Medicine and Health Sciences Commons^™

Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia

Walden Dissertations and Doctoral Studies

Patient satisfaction presents an emerging area of research for healthcare providers because major healthcare providers like Medicare/Medicaid control the finances of healthcare institutions as based on their patient and customer satisfaction. The purpose of this study was to examine the impact of servant leadership on customer service, and patient satisfaction, in the Inland Empire Region of Southern California. The theoretical framework applied to this study was the servant leadership theory. Participants consisted of 82 managerial staff within the University Health System, which is comprised of a teaching hospital, 5 behavioral health centers, 10 federally qualified health centers, and a public …

Novel Mechanisms Of Nitric Oxide Activation In The Kidney, Randee Sedaka

All ETDs from UAB

Globally, adult sodium consumption has far exceeded daily intake recommendations, leading to one in ten cardiovascular deaths. Given the rise in hypertension prevalence, uncontrolled hypertension with antihypertensive medication use, and significant associations between high salt intake and high blood pressure, there is a need to better understand the mechanisms involved in hypertension. Nitric oxide synthase 1 (NOS1) is a well-established regulator of fluid and electrolyte balance in the renal collecting duct (CD) with highest activity in the inner medulla (IM). We previously reported that high salt (HS) intake stimulates CD endothelin B receptor (ETBR)/NOS1-dependent generation of NO, thereby inhibiting the …

Diurnal Dysfunction In Control Of Sodium Excretion In Diet-Induced Obesity, Reham Soliman

All ETDs from UAB

The renal endothelin system plays a key role in sodium excretion, particularly under high salt (HS) diet. HS stimulates renal endothelin-1 (ET-1), which binds and activates the endothelin receptor B (ETB) to excrete the excess salt. Loss of ETB receptor is linked to the development of hypertension under HS. Central clock genes are important in maintaining rhythmic patterns of sodium excretion and ET-1 is identified as a target for clock genes, including Period and Bmal1. ET-1 excretion follows a diurnal rhythm along with sodium excretion. Sexual dimorphism is evident in the diurnal regulation of endothelin-mediated natriuresis and its downstream targets. …

Mitochondrial Priming Of Tumor Initiating Cells Involves Repression Of Mitochondrial Fission Activity Towards Redox Regulation Of The Cell Cycle Regulator Cyclin E, Brian Spurlock

All ETDs from UAB

Mitochondrial dynamics primarily refers to the opposing fission or fusion events between individual mitochondria, which maintains steady-state mitochondrial morphology in cells. Fission and fusion activities maintain the energetics of normal and neoplastic stem cells. We developed the novel approach mito-SinCe2 to study the bidirectional relationship between mitochondrial dynamics and energetics. Application of this method led to the hypothesis that mitochondria-dependent ovarian tumor initiating cells interconvert between 3 states with distinct mitochondrial energetics/dynamics relationships. Cells in one state, characterized by high mitochondrial ROS and low fission activity, appear to be primed for self-renewal by mitochondria. We call these cells mitochondria-primed stem …

Role Of Endogenous Tau In Lewy-Like Pathology, Lindsay Stoyka

All ETDs from UAB

Lewy Body Diseases (LBDs) are a group of disorders characterized by intracellular inclusions of misfolded alpha-synuclein (α-synuclein). Of these, Parkinson’s Disease (PD) is the most common neurodegenerative movement disorder, and Dementia with Lewy Bodies (DLB) is the second most common neurodegenerative dementia. PD is characterized clinically by bradykinesia, resting tremor, rigidity, and postural instability. In addition, up to 80% of patients eventually develop dementia, termed Parkinson’s Disease Dementia (PDD). DLB is characterized by onset of dementia before or concurrently with parkinsonism. Currently, no disease-modifying therapies exist for either of these diseases. Lewy pathology is found in regions important for cognition …

Pheochromocytoma: A Systematic Review Of The Diagnosis, Treatment, And Risk Factors, Brandon A. Singletary

All ETDs from UAB

ABSTRACT Pheochromocytomas and extra-adrenal paragangliomas (PGLs) are forms of neuroendocrine tumors which when left untreated lead to debilitating complications of cerebral hemorrhaging, stroke, and death. Typically, the tumors present with symptoms of episodic headaches, sweating, and palpitations, however hypertension is considered one of the more predominant signs. As a result of the rarity of the disease and wide range of symptoms, there are often difficulties in screening and diagnosis to identify these tumors. While there are many case studies and results in small populations, large epidemiologic driven studies are limited. To date the majority of large-scale studies exist in countries …

