Digital Commons Network^™

Identifying Micrornas Panel Associated With Hepatocellular Carcinoma In Serum Of Chronic Hepatitis C Patients, Areeg Dabbish

Theses and Dissertations

Introduction: early detection of hepatocellular carcinoma (HCC) will reduce morbidity and mortality rates of this poorly diagnosed widely-spread disease. Dysregulation in microRNA (miRNAs) expression is associated with HCC progression. Objective: Is to identify a panel of differentially expressed miRNAs (DE-miRNAs) to enhance HCC early prediction in hepatitis C virus (HCV) infected patients. Methodology: Candidate miRNAs were selected using bioinformatic analysis of microarray and RNA-sequencing datasets, resulting in nine DE- miRNAs (miR-142, miR-150, miR-183, miR-199a, miR-215, miR-217, miR-224, miR-424 and miR-3607). Their expressions were validated in the serum of 44 healthy individuals, 62 non-cirrhotic HCV patients, 67 cirrhotic-HCV and 72 HCV-associated …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Examining The Need For Parental Satisfaction With The Msu Extension Equine Assisted Therapy Program, Ashlyn Ann Kiker

Theses and Dissertations

Animal assisted interventions are becoming more prevalent in our society. Animal interventions have become a popular therapy technique that exist to aid a variety of disabilities. Equine therapeutic riding has become one of the most popular forms of animal assisted therapy for both children and adults. While research shows the importance and benefits of animal assisted therapy for children, there is a lack of research concerning parental satisfaction within therapeutic riding programs.

This study tested a newly developed instrument for measuring parental satisfaction for therapeutic riding programs. The Parent/Caregiver Evaluation Tool (Kerr, 2021) was administered to parents/caregivers whose children participated …

A Review Of Calcineurin Biophysics With Implications For Cardiac Physiology, Ryan B. Williams

Theses and Dissertations

Calmodulin is a prevalent calcium sensing protein found in all cells. Three genes exist for calmodulin and all three of these genes encode for the exact same protein sequence. Recently mutations in the amino acid sequence of calmodulin have been identified in living human patients. Thus far, patients harboring these mutations in the calmodulin sequence have only displayed an altered cardiac related phenotype. Calcineurin is involved in many key physiological processes and its activity is regulated by calcium and calmodulin. In order to assess whether or not calcineurin contributes to calmodulinopathy (a pathological state arising from dysfunctional calmodulin), a comprehensive …

Implementation Of Teach-Back For Discharge Teaching In A Critical Access Hospital: A Quality Improvement Project, Katie Beth Notch

Theses and Dissertations

A lack of comprehension of discharge instructions may cause high readmission and emergency room revisit rates for organizations. At the project site, there was no current evidence-based practice to ensure patient comprehension of discharge instructions. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the Institute for Healthcare Improvement (IHI) Always Use Teach-Back Toolkit would impact emergency room revisit rates among adult medical-surgical patients in a critical access hospital in rural Minnesota over four weeks. Afaf Meleis’ transitions theory and the Iowa model for evidence-based practice were the scientific underpinnings of the project. …

Direct And Indirect Effects Of Alcohol Craving And Demand On Obsessive And Compulsive Drinking Characteristics: The Role Of Impulsivity, James V. Turner Iv

Theses and Dissertations

This study’s goal was to test a novel model of obsessive-compulsive thoughts about drinking. Young adults completed tasks measuring potential drinking characteristics. Findings indicated demand was related to higher OCTD, a significant effect of CIC on OCTD via demand, and that the relationship was particularly strong for impulsive individuals.

