Medicine and Health Sciences Commons^™

Mental Toughness As A Predictor For Pre-Season Depression And Anxiety Symptoms, And Changes Over The Course Of An Athletic Season, Colleen J. Bohannan

College of Graduate Studies: Theses & Dissertations

Background: Mental toughness (MT) has been considered necessary for individuals to be successful in the athletic setting. A connection has been theorized between MT and mental health. Purpose: ­­­­­­­­­­­­­­­­­­­­­­The purpose was to investigate if MT could be utilized as a predictor of the presence of depression and/or anxiety symptoms. This study also explored if MT, and depression/anxiety symptoms change over the course of a competitive season. Methods: 43 individuals (19.42 ± 1.26 years) participating in a fall team sport from the same Division I University participated in the study. Data was captured during pre-season, high stakes, and end of season, …

Pain, Severity, And Attentional Capacity Following Acute Musculoskeletal Injury, Rebekah F. Roessler

College of Graduate Studies: Theses & Dissertations

Background: As recreational activities grow in popularity, there is a concurrent rise in musculoskeletal injury. Injury severity is determined through clinical evaluation and defined by a grading scale. Pain is included in the definition of each injury grade, despite the lack of any conclusive evidence relating injury severity and the associated pain. Additionally, previous studies report impairments in cognitive performance due to chronic and acute pain. The aim of this study is to determine the relationship between the perceived pain intensity and the clinically diagnosed severity of an acute musculoskeletal injury, and to determine if attentional capacity is influenced by …

Melatonin Protects Mcao-Induced Neuronal Loss Via Nr2a Mediated Prosurvival Pathways, Fawad Ali Shah, Gongping Liu, Lina T. Al Kury, Alam Zeb, Muzaffar Abbas, Tao Li, Xifei Yang, Fang Liu, Yuhua Jiang, Shupeng Li

All Works

© 2019 Shah, Liu, Al Kury, Zeb, Abbas, Li, Yang, Liu, Jiang and Li. Stroke is the significant cause of human mortality and sufferings depending upon race and demographic location. Melatonin is a potent antioxidant that exerts protective effects in differential experimental stroke models. Several mechanisms have been previously suggested for the neuroprotective effects of melatonin in ischemic brain injury. The aim of this study is to investigate whether melatonin treatment affects the glutamate N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor signaling in cerebral cortex and striatum 24 h after permanent middle cerebral artery occlusion (MCAO). Melatonin (5 mg/kg) …

Effects Of A Sensory Diet On Attention And Participation In Children With Autism, Leighanne Smith-Mrkaja

Theses and Dissertations

This applied dissertation was designed to provide initial knowledge regarding sensory diets and sensory-based interventions. The need for classroom-based sensory interventions are not always considered, especially with the high number of students diagnosed with ASD at the researcher’s school. Often sensory intervention may not be considered educationally relevant, especially in the prekindergarten level. With the proper training and materials, as well as the guidance of the school-based occupational therapist, teachers, other therapists, classroom assistants, parents, and school-based staff might be able to utilize sensory-based activities like sensory diets to increase participation, positive behaviors, and attention. The following applied research study …

Regulation Of Intestinal Innate Lymphoid Cells In Acute And Chronic Inflammation, Sarah Dulson

All ETDs from UAB

The Innate Lymphoid Cell (ILC) population encompasses five subpopulations that are increasingly appreciated to participate in immune responses to inflammation and injury as well as directly influence homeostasis in tissues throughout the body. ILCs are enriched at mucosal surfaces, such as the gastrointestinal tract, where they are transcriptionally poised for rapid activation. Therefore, ILCs contribute significantly to protective responses to infection, and can exacerbate inflammation and disease when dysregulated. Herein, we demonstrate two pathways that regulate intestinal ILC phenotype and function and delineate the impact of these pathways on both protective and pathogenic roles of ILCs. Using a murine model …

Bet Bromodomain Inhibition As An Approach For Treatment Of Cholangiocarcinoma, Samuel Charles Fehling

All ETDs from UAB

Cholangiocarcinoma (CCA) is a highly aggressive neoplasm which arises from the epithelial layer of the biliary tract. It is the second most common primary hepatic malignancy. As CCA is typically diagnosed at late disease stage, the current standard of care, resection followed by gemcitabine with cisplatin, is not effective. Further, up to 90% of CCA patients are ineligible for resection. Of those eligible for resection, postoperative chemotherapy does not prolong overall survival leading to a 5-year survival of ~30%. Previously, mutations have been identified in KRAS (17% of CCA cases), TP53 (44%) and SMAD4 (17%) but none have been recognized …