Toxin Secretion By Mycobacterium Tuberculosis, Uday Tak

All ETDs from UAB

Mycobacterium tuberculosis (Mtb) is a highly infectious airborne bacterial pathogen, and the causative agent of human tuberculosis. Mtb infects approximately one-third of the human population, and is responsible for more deaths than any other infectious disease in the history of mankind. Mtb is an intracellular pathogen and primarily infects myeloid cells, such as macrophages in the human lung. In macrophages, Mtb establishes a replication niche within membrane-bound vacuoles named phagosomes, while subverting immunity. The intracellular survival of Mtb depends on manipulation of host cellular processes through secreted effector proteins. Ultimately, this intracellular vacuole is ruptured by the type VII secretion …

Exploring The Nursing Work Environment And Patient Outcomes Associated With Nurse-Reported Workplace Bullying: A Mixed Methods Study, Colleen Anusiewicz

All ETDs from UAB

Workplace bullying (WPB) in nursing is a workplace problem that can undermine the safety culture necessary to minimize adverse patient events and improve health care quality. Nurses continue to experience and report WPB despite a substantial and growing body of evidence reflecting the negative effects of WPB on nurses, published position statements and alerts, and the initiation of workplace violence policies and protocols. To decrease WPB and inform the development of effective anti-bullying interventions, there has been a shift in focus from individual factors and interpersonal relationships among nurses and health care workers to organizational factors that contribute to nurse-reported …

Understanding The Impact Of Diet And Obesity On Anti-Tumor Immunity And Therapeutic Efficacy In Kidney Cancer, Rachael Miller Orlandella

All ETDs from UAB

Obesity is regarded as a major risk factor for developing renal cell carcinoma (RCC). Advanced-stage RCC exhibits chemotherapeutic resistance, but is responsive to immunotherapies such as the immune checkpoint inhibitor anti-programmed cell death-1 (anti-PD-1). Despite some clinical successes, response rates remain low for anti-PD-1 monotherapy (20-30%). Preclinical evaluations of immunotherapeutic strategies typically use lean mice and do not account for patient comorbidities. This may explain the underwhelming success rates following clinical translation of new cancer treatments. Recent studies found that obesity was associated with favorable outcomes and responses to immunotherapy in melanoma. However, the effects of obesity on anti-tumor immunity …

Role Of Trib3 In Progression And Pathogenesis Of Diabetic Retinopathy, Priyamvada Milind Pitale

All ETDs from UAB

Diabetic retinopathy (DR) is reported to be one of the leading causes of blindness in the United States by Center for Disease Prevention and Control. As the estimated prevalence of the disease will likely triple by 2020, the research in this area should focus on identifying novel targets and therapeutic approaches. One of the therapeutic approaches for DR is the reprograming of retinal metabolism to delay the progression of the disease. The unfolded protein response (UPR) is recognized as a cellular pathway activated in diabetic retina which interacts with key transcription factors to physiologically regulate glucose, lipid homeostasis, and angiogenic …

Novel Hiv Adaptation Strategy Against Host Cd8 T Cell Immunity, Kai Qin

All ETDs from UAB

Since the 1980s, HIV infection has caused millions of death and tremendous economic losses worldwide. Despite great scientific advances, the only effective therapy to date, antiretroviral therapy (ART), merely delays disease progression yet cannot eradicate viral infection. Therefore, an effective HIV vaccine that can prevent the acquisition of infection would be a desirable alternative. The critical role of CD8 T-cell immunity in HIV infection has been well documented and therefore not surprisingly a great deal of effort has been focused on developing an effective CD8 T-cell based HIV vaccine. However, by far, such CD8 T-cell based HIV vaccine trials have …

Investigating The Roles Of The Renal Primary Cilium Through The Use Of Intravital Imaging, Dustin Zachary Revell

All ETDs from UAB

Primary cilia are small microtubule based appendages present on nearly every cell type in the mammalian body, and are highly conserved from organisms as simple as algae to humans. Cilia function as complex signaling centers integrating a variety of pathways and play critical roles throughout development and in maintaining homeostasis. Mutations to ciliary proteins in humans result in a wide array of diseases termed ciliopathies, which have a broad range of symptoms affecting nearly every organ in the body. Renal primary cilia are present on the apical side of tubular epithelium, where they project into the lumen and are thought …

Sustaining Successful Efforts To Increase Home Visiting Referrals Thornburg Early Childhood Education Grant 2020 Summary Report, Theresa H. Cruz, Ivy Vitanzos Cervantes, Leona K. Woelk

Reports & Documents

No abstract provided.

