Samford University
  • Birmingham, United States
Recent publications
In her 2017 book Democracy in Chains, historian Nancy MacLean identifies John C. Calhoun as the “lodestar” of public choice theory and argues that the conservative Southern Agrarian poets (Donald Davidson, Allen Tate, Robert Penn Warren, and others) were influential in the formation of 1986 Nobel Laureate James M. Buchanan’s worldview. We test this argument with reference to the scholars cited in Buchanan’s collected works and elsewhere. The evidence for any direct or even indirect influence of Calhoun and the Agrarians is very scant, and we conclude that Buchanan’s intellectual program was shaped far more by Knut Wicksell, Frank Knight, and the Italian public finance tradition than by Calhoun or early twentieth-century segregationists.
Pregnancy is life altering for women. For an adolescent girl, a pregnancy can set her on a radically different life trajectory, potentially toward a life of poverty. Across the world, governments differ in the way they respond to teenage pregnancy, especially in light of policies toward schoolgirls finishing their education. We explore how religion correlates with policy and practice toward teenage pregnancy, examining whether teenage moms are supported if they want to return to school after giving birth. We consider whether the predominant religion in a country corresponded to the type of policies that were passed. We use Gallup World data to predict whether a country that criminalizes or expels pregnant schoolgirls by their self-reported religion. We also run a simple ordinary least squares regression to estimate a linear probability model with the outcome that indicates whether the country expels pregnant teens from school or considers teen pregnancy a criminal expense. Findings indicate that countries that were primarily Protestant Christian were much more likely to have restorative policies toward girls who were pregnant or had given birth, supporting them if they decided to pursue school completion.
OBJECTIVE To evaluate associations between a broad range of approaches to classifying diet and incident type 2 diabetes in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. RESEARCH DESIGN AND METHODS This study included 8,750 Black and White adults without diabetes at baseline. Diabetes was defined according to fasting glucose ≥70 mmol/L, random glucose ≥111 mmol/L, or use of diabetes medications. The exposures were diet scores for Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), dietary inflammatory index (DII), dietary inflammation score (DIS), and empirical dietary patterns (plant-based and Southern) determined using data collected with use of the Block98 food-frequency questionnaire. Modified Poisson regression was used to assess association of dietary measures with risk of incident type 2 diabetes, with models adjusted for total energy intake, demographics, lifestyle factors, and waist circumference. RESULTS There were 1,026 cases of incident type 2 diabetes during follow-up (11.7%). Adherence to the Southern dietary pattern was most strongly associated with risk of incident type 2 diabetes after adjustment for demographics and lifestyle (quintile [Q]5 vs. lowest Q1: risk ratio [RR] 1.95; 95% CI 1.57, 2.41). Of the diet scores, DIS (Q5 vs. Q1 RR 1.41) and MIND (Q1 vs. Q5 RR 1.33), demonstrated anti-inflammatory diets, had strongest associations with lower diabetes incidence. CONCLUSIONS We found associations of several dietary approaches with incident type 2 diabetes. Investigation into mechanisms driving the association with the Southern dietary pattern is warranted. Further research into use of DIS, DII, and MIND diet score should be considered for dietary recommendations for diabetes prevention.
The family is an institution within which exchange takes place. The state depends on the productivity of families for its current and future revenues. Yet, work on family policy often ignores the role of local knowledge, incentives, and special interests, while families themselves are often overlooked in accounts of the unintended consequences of public policy. The work of Julian Simon is a notable exception. Building upon his insights about the family’s production of children in particular, this paper offers a way to think about family policy that is consistent with both family economics and public choice. I conclude by applying some basic principles to better understand three patterns: the gap between intended and actual fertility in the developing world today, the lack of successful pro-natal public policy, and the oscillation of totalitarian family policy.
A robust literature has outlined the risks to children separated from parental care. Recently, there has been an effort to reform services to this population. However, the research driving reform has often neglected the voices of adults with care experience, especially those from the Global South. The current research explored recommendations for care reform from 542 adults who had experienced alternative care during childhood in 12 nations in the Global South. Data revealed three themes to improve care: (1) child focus and participation, (2) the need for family placements, and (3) the importance of support services. Implications are discussed.
