Antidepressants On Hippocampal Circuits, Allie J. Widman
The Effects Of Ketamine And Other Rapid Antidepressants On Hippocampal Circuits, Allie J. Widman
All ETDs from UAB
Major Depressive Disorder (MDD) in a common mental disorder that can impair cognitive functioning and negatively impact hippocampus. While several pharmacological treatments are currently available for MDD, most target the monoamine system, providing little variety in approaching treatment. Additionally, a large percentage of people with MDD have an inadequate response to this drug class, leaving them with little optimism of a full functional recovery. Recently, low-dose ketamine, an open-channel N-methyl D-aspartate receptor (NMDAR) antagonist, produced rapid antidepressant effects in humans, including people who do not respond to monoamine-based therapies, that lasted for days. The antidepressant-like behavioral effect of ketamine is …
Assessing The Comparative Effect Of Tocilizumab On Risk Of Cardiovascular Disease Among Rheumatoid Arthritis Patients Using Claims Data: A Direct Comparison Among Biologic Disease-Modifying Antirheumatic Drugs, Fenglong Xie
All ETDs from UAB
ASSESSING THE COMPARATIVE EFFECT OF TOCILIZUMAB ON RISK OF CARDIOVASCULAR DISEASE AMONG RHEUMATOID ARTHRITIS PATIENTS USING CLAIMS DATA: A DIRECT COMPARISON AMONG BIOLOGIC DISEASEMODIFYING ANTIRHEUMATIC DRUGS FENGLONG XIE PhD-EPID ABSTRACT Tocilizumab is a humanized monoclonal anti-body against the interleukin-6 receptor and is effective in the treatment of rheumatoid arthritis (RA) [1]. Multiple studies have observed unfavorable changes in the lipid profile of tocilizumab-treated RA patients. Few studies have compared the cardiovascular disease (CVD) risk associated with tocilizumab to other biologic disease-modifying antirheumatic drugs (bDMARDS). Due to limitations in existing studies, the real-world association of tocilizumab with CVD risk remains uncertain. …
Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen
Interorganizational Relationships And Hospital Adoption Of Surgical Robots, Stephen Cullen
All ETDs from UAB
INTERORGANIZATIONAL RELATIONSHIPS AND HOSPITAL ADOPTION OF SURGICAL ROBOTS STEPHEN G. CULLEN EXECUTIVE DOCTORIAL PROGRAM IN HEALTHCARE LEADERSHIP ABSTRACT The study investigates the relationship between interorganizational relationships (IORs) and hospital adoption of robotic surgery in the United States over a ten-year period. As a competitive strategy for hospitals, IORs should matter in a hospital’s decision to adopt a surgical robot given associated costs and risks. While literature exists on IORs and technical innovation, there is a gap in the literature on IORs and hospital adoption of surgical robots. This study explores four types of IORs (i.e., networks, systems, contract management, and …
Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis
Effects Of Dietary R,S-1,3 Butanediol Diacetoacetate On Components Of Energy Balance, Rachel A H Davis
All ETDs from UAB
Ketogenic diet (KD) has been used to attenuate the decline in energy expenditure occurring from calorie restriction-induced weight loss, but long-term adherence can be difficult due to the strict nature of the diet. The growing body of evidence supporting KD-treatment of neurologic and metabolic diseases, as well as obesity, has prompted interest in the ability to increase circulating ketones via exogenous delivery. Ketone esters (KE) can raise blood ketone concentrations similarly to fasting and appear to reduce food intake acutely, but studies assessing effects on energy balance are limited and provide a potentially promising direction for weight control. Previous investigations …
Examining The Relationship Between Operational And Clinical Performances Of Federally Qualified Community Health Centers, Ganisher K. Davlyatov
Examining The Relationship Between Operational And Clinical Performances Of Federally Qualified Community Health Centers, Ganisher K. Davlyatov
All ETDs from UAB
