UAB Digital Commons (Univ. of Alabama at Birmingham)

University of Alabama at Birmingham

April 15, 2025
Attend virtual town hall on Campus Engagement Survey results
Get a summary of universitywide results and offer feedback in a Zoom session 1 p.m.
April 23 (format changed due to scheduling conflict). President Ray Watts, Rich Boyer
from survey partner ModernThink and Provost Janet Woodruff-Borden will give remarks
and discuss UAB’s overall results with faculty and staff. The event also will be recorded.
Register online.
“This has changed my life”
After three years of pain, and more than a
dozen visits to specialists, UAB patient
Natalie Ryals has regained full function in
her knee thanks to a visit with Dale
Colorado, D.O., associate professor in the
Department of Physical Medicine and
Rehabilitation. Follow her story.
Faculty Development Grant
Program participants share
their projects April 18
Nearly two dozen faculty members will
share results from their research,
scholarship and creative activities funded
through the FDGP, which supports early-
career faculty. The event takes place from
11 a.m.-2 p.m. in the ASC lower lobby.
Things to know
Do you have an idea with commercial potential? Apply now
The Blazer Bridge Fund, administered by the Harbert Institute for Innovation and
Entrepreneurship, is focused on supporting the development of novel intellectual
property to attract licensee interest and/or position the technology for intellectual
property protection. The fund aims to support five to six projects per round at a maximum
of $50,000 per project. Submissions are due May 27; details are online.
👶 Read about one of last year's Blazer Bridge Fund recipients, a project to predict and
prevent apnea in premature babies.
Regional Wellness Day is
Thursday
This free event from UAB’s O’Neal
Comprehensive Cancer Center and the City
of Birmingham will offer screenings for
common health concerns. Register online to
get free testing from 3-7 p.m. April 17 at
Birmingham Crossplex.
Faculty: Chair and dean survey
open now
The biennial chair and dean survey from the
Faculty Senate was shared via email April 9
and remains open until April 25. Look for an
email from Echospan Support
(sender@echospan.com). Learn more
online.
Upcoming change to Microsoft
Groups settings
Starting April 25, public-facing Microsoft
Groups will be switched over to private to
help safeguard UAB data. Current group
members will see no change in access, but
group owners will need to add people to
their group instead of users joining on their
own.
Share your perspective on outdoor lighting on campus
To help inform the upcoming 2025 UAB Campus Master Plan update, the Campus
SHINE Lab and UAB Facilities will be conducting short surveys at key locations at night
from 8:30-10 p.m. April 16 on the Campus Green, 7:30-8:15 p.m. April 17 at the
Education-Engineering Complex and 8:20-9 p.m. April 17 at Sterne Library.
🌕 The UAB community is also invited to workshops on responsible outdoor lighting at
night at the Solar House 5:30-8 p.m. April 21, and 9:30-11 a.m. and 3:30-5 p.m. April 25.
Deadline: Nominations for UAB VIP close tomorrow
Nominate a colleague for the Second Quarter 2025 UAB VIP Award by April 16.
💸 Save money on goods and services with UAB Perks
Check out current offers on hotels, restaurants, tickets and more through the UAB
Employee Perks Program. Go to uab.edu/perks to start saving.
Research & learning
Shared Values: Respect All
Learn how UAB’s Shared Values: We CARE
influence behavior, relationships and
decision-making on campus and can guide
your everyday work.
⏰ 11 a.m. April 15
📍 virtual
🗓 Register online
Smart Growth: AI Applications
for Small Business Success
This workshop is perfect for students and
small business owners looking to start or
grow their business with the power of AI and
marketing. RSVP to tamikalr@uab.edu.
⏰ 11 a.m. April 22
📍 Collat School of Business, room 201
🗓 Details online
Apply for these funding opportunities
UAB's Civitan International Research Center is requesting proposals for two pilot grant
and award programs:
→ Emerging Scholars Award: a $30,000 one-time award to graduate students or
postdoctoral fellows to support their research related to neurodevelopmental disorders.
Proposals are due by April 30; details online.
→ FCIDD McNulty Scientist: $75,000 per year for three years to a UAB faculty member
to support their research related to neurodevelopmental disorders. Proposals are due by
May 30; details online.
More learning opportunities
Building Your Scholarly Narrative: The
Power of Publishing Metrics, 11 a.m. April
15
Acing the Interview: Essential Tips for
Alumni in Today's Job Market, noon April
15
Social Justice Cafe, 4 p.m. April 16
Mindfulness in Interactions, 11 a.m.
April 17
Adobe Illustrator Workshop, 1 p.m.
April 17
Understanding Your True Colors, 1:30
p.m. April 22
Mark your calendars
“Pirates” and more from the
Department of Music
Catch UAB Opera's “The Pirates of
Penzance” at 7:30 p.m. April 18 and 2:30
p.m. April 19, along with the Wind
Symphony and Symphony Band at 7 p.m.
April 16, a Young Performing Artist recital
with Hanna Lee at 4 p.m. April 20 and the
UAB Gospel Choir at 7 p.m. April 21.
More events upcoming
Napoleon Dynamite Live, 7 p.m. April 17 The Heroes and Healers Gala, 6:30
p.m. May 2
More news online
Get campus news at uab.edu/reporter and uab.edu/news. Check the Campus Calendar
for more events on campus, and submit your own. If you have news you want to share,
use the Request Publicity form online.
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Communications. It is an official communication of UAB, companion to the UAB Reporter news site and
the recommended alternative to mass e-mails.


