Medicine and Health Sciences Commons^™

Adult Nursing Students’ Perceptions Of Social Presence In Facilitator-Created Subject- Specific Videos In An Online Nursing Course, Jamie Anne Marcus

Theses and Dissertations

The literature established that online instruction consists of cognitive, teaching, and social presence. Studies on the element of social presence linked text-based delivery of instruction with learners’ feelings of isolation and disengagement. This research findings prompted this facilitator creation of five-to-seven-minute companion videos that aligned and complemented weekly text-based learning modules to ascertain students’ perceptions of these videos as a medium for channeling social presence.

Post-video viewing surveys yielded responses to pragmatic and emotional questions. Pragmatic questions were aimed at the visual impact of professor’s delivery of information. Emotional questions gauged the students’ feelings of connectivity with the facilitator. Triangulated …

Endodontic Post Retention With Resin Cements (Ilumi Fiber Post), Faimeena Farheen

All ETDs from UAB

Objectives: Loss of post retention is the leading cause in the cemented post. There is no good method of bonding a fiber post in a post space with resin cements because adhesive cementation into a prepared post space is difficult- due to an inability to place, dry and light cure the adhesive and the cement. A new post system (iLumi) that transmits light to the apex of the post has recently been developed. We want to know if this system will improve post retention in each section (coronal, middle and apical) of the prepared post space and if this curing …

Membrane Capacitance Derived From Bioimpedance Spectroscopy Is Associated With Insulin Resistance In Relatively Healthy U.S. Women, But Not Men, Valene Garr Barry

All ETDs from UAB

Current screening methods have failed to detect more than 50% of the 120 million U.S. adults with insulin resistance and/or metabolic syndrome, conditions that substantially increase one’s risk for cardiometabolic disease (CMD).1 Evidence exists that metabolic health is associated with cell membrane composition, which is reflected in the electrical properties of the body cell mass. The objective of this study was to determine whether bioimpedance spectroscopy can identify insulin resistance and/or metabolic syndrome by evaluating membrane capacitance (CM). We hypothesized that CM would be higher in individuals with insulin resistance and/or metabolic syndrome when compared to healthy individuals. This cross-sectional …

Interactions Between Posture And Locomotion In Nonimpaired And Poststroke Walking, Sarah Anne Graham

All ETDs from UAB

Background: Inappropriate paretic-limb force generation is a hallmark of impaired walking function poststroke. In addition to weakness, the paretic limb misdirects foot forces during stance, which may be due to inappropriate postural influence over weakened locomotor control. Purpose: Investigate neural control interactions between posture and locomotor functions by manipulating postural influence during walking of nonimpaired and individuals poststroke. I present four studies investigating measures associated with locomotor function and foot-force direction under varying postural demands during walking. Methods: Study 1 compared comfortable walking speed (CWS) outcomes following two body-weight-support (BWS) training protocols for N=29 participants with chronic (≥5 months) poststroke …

Effects Of Medicaid Expansion On The Financial Performance Of Rural Hospitals, Keith Darryl Brady

All ETDs from UAB

EFFECTS OF MEDICAID EXPANSION ON THE FINANCIAL PERFORMANCE OF RURAL HOSPITALS KEITH BRADY DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT The purpose of this research was to examine the effects of Medicaid expansion on the financial performance of rural hospitals. The analysis compares Medicaid revenue, uncompensated care cost and operating margins between rural hospitals in states that expanded Medicaid and rural hospitals in states that did not expand Medicaid. Strategic Management Theory was used to develop a theoretical framework to address three primary hypotheses. Secondary data from the Medicare Cost Report (MCR), the Agency for Healthcare Research and Quality …

An Analysis Of The Association Between An Established Chief Experience Officer Position And Hospital Patient Experience Scores Within Three States, William Robert Breen

All ETDs from UAB

Few industries operate with as much capacity to personally satisfy or disappoint, as does the U.S healthcare industry. Healthcare outcomes sought by society include wellness, safety, healing, and, ultimately, experiences. While healthcare involves complex relationships between patients, families, providers, payers, and regulators, the use of management theory can be insightful in studying and explaining the motivations and strategic decisions of healthcare managers. The healthcare industry is currently reacting to multiple stakeholders demanding improvements to the patient experience. New ways to measure patient experiences in healthcare are emerging. Some healthcare organizations are implementing new management structures, i.e., the role of Chief …

The Evolving Landscape Of Mechanical Circulatory Support In The United States: Observations From National Registries, Ryan Segler Cantor

All ETDs from UAB

Mechanical circulatory support (MCS) is a rapidly evolving field. This dissertation describes trends in patient selection, device utilization, and outcomes for adult and pediatric patients receiving MCS in the United States by examining data from two national registries. Trends in adult MCS device recipients and their support outcomes were evaluated using data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS), a national registry collecting detailed information for patients implanted with Food and Drug Administration (FDA)-approved durable MCS devices. Between June 2006 and December 2016, INTERMACS enrolled more than 19,000 patients. During this time, the widespread use of devices …

Mechanistic Connections Between Metabolic And Differentiation Programs In T Cells, Danielle Alexandria Chisolm

All ETDs from UAB

Cellular metabolism is closely coupled to differentiation gene programs in many developmental systems. In part, this is due to a similar complement of transcription factors playing dual roles in regulating both the gene expression programs associated with specific metabolic pathways and the differentiation gene program of the cell. In T cells, T cell receptor- (TCR) and IL-2-sensitive transcription factors coordinate the programming of metabolic states with the effector and memory gene programs. Currently, our understanding of the mechanisms by which metabolic states contribute to the regulation of T cell differentiation gene programs is unclear. Metabolites are directly involved in epigenetic …

