Medicine and Health Sciences Commons^™

Evidence For A Bioelectrical Marker Of Insulin Resistance In Premenopausal Women: Membrane Capacitance, Valene E Garr Barry

All ETDs from UAB

Insulin resistance (IR) is associated with poor metabolic and reproductive outcomes among premenopausal women. Early identification of women with IR might mitigate these outcomes. However, clinically suitable methods to identify women with IR are unavailable due to high cost, high patient burden, or limited reliability. The objective was to examine a bioimpedance-based approach to identifying women with IR using membrane capacitance (CM). CM is a measure of cell membrane health and function, which is independently associated with IR and may be a suitable predictor. We validated the association of CM with IR and established the clinical utility of CM as …

An Exploration Of The Manifestation Of Parentification Among Young Carers Of Persons With Huntington’S Disease, Bailey Hendricks

All ETDs from UAB

Due to the progressive deterioration of motor, cognitive, and psychological function experienced by individuals diagnosed with Huntington’s disease, there is the potential for children in the home to adopt a caregiving role. These young carers typically serve as informal, secondary caregivers, providing multifaceted, extended care without any lessening of typical family, home, or school/work-related responsibilities. In time, this role may result in parentification, a type of role reversal with both positive and negative outcomes for the child. A secondary analysis of qualitative data of the experiences of children who have a parent with Huntington’s disease was conducted. Transcripts of qualitative …

Rural And Urban Differences In Vegetable And Fruit Consumption Among Older Cancer Survivors In The Deep South: An Exploratory Cross-Sectional Study, Harleen Kaur

All ETDs from UAB

Background: Rural Americans have poorer overall health and physical functioning than their urban counterparts. A varied diet, rich in vegetable and fruit (V&F) consumption may improve health; however, little is known about rural-urban differences in V&F consumption, especially in older cancer survivors. Objective: To assess differences in V&F consumption among older cancer survivors residing in urban- and rural-designated areas, and explore whether differences exist by sex, race, and cancer type. Design: This was a cross-sectional secondary analysis. Participants/setting: Screening data from the Harvest for Health trial was obtained on 731 Medicare-eligible cancer survivors across Alabama. Main outcome measures: V&F consumption …

Service Profiles In Substance Use Disorder Treatment: The Role Of Institutional And Organizational Factors, Reena Joseph Kelly

All ETDs from UAB

Substance use disorders (SUDs) are a growing crisis globally and in the US, and place an enormous health, social, and financial burden on the nation. To address the complex nature of SUDs, treatment typically involves a combination of different types of services to address the medical, behavioral and social needs of the patient and care is often delivered by specialized SUD treatment facilities. Despite recommendations for a broad suite of services, individual facilities vary in the specific services that they offer. This study examined whether and why systematic differences exist between treatment facilities based on their service mix and whether …

Gait Adaptability With Healthy Aging And Parkinson’S Disease, Daniel Kuhman

All ETDs from UAB

Human locomotion often occurs through environments with complex sets of external demands (e.g., obstacles, uneven surfaces, altered terrain, etc.). Fortunately, humans have developed locomotor systems capable of rapidly adapting gait patterns to navigate these environments. Advanced age and neurological disorders such as Parkinson’s disease (PD) are associated with physiological changes that add to the complexity of locomotion – these individuals must not only adapt to changing environmental demands, but also to changes in internal function (e.g., reduced muscle strength, dysfunctional sensorimotor integration). While there is a growing body of literature indicating that healthy older adults maintain adaptability, less is known …

Actual And Perceived Balance Abilities While Performing Tasks That Challenge Balance In Older Adults And Individuals With Parkinson's Disease., Jutaluk Kongsuk

All ETDs from UAB

Walking is a fundamental activity for one to interact effectively with one’s environment. Walking in the community often requires both a wide range and constant modification of walking speed. Decreased walking capacity, that is the maximum speed that a person can physically achieve, results in a decline in both functional mobility and personal independence, contributing to decreased community participation among individuals whose walking is impaired. The most common test of walking speed (i.e., overground comfortable and maximum walking speed) may not reflect the full capacity of individuals to regulate gait control. Whereas walking with progressively increasing treadmill speeds allows researchers …