English

April 15, 2025 eReporter

2025 ASEM 620 Capstone Projecthttps://digitalcommons.library.uab.edu/asem/1004/thumbnail.jp

Snyder, Bracken

Margin in the Consulting Industry: 
A Consultant’s Perspective
Bracken Snyder
School of Engineering, Advanced Safety Engineering and Management
The University of Alabama at Birmingham
ASEM 620 – Capstone Project, Part 2
Ivan Pupulidy, PhD
April 25, 2025
1
2
3
Note: sourced form Terracon Consultants Inc., https://www.terracon.com/wp-content/uploads/2024/12/2021_1230_IIF-RulestoLiveBy_Pocket-Trifold_FINAL.pdf
Vehicle Fire, February 2025
4
Training highlights
11 vehicles lost over 8 years
About $500,000 in lost 
equipment
Compares incident to the deadly 
fires
Place responsibility on field 
workers
5
6
Complex Adaptive System Pupulidy, I. & Vesel, C. (2022). 4 Systems Table. The University of Alabama at Birmingham, ASEM 617.
7
What is Margin?
• “the collective state of the environment 
and our position in it” (WildlandFireLLC, 
2014).
Sourced from Rasmussen, J. (1997). Risk management in a 
dynamic society: A modelling problem. Safety Science 
27(2), 190. https://doi.org/10.1016/S0925-7535(97)00052-0
8
Organizational 
Structure
• “Risk management is an activity with 
multidisciplinary characteristics, which 
makes centralization a limited type of 
management” (Ponte, G.P., 2021, p. 433). 
9
Value Frontline Workers
• “No one has a better perspective to manage risks 
than those who operate the systems on a daily basis 
that are meant to be protected” (Ponte, G.P., 2021, 
p. 433). 
• “By the very nature of your position, whatever your 
position is, you are separated from the work-as-
actually-done” (Conklin, 2019, p. 65)
Real Work
Real Risk
10
Three Questions
• “What's the task you do 
that exposes you to a 
hazard that could result in 
a serious injury or 
fatality?”
• “what is it that keeps you 
from being seriously 
injured or killed?”
• “is that enough?”
11
Conklin, T. (Host). (2016, June 25). It is not "If" but "When" - Steve Scott on Controls (No. 76) 
[Audio podcast episode]. In PreAccident investigation podcast. PAPod. 
https://preaccidentpodcast.podbean.com/e/papod-76-it-is-not-if-but-when-steve-scott-
on-controls/ 
Psychological Safety
• “a condition in which you feel included, safe to 
learn, safe to contribute, and safe to challenge 
the status quo—all without fear of being 
embarrassed, marginalized, or punished in some 
way” (Clark, 2020, P.2)
12
The Blame Problem
Need for certainty: “the desire for a quick and firm answer to a 
question and the aversion toward ambiguity and uncertainty” 
(Kruglanski and Orehek, 2012, p. 4). 
“blame does not fix the system” (Conklin, 2019, p. 54). 
When a failure in a system occurs, it is a “common response is to cast 
blame… Ultimately, these can constrain people’s ability to manage 
future situations adaptively” (Gibson & Pupulidy, 2014, p.3). 
13
Leadership in normal 
operations
• “resilience agenda argues for a focus on 
operational success and deems the study 
of normal work more appropriate than 
safety science’s traditional focus on 
failures and accidents” (Bergström et al., 
2015, p. 131). 
14
What can Terracon do?
Pre-work
Decentralize Safety
Evaluate 
boundaries
Adjust Pre-Task 
Planning
During-work
Sensemaking and 
Adaptation
Free channels of 
Communication
Post-work
Project debriefings
15
Margin of 
Maneuver
• “a way to visualize interconnections; to bring intuitive 
senses into the moment of work; to describe perceived 
changes qualitatively; and to be able to share that 
information easily” (Gibson & Pupulidy, 2014, p.14).
16
17
18
References
• Bergström, J., Winsen, R., Henriqson, E. (2015). On the rationale of resilience in the domain of safety: A literature review. Reliability 
Engineering & System Safety, 141, 131-141. https://doi.org/10.1016/j.ress.2015.03.008
• Clark, T. R. (2020). The four stages of psychological safety. Porchlight.
• Conklin, T. (Host). (2016, June 25). It is not "If" but "When" - Steve Scott on Controls (No. 76) [Audio podcast episode]. In PreAccident 
investigation podcast. PAPod. https://preaccidentpodcast.podbean.com/e/papod-76-it-is-not-if-but-when-steve-scott-on-controls/ 
• Conklin, T. (2019). The 5 principles of human performance: A contemporary update of the building blocks of human performance for the new 
view of safety. Pre-Accident Investigation Media.
• Gibson, C. A., Pupulidy, I. (2014). Margine of maneuver: Improving strategic and operational performance to reduce risk and mishaps.
• Kruglanski, A. W., & Orehek, E. (2012). The need for certainty as a psychological nexus for individuals and society. In M. A. Hogg & D. L. 
Blaylock (Eds.), Extremism and the Psychology of Uncertainty (pp. 3 – 18). Blackwell Publishing Ltd
• O’Toole, J., & Bennis, W. (2009, June 1). A culture of candor. Harvard Business Review. https://hbr.org/2009/06/a-culture-of-candor 
• Ponte, G. P. (2021). Risk management in the oil and gas industry: Offshore and onshore concepts and case studies. Elsevier
• Pupulidy, I. & Vesel, C. (2022). 4 Systems Table. The University of Alabama at
Birmingham, ASEM 617.
• Rasmussen, J. (1997). Risk management in a dynamic society: A modelling problem. Safety Science 27(2), 183-213. 
https://doi.org/10.1016/S0925-7535(97)00052-0
• WildlandFireLLC. (2014, April 30). An introduction to the concept of margin [Video]. Youtube. 
https://www.youtube.com/watch?v=B5CCqmxgc3s
19