This dissertation studied the role of Health Information Technology (HIT) adoption on clinical performance; the effects of clinical performance on chief executive officer (CEO) compensation; and the association between CHC’s financial and clinical performances in Community Health Centers (CHC). Data from the Uniform Data System (UDS) and the Internal Revenue System (IRS) 990 Forms were extracted for the period 2011-2016. Generalized estimating equations models with state and year fixed effects were performed. To test the relationship between the age and extent of HIT adoption and clinical performance, Resource-Based View of the Firm constructs were used. The age of HIT adoption …
Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki
Cheminformatic Discovery And Characterization Of Copperdependent Bacterial Inhibitors, Alex Dalecki
All ETDs from UAB
Deaths due to antibiotic-resistant bacteria are predicted to exceed 10 million per year by 2050, endangering our ability to conduct fundamental medical procedures such as immunosuppressive therapy or even basic surgery. Unfortunately, we are largely falling behind in the evolutionary arms race against common pathogens. Not only are we in sore need of new antibiotics, we also evidently need altogether new approaches to drug discovery itself, as our familiar avenues are increasingly failing to meet demands. In this dissertation, we describe a promising new source of antibacterials: copper-dependent inhibitors (CDIs), compounds that exert significant antibiotic activity only in the presence …
Elucidating The Role Of Hedgehog Signaling In Modulating Macrophage Function In Breast Cancer, Ann Hanna
Elucidating The Role Of Hedgehog Signaling In Modulating Macrophage Function In Breast Cancer, Ann Hanna
All ETDs from UAB
In the tumor microenvironment, breast cancer cells participate in crosstalk with the surrounding stroma. This tumoral-stromal interaction forms a balance that dictates tumor suppressing or tumor promoting response mechanisms. Macrophages in the tumor microenvironment are plastic and can mediate several functions depending on their activation states. Tumor associated macrophages co-exist as two major phenotypes: anti-tumorigenic and immune-eliciting classically activated M1 as well as tumor-promoting and immune-suppressive alternatively activated M2 macrophages. Alternatively activated macrophages are specifically associated with more aggressive stages and poor clinical outcomes in breast cancer patients as they suppress the tumoricidal properties of the immune system, thus facilitating …
Applications Of Next-Generation Sequencing And Functional Genomics In Translational Medicine, Andrew Hardigan
Applications Of Next-Generation Sequencing And Functional Genomics In Translational Medicine, Andrew Hardigan
All ETDs from UAB
The development of next-generation sequencing (NGS) technologies has led to unparalleled advances in our understanding of the genetic basis of disease, evolution, and genetic and genomic regulation. Building on the advances made in the Human Genome Project and more recent efforts such as the Encylopedia of DNA Elements (ENCODE) and the Roadmap Epigenomics Project, whole-genome and whole-exome sequencing (WGS/WES) and a wide variety of NGS-enabled functional assays are bridging the gap between scientific discovery and clinical medicine. This trend towards genomically informed “bench-to-bedside” translational medicine is driven in large part by the sharply decreasing costs for NGS in both clinical …
A Qualitative Descriptive Study Exploring The Adaptation Of Families Of Children With Multiple Sclerosis From The Perspective Of Family Caregivers, Yolanda Carol Harris
A Qualitative Descriptive Study Exploring The Adaptation Of Families Of Children With Multiple Sclerosis From The Perspective Of Family Caregivers, Yolanda Carol Harris
All ETDs from UAB
Two to 5% of the US population of individuals afflicted with multiple sclerosis (N = 400,000) are diagnosed prior to the age of 18 with pediatric onset multiple sclerosis (POMS). Most children and teens with POMS have a relapsing remitting course of the disease with unpredictable relapse onset causing cognitive and physical disability. This can result in school absences, hospital and outpatient visits, poor academic performance and interruption in normal social activities. In turn, these individuals may develop an inability to provide self-care, which could lead to poor quality of life. POMS can affect the individual diagnosed but may also …