Medicine and Health Sciences Commons^™

Randomized Control Trial Of A Novel Dental Gel As An Adjunct To Scaling And Root Planing In Subjects With Stage Ii & Iii Periodontitis, Efstratios Choreftakis

All ETDs from UAB

Scaling and root planing (ScRP) is the gold standard for non-surgical periodontal therapy, yet no dentifrice has been definitively shown to improve its outcomes. This randomized controlled trial evaluated the effectiveness of LivFresh Dental Gel as an adjunct to ScRP in patients with Stage II and III periodontitis. Twenty-one participants were assigned to either a test group using LivFresh Dental Gel or a control group using a standard sodium fluoride dentifrice. Clinical parameters—including probing depth (PD), clinical attachment level (CAL), gingival index (GI), plaque index (PI), and bleeding on probing (BOP)—were assessed at baseline, 30, 90, and 180 days. The …

Identifying The Neurobiological Substrates Of Gulf War Illness, Chloe Lisette Jones

All ETDs from UAB

Gulf War Illness (GWI) affects approximately 30% of veterans who served in the 1991 Persian Gulf War and is characterized by chronic pain and fatigue, as well as cognitive, mood, gastrointestinal, and respiratory symptoms. Animal research has suggested that GWI is caused by a combination of neurotoxicants such as nerve gas, anti-nerve agent pills, and pesticides, though a definitive pathophysiological model has not been established. In this human observational study, 20 veterans with GWI and 20 healthy Gulf War veterans (HV) underwent whole-brain magnetic resonance spectroscopy (MRS) to non-invasively measure several metabolites associated with neuroinflammation. Whole blood was also collected …

A High-Salt Diet Modulates Renal Afferent Nerve Activity; Potential Role Of The Endothelin System, Jiaxi Shen

All ETDs from UAB

Hypertension is a prevalent disease around the world. Increased blood pressure leads to a higher risk of stroke and coronary heart disease. Diet, lifestyle, and gene regulation are potential causative factors, and salt-sensitive hypertension is one common types of hypertension. In response to a high-salt diet, blood pressure may elevate with increasing risks of cardiovascular disease (CVD). Endothelin-1, which binds to endothelin A (ETA) and B (ETB) receptors, is strongly involved in controlling the blood vessels and sensory nerve signaling pathway between the kidney and the central nervous system during high salt dietary challenge. The function of the ETB receptor …

Myelin Mapping In Psychosis, Victoria Lynn King

All ETDs from UAB

It is well established that myelin in the central nervous system is an axonal insulator which speeds the conduction velocity of action potentials. However, its role in the cortex has also been shown to support metabolic demands and aid in cortical plasticity. Myelin develops throughout childhood and adolescence from sensorimotor areas to association areas and peaks during adolescence. Importantly, this is the same time that psychosis-spectrum disorders (PSDs) begin to present clinically; thus, given the critical role of myelination in shaping the mature cortex, disruptions in this process – particularly during adolescence – are thought to partially explain the onset …

Impact Of Alpha-Synuclein Aggregation On Corticostriatal Synaptic Function And Morphology, Charlotte Franziska Brzozowski

All ETDs from UAB

Lewy Body Dementias (LBDs), including Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB), are defined by α-synuclein (α-syn) accumulation in Lewy Pathology (LP). LP is abundant in cortical layer V intratelencephalic (IT) neurons, a subset of neurons that also degenerate in the pre-supplementary motor area (preSMA) in humans, which is homologous to the secondary motor cortex (M2) in mice, as observed in PD postmortem tissue. IT neuron projections to the striatum are an intrinsic part of the motor basal ganglia circuitry, believed to modulate cognitive aspects of executive motor control, such as updating motor plans. M2 projections to …

Turn On, Tune In, Drop Shame: Exploring The Unique Therapeutic Potential Of Psychedelics For Sexual And Gender Minority Populations, Nicholas Carlisle

All ETDs from UAB

Sexual and gender minority (SGM) individuals face significant disparities in mental and physical health compared to their heterosexual and cisgender counterparts, due in part to chronic exposure to distal and proximal minority stressors. Shame – a self-focused characterized by a global sense of personal deficiency or unworthiness – has emerged as a key intrapersonal mechanism linking minority stressors to adverse health outcomes. This dissertation explores the role of shame in SGM health inequities and investigates the emerging potential of psychedelics to reduce shame and improve health and wellbeing in these populations. This three-paper dissertation begins with a scoping review (Paper …