Effects Of Provider Support And Psychosocial Stressors On Maternal Health-Promoting Behaviors, Mary Catherine Jessen

Theses and Dissertations

ABSTRACTEFFECTS OF PROVIDER SUPPORT AND PSYCHOSOCIAL STRESSORS ON MATERNAL HEALTH-PROMOTING BEHAVIORS

Despite technological and structural advances in the organization and delivery of health care services to pregnant women and infants, the U.S. ranks low on perinatal outcomes with profound disparities. Engagement in health-promoting behaviors during pregnancy is critical in improving birth outcomes. Women, particularly women of color, continue to experience unmet needs for emotional support with providers. Women of color experience being treated differently based on their race. The purpose of this study was to 1) examine the relationships between stress, provider support, and specific maternal health promoting behaviors (MHPB) …

Development Of A Novel Strategy To Improve Checkpoint Immune Response In Pancreatic Cancer, Poornima Devi Shaji

Theses and Dissertations

Pancreatic Cancer is the 3rd lethal causing cancers in United States with a survival rate less than 5-7%. In advanced unresectable pancreatic cancer, treatment options are restrained to surgery because of its extreme aggressiveness. Immunotherapy, one of the current advanced treatments has shown promising response in other cancers. However, this therapy is limited in pancreatic cancer due to desmoplasia and fibrotic tumor microenvironment (TME).

Our superparamagnetic iron oxide nanoparticles (SPIONS) of curcumin (Curcuma longa, principal curcuminoid of turmeric) have potential ability to inhibit desmoplasia and tumor stroma with an increased bioavailability. This would soften up the tumors for …

Exploring Self-Perceived Employability In People With Disabilities And Other Intersecting Identities, Kerra Lajoy Daniel

Theses and Dissertations

People with disabilities are the largest minority group in the world representing 26% of the world’s population. More specifically, in the U.S. 61 million Americans have a diagnosed disability. However, intersectionality studies have not been inclusive of this particular population and disability studies have yet to extensively examine intersectionality in PWDs. Centering individuals with disabilities who also identify with multiple marginalized social identities , such as being a woman, a person of color or a member of the LGBT community is important since these individuals’ experiences are not uniform in nature. PWDs experience higher rates of discrimination, unemployment, and …

Comparison Of Statistical Methods For Modeling Count Data With An Application To Length Of Hospital Stay, Gustavo A. Fernandez

Theses and Dissertations

Hospital length of stay (LOS) is a key indicator of hospital care management efficiency, cost of care, and hospital planning. Therefore, understanding hospital LOS variability is always an important healthcare focus. Hospital LOS data are count data, with discrete and nonnegative values, typically right-skewed, and often exhibiting excessive zeros. Numerous studies have been conducted to model hospital LOS to identify significant predictors contributing to its variability. Many researchers have used linear regression with or without logarithmic transformation of the outcome variable LOS, or logistic regression on a dichotomized LOS. These regression methods usually violate models’ assumptions and are subject …

A Grounded Theory Study: Barriers And Expectations Of Elementary Educators Who Teach Students With Autism, Abbie M. Munoz

Theses and Dissertations

This qualitative research study’s purpose is to garner a better understanding of the barriers and expectations of general and special education elementary teachers when teaching students with autism. Pervious research indicates that school aged children being identified with Autism Spectrum Disorder has significantly increased (Evans, 2016). According to federal law (Individuals with Disabilities Education Improvement Act, 2004; No Child Left Behind, 2001) teachers are required to educate all students in their classroom including students with special needs. While several studies have been conducted on how to education and support students with autism in the classroom, few qualitative studies have been …

Factors Influencing Intent To Take A Covid-19 Test In The United States, Sheila Rutto

Theses and Dissertations

In 2020, COVID-19 became the first pandemic in the world’s history that brought the entire world to an abrupt and unexpected halt. Since the first reported case of the disease to date, the novel coronavirus has been able to wreak havoc in literary every corner of the globe and left an ever-growing number of unprecedented fatalities. The normal way of life has been disrupted, and the level of uncertainty about the end of this pandemic continues to manifest to many. Due to the urgency to bring this pandemic under control, medical officers have been able to recommend actions that people …