The Association Between Medicaid Expansion, Medicaid Disproportionate Share Payments And The Financial Performance Of Safety Net Hospitals, Jon Law

All ETDs from UAB

Safety Net Hospitals (SNHs) provide necessary emergency and acute care to all individuals, regardless of their ability to pay for health care. Medicaid Expansion and Disproportionate Share (DSH) payments are two Medicaid programs that may mitigate the financial vulnerability of SNH’s. Some assert that Medicaid Expansion, as part of the Patient and Affordable Care Act (ACA), may provide financial relief for SNHs. It offers payment mechanisms for millions of uninsured individuals. DSH expenditures per capita for each state vary widely. There is some likelihood that SNHs in some states may benefit greater than others. The study was framed within the …

Chemical, Physical, And Antibacterial Properties Of Contemporary Pulp Capping Materials, Yu-Yin Lin

All ETDs from UAB

The purpose of this project was to compare the chemical, physical, and antibacterial properties of right contemporary direct pulp capping materials. The material categories included in this study were calcium hydroxide (Dycal, Lime-Lite and Ultra-Blend plus), calcium silicate (MTA Angelus, Biodentine, TheraCal LC), calcium aluminate (Ceramir Protect LC), and resin ionomer (Bio-Cap). Calcium release and pH changes were measured via a calcium ion-selective electrode (Vernier Company) and pH sensor (Vernier Company) respectively, after specimens were immersed in 36.8oC deionized water for 1, 7, 28 and 90 days. Water solubility was calculated with weight loss of the specimens from 0 to …

Implications Of Genetic Variation On Patient Disease And Therapeutic Options, Ashlee Long

All ETDs from UAB

Advancements in sequencing technology have enabled the widespread utilization of genetic testing, increasing the diagnosis and understanding of genetic disease. Clinicians and researchers are now faced with the difficulty of interpreting genetic results and understanding how genetic variation can impact patient disease phenotype. Herein we utilized three different genes (frataxin, neurofibromin 1, and NTRK2), which result in Friedreich’s Ataxia (FRDA), Neurofibromatosis Type 1 (NF1), and NTRK2-associated phenotypes respectively, to discuss the impacts of genetic variants on molecular phenotype and explore potential therapeutics. To determine how genetic variation of repeat sequences affects different patient tissues, DNA and protein were extracted from …

A Randomized Controlled Trial To Compare The Histomorphometric And Clinical Outcomes Of Soft Tissue Augmentation At The Time Of Lateral Ridge Augmentation Procedures, Kenneth Liu

All ETDs from UAB

Guided bone regeneration (GBR) can be used to augment deficient alveolar ridges in preparation for dental implant placement. Mucogingival deformities can result from the periosteal releasing incision during GBR. This can be addressed by additional soft tissue augmentation procedures to increase the width of keratinized tissue and vertical soft tissue thickness, both of which have demonstrated clinical benefits around implants. The drawbacks of soft tissue augmentation following ridge augmentation include an additional procedure, increased patient morbidity, and less patient acceptance of treatment. In general, soft tissue augmentation can be performed at various time points throughout treatment, but literature on soft …

The Role Of Race, Sex, And Place In The Association Of Diabetes And Cardiovascular Disease, Gargya Malla

All ETDs from UAB

Cardiovascular disease risk is higher among adult with diabetes than those without diabetes. This increase in risk may vary by race, sex, and neighborhood characteristics. Recent US data showed a resurgence in stroke and coronary heart disease (CHD) among adults with diabetes, and an increase in heart failure (HF) mortality. Therefore, this dissertation investigated how cardiovascular disease risk may vary by race, sex, and neighborhood characteristics for adults across the glycemic spectrum.Data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, an ongoing prospective cohort of 30,239 Black and White adults age 45 years at baseline (2003-07) …

Delineation Of B Cell Follicle Associated Cd4+ T Cell Subsets, Ryan James Mcmonigle