Amygdala Npy+ Interneurons Are Activated By Aversive Stim-Uli, Patric Perez

All ETDs from UAB

Neuropeptide Y (NPY) serves as a critical endogenous anxiolytic and stress-buffering molecule, yet the temporal and spatial dynamics of NPY+ cells during fear learning re-main unknown. Temporal dynamics can be measured with in vivo calcium imaging tech-niques, which enable real-time monitoring of cell-type-specific neural activity in freely behaving animals. Snapshots of neuronal activation can be measured using c-Fos im-munohistochemistry, thereby providing excellent spatial resolution. Here, I employ cut-ting-edge approaches to characterize the temporal and spatial activation patterns of NPY+ cells in amygdala, a key fear-regulating brain region negatively impacted by aversive events. I first used in vivo fiber photometry, together …

Understanding Psychotic Disorders Using Normative Modeling-Derived Individual-Level Brain Structural Abnormalities, Natalie Remiszewski

All ETDs from UAB

Psychosis is an heterogenous condition that occurs in many psychiatric disorders. It has a variable symptom presentation and recent initiatives have suggested that investigating the underlying neurobiology of psychiatric disorders rather than their symptomatology would provide a more accurate picture for diagnosis, prognosis, and treatment. Grey matter has been implicated in the pathophysiology of psychosis and psychotic disorders, though significant natural variation due to age and sex have impeded the distinction of pathologically relevant grey matter abnormalities in psychosis. Additionally, case-control approaches to exploring grey matter abnormalities in psychotic disorders often obscure subtle variation in individuals. Here, we utilize a …

Strength Of Self-Adhesive Resin Cements To Shortened Zirconia Crowns With And Without An Additional Coat Of Adhesive, Abraham John

All ETDs from UAB

Self-adhesive cements have gained popularity due to their ease of manipulation as they do not require a separate etch, primer, or bonding agent to bond to the tooth or crown surfaces. However, the use of an adhesive bonding agent with a self-adhesive resin cement has been claimed to improve its bond strength. The objective of this study is to compare the retention bond strength of 2 self-adhesive cements on to the tooth surface with and without the use of bonding agents with a known control. Materials and Methods: A total of 50 extracted non-carious second premolar teeth were collected. The …

Murder On The Axonal Express: Synucleinopathy Disruption Of 14-3-3 Protein-Protein Interactions Impairs Axonal Trafficking, Frank Sanders Pair

All ETDs from UAB

14-3-3s are a family of proteins highly expressed in the brain. These proteins exert their functions mainly through protein-protein interactions (PPIs) and have thousands of binding partners. 14-3-3s have been shown to be present in pro-teinaceous aggregates of alpha-synuclein (αsyn), a pathological hallmark of synucleinopathies. This includes such diseases as Parkinson’s Disease (PD) and Dementia with Lewy Bodies (DLB). 14-3-3 proteins, particularly the 14-3-3θ isoform, have been shown to be protective in multiple synucleinopathy models. However, reduced soluble levels of 14-3-3s and increased phosphorylation of 14-3-3θ at S232 observed in synucleinopathies like DLB may impair their protec-tive ability, potentially due …

Attitudes Of Optometrists Towards Referring Patients For Nutrition And Lifestyle Changes To Treat Diabetic Retinopathy And Age-Related Macular Degeneration, Samantha Chapman

All ETDs from UAB

Some ocular diseases, including diabetic retinopathy and age-related macular degeneration, have direct links to systemic diseases or the condition of the body as a whole. Specific diet and lifestyle changes have been studied in relation to these two diseases and, while it is not within the scope of optometry to prescribe these changes for patients, an optometrist may refer to a variety of specialists so that patients can receive the most holistic care available. The primary goal of this study is to assess the attitudes of currently practicing United States optometrists towards referring to nutrition and lifestyle professionals and their …

Staff Education On Mindfulness-Based Therapy To Address Compassion Fatigue, Samson Ajibola Omowumi