Perceptions Of Physical Activity Engagement Among African American Emerging Adults At Georgia Southern University - Statesboro Campus, Addison Mickens

College of Graduate Studies: Theses & Dissertations

Introduction: Physical Activity (PA) is critical to the health and well-being of African American emerging adults, ages 18-25. Research suggests that African American (AA) college students engage in less PA than other racial/ethnic groups. Few studies have examined the relationship between the collegiate built environment (CBE) impact on PA in this population. The Social Ecological Model (SEM) and the Social Cognitive Theory (SCT) were used to show how the environment facilitates influence on the behavior through physical and social factors affecting the behavior of engaging in PA. Methods: The purpose of this cross-sectional, concurrent multi-method study was to determine barriers …

Obesity And Obstructive Airways Disease: Clinical Correlates And Therapeutic Considerations, John Magagna, Cali Loblundo, Raymond B. Penn, Deepak A. Deshpande, Ajay P. Nayak

Student Papers, Posters & Projects

Obese patients are more likely to suffer from severe asthma symptoms and less likely to be able to control them. In obese patients, there is evidence that shows decreased efficacy of inhaled corticosteroids and beta-2 adrenergic agonists, the core treatment options for achieving and maintaining asthma control. This may be due to mechanical reasons like decreased ventilation and medication delivery, but there are many more pathologies of obesity that interact with pathways of both asthma pathology and asthma control. This review explores the epidemiological significance of obesity, many physiological changes in patients with obesity, the physiological interactions of asthma and …

Root Coverage Predictability In The Treatment Of Gingival Recessions On Mandibular And Anterior Teeth, Michele Agusto

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction. Mandibular anterior teeth are most frequently affected by gingival recessions. However, data regarding mucogingival treatment aimed at root coverage in this specific location is limited.

Aim. To systematically review the literature addressing the focused question: “What is the effectiveness, efficacy and efficiency of different surgical approaches on clinical and patient-related outcomes in the treatment of buccal gingival recessions on mandibular anterior teeth?”

Material methods. Electronic (Medline, Scopus, and Cochrane databases) and hand literature searches were performed for studies including at least one arm involving the use of pedicle flaps and/or free soft tissue grafts in the …

Modulation Of Parasympathetic Reactivation Post-Exercise Via Slow Breathing, Brent Burg

CSB and SJU Distinguished Thesis

During exercise sympathetic nervous activity increases and parasympathetic nervous activity decreases to fuel energy demands. Heart rate variability (HRV) indicates activity of the autonomic nervous system and the balance of its two branches. Slow breathing (SB) (6 breaths/minute) increases parasympathetic activity both spontaneously during practice and at rest after long-term practice. Thus, SB may increase parasympathetic activity after exercise. PURPOSE: This study aimed to determine whether post-exercise SB increases parasympathetic activity as measured by HRV. METHODS: Ten recreationally active college aged males (21 +/-1 years old) completed the study. A VO2max test was used to determine 70% of VO2max for …

Electrospinning Piezoelectric Fibers For Biocompatible Devices, Bahareh Azimi, Mario Milazzo, Andrea Lazzeri, Stefano Berrettini, M. Jasim Uddin, Zhao Qin, Markus J. Buehler, Serena Danti

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Chemistry)

The field of nanotechnology has been gaining great success due to its potential in developing new generations of nanoscale materials with unprecedented properties and enhanced biological responses. This is particularly exciting using nanofibers, as their mechanical and topographic characteristics can approach those found in naturally occurring biological materials. Electrospinning is a key technique to manufacture ultrafine fibers and fiber meshes with multifunctional features, such as piezoelectricity, to be available on a smaller length scale, thus comparable to subcellular scale, which makes their use increasingly appealing for biomedical applications. These include biocompatible fiber-based devices as smart scaffolds, biosensors, energy harvesters, and …