Adiposity And Health In Zoo African And Asian Elephants, Daniella Chusyd

All ETDs from UAB

African (Loxodonta africana) and Asian (Elephas maximus) elephant populations are rapidly declining due to poaching, and habitat fragmentation and loss. Due to the precarious situation elephants are facing worldwide, captive elephant populations are being viewed as an insurance policy against extinction. Unfortunately, captive elephant populations are not self-sustaining, in part because of reproductive and health issues. One hypothesis for the observed reproductive and health issues is zoo elephants are obese. The current method of assessing obesity in elephants is based on a qualitative visual tool, the body condition score, which does not quantify fat mass. The purpose of this dissertation …

A Randomized Trial To Evaluate The Effect Of Allograft Bone Particle Size On Histomorphometric And Clinical Outcomes Following Ridge Augmentation Procedures, Hussein Basma

All ETDs from UAB

Ridge deficiency is an unfortunate obstacle that obviates the placement of dental implants or results in placing them at an angle that compromises the prosthetic restoration. An ideal volume is essential for implant placement in an optimal three-dimensional position. Several methods for augmenting the alveolar ridge in preparation for implant placement have been described. Autogenous bone grafts, considered to be the “gold standard”, are associated with significant morbidity and require a second surgical site. Guided bone regeneration (GBR), is an alternative technique that use bone-substitute materials as adjuncts to or replacements for autografts in bone augmentation procedures to overcome the …

Functional Analysis Of Cdc45 In The Replication Fork And In Response To Replicative Stress, Amanda Debrot

All ETDs from UAB

DNA replication is a highly conserved and tightly regulated process, with a variety of factors acting to ensure faithful duplication and stability of chromosomal DNA. During replication, positive supercoils form ahead of the advancing replication fork. DNA topoisomerase 1 (Top1) acts to prevent DNA damage by relieving the torsional strain created by these supercoils. The camptothecin (CPT) class of chemotherapeutics target Top1, creating a long-lived DNA-Top1-CPT covalent complex, which leads to S-phase specific DNA lesions and cellular death. Our lab previously performed a genetic screen to isolate mutant proteins that enhance cell sensitivity to Top1-mediated DNA damage. One of the …

The Association Between Designation As Leader In Lgbt Healthcare Equality And Hospitals' Patient Experience Scores, Rita Dileo

All ETDs from UAB

ABSTRACT There are an increasing number of LGBT individuals who openly acknowledge their sexuality and are visibly part of society. Unfortunately, a stigma remains among this group and a fear of discrimination that prevents many individuals from seeking healthcare. This is a long-standing issue and further challenged by lack of culturally competent LGBT healthcare providers. Using a conceptual framework based on the Resource Dependence and Resource-Based theories, the association between designation as a 2016 Leader in LGBT Healthcare Equality and patient experience scores are evaluated. Regression analyses were performed to assess the association between market factors, organizational characteristics, HCAHPS survey …

Constraint-Induced Movement Therapy To Improve Gait And Mobility Of People With Chronic Stroke: A Mixed Methods Study, Sarah Monteiro Dos Anjos

All ETDs from UAB

Walking impairment after stroke impacts on participation and quality of life. Different techniques have been developed in the last decades to overcome walking difficulties after stroke, however, few have been shown to be efficacious. Constraint-induced Movement Therapy (CIMT) is a family of techniques that has been reported as one the most effective intervention for improving functional use and motor skills of a more-affected upper extremity (UE). The intervention protocol includes: 1) intensive supervised training; 2) use of shaping as a strategy for the motor training, 3) a group of behavioral strategies called the transfer package, and 4) procedures to increase …

Susceptibility To Late-Onset Sepsis Is Controlled By The Neonatal Microbiome And Intestinal Immune System, Jeffrey Robert Singer

All ETDs from UAB

When mammals leave the womb, they encounter a world teeming with microbial life. Their intestinal tract, which will ultimately harbor an ecosystem of trillions of bacteria, must progress through a process called ecological succession. Late-onset sepsis (LOS) commonly occurs in preterm infants when pioneer members of the intestinal microbiome cause systemic infections. Both antibiotics and probiotics are used as prophylaxis for LOS, but mechanisms underlying susceptibility to the disease remain unclear. This is in large part due to a lack of animal models that mimic the relevant pathophysiology of LOS. This study begins with the development of a novel model …

The Influence Of Perceived Stress And Sleep Disturbance On Fatigue And Blood Pressure As Mediated By Cortisol In Children With Sickle Cell Disease, Heather Carol Soistmann

All ETDs from UAB

ABSTRACT Introduction: Life expectancy is improving for those with sickle cell disease (SCD); however, with this improvement come increasing risks for long-term health complications. Early identification of health concerns could lead to improved long-term health outcomes. Two health concerns in school-age children with SCD are fatigue and blood pressure (BP). Previous research with other populations indicates perceived stress and sleep disturbance may influence outcomes of fatigue and BP. Further, cortisol, a stress hormone, may mediate the proposed relationships. Therefore, the purpose of the study was to determine effect sizes of relationships between fatigue, BP, perceived stress, and sleep disturbance in …

The Primary Cilium Regulates Interstitial Immune Cells During Renal Cystogenesis, Cheng Song

All ETDs from UAB

Renal cysts are a pathological condition that can lead to end-stage renal failure and death. The mechanisms that underlie renal cyst development are under active investigation, and emerging evidence has revealed defects in a number of proteins required for cilia assembly or signaling, such as intraflagellar transport (IFT) proteins and the polycystins. Characterization of mice harboring conditional IFT mutations suggests that the rate of cyst formation is dependent upon the timing of cilia loss. Induction of cilia loss in juvenile mice results in rapid cyst development, while induction of cilia loss in adult mice leads to a slower progressing form …

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

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

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

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

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

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

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

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

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

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

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

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

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

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, …