All ETDs from UAB

High affinity antibody responses rely on the interaction between CD4+ T cells andB cells, but these cell populations are segregated into different regions of secondary lymphoid organs (SLO). Early-stage follicular helper CD4+ T cells (Tfh cells) upregulate the B cell follicle-homing chemokine receptor CXCR5 in order to move from the T cell zone to the B cell follicle and establish interactions with cognate B cells that are essential for T-dependent humoral immune responses. Cognate Tfh and B cell interactions progress to the formation of germinal center (GC) reactions, where B cell receptors undergo rapid evolution to substantially increase antigen recognition …

Value Analysis Of Electronic Health Records, Shikha Shah Modi

All ETDs from UAB

The Electronic Health Record (EHR) is defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (HIMSS, 2011). EHRs have become an important part of the current health system as a result of government regulations, technology advancements, health care challenges, and market conditions. EHRs are considered an expensive investment; however, the complexity of adopting and implementing EHRs also demands attention. Given the complexity of health information technology (HIT) systems and the hefty investment that is required in the adoption of EHRs, a return on investment is expected, and it …

Color Vision Testing With Readily Available Materials, Angel Perez

All ETDs from UAB

COLOR VISION TESTING WITH READILY AVAILABLE MATERIALS ANGEL PEREZ VISION SCIENCE ABSTRACT The perception of color is a process by which the brain discriminates different light wavelengths stimulating the cone photoreceptors in the retina of the eye. In humans each cone contains a photopigment making it most sensitive to either short (red), medium (green), or long (blue) wavelengths of light. However, when one of the cone pigments is defective or missing, color discrimination is reduced, resulting in color vision deficiency due to a deficient sex-linked chromosome in most cases. Color vision deficiency has the potential to impede many everyday activities, …

Evaluation Of Antimicrobial Effect Of Licorice Extrcat Agiasnt Oral Microorganisms, Roshanak Rastegar

All ETDs from UAB

Introduction: The causative factors of dental caries have been studied for many years, however, preventing the formation of dental caries remains an elusive task. Microorganisms have been the focal point of numerous studies as a prime cariogenic factor. Streptococcus mutans and Candida albicans have been frequently co-isolated from dental biofilm in patients with early childhood caries (ECC) and studies have demonstrated the synergistic effects of these two microorganisms in promoting tooth demineralization. Acid and glucan production, which are two virulence factors produced by S. mutans that mediate biofilm formation and tooth decay, have been shown to be promoted during co-colonization …

The Psychological, Social, And Bioinformatic Considerations For The Return Of Continental Genetic Ancestry Estimates And Other Secondary Sequencing Results, Jaimie Leighan Richards

All ETDs from UAB

With recent advances in sequencing technologies, large scale genome wide sequencing has advanced our understanding of disease risk and etiology. These tests, however, often provide secondary data beyond the scope of the original sequencing objectives, and our understanding of how and if participants want to receive these secondary results is important as clinical and research-based sequencing becomes commonplace. To address this, we completed a systematic review of quantitative research that measures attitudes and preferences on the return of genomic sequencing results. Based on that review, we studied the return of genetic ancestry since these results, popularized in direct-to-consumer sequencing companies …

Assesing The Degree Of Intereron Gamma Induced Stat1 Activation On Peripheral Lymphocytes In Patietns With Rheumatoid Arthritis, Vishal Sharma

All ETDs from UAB

Rheumatoid Arthritis (RA) is a systemic autoimmune disease with debilitating side effects, from joint swelling to bone erosion and bone deformation. Geographically, RA affect 0.5 – 1% of the worldwide populations, affecting women more than men. Studies have shown that CD4 T cells infiltrate RA synovium and are key to the pathogenesis of RA. Furthermore, drugs targeting co-stimulatory T cell molecules such as abatacept can be beneficial in controlling RA disease activity.Interferon gamma (IFN) is a pleotropic cytokine that contributes to inflammation by aiding in CD4 T cell differentiation into Th1 subtype, enhancing MHC class II presentation, supplementing lymphocyte trafficking, …

Mechanism Of Stat3 Mediated Drug Persistence In Chronic Myeloid Leukemia Stem Cells, Sweta B. Patel