Margin in the Consulting Industry: A Consultant\u27s Perspective

May 20, 2025
Keeping the faith
Learn how compassionate care remains the guiding light for UAB St. Vincent's chaplains
and meet four of them in this story from UAB Magazine.
Student Success Summit
explores ways to enhance UAB
experience
More than 200 attendees packed the Hill
Center ballrooms for the fifth annual event,
which focused on preliminary plans from the
SUCCESS Initiative’s working groups. Read
a recap here.
Take a sneak peek at Gorrie Hall
With the ribbon-cutting only two weeks
away, catch a few of the views from the
impressive new home for the School of
Engineering.
Blossom as a leader
The Shifting to Leader Ready program is for
emerging and aspiring leaders, those
looking to be promoted to a people-leader
position, or those who have been identified
for future people-leader roles. Register
now for this training, held in Medical
Towers room 419A from 9-11 a.m. June 12.
Things to know
Hear staff-specific engagement survey results tomorrow
Join the UAB Staff Council at the Alumni House at 8:30 a.m. May 21 to hear from
Jerad Watson and Susan Coan from Learning and Development as they discuss the
results of the Campus Engagement Survey, specific to UAB staff; details online.
Apply now for these two faculty fellows programs:
→ The UAB Faculty Interprofessional Leadership Fellows program is designed to
develop faculty members’ interprofessional education and leadership capacity as they
learn from and work with academic and practice leaders within the university as well as
across the nation. Apply by June 13; details online.
→ UAB Education Abroad is still accepting applications for the 2025-2026 Faculty
Fellows in Education Abroad cohort. This program provides a venue for faculty to
design a new course or to modify an existing course to include a faculty-led education
abroad component. Apply by July 1; details online.
Faculty: Interested in this leadership position?
The Honors College invites applications for the position of assistant dean from student-
focused faculty members. See the full position description online.
Blazer achievements
Three UAB students receive
Department of State’s Critical
Language Scholarship
The highly competitive program aims to
increase the number of Americans proficient
in critical foreign languages. Wajiha Mekki
and Haneen Zeinelabdin will study Arabic;
Jenna Hooper will study Chinese.
Research & learning
Putting Box AI to work for you
Discover how faculty and staff at UAB can
use the AI tools built into Box, the
university’s approved cloud file-sharing
platform, in the latest AI @ Work webinar.
⏰ 11 a.m. May 28
📍virtual
🗓 Register online
Symposium to explore how interprofessional innovation
elevates patient safety
The seventh Interprofessional Healthcare Symposium on July 25 features a keynote
and hands-on breakout session from the Cleveland Clinic’s Neil Mehta, M.D., on using
generative AI to enhance interprofessional education. See details and register online.
Deadline for Xenium voucher RFA is this week
Applications for vouchers to support experiments (up to $35,000) using the new 10X
Genomics Xenium for single-cell spatial transcriptomics are due by Friday, May 23.
More learning opportunities
DISC - Understanding Your Behavioral
Style, 9 a.m. May 21
Accidents Are Not Accidental: Keeping
Children Safe from Injuries, 10 a.m. May
21
Introduction to 3D Printing, 11 a.m. May
21 (plus other sessions all summer)
Psychological Safety, 1 p.m. May 29
Paying Forward Is Easier Than You
Think, 8 a.m. June 3
Emotional Intelligence, 1:30 p.m. June
3
Adobe XD Workshop: Design Your
Own Interactive Portfolio, 1 p.m. June
5
Mark your calendars
Be Seen Serving in Green
Gather your coworkers and sign up through
BlazerPulse to join the UAB Staff Council
and volunteer at UAB's on-campus food
pantry.
⏰ June 4 & 5
📍 Blazer Kitchen (1613 Building)
🗓 Register online
Register now for Andy Kennedy basketball camps 🏀
UAB Men's Basketball Head Coach Andy Kennedy is hosting a day camp for boys and
girls in second through ninth grade from June 16-18 and a mini-camp for boys and girls
in first through seventh grade from July 21-24. Email Alex Hausladen with questions
and register online.
More news online
Get campus news at uab.edu/reporter and uab.edu/news. Check the Campus Calendar
for more events on campus, and submit your own. If you have news you want to share,
use the Request Publicity form online.
Lectures Arts Athletics
Follow UAB on LinkedIn Visit UAB on Facebook
Direct questions about the eReporter to reporter@uab.edu.
Read UAB Reporter Request Publicity
Clinical Trials eReporter Archive
The eReporter is published by and for the UAB community as a service of the Office of Marketing and
Communications. It is an official communication of UAB, companion to the UAB Reporter news site and
the recommended alternative to mass e-mails.


