Medicine and Health Sciences Commons^™

Clinical Reasoning Development: Exploring The Role Of Instructor Feedback During Health Professions Clinical Education Experiences, Ryan T. Orrison

Graduate Research Theses & Dissertations

The growing complexity of the healthcare environment and the need to equitably address the health and well-being of a diverse patient population has increased the requirement for practical instruction and assessment of clinical reasoning in the training of health professionals. Formative assessment, in the form of feedback, is recognized as an essential instructional component in teaching clinical reasoning. This study aimed to investigate the role of feedback in developing clinical reasoning during clinical education.

This investigation consisted of three unique studies completed in phases. The scoping review methodology in phase one revealed six themes from the included articles (n = …

Latine Caregiver Perspectives Of Their Child’S Speech And Language Services, Marisol Perez

Graduate Research Theses & Dissertations

Early Intervention (EI) speech-language pathologists (SLPs) are mandated to provide culturally responsive services to culturally and linguistically diverse (CLD) clients. However, little is known about Latine caregivers’ perspectives on receiving these services. The purpose of this study was to examine Latine caregivers’ perspectives on their child’s speech and language services by answering the following research questions: 1) How do intrinsic factors relate to Latine caregiver satisfaction with their family’s speech and language services? 2) Does perception of clinician cultural sensitivity relate to Latine caregiver satisfaction with speech and language services? 3) What do Latine caregivers perceive as determinants (facilitators and …

Molecular Investigation Of Tick-Borne Pathogens In Feral Swine (Sus Scrofa) From Seven Us States, Sofiane Aiche

Masters Theses

Feral swine (Sus scrofa) have been proposed as part of the lifecycles of multiple tickborne pathogens (TBP). This is a result of the increase in feral swine populations and increased tick populations and geographic ranges. Few surveys exist on the TBP relevant to human and wildlife of feral swine in the US. The aim of this study is to investigate the prevalence of 10 TBP: Anaplasma spp., Borrelia spp., Cytauxzoon felis, Hepatozoon spp., Babesia spp., Mycoplasma spp., Trypanosoma cruzi, Toxoplasma gondii, Yersinia pestis, and Rickettsia spp. A total of 87 feral swine blood samples …

Influence Of Attack Performance On The Ovc Volleyball Regular Seasons 2022 & 2023, Ignacio Valdemoros

Masters Theses

Understanding the outcome of volleyball games is necessary for coaches before, after, and during a season. There are several ways to gain this understanding, but statistical analysis is fundamental to see the minimum patterns of behavior that influence wins and losses in Volleyball. Furthermore, this analysis helps identify the optimal approach to achieving a goal and determining the most effective alternative to success. Scoring points in Volleyball involves three key skills: serving, blocking, and attacking. Among these skills, attacking plays the most relevant role in determining the outcome of a match. The position on the court (e.g. Outside Hitter, Middle …

Abelson (Abl) Tyrosine Kinase Inhibitors Reduce Porcine Reproductive And Respiratory Syndrome Virus (Prrsv) Replication In Vitro, Jenna Parliament

Electronic Theses and Dissertations

Porcine reproductive and respiratory syndrome virus (PRRSV) is an enveloped, positive-sense, single-stranded RNA virus from the Arteriviridae family. PRRSV causes respiratory illness and reproductive failure in infected pigs. Outbreaks occurring in the United States and worldwide cause significant economic losses annually. Abelson (Abl) tyrosine kinase is a non-receptor tyrosine kinase, which plays a central role in regulating many cellular processes such as actin reorganization, cell proliferation and differentiation by transducing extracellular and intracellular signals. Abl inhibitors have been shown to restrict the entry of membrane fusion of enveloped viruses, such as severe acute respiratory syndrome coronavirus, Middle Eastern respiratory syndrome …

2,3,4 Trihydroxybenzoic Acid, A Plant Secondary Metabolite Inhibits Cancer Cell Growth, Mina Akter