All ETDs from UAB

Drug persistence is one of the major impediments for cancer therapeutics. There are two known evolutionary models for tumor drug persistence. First, a pre-existing sub-population is inherently resistant to treatment; and second, a sub-population acquires resistance by drug-induced molecular reprograming. One ideal model to study the mechanism of drug persistence is chronic myeloid leukemia (CML), a hematopoietic stem cell (HSC) disorder. HSCs acquire a single translocation between chromosome 9 and 22, forming BCR-ABL, a constitutively active tyrosine kinase. Tyrosine kinase inhibitors (TKI), the standard regimen, have been able to efficaciously control CML and yet many patients relapse upon treatment discontinuation …

A Pilot Study Of Oral Health Related Quality Of Life During Gynecologic Cancer Treatment, Stephanie Kushnir

EWU Masters Thesis Collection

Purpose: The purpose of this study was to determine if oral health education increases oral health related quality of life in gynecologic oncology patients.

Methods: In this pilot study, 23 participants (18 - 70+ years) with a history of gynecologic cancer were recruited to participate in the study. Participants completed an Oral Health Impact Profile (OHIP-14) questionnaire prior to and after given education packet.

Results: At baseline, the mean pre-test OHIP-14 score was 6.7 (SD 8.4) and mean OHIP-14 post-test score was 8.8 (SD 8.4). Pearson Correlation was .90. P (T< = t) one-tail p < .008. Demonstrating statistical significance.

Conclusion: OHIP-14 scores increased after four-weeks, higher scores of …

Virtual Objective Structured Clinical Examinations As A Framework For Active Learning And Assessment: A Retrospective Analysis Of Dental Hygiene Student And Instructor Perceptions, Kellie Whitcomb

EWU Masters Thesis Collection

Purpose: Millennials have unique needs as learners and have come to expect the use of technology in education. Utilizing technology to implement formative virtual objective structured clinical examinations (vOSCEs) may engage millennial students due to the non-linear nature and active pedagogy while also preparing them for provisional or full licensing exams. The purpose of this study was to determine what implications there may be for future formative vOSCE use in dental hygiene programs by assessing dental hygiene student and clinic faculty experience with vOSCEs.

Methods: Research was from a qualitative perspective. The design was a retrospective phenomenological cohort study utilizing …

Estimating Infant Hip Joint Moments Using A Novel Musculoskeletal Model, Yeram Lim, Victor Huayamave, Christine Walck, Erin Mannen, Safeer Siddicky

Publications

Musculoskeletal models offer a convenient method to non-invasively study human development, function, and pathologies. While adult musculoskeletal models have been extensively studied [1], infant populations have been widely underserved. However, understanding infant joint biomechanics during the first year of life is vital considering abnormal loads may be detrimental to growth and development. Joint moments from an infant musculoskeletal model could help assess pathologies such as developmental dysplasia of the hip (DDH). Previous computational studies involving infant biomechanics [2, 3] lacked the modeling of active muscle response which may affect musculoskeletal development [4]. As such, the purpose of this study is …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda G. Kimsey, Charles F. Owens, Samuel T. Opoku, Angela Peden, William A. Mase

Journal of the Georgia Public Health Association

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

White Paper On Engineering Controls For Bioaerosols In Non-Industrial/ Non-Healthcare Settings, Cheri L. Marcham, American Conference Of Governmental Industrial Hygienists

Publications

The list of disease pathogens that can be transmitted in the air is extensive. This list includes the common cold, SARS, measles, Hansen's disease (leprosy), polio, influenza, Legionella (Legionnaires’ disease and Pontiac fever), and tuberculosis (TB). TB, SARSCoV-1, avian influenza, varicella, and now SARS-CoV-2 all have received public notice due not only to their known or assumed ability to be transmitted in the air rapidly from one individual to another, but also for their virulence. Other bioaerosols that can be transmitted through the air include bacteria, fungal spores and fragments, dust mites, and pollen. This document was developed to address …

Impact Of Behavioral Side Effects On The Management Of Parkinson Patients Treated With Dopamine Agonists., Mohammad Edrees Mohammad, Joaquin A Vizcarra, Xiomara Garcia, Shnehal Patel, Adam Margolius, Xin Xin Yu, Hubert H Fernandez