Purpose: Ammonia inhalants (NH3) are anecdotally used in competition by athletes for their purported stimulant effects. However, evidence on the efficacy of NH3 is conflicting, and little to no studies to date have investigated its effect on repeated exercise. The purpose of this study was to examine the effects of NH3 on psychophysiological responses and performance during repeated high-intensity exercise. Methods: In a counterbalanced crossover design, physically active females completed two repeated high-intensity sprint trials with a different treatment: Control (CON; water) or Ammonia Inhalants (NH3; 0.33 cc). For each trial, participants completed 3 × 15s Wingate anaerobic tests (WAnT) separated by 2 min of active recovery. Prior to each WAnT, participants took a single 3-s inhale of the corresponding treatment. After the succession of each WAnT, heart rate (HR) and rate of perceived exertion (RPE) were documented. Subjective feelings of alertness and “psyched up” energy were measured using a visual analog scale. Trials were separated by at least 48 hr. Results: The results indicate that over the WAnTs, mean power (p = .017) and peak power (p = .006) were significantly higher with NH3 compared to CON despite a lack of changes in fatigue index (p = .928). HR (p = .101) and RPE (p = .897) were not different with varying treatments. Perceived alertness (p = .010) and psyched-up energy (p = .002) were significantly higher with NH3 versus CON. Conclusion: These findings provide empirical support for the use of NH3 to improve repeated high-intensity exercise performance in females that may be underpinned by alterations in subjective alertness and energy.
Transition‐metal‐catalyzed annulation reactions to synthesize indenones are reviewed, beginning with the Larock indenone synthesis and focusing on the most recent advances in technology. Proposed reaction mechanisms, and the evidence supporting them, are highlighted throughout this review. Current limitations in these reactions are described in detail. Obtaining high regioselectivity remains challenging with several different classes of alkyne. In particular, high‐yielding and regioselective reactions with alkyl‐substituted alkynes remain elusive, as do reactions with terminal alkynes. In the final section, the case is made that indanone synthesis reactions employing alkenes should be further explored.
As a result of the COVID-19 pandemic, some governments issued mandates requiring that residential care providers rapidly return children and youth to family. The goal of the present study was to assess outcomes in a sample of families experiencing rapid unprepared return. Specifically, we sought to evaluate the placement stability, assess support services provided to families, and examine how services received impacted parental stress and family functioning. Participants and Setting: 115 families who had experienced rapid unprepared return across five nations, including Ethiopia, India, Kenya, Mexico, and Uganda. Using a quantitative design, results examined (1) placement stability, (2) services received, and (3) the impact of services on family wellbeing. Data revealed the majority of families were still intact after 1 year. More robust support services were associated with lower parental stress and better family functioning. Occupational/financial support, such as financial assistance and job training, and material support, such as home repairs and food assistance, were vital to family wellbeing 1 year following rapid unprepared return. Rapid unprepared return creates risks to families and children, and should not be continued or repeated. However, emergency situations, government mandates or unexpected crises may force conditions for rapid unprepared return. For families that have experienced rapid unprepared return, intensive support and appropriate case management can improve the likelihood of positive outcomes and improve family wellbeing.
Background Practice facilitators (PFs) provide tailored support to primary care practices to improve the quality of care delivery. Often used by PFs, the “Key Driver Implementation Scale” (KDIS) measures the degree to which a practice implements quality improvement activities from the Chronic Care Model, but the scale’s psychometric properties have not been investigated. We examined construct validity, reliability, floor and ceiling effects, and a longitudinal trend test of the KDIS items in the Southeastern Collaboration to Improve Blood Pressure Control trial. Methods The KDIS items assess a practice’s progress toward implementing: a clinical information system (using their own data to drive change); standardized care processes; optimized team care; patient self-management support; and leadership support. We assessed construct validity and estimated reliability with a multilevel confirmatory factor analysis (CFA). A trend test examined whether the KDIS items increased over time and estimated the expected number of months needed to move a practice to the highest response options. Results PFs completed monthly KDIS ratings over 12 months for 32 primary care practices, yielding a total of 384 observations. Data was fitted to a unidimensional CFA model; however, parameter fit was modest and could be improved. Reliability was 0.70. Practices started scoring at the highest levels beginning in month 5, indicating low variability. The KDIS items did show an upward trend over 12 months (all p < .001), indicating that practices were increasingly implementing key activities. The expected time to move a practice to the highest response category was 9.1 months for standardized care processes, 10.2 for clinical information system, 12.6 for self-management support, 13.1 for leadership, and 14.3 months for optimized team care. Conclusions The KDIS items showed acceptable reliability, but work is needed in larger sample sizes to determine if two or more groups of implementation activities are being measured rather than one.