Electronic Theses and Dissertations

Nature offers many sources such as fruits, beverage crops, vegetables, herbs, spices, tea, dark chocolate, and wine, that are rich in hydroxybenzoic acids (HBAs). They are a prominent phenolic acids with excellent biochemical and antioxidant properties. Due to the vast dietary health benefits of HBAs such as anti-inflammatory, anti-allergenic, immunoregulatory, antimicrobial, antithrombotic, antidiabetic, anticancer properties and cardioprotective capabilities, they are attracting the attention of physicians and researchers alike to understand their mechanisms of action. It is anticipated that the understanding of the role of HBAs for their greater use in diet/supplements is beneficial to reverse common illnesses such as inflammation, …

Insulin Responses, Diet Composition, And Fat Loss, Amanda Finn

All ETDs from UAB

Some but not all studies show participants who have higher baseline insulin responses lose more weight on a low glycemic load compared to a high glycemic load diet. Most prior research tested the relationship between insulin and weight changes with only one insulin response variable, such as insulin from an orally or intravenously (IV) administered metabolic test. We tested whether insulin responses (IV or oral) predicted changes in body fat among participants undergoing diet-induced weight loss. This study was a secondary analysis of a clinical trial. In the parent study, participants were randomized to either a reduced carbohydrate (ReducedCHO) or …

Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi

All ETDs from UAB

Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …

The Role Of Fibroblast Growth Factor Receptors In Inflammatory Airway Diseases, Molly Easter

All ETDs from UAB

Chronic inflammation plays a role in the development and progression of airway diseases such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). COPD is caused primarily by chronic cigarette smoke exposure. Conversely, CF is a single gene disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR). Although the causes of COPD and CF are different, there are common pathological features. Studies show that chronic inflammation plays a significant role in the pathogenesis of both COPD and CF. Moreover, chronic inflammation induces ageing-associated pathomechanisms like cellular senescence, which exacerbates chronic inflammation. Previous work demonstrates that …

Non-Catalytic Regulators Of The Secretory Pathway, Peyton Vanwinkle

All ETDs from UAB

This thesis focuses on two key questions: 1) how are bone development and regeneration regulated by the CREB3L1 transcription factor; and 2) what is the mechanism of action of the endoplasmic reticulum resident protein JAGN1, which when dysregulated, causes severe congenital neutropenia (SCN)? CREB3L1 regulates bone development and regeneration in mammalian models by facilitating the expression of COL1A1 and components of the secretory pathway required for collagen secretion. We generated two zebrafish models of Creb3l1 dysfunction (creb3l1ΔbZIP/ΔbZIP and creb3l1TA+/TA+). Both models showed that Creb3l1 functions in regulating col1a1a transcription and overall regenerate size are conserved in zebrafish. However, we also …

Utilization Of Romosozumab During Covid-19 Pandemic Among U.S. Medicare Beneficiaries, Ye Liu

All ETDs from UAB

Osteoporosis is increasingly recognized as a major public health issue in the aging U.S. population. Shortly after the licensure of romosozumab, an injectable medication indi-cated for women with postmenopausal osteoporosis at high risk of fracture administered by health care provider monthly, the COVID-19 pandemic broke out, which caused ma-jor disruptions to the delivery of health care across the nation. The pandemic dispropor-tionately affected minority and economically disadvantaged communities, exacerbating many pre-existing health disparities. Romosozumab has the highest dosing frequency among common injectable osteoporosis medications in the U.S. that require an office visit for injection, making romosozumab adherence more susceptible to …

Diagnostic Imaging Approaches: Pet Imaging In Monitoring Immune Responses In Oncology And Tuberculosis, Chanelle Hunter