Competitive Strategies Of Hospitals: Antecedents And Association With Financial Performance, Akbar Ghiasi

All ETDs from UAB

In this three-paper dissertation, first, we examined the relationship between strategic group membership and hospital financial performance in terms of operating margin. The results revealed the important role of strategy on financial performance of a hospital. In the second paper, organizational and environmental antecedents of hospital’s business strategy choice were studied. The results showed that environmental and organizational factors may predict the business strategy choice of hospitals. The third paper investigated the moderating effect of environmental instability on the relationship between strategic group membership and financial performance. Environmental instability does not strongly affect the relationship between hospital strategic group membership …

Baf Chromatin Landscaping During Bone Formation And Maintenance, Tanner Cole Godfrey

All ETDs from UAB

Bone loss is a worldwide problem resulting in increased risk of fracture. Osteoblasts are responsible for bone synthesis; therefore, treatments promoting osteoblast differentiation and/or activity would result in increased bone formation. The regulation of DNA accessibility is a key mechanism controlling gene expression and cellular differentiation. BAF (BRG1 Associated Factor) mediated chromatin remodeling increases DNA accessibility by sliding or ejecting nucleosomes. This process can occur in a cell type specific manner based on the composition of BAF. In many tissue types, a unique combination of BAF subunits has been identified to be responsible for the maintenance or differentiation of that …

Nursing Staff Approaches To Providing Oral Hygiene In Stroke Survivors With Dysphagia: A Grounded Theory Study, Willard Edward Brewer

All ETDs from UAB

The purpose of this qualitative grounded theory study was to explore how the nursing staff approaches oral hygiene in stroke survivors with dysphagia during the rehabilitation phase of recovery and what guides their decisions. Oral hygiene is a proven effective task known to prevent systemic health disparities (i.e. aspiration pneumonia, diabetes, gastrointestinal disparities, and even stroke). However, there are no current evidenced-based guidelines that provide instruction on how to execute oral hygiene to stroke survivors with dysphagia. Little is known about how nurses make decisions to implement oral hygiene in stroke survivors with dysphagia. Using a theoretical sampling strategy, data …

Integration Of Cone Photoreceptor Signals In Macaque Lgn Neurons, Paul B. Brown

All ETDs from UAB

Despite advances in the understanding of the primate visual system, much is yet to be learned about the way light signals sum to create our perception of the world. This is especially true at the simplest level of visual processing—the summation of two individual cone photoreceptor signals. How such signals combine to create visual perception has not been assessed in vivo. We used an adaptive optics scanning laser ophthalmoscope (AOSLO) to deliver binarized noise movies to identified groups of cones within the receptive fields of neurons in the macaque lateral geniculate nucleus (LGN). Recordings of neural action potentials within the …

The Impact Of Redox Stress In Primary Hyperoxaluria Type 1, Brianna Buchalski

All ETDs from UAB

Primary Hyperoxaluria (PH) is a family of three inborn errors of glyoxylate metabolism resulting in endogenous oxalate overproduction. PH1 is the most common and most severe form of the disorder when compared to PH2 and PH3. PH1 can result in systemic oxalosis or end stage renal disease, and there is currently no cure for this disorder. The only curative treatment is combined liver/kidney transplant. The difficulty in defining a cure for the disorder arises from poor knowledge of the sources of endogenous oxalate and a lack of understanding in the underlying pathophysiology of the disorder. For these reasons, we have …

Receptor Sialylation By St6gal-I Promotes Tumor Progression By Enhancing Tumor Cell Survival And Epithelial To Mesenchymal Transition, Colleen Maeve Britain

All ETDs from UAB

The upregulation of a certain subset of glycosyltransferases was an early marker for cancer development. Specifically, ST6Gal-I, which adds an α2-6 linked sialic acid to N-glycans on proteins bound for the plasma membrane or secretion, is selectively upregulated upon malignant transformation. Our laboratory has shown that ST6Gal-I is implicated in many facets of tumor biology and is an important mediator of tumorigenesis. For example, ST6Gal-I activity promotes the survival of cells when challenged with hypoxia, FasL, or TNFα, confers resistance to chemotherapeutics, enhances tumor cell migration and invasion, and fosters a cancer stem cell phenotype. The work presented in this …

Context Fear Memory Formation Is Regulated By Hippocampal Lncrna-Mediated Histone Methylation Changes, Anderson Alan Butler