Embracing accountability to others for one’s responsibilities within relationships is important for flourishing, yet underexamined. An interdisciplinary team defined the construct of accountability and developed an 11-item single-factor Accountability Scale. In national samples with US census demographic representation (total N = 1257), we conducted psychometric analyses using methods from classical test theory (exploratory and confirmatory factor analyses) and item response theory. The Accountability Scale demonstrated internal consistency, construct validity, test-retest reliability, and incremental validity. Accountability correlated positively with relational variables (agreeableness, empathy) responsibility-oriented variables (conscientiousness, self-regulation), virtues (gratitude, forgiveness, limitations-owning humility), relational repair, perceived meaning presence, and flourishing, inversely with symptoms (personality disorders, temper, anxiety, depression), and weakly with searching for meaning and social desirability. Accountability scores superseded demographic variables, conscientiousness, and agreeableness to predict relational repair, perceived presence of meaning in life, and flourishing. We offer the accountability construct and scale to advance human flourishing research and applied work.
Purpose/background: Antipsychotic-associated sialorrhea is a problematic adverse effect with potentially negative consequences on quality of life and medication adherence. While clozapine is the antipsychotic that is most associated with sialorrhea, there have been published reports of other second-generation antipsychotics associated with sialorrhea, including aripiprazole, olanzapine, quetiapine, and risperidone. Although drooling is mentioned within the package insert for paliperidone, to date there have been minimal published reports in which paliperidone is implicated as the offending agent. Methods/procedures: Here, we present a case of sialorrhea in a 56-year-old male with schizoaffective disorder who had a supratherapeutic paliperidone level after both oral and intramuscular paliperidone use. Findings/results: Paliperidone was ultimately cross tapered to aripiprazole, and the patient was given atropine drops and benztropine with resolution of the sialorrhea. We provide a review of the literature regarding the other available reports of paliperidone-associated sialorrhea, possible mechanisms behind pathophysiology, as well as reports from the World Health Organization and Food and Drug Administration adverse event reporting systems. Implications/conclusions: Clinicians should be aware of the potential for paliperidone and other nonclozapine second-generation antipsychotics to be associated with sialorrhea, especially given the increased frequency of their use for a variety of psychiatric disorders.
A copper porphyrin and two copper phthalocyanine complexes were incorporated into a hierarchically porous carbon support formed by a sol-gel resorcinol-formaldehyde polymerization templated by F-127 block copolymer. The F127 self-organization leads to formation of mesostructure that on carbonization produces mesopores. Striking differences in catalytic activity for iodobenzene/imidazole cross coupling were observed between Alcian Blue-8gx (CuPc-8gx) (active) and copper phthalocyanine disulfonate (CuPc2S) (inactive). FTIR and EPR spectroscopy confirmed that phthalocyanine remained in the carbon after it was formed by heating to 500 °C, but that no complex survived heating to 800 °C. Electron microscopy (SEM and TEM) showed that the two dyes were differently distributed within the carbon support and found very different sizes of copper nanoparticles: 1.5 nm for CuPc-8gx and 86 nm for CuPc2S. Based on quenching of pyrene fluorescence by the two dyes it was concluded that CuPc-8gx was incorporated into F127 micelles. During polymerization the CuPc-8gx remained associated with F127 and so was incorporated into the polymer and subsequently the carbon. CuPc2S was not associated with F127 micelles, was not incorporated into the polymer and instead precipitated out during drying. This led to large CuPc2S nanoparticles, which resulted in very large copper nanoparticles with no catalytic activity.