All ETDs from UAB

Positron emission tomography (PET) imaging agents play a transformative role in personalized medicine through their application in disease diagnosis and immunotherapy monitoring, focusing on chemokine receptors, TH1-activated immune cells, and tuberculosis (TB) diagnostics. In immuno-oncology, accurately assessing TH1-activated immune cells in the tumor microenvironment (TME) is vital for evaluating cancer immunotherapy efficacy. Chemokine receptors, crucial in cellular signaling and inflammatory reactions, play a significant role in TH1 responses, thus serving as a potential area of interest in elucidating these anti-tumor responses. Through our work a novel CXCR3-targeting immunoPET probe, [89Zr]DFO-αCXCR3, was developed to detect and quantify these cells. This probe …

Crown Fatigue Resistance And Enamel Wear Of 3d Printed Resin Compared To Lithium Disilicate, Pranit Vasant Bora

All ETDs from UAB

Purpose: The purpose of this study is to compare the wear characteristics and fatigue resistance of two dental crown materials: SprintRay Ceramic Crown, a 3D-printed resin material, and IPS™ e.Max CAD, a lithium disilicate material. Methods: This study evaluates wear and fatigue characteristics of dental crowns made from Ceramic Crown (SprintRay) and IPS e.max CAD LT (Ivoclar). For fatigue testing, custom fatigue devices were utilized to subject the crowns to cyclic loading, simulating occlusal forces. The specimens underwent 100,000 cycle intervals until 1.5 million cycles at a load of 40N of fatigue loading, with inspections conducted for signs of debonding, …

Phosphate Drives Pulmonary Inflammation Through Fgfr1, Erk, And Akt Signaling, Seth Bollenbecker

All ETDs from UAB

Chronic kidney disease (CKD) is characterized as irreversible progressive loss of renal function and affects over one tenth of the global population. Although CKD-associated comorbidities contribute significantly to its mortality, the lungs are often not considered. Lung diseases make up three of the top six leading causes of death worldwide and share many comorbidities with CKD. Clinical reports show that CKD patients are more likely to develop obstructive and restrictive lung diseases, but the mechanisms underlying this propensity for CKD-associated pulmonary complications are unknown. Hyperphosphatemia and associated elevations of fibroblast growth factor (FGF) 23, two of many consequences of reduced …

Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee

All ETDs from UAB

There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …

Predictive Modeling Using Clinical Data And Compositional Microbiome Data, Li Zhang

All ETDs from UAB

This dissertation focuses on developing predictive modeling using data from two areas: clinical data and microbiome data. Compositional data in real life are mainly represented by relative proportions. With the advancement of next-generation sequencing (NGS) technology, researchers can now collect a large volume of metagenomic sequencing data, which is valuable for investigating associations between the microbiome and host diseases. Current methods for dealing with such data are either constrained by generalization or limited by application. In the first part, to address this, we propose Bayesian compositional generalized linear models for analyzing microbiome data (BCGLM). This model incorporates a structured regularized …

The Multifaceted Role Of Neutrophil Heterogeneity In Covid-19 Pathogenesis, Marcus Darrell Davis

All ETDs from UAB

COVID-19 is a respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The disease is characterized by an excessive inflammatory response and dysfunction of the immune system triggered by immunopathological mechanisms. Neutrophils are the most abundant circulating leukocytes, playing a critical role in the pathogenesis of multiple inflammatory conditions. Several studies have demonstrated that neutrophils are key contributors to COVID-19 disease pathogenesis; however, their role in disease progression remains unclear. Here, we demonstrate immune dysregulation in COVID-19 patients characterized by a significant expansion of neutrophil numbers and reduced frequency of T-cell populations. We identify an immature …

Access To And Service Utilization Of Alabama Medicaid's Section 1115 Demonstration Waiver Program, Sarah Lee Bowler