Walden Dissertations and Doctoral Studies

The nature of nursing practice—persistent exposure to patient suffering—often results in compassion fatigue for staff. Compassion/emotional fatigue can affect nurses’ mental well-being, which can manifest in burnout, decreased empathy, and emotional numbness. These outcomes can eventually reduce job satisfaction for nurses and nursing assistants, increase errors during patient care, and lead to poorer patient outcomes. Prioritizing caregivers' mental health may improve the quality of nursing care. Mindfulness-based therapy (MBT) is an approach that may ensure the mental health and emotional stability of those who care for patients while also being a comparatively easy, accessible, and affordable tool. The goal of …

Education For Home Infusion Nurses, Ann Marie Wilson

Walden Dissertations and Doctoral Studies

This document presents an executive summary of a staff education initiative designed for home infusion nurses, submitted in fulfillment of requirements for the Doctor of Nursing Practice at Walden University. The project aims to address the specialized educational needs of nurses in the home infusion setting, where evolving clinical procedures and patient safety standards demand advanced competency and knowledge. Through the development and implementation of targeted educational strategies, the project seeks to enhance nurses' skills, promote best practices in infusion therapy, and improve health outcomes for patients receiving infusion care at home. Key objectives include identifying gaps in current education, …

From Novice To Expert: A Quality Improvement Project For Novice Faculty Role Confidence, Delainey Asher

Doctor of Nursing Practice Projects

A major contributor to the overall nursing shortage is the lack of adequately prepared faculty. This is especially prevalent among novice educators who struggle with transitioning from clinical expert to novice educator. Novice educators report challenges with role confidence and limited knowledge of mentorship, contributing to retention and faculty development concerns. The purpose of this quality improvement project was to evaluate the impact of a targeted six-week educational intervention on novice nurse educators’ role confidence and knowledge of mentorship. Guided by the Plan-Do-Study-Act (PDSA) change framework, the project employed a repetitive cycle for improvement: identify the problem, plan and implement …

Staff Education To Implement The Phq-9 For Depression Screening, Lydia Emuobosa Opara

Walden Dissertations and Doctoral Studies

Depression is common yet frequently underdiagnosed in group home settings serving adult and geriatric residents. This Doctor of Nursing Practice (DNP) project aimed to improve staff knowledge and promote routine use of the Patient Health Questionnaire-9 (PHQ-9), a validated depression screening tool, through an evidence-based educational intervention. A practice gap was identified at the project site due to inconsistent use and documentation of the PHQ-9, primarily linked to staff knowledge deficits. The project explored whether educating staff on PHQ-9 administration, scoring, and documentation would lead to improved knowledge, as measured by pre- and post-intervention assessments. Guided by the ADDIE instructional …

Evaluating The Active Learning Experience Of Prelicensure Nursing Students By Role And Level In Simulation, Delisa Flynn

Dissertations

As the complexity of healthcare continues to grow, it is essential that nursing graduates enter the workforce with strong clinical judgment, confidence, and practice readiness. Simulation is an active learning strategy that creates a realistic, hands-on experiences for learners. Despite its widespread use, the impact of simulation roles within a simulated experience (participant versus observer) on student engagement remains unclear, particularly across different levels of nursing education. This study investigated differences in active learning engagement among sophomore and senior prelicensure nursing students (N = 161) based on their assigned role in a high-fidelity simulation scenario. Grounded in Kolb’s Experiential Learning …

Advances In Indole Chemistry: Regiodivergent Annulations And Bridged Azacycle Synthesis, Zachary Tihomir Protich

Dartmouth College Ph.D Dissertations

An important aspect for the research and development of new drug therapies is the ability to use modular synthetic methods to rapidly access structurally diverse drug-like building blocks. Nitrogen-containing heterocycles represent one of the most prevalent structural motifs found in pharmaceutical agents and biologically active natural products. However, despite their ubiquity, existing methods for accessing these structures often remain limited in scope, efficiency, and structural diversity, particularly when targeting densely functionalized or sterically demanding scaffolds from simple starting materials.