Background In a randomized, controlled trial, we showed that high-intensity rehabilitation, combining resistance training and body-weight interval training, improves sleep efficiency in Parkinson's disease (PD). Quantitative sleep EEG (sleep qEEG) features, including sleep spindles, are altered in aging and in neurodegenerative disease. Objective The objective of this post-hoc analysis was to determine the effects of exercise, in comparison to a sleep hygiene, no-exercise control group, on the quantitative characteristics of sleep spindle morphology in PD. Methods We conducted an exploratory post-hoc analysis of 24 PD participants who were randomized to exercise (supervised 3 times/week for 16 weeks) versus 26 PD participants who were assigned to a sleep hygiene, no-exercise control group. At baseline and post-intervention, all participants completed memory testing and underwent polysomnography (PSG). PSG-derived sleep EEG central leads (C3 and C4) were manually inspected, with rejection of movement and electrical artifacts. Sleep spindle events were detected based on the following parameters: (1) frequency filter = 11–16 Hz, (2) event duration = 0.5–3 s, and (3) amplitude threshold 75% percentile. We then calculated spindle morphological features, including density and amplitude. These characteristics were computed and averaged over non-rapid eye movement (NREM) sleep stages N2 and N3 for the full night and separately for the first and second halves of the recording. Intervention effects on these features were analyzed using general linear models with group x time interaction. Significant interaction effects were evaluated for correlations with changes in performance in the memory domain. Results A significant group x time interaction effect was observed for changes in sleep spindle density due to exercise compared to sleep hygiene control during N2 and N3 during the first half of the night, with a moderate effect size. This change in spindle density was positively correlated with changes in performance on memory testing in the exercise group. Conclusions This study is the first to demonstrate that high-intensity exercise rehabilitation has a potential role in improving sleep spindle density in PD and leading to better cognitive performance in the memory domain. These findings represent a promising advance in the search for non-pharmacological treatments for this common and debilitating non-motor symptom.
The prefrontal cortex (PFC), hippocampus, and amygdala play an important role in emotional health. However, adverse life events (e.g., violence exposure) affect the function of these brain regions, which may lead to disorders such as depression and anxiety. Depression and anxiety disproportionately affect women compared to men, and this disparity may reflect sex differences in the neural processes that underlie emotion expression and regulation. The present study investigated sex differences in the relationship between violence exposure and the neural processes that underlie emotion regulation. In the present study, 200 participants completed a Pavlovian fear conditioning procedure in which cued and non-cued threats (i.e., unconditioned stimuli) were presented during functional magnetic resonance imaging. Violence exposure was previously assessed at four separate time points when participants were 11–19 years of age. Significant threat type (cued versus non-cued) × sex and sex × violence exposure interactions were observed. Specifically, women and men differed in amygdala and parahippocampal gyrus reactivity to cued versus non-cued threat. Further, dorsolateral PFC (dlPFC) and inferior parietal lobule (IPL) reactivity to threat varied positively with violence exposure among women, but not men. Similarly, threat-elicited skin conductance responses varied positively with violence exposure among women. Finally, women reported greater depression and anxiety symptoms than men. These findings suggest that sex differences in threat-related brain and psychophysiological activity may have implications for mental health.
This study examines the impact of federal grant awards on the financial health of recipient nonprofits. Although a modest body of research finds that government grants are beneficial to nonprofit fiscal health, a large Urban Institute study (2010, 2013, 2015) found that nonprofit managers receiving government grants consistently report fiscal harm due to awards that do not cover all program costs, late payments, and significant administrative burden. Those findings raise the question of whether government funding leads to net benefits or net harm for organizations given the administrative and fiscal burdens identified. This study tests that question using a large panel of federal grants to estimate the impact of government awards on three measures of nonprofit financial health. We find that government grants promote an increase in nonprofit size, improve operating margins, and increase financial reserves for recipient organizations. These benefits endure after the receipt of the award.