All ETDs from UAB

Background: Much research has been done investigating health disparities in the field of publicly-funding family planning. However, no longitudinal analysis has been conducted to examine the impact of Alabama Medicaid’s Section 1115 demonstration waiver on access to care, experience of barriers reported by enrollees, and repeat utilization of services. Methods: Medicaid enrollment and visit claims data were used to answer the questions related to access and service utilization. Annual Plan First survey data were used to investigate the experience of barriers to care among enrollees. For all three research questions, descriptive statistics were calculated, and linear probability models were used …

The Prescription Drug Monitoring Program And Its Effect On Drug Overdose Mortalities, Charles Lee

All ETDs from UAB

The opioid epidemic is a growing concern, and the health and economic impacts on rural and urban counties are increasing. Between 1999 and 2019, approximately 841,000 people died from drug overdoses involving heroin, synthetic opioids, and prescribed opioids with 71,000 dying in 2019. This study examined the relationship between drug overdose mortalities and three independent variables, (a) Medicaid expansion, (b) Years PDMP active, and (c) Academic detailing engagement. Results of this study will contribute to the literature by determining if the Medicaid expansion, years prescription drug monitoring programs active, and academic detailing engagement decrease drug overdose mortalities. This study includes …

Unmasking Molecular Mechanisms Of Multiple Maladies Through Multiomic Methodologies, Luke Potter

All ETDs from UAB

Much modern biomedical research is invested in determining causative molecular mechanisms and identifying potential therapeutics within human disease or injury. Traditional experiments such as over-expressing or “knocking out” the level of a gene’s abundance can determine the specific contribution of a single gene to a pathology and are a vital component of scientific research. However, taking a big picture approach through the application of ‘omics technologies can lead to a broader overall understanding of a pathology and can potentially generate numerous specific hypotheses to be tested using the more traditional molecular approaches. In this dissertation, transcriptomic and epigenomic technologies, measuring …

Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles

All ETDs from UAB

USING HOPE TO COPE: CHRONIC STRESS, RELIGIOUS COPING, AND MASKED HYPERTENSION IN AFRICAN AMERICAN ADULTS: THE JACKSON HEART STUDY ABSTRACT Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office. Few data are available on the association of chronic stress with BP measured outside of the office setting. Religious coping, applying religious beliefs to adapt to stressful situations, and functional and structural social support may protect against MHT by promoting active coping behaviors and increasing emotional well-being. High levels of religious involvement and high social support have been …

Effect Bioactive Material Have On Tooth Demineralization, Taillk Gomes

All ETDs from UAB

The objective of this in vitro study is to compare the inhibition of demineralization of root dentin caused by the presence of different restorative materials using Vickers Hardness (HV) test (microhardness) test and polarized light microscopy (PLM).

The Impact Of O-Glcnac Signaling On Dna Hydroxymethylation In Temporal Lobe Epilepsy, Rudhab Bahabry

All ETDs from UAB

Temporal Lobe Epilepsy (TLE) is the most prevalent form of focal epilepsy and the most treatment-resistant type. This condition is characterized by recurrent, unprovoked seizures typically originating in the hippocampus. Epigenetic modifications such as DNAme changes have been implicated in brain functions such as synaptic plasticity, learning and, memory, and cognition. The oxidation of DNA 5-methylcytosine (5-mC) and its oxidized form, 5-hydroxymethylcytosine (5-hmC) catalyzed by Ten-Eleven Translocation (TET) family of dioxygenases and linked to epilepsy's hyperexcitable state. Post‐translational modifications (PTMs) of proteins, such as O-GlcNAcylation, facilitate cells' immediate responses to intracellular or extracellular environmental stimuli by modifying the functions of …

The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain

All ETDs from UAB

Background: Fragility fractures pose a significant healthcare and economic burden in the United States. While age and bone mineral density (BMD) are the primary established risk factors for fragility fractures, the relationship between cardiovascular disease (CVD) and fractures remains underexplored. The primary objective of this analysis was to estimate the association of CVD risk with fractures in postmenopausal women. Methods: Utilizing 30 years of data from the WHI, Atherosclerotic Cardiovascular Disease (ASCVD) risk scores were computed using baseline age, race, systolic blood pressure, total cholesterol, high-density lipoprotein, diabetes, anti-hypertension medications, and smoking. Fracture outcomes encompassed any clinical fracture, major osteoporotic …