Positive Well-Being And Satisfaction With Life: Variables Affecting The Quality Of Life Of People With Bipolar Disorder, Maria Del Trevino-Zuniga

Theses and Dissertations

Bipolar disorder (BD) is a highly prevalent and severe mental illness of significant public health importance. Characteristics of BD include dramatic shifts in mood, energy, and activity levels affecting a person's ability to carry out day-to-day tasks. These shifts in mood and energy levels are more severe than everyone's regular ups and downs (Rihmer & Kiss, 2002). Managing BD is complex; and social and occupational life disruptions are well-documented, including higher divorce rates, unemployment, and suicide (Marrag et al., 2015). Research has consistently shown individuals with BD have a higher mortality rate compared with the general population (Walker et al., …

The Association Of Antidepressants Use With Healthcare Utilization, Patient-Reported Outcomes, And Alzheimer's Disease And Related Dementias (Adrd) Among Medicare Beneficiaries With Depression, Abdulrahman Abdullah A Alnijadi

Theses and Dissertations

Background: Depression and Alzheimer's Disease and Related Dementias (ADRD) are common among older adults. Currently, depression is recognized as one of the risk factors for ADRD. There is conflicting evidence on the association between depression and ADRD. Inadequate detection, diagnosis, and management of depression appear to pose a significant risk to the quality of life and healthcare utilization among older adults. To date, there are few studies on the impact of depression on self-reported healthcare utilization and self-reported health outcomes among Medicare beneficiaries.

Objectives: The aims of this study were to (1) quantify the association between depression and ADRD, quality …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Hear My Voice: Qualitative Studies To Explore What Empowers Patients To Talk With Their Doctor And Participate In Making Health Care Decisions, Alicia Marie Oostdyk

Theses and Dissertations

Patients with fibromyalgia are faced with many decisions throughout the process of seeking and obtaining health care. For patients to feel empowered to take action, it is essential they feel as if they can play a role in making decisions up to their desired level of participation. However, it is unclear what constitutes empowerment in shared decision making between patients and providers. For patients with fibromyalgia, who deal with complex symptomology and individualized treatment choice, it is important to know what makes them feel empowered to participate in care. The objective of this dissertation is to create a patient-centered definition …

The Impact Of Structural Determinants On Pregnancy Intention And Reproductive Decision Making Among African American Women, Jill Strickland Denson

Theses and Dissertations

ABSTRACTTHE IMPACT OF STRUCTURAL DETERMINANTS ON PREGNANCY INTENTION AND REPRODUCTIVE DECISION MAKING AMONG AFRICAN AMERICAN WOMEN

BACKGROUND: Nearly half of U.S. pregnancies are unintended with African American women having the highest rates of unintended pregnancies and many of the poorest pregnancy-related health outcomes. Intersectional approaches are needed to better understand how intersecting oppressions effect pregnancy intentions in African American women’s lives. This study examined African American women’s intersectional identities related to pregnancy intention, experiences accessing reproductive care, and making reproductive decisions. METHODS: This mixed-methods participatory study used Group Concept Mapping (GCM) along with four questionnaires (reproductive history, Adverse Childhood Experiences, …

Anxiety And Social Withdrawal Among Children: Associations With Emotion Awareness And Emotion Regulation Strategy Use At The Intra- And Interpersonal Levels, Janae Ellen Teer

Theses and Dissertations

Anxiety and social withdrawal are two frequently experienced internalizing conditions among children. These early-onset challenges are associated with numerous maladaptive outcomes in the academic, social, and psychological domains (Levitt & Merrill, 2009; Long, 2018; Sanchez et al., 2018; Shernoff et al., 2017). While identifying anxious and socially withdrawn children in the classroom is difficult as symptoms generally occur internally, distinguishing between the conditions is perhaps more challenging as the two are closely associated, oftentimes overlapping constructs (Barzeva et al., 2019; Rubin et al., 2009). Particularly, it is unclear whether anxiety and social withdrawal are similarly or differently associated with key …