May 20, 2025 eReporter

MARCH 5-11, 2025
Spring break is next week! Are you headed home for rest and relaxation or hitting
the road for an adventure? 
VOTE NOW
NEWS & ANNOUNCEMENTS
Plant a free tree  🌳 
Join UAB Sustainability at the Recycling Center for a tree sapling giveaway on
Friday, March 7. Learn more about the importance of planting trees and receive a
sapling to plant on your own.
Enjoy spring break  ☀ 
UAB's spring break is March 10-16. Transportation will suspend some Blazer
Express routes. Safety Escort and MARS will operate as usual. Blazer Weekly will
be on hiatus until the following week. 
Find help for pregnant, parenting Blazers  🍼 
Attend the Title IX Pregnancy and Parenting Lunch and Learn on Wednesday,
March 19, for a presentation and resource fair. Lunch will be provided; register in
advance. 
DATES & DEADLINES
March 9 - Daylight saving time begins
March 10-16 - UAB spring break
March 17 - Final payment deadline for Blazer Flex Plan
April 25 - Commencement registration deadline - RSVP now to walk
MAKE THE MOST OF IT
Student Resources for Success
Free vision screenings
UAB Eye Care, located at 1716 University Blvd, is
offering free eye screenings to the community on
certain days—look for the Free Vision Screening sign
on the sidewalk out front. No appointment or
insurance is necessary. Hours are 8 a.m. to 5 p.m.
Questions? Call 205-975-2020.
UP NEXT
Check the Campus Calendar for more events this week
Off-Campus Housing Fair: Today, March 5, learn about nearby
apartments for rent and maybe even find a roommate.
Popcorn with the Provost: Today, March 5, stop in the Hill Student
Center's first floor lounge to meet Provost Dr. Janet Woodruff-Borden.
Baseball vs Auburn: Tonight, March 5, support the Blazers as they take
on Auburn at Regions Field.
Blind Date with a Book giveaway: Thursday, March 6, visit Sterne
Library to receive a surprise book.
Lecture: Does Artificial Intelligence Make Human Creativity
Obsolete?: Thursday, March 6, visit the Spencer Honors House to
ponder philosophical perspectives on creativity.
If you have news you want to share, use the Request Publicity form online. Want
to dialogue with the editors? Contact us.
FOLLOW US ON SOCIAL


March 5, 2025 Blazer Weekly

2025 oral presentationhttps://digitalcommons.library.uab.edu/uabh-rd-all/1376/thumbnail.jp