Associations Between Grit, Life Satisfaction, And Academic Outcomes In Elementary And Middle School Students, Charles Jaylon Williams

All ETDs from UAB

Grit is used to predict various positive benefits within students. Grit is trying to get back up to attempt another try at one’s goal after failure. Recently, grit has been seen as a potential candidate in improving the life satisfaction and academic performance of individuals. Grit is conceptualized as having two components, perseverance of effort and consistency of interest. Perseverance of effort is trying again until you finally accomplish your goal, while consistency of interest is a constant drive to complete one’s goals over a long-time span. This study measured the effects that grit has on elementary and middle school …

Investigating Hiv-1 Transmission To Human Cervix Using Reporter Virus Technologies, Dana Frances Indihar

All ETDs from UAB

Around 39 million people globally are currently infected with Human immunodeficiency virus 1 (HIV-1), more than half of whom are women. HIV-1 is a retrovirus that infects and depletes an individual’s immune cells, culminating in the development of acquired immunodeficiency syndrome (AIDS) if not managed with anti-retroviral therapies (ART). Most women acquire HIV-1 through heterosexual intercourse. However, the early mechanisms and virologic determinants of HIV-1 transmission to women remain unclear. Herein, we demonstrate transmitted/founder (TF) HIV-1 representing two genetically and pathogenically distinct subtypes (A and D) in vivo have distinct replication phenotypes in an ex vivo cervical explant tissue (CET) …

Physical And Optical Properties Of Material Used For Injection Molding, Nadia Christine Farias Machado

All ETDs from UAB

Background: This project investigates the materials used in injection molding dental resin composites which involves injecting flowable composite into a clear mold. Understanding the physical and optical properties of both the resin composite and the clear mold material is crucial for successful clinical outcomes. For the clear mold material, its translucency, curing light transmission, and rigidity are vital factors. Correlations may be present between trans-lucency and curing light transmission. For the resin composite, comparing wear, hardness, translucency, radiopacity, shrinkage stress, flexural strength, and modulus will affect mate-rial performance. Finally, the depth of cure of the material will be dependent on …

Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair

All ETDs from UAB

In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …

Novel Roles Of Rab35 In Development And Disease, Kelsey Ruth Clearman

All ETDs from UAB

As the largest and most dynamic family of GTPases within the mammalian cell, Rabs play an essential role as molecular switches in regulating intracellular vesicular trafficking and serve as significant signaling transducers. Over the last few decades, Rabs have been identified to regulate endocytic, transcytosis, and exocytotic pathways, and mutations in Rabs, or alterations in downstream effectors lead to embryonic lethality and diseases such as cancer and ciliopathies. Ciliopathies are a class of pathologies that result from defects in structure or function of the primary cilia. Primary cilia, found on virtually all mammalian cells, is a microtubule-derived appendage that relies …

The Modification Of Single Domain Antibody Framework And Variable Regions To Impart Novel Pharmacodynamic And Pharmacokinetic Properties, Lucinda Ann Hall

All ETDs from UAB

In recent years, nanobodies have become important theranostic molecules, and research has focused on improving their pharmacokinetics and binding for novel targets. Nanobodies are characterized by their high kidney uptake, leading to potentially unsafe exposure of the kidneys when delivering cytotoxic payloads. Researchers hypothesize that positively charged amino acids contribute to this kidney uptake. To address this, we assessed the impact of substituting lysine residues within the 2Rs15d HER2 nanobody scaffold to alanine on its in vivo pharmacokinetics using positron emission tomography (PET) imaging. We found that nanobodies bearing lysine-to-alanine substitutions maintained their affinity for HER2. Characterization of the K88A …