All ETDs from UAB

The post-translational modification of histones regulates gene expression and is critical for the formation and maintenance of hippocampus-dependent long-term memories. Changes in gene-specific expression of various epigenetic marks during the aging pro-cess are sufficiently consistent as to be used as an aging landmark or epigenetic clock in both humans and other species; however, the molecular mechanisms which govern the application of these marks aging are poorly explored. Recently, long noncoding RNAs (lncRNAs) have been implicated as regulators of histone methyltransferases and other chromatin-modifying enzymes (CMEs). Despite the relevance of such mechanisms to both aging and memory formation, the behavioral relevance …

Significance Of Acculturation, Assimilation, And Allostatic Load As Risk Factors For Obesity Among Hispanics, Yenni Elvia Cedillo Juare

All ETDs from UAB

Obesity has increased during the last two decades in the United States (U.S.) and is considered a major risk factor for chronic diseases within the Hispanic community. The burden of obesity in Hispanics is associated with higher rates of morbidity and mortality and an increase in healthcare costs. Hispanics’ challenges after migration extend to subsequent generations, putting the population at risk for disease development. Specifically, migration can lead to the adoption of health behaviors, beliefs, values, and language of the host country, a process known as acculturation, which has been associated with changes in health behaviors. Among the Hispanic population, …

Sexual Behaviors And Non-Initiation Of The Hpv Vaccine Among Young Adult Cancer Survivors, Brooke Cherven

All ETDs from UAB

Advances in treatment for childhood cancer have led to increased survival rates. There are currently an estimated 400,000 survivors of childhood cancer living in the United States who are at risk for developing subsequent malignancies, including cancers associated with the human papillomavirus (HPV). HPV is the most common sexually transmitted infection; sexual behaviors associated with increased risk for HPV acquisition include younger age at first intercourse, multiple sexual partners, and inconsistent condom use. The prevalence of high-risk sexual behaviors, and the relationship between sexual behaviors and HPV vaccine non-initiation among young adult cancer survivors is unknown. This study used data …

The Strategy Of Federally Qualified Health Centers: The Influence Of Context And Performance Implications, Seongwon Choi

All ETDs from UAB

The three papers included in this dissertation attempt to provide empirical evidence on the relationship among strategies employed by Federally Qualified Health Centers (FQHCs), the contextual factors and consequent performance. The findings of these studies contribute to the existing body of literature on FQHC strategies and performance. In addition, the findings also provide key practical implications to FQHC managers as well as policymakers. Overall, the results of this dissertation suggest that the FQHC strategy on spatial differentiation is associated with a set of organizational and environmental factors. However, there was little support for the relationship between Medicaid expansion and FQHC …

A Survey Of Shoulder Injuries In Commercial Truck Drivers Using A Retrospective Medical Record Review, Bryan Combs

All ETDs from UAB

Introduction: Musculoskeletal injuries in the occupational setting have significant impact on the worker, employer, and healthcare system. Commercial truck drivers (CTD) experience some of the highest rates of injury, missed days of work, and workers’ compensation costs compared with other workers. In this population, back injuries occur most commonly, followed by shoulder injuries which require 5 times more days away from work. Commercial truck drivers are significantly impacted by shoulder injuries; however, little is known about the unique mechanisms of injury, specific injuries, or possible preventative measures among this group of workers. Methods: A retrospective medical record review was completed …

Mechanisms Of Acute Kidney Injury: The Role Of Ferritin Heavy Chain In Renal Heme-Unology, Laurence Marie Black

All ETDs from UAB

The kidneys are complex, multi-faceted organs that are responsible for regulatory processes, such as fluid homeostasis, hormone production, blood pressure regulation, and systemic toxin removal. Sudden disruption of these processes by acute kidney injury (AKI) causes rapid decline in renal function as well as significant morbidity and mortality. AKI is a significant clinical concern, affecting up to 13.3 million people globally each year and has the propensity to progress to chronic kidney disease (CKD), though the mechanism remains undefined. One reason for this is due to the lack of understanding of models used to study both AKI and CKD, hindering …

Randomized Controlled Trial Of Influenza Vaccine In Patients With Heart Failure To Reduce Adverse Vascular Events (Ivve): Rationale And Design, Mark Loeb, Hisham Dokainish, Antonio Dans, Lia M. Palileo-Villanueva, Ambuj Roy, Ambuj Roy, Kamilu Karaye, Jun Zhu, Yan Liang, Gerald Yonga

Internal Medicine, East Africa

Background: Influenza is associated with an increase in the risk of cardiac and other vascular events. Observational data and small randomized trials suggest that influenza vaccination may reduce such adverse vascular events.