Relationships Between Perceived Quality Of Life And Spiritual Beliefs, Education Level, Socioeconomic Status, Gender, And Ethnicity In Cancer Patients And Cancer Survivors, Eva Arjona

Theses and Dissertations

The purpose of this study was to identify a relationship between perceived Quality of Life and religious/spiritual beliefs. Additionally, it aimed to explore relationships between perceived QOL and age, gender, ethnicity, education level, and Socioeconomic Status (SES). The research question examined in this study was: What is the relationship between perceived quality of life and spiritual beliefs, education level, socioeconomic status, age gender, and ethnicity in cancer patients and cancer survivors? A total of 100 cancer patients or cancer survivors were surveyed for this study. A regression analysis was conducted to explore relationships among the variables; the alpha level was …

Ultrasonography As Biofeedback To Increase Muscle Activation During The Mendelsohn Maneuver In Healthy Adults, Ching-Hsuan Peng

Theses and Dissertations

The purpose of this study was to examine the effect of applying real-time ultrasound as visual feedback in addition to verbal instruction/tactile feedback to facility the accuracy of learning the Mendelsohn maneuver. The Mendelsohn maneuver is one of the commonly used swallowing exercises targeting hyolaryngeal elevation and prolonging upper esophageal sphincter opening during swallow. It was hypothesized that the additional visual cueing provided by ultrasound would significantly increase sEMG activity which may be associated with increased duration and extent of hyolaryngeal elevation during the Mendelsohn maneuver as compared to the effect of verbal instruction/tactile feedback alone. A total of twenty-four …

The Spatial Prevalence And Associated Factors Of Opioid Overdose Mortality In Milwaukee County, Wisconsin, Andrew Schendl

Theses and Dissertations

Mortality from opioid overdose has become the leading cause of non-natural death in Milwaukee County, WI in recent years. In order to better understand the opioid epidemic and formulate pro-active responses to the crisis at the local level, this study examines the spatial prevalence and associated factors of opioid overdoses that end in mortality in Milwaukee, WI using the spatial econometrics model. The social determinants of health framework is used to identify the potential related socioeconomic factors associated with opioid abuse. Using principal component analysis, 6 primary components were identified from the chosen social determinants and used as explanatory variables …

Verbal Fluency In Women With The Fmr1 Premutation And The Broad Autism Phenotype, Emily Szabo

Theses and Dissertations

Women who carry a premutation allele on the FMR1 gene can experience limitations due to their genetic status, including executive function deficits. These subtle deficits are often shared by women who possess the broad autism phenotype (BAP). Poor understanding and limited research on the extent of these executive functioning deficits has led to limited clinical management of these two groups. The current study aimed to clarity whether there is a difference in verbal fluency abilities in mothers that possess the FMR1 premutation, mothers of children with autism who are at risk for the BAP, and mothers of typically developing children, …

Roli I Kujdesit Infermieror Në Mjekësinë Familajre, Zahide Halimi

Theses and Dissertations

Hyrje: Para vitit 1989 shërbimet e pacientëve në spital operonin përmes gjashtë spitaleve. Kujdesi primar shëndetësor u ofrua përmes klinikave të mëdha (shtëpive shëndetësore) në 29 komuna që mbikëqyrnin një rrjet të klinikave të vogla (ambulanta dhe punkteve).

Shumica e shqiptarëve të Kosovës u pushuan nga drejtimi dhe pozitat e larta në të gjitha shërbimet publike gjatë viteve 1990 deri në 1992. Shoqata Nënë Tereza krijoi një sistem paralel të kujdesit shëndetësor parësor me 96 klinika në të gjithë Kosovën, të punësuar dhe të përdorur nga kosovarët shqiptarë.