Assessment Of Eating Habits And Lifestyle During Coronavirus Pandemic In The Mena Region: A Cross-Sectional Study, Leila Cheikh Ismail, Tareq M. Osaili, Maysm N. Mohamad, Amina Al Marzouqi, Amjad H. Jarrar, Antonis Zampelas, Carla Habib-Mourad, Dima Omar Abu Jamous, Habiba I. Ali, Haleama Al Sabbah, Hayder Hasan, Latifa Mohammed Rashid Almarzooqi, Lily Stojanovska, Mona Hashim, Reyad R.Shaker Obaid, Samar Elfeky, Sheima T. Saleh, Zahieh A.M. Shawar, Ayesha S. Al Dhaheri

All Works

© The Authors 2020. The coronavirus disease (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviors among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from 18 countries participated in the current study. During the pandemic, over 30% reported weight gain, 6.2% consumed five or more meals per …

Calcium Signaling In Endocardial And Epicardial Ventricular Myocytes From Streptozotocin-Induced Diabetic Rats, Lina T. Al Kury, Vadym Sydorenko, Manal M.A. Smail, Muhammad A. Qureshi, Anatoly Shmygol, Dimitrios Papandreou, Jaipaul Singh, Frank Christopher Howarth

All Works

© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd Aims/Introduction: Abnormalities in Ca2+ signaling have a key role in hemodynamic dysfunction in diabetic heart. The purpose of this study was to explore the effects of streptozotocin (STZ)-induced diabetes on Ca2+ signaling in epicardial (EPI) and endocardial (ENDO) cells of the left ventricle after 5–6 months of STZ injection. Materials and Methods: Whole-cell patch clamp was used to measure the L-type Ca2+ channel (LTCC) and Na+/Ca2+ exchanger currents. Fluorescence photometry techniques were used to measure …

The Comparison Of Two Diabetes Self-Management Education Programs In The Reduction Of Patient A1c Levels, Edward Sharpless

All ETDs from UAB

This dissertation was a quasi-experimental research study exploring the effectiveness of two educational teaching methods with patients with diabetes. One teaching method utilized an education framework called the Conversation Map tools, a group-based, highly interactive learning experience using colorful visual tools, activity cards and sharing of real-life experiences. The other method was a traditional, lecture-style class taught by a health educator using overhead slides and handouts.

Secondary data from a regional health system in the Western U.S. was used to test the hypothesis that participants in the Conversation Map classes would report a larger drop in A1c levels compared to …

Fixed And Variable Costs At Critical Access Hospitals, Jeremy J. Lyman

All ETDs from UAB

Cost structures (the ratio of fixed to variable costs) vary across and within indus-tries. Hospital managers and policymakers can make better decisions when they under-stand cost structures, including marginal costs (the change in the total cost that arises when the quantity produced is increased by one unit). Although some studies have inves-tigated hospital cost structures, the results have been mixed and less than definitive, and very little attention has been given to critical access hospitals and marginal costs specifi-cally. Rural hospitals, including critical access hospitals, have increasingly experienced financial distress. Between 2005 and 2019, 159 rural hospitals closed across the …

Challenges And Promising Strategies For Maximizing Pregnant Women's Adherence And Retention In Niv Care In The Context Of Option B+ In Kenya, Anna Helova

All ETDs from UAB

Under the current Kenyan guidelines, pregnant/postpartum women who test HIV-positive are immediately put on the lifelong antiretroviral (ART) therapy (Option B+) and are initiated into the prevention of mother-to-child (PMTCT) protocol. Gaps at each step of the PMTCT continuum undermine the positive impact of lifelong ART. Challenges at the individual, interpersonal, community, and health facility-levels contribute to these gaps. A community-based mentor mother (cMM) program tested under the Mother-Infant Visit Adherence and Treatment Engagement(MOTIVATE!) Trial (NICHD R01 R01HD080477; ClinicalTrials.gov#14-0331) is a potential approach to address these challenges. The three manuscripts comprising this dissertation used qualitative and quantitative methods with the …

Impact Of Registered Nurse Staffing Ratio On Nursing Home Operating Margins And Quality Measure Star Ratings, Douglas R. Whitman

All ETDs from UAB

Today’s nursing homes are under immense pressure from government regulators to improve quality while the government simultaneously tightens reimbursement rates. These two forces squeeze operating margins. The question facing nursing home operators is how to improve quality without breaking the bank. This study looks at the association of more registered nurses (RN) with quality and margins in U.S. nursing homes. This research project fills literature gaps which previously found improved nursing home quality correlates with more RNs. However, prior studies used self-reported data and typically considered only two or three quality measures. This study uses recently released electronic payroll data …