Research Design and Methods: In a randomized controlled trial patients with heart failure are randomized to receive either inactivated influenza vaccine or placebo annually for 3 years. Patients aged ≥18 years with a clinical diagnosis of heart failure and NYHA functional class II, III and IV are eligible. Five thousand patients from 10 countries where influenza vaccination is not common (Asia, the Middle East, and Africa) have been …

Physical Activity Promotion Among Adolescents With Pediatric Onset Multiple Sclerosis, Elizabeth Morghen Sikes

All ETDs from UAB

Pediatric onset multiple sclerosis (MS) is a chronic and disabling disease of the central nervous system with an onset before 18 years of age. Youth with pediatric onset MS may benefit from physical activity as evidenced by past research suggestsing higher levels of physical activity are associated with reduced physical and psychosocial disease manifestations. Unfortunately, published estimates of physical activity participation among those with pediatric onset MS are very low (<10 min/day). This dissertation aimed to describe the current literature regarding physical activity among youth with pediatric MS, and to further explore experiences, patterns, correlates, and potential confounders of physical activity for the ultimate purpose of informing future behavior change interventions. Results are presented through five single study chapters. Briefly, interventions developed to promote physical activity for adolescents with pediatric onset MS should be individually tailored, include a strong social component, aim to educate regarding safety and outcomes of physical activity, and differentially target weekday and weekend day activity and sedentary behavior. Social cognitive theory (SCT) is an appropriate method for promoting physical activity behavior change among youth with pediatric onset MS, and SCT constructs including exercise goal setting, barriers self-efficacy, outcome expectations, and social support should be incorporated in the intervention as appropriate. Further, physical activity is seemingly an appropriate method for the management of functional limitations for youth with pediatric onset MS. Clinicians and researchers seeking to promote physical activity among those with pediatric onset MS may find this dissertation especially useful in providing a framework for the development of behavior change interventions.

Characterization Of Chemical Uptake And Aryl Hydrocarbon Receptor Mutations In Zebrafish, Jaclyn Paige Souder

All ETDs from UAB

In a society driven by technology and industry, we must be increasingly aware of how changes to our environment impact our health. This is especially true concerning embryonic development, which is easily influenced by extra-embryonic factors, including environmental contaminants. Determining how exogenous compounds are absorbed, which receptors they act through, and how these receptors act endogenously is important to fully understand to what extent developmental exposures impact fetal and adult health. I have used the zebrafish model system to address these questions for two classes of environmentally-relevant chemicals—estrogens and dioxins. First, I developed an assay to measure the uptake of …

Acetylcholine Signaling In Glioblastoma Invasion And Peritumoral Hyperexcitability, Emily Grace Thompson

All ETDs from UAB

Glioblastomas are the most common and deadly form of primary brain cancer in adults. Current treatment strategies are aggressive, including a combination of surgical resection, radiotherapy, and chemotherapy. However, median patient survival has remained stagnant at 12 to 15 months for the last several decades. This dismal patient outcome has prompted efforts to understand the unique characteristics of these tumors, since traditional therapeutics have not been efficacious. Extensive invasion is a salient feature of glioblastomas that significantly diminishes the effectiveness of current treatment strategies and is ultimately the cause of tumor recurrence within 2 years in approximately 80% of patients. …

Intraocular Pressure Dynamics, Daniel Coleman Turner

All ETDs from UAB

While cataracts (the leading cause of blindness worldwide) can be reversed surgical-ly, glaucoma is the leading cause of irreversible blindness, affecting over 70 million people worldwide [1]. Elevated intraocular pressure (IOP) and age are the primary risk factors for glaucoma [2] and lowering IOP is the only proven treatment for the disease [3]. IOP and its fluctuations affect nearly every aspect of ocular physiology and homeo-stasis, as well as playing a dominant role in glaucoma pathophysiology, yet very little is known about IOP due to the current clinical standard of measuring mean IOP during infre-quent clinic visits. We use a …

The Anti-Tumor Effects Of Hur Inhibition In Glioblastoma, Jiping Wang

All ETDs from UAB

Glioblastomas (GBMs) are the most malignant primary brain tumor. GBMs represent 14.7% of total primary CNS tumors and 47.7% of malignant CNS tumors. The median survival of GBM is 18-20 months, while five-year survival rate is only 5.6%. GBMs are maintained by glioma stem cells (GSCs), and poor treatment outcomes are linked to the high resistance of GSCs to radiation and chemotherapy, and the immunosuppressive tumor microenvironment. The mRNA binding protein HuR is a key regulator of tumor growth and development based upon the fact that HuR targets mRNAs that are broadly involved in tumorigenesis. We have previously shown that …