In Great Smoky Mountains National Park (GRSM or Park), American black bears (Ursus americanus) sometimes exhibit conflict behavior that requires resource managers to act. Management options for conflict bears are limited, and it is necessary to evaluate their effectiveness. We analyzed 26 years (19902015) of bear capture data and calculated and compared the success rates of the 2 main techniques used to manage bears exhibiting conflict behavior in GRSM: capture and relocation, and capture and on-site release. Overall success rates, defined as a captured bear that was not recaptured for later conflict behavior, for all conflict bears captured was 74%. Bears that were relocated after their first capture were more successful (87%) than those that were released on-site following their first capture (61%), and median time before recapture was greater for relocated bears (293 days) than those released on-site (65 days).
Introduction Approximately 30% to 50% of hospital discharge antimicrobials are inappropriate. Limited data exist on approaches to improve antimicrobial prescribing practices at the time of discharge from a community hospital. Objective: To assess the impact of a comprehensive pharmacist-led antimicrobial stewardship intervention at discharge. Methods We conducted a quasi-experimental, pre-post study. A biphasic intervention took place on 2 medicine units from November 2019 to May 2020 at a community hospital. Baseline data were collected, followed by prescriber education on antimicrobial stewardship to both units (education phase). Next, a pharmacist-led intervention took place on one unit (intervention phase). The primary outcome was composite appropriateness of an oral antimicrobial prescribed to an adult at the time of discharge, defined by narrow spectrum of activity, dosing, and duration of therapy. The primary outcome was assessed using Fisher exact test. Results Baseline composite appropriateness was 30% (n = 12) on the control unit and 30.8% (n = 20) on the intervention unit. From baseline to posteducation, no significant change in composite appropriateness was found on the control (30% to 26.7%, P = 0.256) or intervention (30.8% to 19.4%, P = 0.09) unit. There was no significant difference between the education to intervention phase (26.7% vs 35%, P = 0.254) on the control unit. On the intervention unit, a significant difference in composite appropriateness was found from the education to intervention phase (19.4% vs 47.8%, P = 0.017). Conclusion and Relevance A pharmacist-led intervention improved appropriateness of oral antimicrobials prescribed at discharge. One-time education was insufficient for improving antimicrobial stewardship.
Although few studies have explored predictors of congregational vitality (i.e., ministry-oriented strengths, not attendance or growth) and sustainability, inter-organizational relationships matter for organizational wellbeing because of their impact on trust, cooperation, and information access. However, investigating the relationship between social capital and congregational vitality and sustainability has not previously been possible due to data limitations. This article investigates the extent to which brokerage, or bridging together otherwise disconnected congregations, predicts congregational vitality and sustainability in an inter-congregational network of religious congregations from eight counties encompassing and surrounding a major metropolitan area in the southeastern United States. Research on social networks between organizations suggests that brokerage can have positive, negative, and curvilinear relationships with organizational outcomes, and this literature does not provide a clear expectation for how brokerage might relate with congregational vitality and sustainability. OLS regressions are used to predict three forms of vitality and two forms of sustainability using inverse network constraint, a measure of brokerage, as well as a variety of control variables. Statistical significance is estimated through permutation tests, which account for the relationships between congregations. Results indicate that brokerage is positively associated with community vitality and that staff/volunteer sustainability is highest for congregations with moderate levels of brokerage. Brokerage does not predict spiritual vitality, relational vitality, or financial sustainability. This article has practical implications for congregations. Bridging together otherwise disconnected congregations can provide a wide range of ideas, resources, and opportunities, and these benefits can help congregations seeking to minister in their communities. In addition, moderate levels of brokerage can provide more diverse information and resources as well as a supportive, trusting, and cooperative environment. This combination of benefits may be helpful for congregations to disclose challenges with and to seek resources related to staff/volunteer sustainability. In addition, this article contributes to the fields of: congregational studies through exploring predictors of congregational vitality and sustainability; sociology of religion through expanding research using social network analysis; inter-organizational networks, whose research on social capital and organizational outcomes is both complicated and conflicting.
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1,501 members
X. Robert Wang
  • School of Pharmacy
Cheryl D Cropp
  • School of Pharmacy
William Mike Howell
  • Department of Biological and Environmental Sciences
Michael C Thomas
  • Pharmacy Practice
Suresh Mathews
  • Department of Nutrition and Dietetics
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Birmingham, United States