Kujdesi parësor është kujdesi shëndetësorë që është i pranueshëm, i gjithanshëm, i …

Relationship Between Cognitive Performance, Physical Activity, And Socio-Demographic/ Individual Characteristics Among Aging Americans, Imtiaz Masfique Dowllah

Theses and Dissertations

Despite the attenuation of association following adjustments for covariates, participants who engaged in 3–6 hr/wk of vigorous- and > 1 hr/wk of moderate-intensity PA scored significantly higher in tests that assessed executive function and processing speed domains of cognition compared to inactive peers (η2 = 0.005 & 0.007 respectively, p < 0.05). Also, after adjustment, the effects of 1–3 hr/wk of vigorous-intensity PA became trivial for the delayed recall memory domain test scores (β = 0.33; 95% CI: –0.01, 0.67; η2 = 0.002; p = 0.56). There was no clear dose-response relationship between the cognitive test scores and weekly moderate-intensity PA. Interestingly, higher handgrip strength and higher late-life body-mass-index were associated with a higher performance across all cognitive domains. Observed associations provide evidence linking habitual PA with superior cognition health among older adults. Furthermore, increased muscle strength and higher late-life adiposity may …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Nurses’ And Patients’ Perceptions Of The Availability Of Post-Hospital Instrumental Support As A Predictor Of 30- And 60-Day Acute Care Utilization, Beth E. Schultz

Theses and Dissertations

Social support is now part of the social determinants of health objective in Healthy People 2030. Positive social support improves health and well-being. Social support is concerned with people having the support they need within the community, including interacting and communicating with others on a regular basis. Instrumental support is a type of social support that is action oriented, involving one person directly assisting another person. A concept analysis of instrumental support was completed and revealed that the concept is well defined, but the terms used to describe it vary. Other terms in the research literature, most commonly “tangible support”, …

Market Segmentation And Targeted Messaging To Improve Hpv Vaccine Intentions In The College Aged Population, Ashley Caitlin Godwin

Theses and Dissertations

Background: Human Papillomavirus (HPV) is a sexually transmitted infection that can lead to 6 different types of cancer, including cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancer. Every year in the United States, nearly 35,000 cancer cases are estimated to be caused by HPV infection. While catch-up HPV vaccination is recommended through age 26 for those not previously vaccinated, only 21.5% of adults age 18-26 have completed the recommended number of HPV vaccine doses as of 2018. Many interventions have been tested to increase vaccination rates, and one such intervention, framed messaging, has shown promise in increasing intention to vaccinate. …

Diabetes, Anti-Diabetic Medication Use, And The Risk Of Ovarian Cancer, Chantaezia Joseph

Theses and Dissertations

Background- Although ovarian cancer is a rare disease, it is the 5th leading cause of cancer-related deaths among women in the United States. Diabetes is a serious chronic disease that plagues over 436 million adults worldwide and was ranked 7th in causes of death in the US in 2017. Epidemiologic evidence suggests that diabetes may lead to an increased risk of ovarian cancer due to shared risk factors such as sedentary behaviors, smoking and poor diet or through biological mechanisms related to hyperglycemia and obesity, but the epidemiologic evidence yields mixed results. Certain anti-diabetic medications may increase the risk …

Neighborhood Socioeconomic Status, Green Space, And Walkability And Risk For Falls And Fracture Among Postmenopausal Women: The Women’S Health Initiative, Marilyn Elizabeth Wende

Theses and Dissertations

The purpose of this study was to assess whether neighborhood socioeconomic status (SES), walkability, and green space impacts fall and fracture incidence among postmenopausal women, and to assess important modifiers for these relationships, such as fall history, physical activity, physical impairment, race/ethnicity, and rurality. Data from the Women’s Health Initiative study from 1993 to 2012 (N=161,808) was used.

SES had a significant relationship with falling after adjustment (intermediate vs low SES OR=0.99, p=0.0309; high vs low SES OR=0.99, p=0.1192). Study arm participation and fall frequency at baseline significantly modified this relationship. Walkability had a significant relationship with falling incidence after …