To address this problem, the research described in this dissertation focuses on the design and development of (3+2) annulation reactions for …

Improving Glucose Monitoring Using Smart Phone-Based Monitoring Devices, Yetunde Ogunjumelo

Walden Dissertations and Doctoral Studies

The use of continuous glucose monitoring devices (CGMs) has become essential for improved glycemic control and the prevention of complications among patients. However, a significant number of nurses lack proper training in supporting patients with these devices, leading to a gap in practice. The project addressed the problem of insufficient staff knowledge and confidence in supporting patients with smartphone based CGMs through staff education on CGMs and evidence-based training on glucose monitoring techniques, interpretation of monitoring results, and patient education strategies. The question that guided the project was as follows: Does implementing a staff education program on smartphone-based CGMs improve …

The Impact Of Communication And Job Satisfaction On Registered Nurse Turnover, Kingsley Kenechukwu Onyeama

Walden Dissertations and Doctoral Studies

Health care leaders are challenged with ongoing nursing shortages. The purpose of this quantitative, correlational study was to examine the impact of communication and job satisfaction on registered nurses’ turnover intentions. The conceptual framework integrated Maslow’s Hierarchy of Needs, Herzberg and Mausner’s Motivation-Hygiene Theory, and Social Exchange Theory. Two research questions guided the study: the relationship between communication variables and intent to leave a healthcare organization, and the relationship between job satisfaction and intent to leave. A randomized sample of 156 registered nurses in California, aged 23 to 65 and identified through the California Nurses Database, was recruited via SurveyMonkey. …

Human Adipose Stem Cell-Derived Small Extracellular Vesicles Modulate Glial Cell Response In Aged And Young Tbi Mouse Models, Salma S. Abdelmaboud

USF Tampa Graduate Theses and Dissertations

Traumatic brain injury (TBI) is a leading cause of long-term neurological impairment, with aging significantly increasing vulnerability and worsening outcomes. Older individuals experience greater cognitive and motor deficits after TBI and often show diminished responses to therapeutic interventions. Both aging and TBI independently promote heightened neuroinflammation and cognitive dysfunction, increasing susceptibility to poor recovery. This study investigated the therapeutic potential of small extracellular vesicles (sEVs) derived from human adipose-derived stem cells (hASCs) to promote neurological recovery and modulate neuroinflammation in a mouse model of TBI. Male C57BL/6 mice aged 3, 15, and 20 months underwent controlled cortical impact (CCI) and …

Development Of A Clinical Practice Guideline To Improve Appointment Adherence Among Adults With Depression In An Outpatient Setting Using The Agree Ii Framework, Udenma Okafor-Bryden

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was designed to develop a clinical practice guideline (CPG) to enhance appointment adherence among adults with depression in an outpatient mental health clinic, thereby improving outcomes. The practice-focused question was Will a CPG utilizing a multimodal reminder system improve appointment adherence? Missed appointments in outpatient mental health care contribute to delayed treatment, increased symptom severity, and higher rates of emergency care utilization. These disruptions not only compromise clinical outcomes but also financially burden healthcare systems and disrupt continuity of care. The CPG was developed using the Johns Hopkins evidence-based practice model and a …

Resilience, Elapsed Time Since Exposure To Workplace Violence, And Job Satisfaction Among Emergency Nurses In The United States, Ginny Glisson Ennis

Walden Dissertations and Doctoral Studies

The emergency nursing profession faces a critical challenge with a declining workforce and a high prevalence of workplace violence (WPV), which negatively impacts nurse job satisfaction. This quantitative study examined the relationships among nursing resilience, time elapsed since WPV exposure, and job satisfaction among emergency nurses (ENs) in the United States. Grounded in resilience and Herzberg’s two-factor theories, this study used a cross-sectional, correlational design. A national, anonymous online survey was distributed via social media, using a sharable QR code to recruit participants. The survey consisted of a total of 52 items, and collected demographic data, and time elapsed since …

Increasing Staff Knowledge In An Assisted Living Facility, Lindy Hilding

Walden Dissertations and Doctoral Studies

The practice problem I identified was a rising number of resident falls throughout the past 6-12 months at a 29-bed assisted living facility (ALF). The organization requested an education program on evidence-based practices on fall prevention in older adults. I used the project question to explore if an education program would increase the knowledge of the staff and caregivers at the ALF. Numerous sources of evidence supported the practice guidelines including fall risk assessment tools. During the facility monthly staff meeting, participants completed a six-question knowledge assessment on falls. The participants completed the same assessment after the education program, as …

Learning In Virtual Environments With Varying Levels Of Sensory Information, Maryam Derayati Far