Bushway, Dax

Pareek, Rohan

Ford, Ahley

Malhotra, Shivani

Barnett, Stephanie

PrEP Pro in Huntsville
A pilot study on the effects of PrEP and STI education on PrEP
prescriptions for adolescent girls and young women
Authors
Dax Bushway, MD, PGY-2
Rohan Pareek, MD, OB Fellow
Ashley Ford, MD, Assistant Professor
Shivani Malhotra, MD, Regional Chair for Family Medicine, Associate Professor
Stephanie Barnett, MSW, Office Associate 1
Department of Family Medicine, Huntsville2
Disclosures
No authors have any financial disclosures
Department of Family Medicine, Huntsville3
Definitions
PrEP: pre-exposure prophylaxis for HIV
AGYW: adolescent girls and young women (age 14-24)
STI/STD: sexually transmitted infections/sexually transmitted diseases
Department of Family Medicine, Huntsville4
Study Objectives
- Develop an evidence-based curriculum on HIV epidemiology and PrEP 
prescriptions.
- Use the curriculum to train family medicine residents on thorough sexual history 
taking, HIV/STI education/prevention, and PrEP prescriptions with adolescents.
Department of Family Medicine, Huntsville5
Basis and Need for Study
- As PrEP prescription grows, there is a need to develop systemized ways for 
physicians to take sexual histories and discuss HIV/Sti prevention.
- Family medicine residents are an ideal group of physicians to train because their 
primary care scope includes people across the lifespan and already has a focus 
on women’s health and obstetrics.
- It is anticipated that the PrEP-Pro intervention will increase PrEP prescriptions 
for adolescent girls and young women.
- Furthermore, we expect it to expand comprehensive sexual and reproductive 
healthcare for adolescent girls and young women.
Department of Family Medicine, Huntsville6
Procedure
- FM residents completed three surveys: a baseline knowledge questionnaire, and 
then a 3- and 6-month post-intervention questionnaire.
- Participants received training on sexual history taking and HIV prevention 
options, including PrEP prescription and management. 
- Additionally, in-depth interviews were conducted with pilot FM residents, AGYW 
who accessed care after the PrEP-Pro pilot intervention, and other key 
stakeholders.
Department of Family Medicine, Huntsville7
Primary Outcomes
- Feasibility of the PrEP-Pro intervention
- Accessibility of the PrEP-Pro intervention
Department of Family Medicine, Huntsville8
Secondary Outcomes
- Behavioral changes in sexual history taking by physicians
- PrEP knowledge and prescribing practices
- HIV and STI screening practices
Department of Family Medicine, Huntsville9
Department of Family Medicine, Huntsville10
Questions Regarding HIV Knowledge
N = 13 % N=9 % N = 9 %
TRUE 12 92.3 9 100 9 100
FALSE 1 7.7 0 0 0 0
Strategies to prevent HIV include pre-exposure 
prophylaxis (PrEP).
TRUE 13 100 9 100 9 100
FALSE 0 0 0 0 0 0
TRUE 12 92.3 9 100 9 100
FALSE 1 7.7 0 0 0 0
13-19 0 0 0 0 3 33.3
20-29 7 53.8 7 77.8 5 55.6
30-39 6 46.2 2 22.2 1 11.1
40-49 0 0 0 0 0 0
50+ 0 0 0 0 0 0
1.5 1 7.7 1 11.1 3 33.3
3 6 46.2 4 44.4 2 22.2
5 5 38.5 4 44.4 2 22.2
10 1 7.7 0 0 2 22.2
Exit
Variable Level
Baseline
The rate of Black females living with an HIV diagnosis 
is approximately ___ times more that of white females 
in the U.S.
A status-neutral approach to HIV prevention engages 
both people with HIV and those who are more 
vulnerable to diagnosis
The incidence of HIV is significantly higher among 
Black females than females of other races in Alabama. 
Which age group has the highest HIV incidence in 
Alabama? (Select one)
Baseline (completed exit)
Questions Regarding PrEP Knowledge
- Among participants who completed 
baseline and exit surveys, 
knowledge of FDA approved PrEP 
medications increased.
- Additionally, knowledge regarding 
monitoring while on PrEP 
increased.
N = 13 % N=9 % N = 9 %
People who have sex  0 0 0 0 0 0
 who have sex with a partner living with HIV  0 0 0 0 0 0
People who use injection drugs  0 0 0 0 0 0
Men who have sex with men 0 0 0 0 0 0
All of the above 1 7.7 9 100 9 100
I don't know 12 92.3 0 0 0 0
Tenofovir disoproxil fumarate / Emtricitabine 
(Truvada)  
7 53.8 5 55.6 7 77.8
Tenofovir alafenamide / Emtricitabine 
(Descovy)
7 53.8 4 44.4 4 44.4
Cabotegravir (Apretude 1 7.7 0 0 3 33.3