Neuroscience Articles

Dopamine agonists are one of the main stay of treatment option for Parkinson disease (PD). Side effects that develop from their use are generally categorized into behavioral and non-behavioral. Behavioral side effects include: impulse control behavior disorder (ICD), psychosis and cognitive impairment. Non-behavioral side effects include: nausea/vomiting, "sleep attacks", leg swelling, weight gain and orthostasis. The aim of this study is to evaluate the clinicians' response to PD patients who developed behavioral side effects from dopamine agonists, in comparison to those patients who developed only non-behavioral side effects. We performed a retrospective chart review of all patients diagnosed with …

Integrative Review On The Initiation Of A Systematic Oral Care Education Program, Toni Rochelle Thomas

Doctoral Dissertations and Projects

Hospital-acquired infections, such as non-ventilated hospital-acquired pneumonia (NVHAP), are significant patient safety concerns. The lack of oral care in the non-ventilated acute care patient population is a significant contributor to NVHAP. The nursing staff is on the front line in providing oral care to hospitalized patients but often lacks knowledge and understanding regarding the relationship between oral care and NVHAP. Searching MEDLINE, PubMed, CINAHL, and EBSCO databases for current, peer-reviewed, scholarly articles for English language articles between 2010-2020 led to supporting findings. These findings revealed missed oral care as the most common modifiable risk factor contributing to increased hospital-acquired pneumonia …

Employee Wellness Program Participation: Exploring Participation Of Registered Nurses In East Tennessee, Jacquelyn Turner

Doctoral Dissertations and Projects

Many organizations are faced with the challenge of managing employee retention and absenteeism. While retention strategies are focal to organizational leaders across the board, the growing shortage of nurses nationwide creates a critical concern for healthcare leaders. The purpose of this qualitative case study was to delve into the existing body of research pertaining to the impact of employee wellness programs on employee retention and absenteeism and further explore the reasons why employees choose to/ not to participate in wellness programs offered by employers. The intent of this study was to add to the existing body of knowledge on employee …

Mentor Programs As A Strategic Approach To Nurse Retention: Integrative Review, Nancy Jo Thompson

Doctoral Dissertations and Projects

The purpose of this integrative review is to identify commonalties of mentor program success demonstrated by registered nurse retention to support DNP leaders seeking to address the nursing shortage by retaining newly licensed and experienced registered nurses. Mentor programs offer nurse leaders a low-cost solution with a high return on investment to address nurse retention. The United States is facing a tremendous nursing shortage compounded by multiple factors, including an unprecedented global pandemic. An aging population is leaving the profession while the new generation of nurses struggle to find their niche. Registered nurses make up the largest sector of health …

An Integrative Review: Best Practices In Advanced Practice Registered Nurse (Aprn) Telehealth Services To Improve Outcomes For Children With Chronic Health Conditions, Tamara Sue Moyer

Doctoral Dissertations and Projects

Telehealth is a rapidly growing field that affords individuals the opportunity to receive access to specialty providers, reduce expenses and travel, break down geographic barriers, deliver equality of care, and improve patient outcomes. Equality of healthcare for pediatric patients with chronic health conditions in rural areas face geographic barriers to delivery of care, resulting in poor patient outcomes, and increased costs. An integrative review was completed to identify and describe research findings in an attempt to answer the clinical questions proposed and identify areas in research that can lead to improved patient outcomes. The need to receive access to specialty …

The Basic Rules Of Doing A Good Search And Search Tips - Revised, Roy E. Brown

VCU Libraries Faculty and Staff Publications

This is a handout that is used as a reference for those who are learning to more effectively search databases for assignments and evidence-based practice projects. The revised handout contains information related to the databases that may be searched as well as about Google Scholar.

Please contact the author for a version that can be reused and rebranded.

The Evidence Based Practice Question Development & Search Tips Checklist (Revised), Roy E. Brown

VCU Libraries Faculty and Staff Publications

The Evidence Based Practice Question Development and Search Tips Checklist is a tool that is used in instructional sessions with nurses in reference to evidence-based practice and literature searching. It is intended as a reference handout. The revised handout contains information related to the databases that may be searched as well as about Google Scholar.

It is under a creative commons license. If you would like a version that can be rebranded for your organization to use, please contact the author for an editable version.