A Cephalometric Study Of The Effects Of Class Ii Malocclusion Correction Utilizing The Carriere® Motion 3d Appliance And Essix Retainer, Julie Dean

All ETDs from UAB

Objective: The purpose of this study is to determine the dental and skeletal effects of Class II malocclusion correction with a Carriere® Motion 3D appliance and lower Essix retainer for anchorage, as compared to best-matched controls. Methods: This is a retrospective case-control cephalometric study uses pre- and post-distalization lateral cephalometric images from 44 (32 female, 12 male, average age 13y 7m) class II patients treated with a Carriere® Motion 3D appliance and lower Essix retainer. These films were analyzed to determine treatment effects and compared with 35 (17 female, 18 male, average age 13y 3m) untreated controls from a historical …

The Relationship Between Asthma And Electronic Cigarette Use Among Youth And Young Adults: Mediation And Moderation Approaches, Abdullah M M Alanazi

All ETDs from UAB

Asthma is associated with a higher likelihood of electronic cigarette (e-cigarette) use, which may increase the risk of pulmonary complications. Therefore, we sought to identify factors that influence e-cigarette use that may inform future behavior interventions targeting e-cigarette use prevention. In this dissertation, we used mediation and moderation to model the relationship of health beliefs, psychosocial and behavioral factors that may affect the relationship between e-cigarette use and asthma. We used national samples from public datasets, and a clinical sample recruited from healthcare facilities in Alabama. The results of this study are reported in three different papers. In the first …

Marginalized Models With Heterogeneous Random Effects For Zero-Inflated Longitudinal Count Data, Steve Boateng Ampah

All ETDs from UAB

Longitudinal count data sometimes called panel data come up most often in publichealth and biomedical research, where investigators are interested in assessing the association between an identified exposure and the correlated count outcomes. It is worth mentioning most of these correlated count data exhibit over-dispersion, excess zeros and heterogeneous properties which when ignored during analysis can lead to biased estimates of covariate effects. The traditional zero-inflated count models with random effects have been developed to analyze such correlated count data, however the two sets of regression coefficients from this model, directly allow subgroup interpretations with the first set of coefficients …

Rab27 And 14-3-3 Mediated Regulation Of Alpha-Synuclein Pathology, Rachel Nicole Underwood

All ETDs from UAB

Alpha-synuclein (αsyn) is the key component of proteinaceous aggregates termed Lewy Bodies (LBs) that pathologically define a group of disorders known as synucleinopathies, including Parkinson’s Disease (PD) and Dementia with Lewy Bodies (DLB). αSyn is thought to misfold and spread throughout the brain in a prion-like fashion. Transmission of αsyn necessitates the release of misfolded αsyn from one cell and the uptake of that αsyn by another, in which it templates the misfolding of endogenous αsyn. Identifying regulators of this process is essential to understanding how αsyn propagates and furthers disease progression. In this study, we investigated Rab27 and 14-3-3θ …

T Cells In Synucleinopathies, Gregory Paul Williams

All ETDs from UAB

Synucleinopathies, which include Parkinson disease (PD), dementia with Lewy Bodies (DLB), and multiple system atrophy (MSA), are a collection of neurodegenerative diseases that are in major part defined by the presence of alpha-synuclein (α-syn) rich protein aggregates in the brain. Increasing evidence has highlighted a neuroinflammatory phenotype also associated with these synucleinopathies. This neuroinflammatory phenotype includes the activation of central nervous system (CNS) microglia, increased pro-inflammatory cytokines, and the infiltration of peripheral T cells into the CNS. We sought to further explore the T cell responses associated with PD and MSA. Using two preclinical mouse models of PD and MSA, …

Co-Factors In Fgf Signaling, Christopher Yanucil

All ETDs from UAB

The fibroblast growth factor (FGF) family consists of a group of proteins whose diverse biological functions are mediated by receptor tyrosine kinases, termed FGF receptors (FGFR) 1-4. While paracrine FGFs require heparin sulfate as a co-factor for FGFR bind-ing and signaling, it has been assumed that endocrine FGFs, such as FGF23, do not bind heparin but instead require klotho, a family of transmembrane proteins, as a co-receptor on specific target cells. FGF23 acts as bone-derived hormone that targets tubular epitheli-al cells in the kidney via FGFR1 and α-klotho to reduce renal phosphate uptake. In chron-ic kidney disease (CKD), the kidney …