I don't know  4 30.8 3 33.3 0 0
Tenofovir disoproxil fumarate / Emtricitabine 
(Truvada)  
4 30.8 2 22.2 6 66.7
Tenofovir alafenamide / Emtricitabine 
(Descovy)
6 46.2 4 44.4 7 77.8
Cabotegravir (Apretude 3 23.1 1 11.1 3 33.3
I don't know  7 53.8 6 66.7 0 0
ople with high creatinine clearance at baseline 3 23.1 3 33.3 1 11.1
g, healthy people with normal renal function  1 7.7 1 11.1 0 0
People who are 50 years of age or older  7 53.8 4 44.4 8 88.9
People with no history of renal disease  2 15.4 1 11.1 0 0
People who are not taking their PrEP  1 7.7 1 11.1 0 0
I don't know  4 30.8 3 33.3 0 0
The CDC recommends that providers discuss 
PrEP for HIV prevention with which of the 
following groups?
For people taking tenofovir-based oral PrEP, it is 
recommended that creatinine clearance be 
monitored annually.
For which of the below groups is it recommended 
to test more often (every 6 months)?
Which of the following medications are FDA-
approved as PrEP for people with anal exposure 
to HIV?
Which of the following medications  are FDA-
approved as PrEP for people with receptive 
vaginal exposure to HIV?
Exit
Variable Level
Baseline Baseline 
(completed exit)
Department of Family Medicine, Huntsville11
Questions Regarding Sexual History Taking
- Participants who completed 
baseline and exit surveys felt more 
confident in taking sexual histories 
and felt it was important that they 
know how to take one.
Department of Family Medicine, Huntsville12
Questions Regarding Sexual History Taking
- Participants felt more at ease 
taking a sexual history.
- They also felt they had more skills 
to take a history and put a patient 
at ease when discussing sexual 
health.
Department of Family Medicine, Huntsville13
Questions Regarding PrEP Knowledge and Beliefs
- Participants felt more informed 
about PrEP.
- They more strongly agreed that 
they were about to give 
comprehensive advice about PrEP, 
its adverse effects, and possible 
ways of taking PrEP.
Department of Family Medicine, Huntsville14
Questions Regarding PrEP Knowledge and Beliefs
- After the intervention, participants 
more strongly disagreed with 
statements that PrEP was 
unnecessary and that they did not 
have time to engage in counseling 
and monitoring.
Department of Family Medicine, Huntsville15
Department of Family Medicine, Huntsville16
Primary Outcomes
Prescribing Outcomes
- Overall saw an increase in PrEP 
prescriptions and STI tests
Department of Family Medicine, Huntsville17
Demographics of Patients Prescribed PrEP
- There was an increase in female 
patients prescribed PrEP, however 
there was also an increase in male 
patients.
- There was also an increase in 
black/AA patients prescribed PrEP.
Department of Family Medicine, Huntsville18
Outcome Discussion
- Study achieved the primary outcome of increased accessibility and feasibility of 
PrEP-Pro curriculum.
- Overall, participants more strongly agreed that they could take a sexual history, 
counsel on need for PrEP, and monitor PrEP after the curriculum implementation.
- There was also an increase in PrEP-Pro prescriptions, but the increase was not 
as substantial in the target population: black/AA AGYW.
- Finally, practice characteristics did not change after the PrEP-Pro intervention.
Department of Family Medicine, Huntsville19
Limitations
- This was a pilot study, so the data presented is the result of a new curriculum 
being studied.
- The study finished surveys after 6 months; this study did not continue to monitor 
effects of the intervention over the course a year or more.
- This study was done with a limited number of participants (N value of 5).
Department of Family Medicine, Huntsville20
Future Research
- Interventions with an updated curriculum based on this study’s exit survey data.
- Interventions with a great number of participants.
- In-person standardized coaching on sexual history taking and then measuring 
STI/HIV testing and PrEP prescriptions as a primary outcome.  
- Investigate whether the outcomes observed in this study translate to urban and 
rural settings in other geographic settings in the United States.
Department of Family Medicine, Huntsville21
Questions?
Department of Family Medicine, Huntsville22