Obesity In People With Spinal Cord Injury: Secondary Data Analysis Of National Spinal Cord Injury Database, Huacong Wen

All ETDs from UAB

People with disabilities are 1.5-2.5 times more likely to be obese than those without disabling conditions. We have learned a lot about obesity in the general population. However, the neurological deficits of people with spinal cord injury (SCI) make it difficult to generalize the findings in the general population to the SCI population. Therefore, the purposes of this dissertation were to 1) assess racial differences in body mass index (BMI) change over 5 years; 2) evaluate the role of neighborhood in the relationship between race and obesity; 3) examine the impact of BMI at the time of injury on 1-year …

Exploring Dose Effect Of An Early Palliative Care Intervention For Advanced Heart Failure Patients, Rachel Duncan Wells

All ETDs from UAB

Heart failure (HF), a progressive condition with reduced quality of life (QoL) and high healthcare use, affects 6.5 million US adults. Research supports positive effects of palliative care integration into HF care, but there is limited consensus about the most beneficial intervention ‘dose’ (e.g. amount, duration, frequency, intensity). To date, no studies examining dose in palliative care HF interventions have been completed. Therefore, we examined dose using an existing data from the ENABLE CHF-PC trial (Educate, Nurture, Advise, Before Life Ends Comprehensive Heart Care for Patients and Caregivers; NCT02505425). Operationalizing dose as dichotomous complete/noncomplete of all intervention components (6-weekly, psychoeducational …

Characterization Of The Tgfb Pathway And Its Role In Prostaglandin Metabolism In C. Elegans, Muhan Hu

All ETDs from UAB

Cell to cell communication is fundamental to all life processes, from fertilization to death. The TGFߟ superfamily is a large family of proteins that is involved in a wide array of physiological and pathological processes, including development, wound healing, immune system function, cancer, and reproduction. This group of signaling peptides is well conserved across many organisms, from basic nematode to humans. While many studies have aimed to delineate the functions of TGFߟ, they have also unveiled the complexity of this multifunctional family of ligands. In this thesis, I take advantage of the simple C. elegans model system to study the …

The Role Of The St6gal-I Sialyltrasferase In Protecting Tumor Cells From Hypoxic Stress, Robert Brent Jones

All ETDs from UAB

An emerging concept in cancer biology is that surface glycosylation can play important roles in the regulation of cancer development and progression. Our group and others have shown that ST6Gal-I, a sialyltransferase that adds α2-6-linked sialic acids to N-glycosylated proteins, is upregulated in many cancers. Furthermore, data has indicated that ST6Gal-I acts as a pro-survival factor in a variety of settings, including resistance to chemotherapeutic drugs, radiotherapy resistance, and serum deprivation. The work presented in this dissertation adds to this understanding of ST6Gal-I’s role as a potent pro-survival factor and explores ST6Gal-I’s function in aiding tumor cells to survive hypoxic …

Bk Polyomavirus Activates The Dna Damage Response To Hijack Host Cell Cycle Control, Joshua L. Justice

All ETDs from UAB

BK Polyomavirus (BKPyV) is a DNA tumor virus that latently infects the >90% of humanity. BKPyV infection is inconsequential in healthy individuals; however, the immunocompromised carry increased risk of viral reactivation that can lead to a number of genitourinary diseases. Overall, BKPyV reactivation is a major risk factor for kidney dysfunction and failure following solid organ transplantation. There are no approved therapeutics to treat BKPyV infection, therefore studies have focused on understanding the host/virus interactions that drive infection to identify therapeutic targets. The PyV genome is small and does not encode a polymerase. Cellular transformation by the viral oncogene, T …

A Microfocal Effect In Photoreceptor Light Capture, Vasantha Kumari Kanukuntla

All ETDs from UAB

In human eyes, accomodation brings light rays into focus on the retina in order to achieve a clear images. The plane of best focus within the depth of the retina is thought to be within the photoreceptor layer, but pinpointing the exact focal position axially has not been determined. With help of adaptive optics aberration correction and its ability to have microscopic control of a retinal stimulus, we explored how sensitive human subjects are to defocus on the micron scale. We found that focal position can be reliably judged within 0.02 D, which is equivalent to about 6 microns in …