Psychology Theses and Dissertations

The sensory environment plays a critical role in shaping learners’ attention, engagement, and retention. This thesis investigates how varying levels of sensory input in virtual reality (VR) classrooms influence learning for two age groups—children and young adults—and explores how individual differences in sensory processing moderate these effects. Using immersive VR technology to simulate classroom settings, two experimental studies were conducted. Study One involved 60 children aged 6–15 years, recruited primarily through a university-run summer camp. Study Two included 57 undergraduate students aged 18–36 years, recruited through a research participation pool. In both studies, participants were randomly assigned to either a …

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Understanding Why Individuals Maltreated As Children Do Not Retrospectively Self-Report, Kristin S. Lynch

Dissertations, Theses, and Capstone Projects

Individuals with documented histories of childhood maltreatment who do not retrospectively self-report these childhood experiences demonstrate better emotional and psychological outcomes in adulthood. Understanding why these individuals do not retrospectively self-report is important for the development of effective interventions focused on mitigating the long-term consequences of maltreatment. The current study compared maltreated individuals who did not retrospectively self-report (O-R group) to those who did retrospectively self-report (O+R group) to examine theoretical explanations related to intentional nondisclosure (i.e., social desirability and discomfort during the interview) and memory processes (i.e. infantile amnesia, use of mental health services, avoidant coping …

Ai-Powered Multi-Omics Integration For Predictive Modeling Of Genotype-Environment-Phenotype Relationships, You Wu

Dissertations, Theses, and Capstone Projects

This dissertation presents a series of machine learning frameworks for modeling genotype–environment–phenotype relationships through integrative predictive modeling of multi-omics data. The work addresses three major axes of biological complexity: modeling biological information transmission cross-levels from genes to proteins to phenotypes, predicting molecular features cross-scale from cells to tissues to organisms, and translating phenotypes cross-species from model systems to humans. Each proposed method also tackles key machine learning (ML) challenges in the biomedical domain, including data scarcity, domain shift, out-of-distribution (OOD) generalization, and hierarchical modeling. Specifically, this dissertation introduces five novel deep learning algorithms: MultiDCP predicts drug-induced transcriptomic and viability responses …

Mechanisms Of Sleep Regulation In Drosophila Melanogaster, Anfal A. Abuhilal

Dissertations, Theses, and Capstone Projects

Sleep is a fundamental biological need, and sufficient sleep is required for physical and mental well-being. Sleep is regulated by two biological mechanisms: sleep-wake homeostasis and circadian rhythm. Circadian rhythms are near 24-h rhythms in behavior and physiology that are generated by endogenous mechanisms. In mammals, the suprachiasmatic nucleus (SCN) is the central circadian pacemaker, which is known to receive a significant amount of serotonergic input that likely modulates sleep rhythms. In addition to circadian modulation, sleep is subject to homeostatic regulation. Several neuromodulators have been proposed as mediators of sleep homeostasis. Serotonin has been implicated in sleep drive and …

Old Frames On New Media: Health Misinformation In Black Digital Communities, Merriah Croston

Brown School Graduate Student Theses and Dissertations

Growing evidence suggests that health misinformation has the potential to proliferate on social media. However, our understanding of the problem’s magnitude continues to evolve. Despite several studies on health misinformation and Black communities in the United States (U.S.), few of these studies characterize misinformation within digital settings. This dissertation seeks to address this gap by: 1) synthesizing the literature on health misinformation and Black communities to identify prevalent misinformation topics and claims, characteristics of exposure to and belief in these topics and claims, and successful intervention strategies; 2) quantifying and characterizing the volume of COVID-19 misinformation on Black Twitter during …

Quality Improvement Project The Role Of Targeted Education And Its Impact On Self-Efficacy And Cognitive Impairment Recognition Among Medical Assistants, Jicky Guzman

Doctor of Nursing Practice Projects

Primary care teams develop lasting relationships with patients that can reveal subtle cognitive changes during routine visits (e.g., identity verification and brief mobility checks). Yet, cognitive decline often goes unnoticed and poorly documented, which can lead to delayed care. This quality improvement (QI) project addressed a gap in the detection of mild cognitive impairment (MCI), such as Alzheimer’s disease (AD), among frontline staff. It assessed whether an educational intervention could improve self-efficacy in recognizing early cognitive impairment, measured by the General Self-Efficacy Scale (GSES). Guided by Bandura’s Self-Efficacy Theory and Lewin’s change model, a quasi-experimental pretest–posttest study was conducted at …