PrEP Pro in Huntsville - A pilot study on the effects of PrEP and STI education on PrEP prescriptions for adolescent girls and young women

2025 research posterhttps://digitalcommons.library.uab.edu/uabh-rd-all/1385/thumbnail.jp

Greer, Jacob

Li, Peng

Dudenbostel, Tanja

The Role of Cortisol and Cortisone Levels in Atrial Fibrillation

2025 research posterhttps://digitalcommons.library.uab.edu/uabh-rd-all/1384/thumbnail.jp

Bicknell, Brenton T

Malepati, Akanksha

Taylor, Michael A

Tauscher, Robert

Patel, Krupa

Diagnostic and Prognostic Value of Retinal and Intracranial Hemorrhages in Abusive Head Trauma

https://digitalcommons.library.uab.edu/uabh-rd-all/1404/thumbnail.jp

Cummins, Joshua

Fanning, John

TB or Not TB? That is the Question: A Case of Atypical Carcinoid in a TB Nurse
Joshua Cummins B.S., John Fanning M.D. 
UABHSOM Huntsville Campus, Department of Internal Medicine
University of Alabama at Birmingham Heersink School of Medicine
Introduction DiscussionCase Report
• 73 yo nonsmoking F with a history of chronic diarrhea, diabetes, and a 
recent diagnosis of rosacea who presents with a cough and dyspnea 
after aspirating during a recent trip to Nepal. Of note, she had an 
extensive career as a TB nurse.
• Chest X-ray revealed bilateral infiltrates and possible lung mass; further 
CT imaging showed a well circumscribed 3.4cm upper lobe mass, and 
PET scan showed increased FDG activity (SUVmax of 6.8).
• Referred to oncology, and an IR CT guided biopsy resulted in a small 
apical pneumothorax that remained stable; then discharged
• Returned to the ER the following morning with dyspnea and required 2L 
oxygen; admitted for persistent oxygen requirements
• Biopsy confirmed atypical carcinoid. Underwent uneventful lobectomy
•  Respiratory arrest in PACU following fentanyl administration. CPR and 
Narcan administered with return of spontaneous circulation
• Discharged on hospital day 6 with home oxygen
• Carcinoid tumors are rare neuroendocrine 
neoplasms that secrete various hormones, 
particularly serotonin
• Most are asymptomatic because hormones 
undergo first pass metabolism by the liver
• When located in the liver or lungs, these 
hormones bypass hepatic metabolism
• Effects of these hormones on the body creates 
Carcinoid Syndrome
• Symptoms include facial flushing, diarrhea, 
tachycardia, wheezing, and dyspnea
• Pulmonary carcinoid tumors, particularly 
atypical ones, represent an intermediate grade 
between typical (low) and high-grade 
neuroendocrine tumors
• While lung carcinoid tumors are less likely to 
cause carcinoid syndrome, atypical variants 
have a higher potential to do so
• The chronic diarrhea, rosacea, and cough could 
have been early manifestations of an atypical 
carcinoid tumor rather than unrelated findings
• History as a TB nurse and travel to Nepal 
complicated the picture; tumor’s location in the 
upper lung raised concerns for TB
• A misdirected workup for TB could have 
significantly delayed a carcinoid diagnosis
• Additionally, this patient’s condition worsened 
after both pulmonary procedures, emphasizing 
the need for close monitoring in post-procedure 
patients
References
5-HT secreted into 
portal system
Hepatic First Pass 
Metabolism
No systemic 
symptoms
No First Pass 
Metabolism
Carcinoid Syndrome
• Facial flushing
• Diarrhea
• Tachycardia
• Wheezing
• Dyspnea
• Fatigue
• Nausea
5-HT secreted 
into IVC
5-HT secreted 
into pulm. vein
1. Pinchot SN, Holen K, Sippel RS, Chen H. Carcinoid 
tumors. Oncologist. 2008;13(12):1255-1269. 
doi:10.1634/theoncologist.2008-0207
Primary Contact: Joshua Cummins (jwc3@uab.edu)


TB or Not TB? That is the Question: A Case of Atypical Carcinoid in a TB Nurse

https://digitalcommons.library.uab.edu/uabh-rd-all/1422/thumbnail.jp

McCrary, Racquel

Nimmagadda, Janaki

Yedla, Anupama

Martin, Clinton

Zuranolone: A Game-Changer in Postpartum Depression Care

https://digitalcommons.library.uab.edu/uabh-rd-all/1425/thumbnail.jp

Petriske, Macy Kate

Davis, Chandler

Introduction
References
Case Reports
Skinny but Suicidal: GLP-1 Receptor Agonists and Suicidal Ideation
Macy Kate Petriske, MS3: Chandler Davis, MS3; Clinton Martin MD; Anupama Yedla MD; Janaki Nimmagadda MD
UABHSOM Huntsville Campus, Department of Psychiatry
University of Alabama at Birmingham Heersink School of Medicine
• GLP-1 receptor agonists (GLP-1RAs) have emerged as a 
popular treatment option for type 2 diabetes and obesity, 
offering significant benefits in terms of glycemic control, 
weight loss, and cardiovascular health. 
• Recent pharmacovigilance reports have raised concerns 
regarding potential neuropsychiatric side effects, including 
suicidal ideation (SI). 
• While preclinical studies suggest possible antidepressant 
effects of GLP-1RAs, the clinical evidence remains limited 
and raises questions about the safety of these medications 
in patients with underlying psychiatric conditions. 
• The FDA issued a warning regarding the potential 
neuropsychiatric effects of GLP-1RAs, with reports 
suggesting a risk for suicidal ideation and mood disorders. 
• This case series illustrates a potentially serious, though 
rare, side effect of GLP1-RAs —acute suicidal ideation—
particularly in individuals without a prior history of SI or 
with only passive SI.
1. Drucker, Daniel & Holst, Jens. (2023). The expanding incretin universe: from basic biology to clinical translation. Diabetologia. 66. 1-15. 10.1007/s00125-023-05906-7. 
2. Tempia Valenta, S., Nicastri, A., Perazza, F. et al. The Impact of GLP-1 Receptor Agonists (GLP-1 RAs) on Mental Health: A Systematic Review. Curr Treat Options Psych 11, 310–357 (2024). 
3. Chen X, Zhao P, Wang W, Guo L, Pan Q. The antidepressant effects of GLP-1 receptor agonists: a systematic review and meta-analysis. Am J Geriatr Psychiatry. 2024;32(1):117-127.
4. Tobaiqy M, Elkout H. Psychiatric adverse events associated with semaglutide, liraglutide, and tirzepatide: a pharmacovigilance analysis of individual case safety reports submitted to the EudraVigilance
database. Int J Clin Pharm. 2024;46:488-495. doi:10.1007/s11096-023-01694-7.
5. Ueda P, Söderling J, Wintzell V, et al. GLP-1 receptor agonist use and risk of suicide death. JAMA Intern Med. 2024;184(11):1301-1312. doi:10.1001/jamainternmed.2024.4369.
6. European Medicines Agency (EMA). EMA investigates reports of suicidal ideation and self-harm with GLP-1 receptor agonists. Published July 2023.
7. U.S. Food and Drug Administration (FDA). FDA evaluating reports of suicidal thoughts or actions with GLP-1 receptor agonists. Published January 2024.
8. Schoretsanitis G, et al. Analysis of GLP-1 receptor agonist-associated suicidal ideation using WHO pharmacovigilance data. Lancet Diabetes Endocrinol. 2024;12(2):103-110.
9. López-Ojeda W, Hurley RA. Glucagon-Like Peptide 1: An Introduction and Possible Implications for Neuropsychiatry. The Journal of Neuropsychiatry and Clinical Neurosciences. 2024;36(2):A4-86. 
doi:10.1176/appi.neuropsych.20230226
10. Kim YK, Kim OY, Song J. Alleviation of Depression by Glucagon-Like Peptide 1 Through the Regulation of Neuroinflammation, Neurotransmitters, Neurogenesis, and Synaptic Function. Front Pharmacol. 
2020;11:1270. Published 2020 Aug 14. doi:10.3389/fphar.2020.01270
Case 1: A 59-year-old male with major depressive 
disorder, generalized anxiety disorder, hypertension, 
gout, hyperlipidemia, and type 2 diabetes mellitus 
presented with acute depressive symptoms and SI 
after starting Ozempic (semaglutide) for weight loss. 
Stable on SSRIs for years, the patient reported 
sudden-onset depression and SI following his first 
dose of Ozempic. He discontinued the medication 
after one dose, leading to rapid resolution of 
symptoms without recurrence. The temporal 
relationship between the medication and symptom 
onset strongly suggested a drug-related adverse 
effect, prompting close psychiatric monitoring.
Case 2: A 54-year-old male with bipolar II disorder, 
obesity, and hyperlipidemia developed severe SI with 
a plan to use a firearm two weeks after initiating 
Zepbound (tirzepatide). Previously, he had 
experienced passive SI but never a plan. The patient 
denied external stressors, hallucinations, or delusions 
but reported worsening mood swings and feelings of 
hopelessness. He was hospitalized in a psychiatric 
unit and discharged after one week. The timing of his 
symptoms in relation to Zepbound initiation raised 
concerns about a potential drug-related adverse 
effect.
• GLP-1RAs have shown efficacy in improving metabolic health, but their potential impact on mental 
health requires more attention. 
• Chronic stress and overactivation of the HPA axis are strongly associated with depression and SI. 
GLP-1RAs may contribute to HPA axis dysregulation, increasing vulnerability to mood disorders.
• GLP-1RAs have anti-inflammatory effects, but imbalances in neuroinflammation can impact mood 
and cognition. Overactivation of inflammatory pathways has been linked to major depressive 
disorder.
• While some individuals benefit from GLP1-mediated increased serotonin and dopamine activity, 
others may experience serotonin/dopamine dysregulation, leading to worsened mood symptoms.
• Changes in blood glucose and insulin signaling can affect brain function, potentially triggering 
mood instability in susceptible individuals.
• GLP-1RAs not only regulate metabolism but also impact mood-related brain regions and 
neurotransmitter systems. While some studies suggest potential antidepressant effects, real-
world data raise concerns about mood disturbances and suicidal ideation in certain individuals. 
• Patients in this case developed acute suicidal ideation shortly after initiating GLP-1RAs for weight 
loss, emphasizing the need for clinicians to monitor psychiatric symptoms when prescribing these 
medications. 
• While they had no prior history of suicidal ideation, their experiences suggest that GLP-1RAs may 
trigger or worsen mood disturbances, even in those with pre-existing psychiatric conditions. This 
highlights the importance of patient education on potential neuropsychiatric effects and ensuring 
access to mental health support. 
• Although causality remains uncertain, the association warrants further investigation. With the 
increasing use of GLP-1RAs, clinicians should implement screening and monitoring protocols, 
particularly for at-risk patients. 
• Additional research is needed to better understand the neuropsychiatric safety of these 
medications and inform clinical guidelines.
Figure 2. Adverse Effects of GLP-1RAs on Mental Health2
Figure 1. Actions of GLP-1RAs1
Discussion


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