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Unstable Ventilatory Control During Sleep After High Spinal Cord Injury: The Contribution Of Chemosensitivity And Hypoventilation, Amy Therese Bascom

Wayne State University Dissertations

ABSTRACT

UNSTABLE VENTILATORY CONTROL DURING SLEEP AFTER HIGH SPINAL CORD INJURY: THE CONTRIBUTION OF CHEMOSENSITIVITY AND HYPOVENTILATION

by

Amy T. Bascom

May 2015

Advisor: Dr. Harry G. Goshgarian

Major: Anatomy and Cell Biology

Degree: Doctor of Philosophy

A high prevalence of sleep-disordered breathing (SDB) after spinal cord injury (SCI) has been reported in the literature; however, the underlying mechanisms are not well understood. My studies had 2 aims: 1) to determine the effect of the withdrawal of the wakefulness drive to breathe on the degree of hypoventilation in SCI patients and able-bodied controls and 2) to determine the response of …

A Multiple Case Exploration Of Designers And Reflection In The Design Space, Tamme L. Quinn Grzebyk

Wayne State University Dissertations

For decades, scholars have searched for ways to more effectively teach and practice instructional design. A variety of strategies have been employed to address the ambiguity in and challenges of the field. Much of the focus in the education of instructional designers has been on teaching students how best to use the many models developed for the field (Rowling, 1992). These efforts, while meant to help the new instructional designer succeed, have often been stifled by the ever-changing landscape of what instructional designers are asked to do in their roles after graduation (Kenny, Zhang, Schwier, & Campbell, 2005). Other research …

Adipocyte-Induced Inflammation In Prostate Tumor Progression In Bone: Role Of Cxcr2 And Osteopontin, Aimalie Lynnette Hardaway

Wayne State University Dissertations

Abstract

Prostate cancer (PCa) is the second leading cause of cancer-related deaths among men. Evidence suggests that age and obesity, conditions associated with adipocyte accumulation in the bone marrow, are linked to increased risk of developing PCa and progressing to metastatic disease. Studies presented in this dissertation were based on the hypothesis that metastatic progression in bone is a result of a cooperative effort between bone marrow adipocytes, macrophages, osteoclasts, and PCa cells. We specifically focused on two adipocyte-supplied chemokines, CXCL1 and CXCL2, and bone marrow macrophage-secreted osteopontin as key drivers of pro-inflammatory environment in the bone marrow and important …

An Evaluation Of The Factor Structure, Reliability And Construct Validity Of The Male Role Norms Inventory-Revised For African American/Black Men, Wilfred Michael Allen

Wayne State University Dissertations

Background: In the United States, on average, men die nearly five years younger than women. Among men, the life expectancy for African American/Blacks is 72.1 years compared to 76.6 years for White/European Americans. African-American/Black men experience an earlier onset and more severe disease with higher rates of complications than White/European American men. Masculinity ideology has been identified by researchers as having an influence on health behaviors and ultimately health outcomes. Based on prior research literature, higher levels of masculinity ideology have been associated with fewer health promoting behaviors. As such, there is a need for a reliable and valid measure …

Assessing The Impact Of Native American Elders As Co-Educators For University Students In Stem, Sarah Omar Alkholy

Wayne State University Dissertations

Introduction: Minorities are underrepresented in the science, technology, engineering, and mathematics (STEM) workforce, post-secondary STEM education, and show high academic attrition rates. Academic performance and retention improve when culturally relevant support is provided. The interface of Western Science and Indigenous Science provides an opportunity for bridging this divide. This three parts project is an example of Community-based participatory research (CBPR) that aims to support academic institutions that serve minority students in STEM, and implement educational components (pedagogy) to serve the needs of the underserved community. Method: Part 1: was a cross-sectional used a survey given to participants designed to assess …

What Impacts Life Satisfaction Of Aging Adults Following Stressful Life Events?: An Examination Of The Buffering Effect Of Personal Resources, Cassandra Barragan

Wayne State University Dissertations

Purpose: Existing research has shown that elders experience changes in their life satisfaction following stressful life events. There is an abundance of literature supporting the predictive nature of not only stressful life events on life satisfaction, but social support, autonomy, and financial security. What the literature is lacking, is examination of the buffering effect of social support, autonomy, and financial security on the relationship between stressful life events and life satisfaction. This study hypothesizes that increases in social support, autonomy, and financial security will buffer the impact of SLEs for elders and thus, they will experience increases in their life …

What Are The Relationships Among Cumulative Trauma, Posttraumatic Stress Disorder, Sleep Quality, And Perinatal Outcomes In African American Women?, Nancy J. Hauff

Wayne State University Dissertations

WHAT ARE THE RELATIONSHIPS AMONG CUMULATIVE TRAUMA, POSTTRAUMATIC STRESS DISORDER, SLEEP QUALITY, AND PERINATAL OUTCOMES IN AFRICAN-AMERICAN WOMEN?

NANCY J. HAUFF, MSN, RN

May 2015

Advisor: Judith Fry-McComish, PhD, RN, FAAN, IMH-IV, E

Major: Nursing

Degree: Doctor of Philosophy

Trauma, primarily in the form of intimate partner violence and automobile accidents, accounts for 6-8% of all pregnancy complications. Much less is known about cumulative trauma (CT) exposure especially in African-American women. Women exposed to several types of trauma including childhood abuse, discrimination, or witnessed family violence may develop symptoms of posttraumatic stress or have difficulty sleeping.

The purpose of this …

The Relationship Between Axonal Injury, Biomarker Expression And Mechanical Response In A Rodent Head Impact Acceleration Model, Yan Li

Wayne State University Dissertations

In the United States 1.4 million people sustain traumatic brain injury (TBI) each year, resulting in 235,000 hospitalizations and 50,000 fatalities annually. Traumatic axonal injury (TAI) is a serious outcome of TBI that accounts for 40-50% of hospitalizations due to head injury and one third of the mortality due to TBI, and it is difficult to diagnose and evaluate. The purpose of this dissertation is to determine mechanical injury predictors for TAI and identify potential biomarkers to evaluate TAI.

In this dissertation, a modified Marmarou impact acceleration injury model was developed to allow the monitoring of velocity of the impactor …

The Therapeutic Targeting Of Folate Receptor Alpha Positive Tumors Via Folate Receptor Selective Novel 5- And 6- Substituted Pyrrolo [2,3-D]Pyrimidine Antifolates", Shermaine Kimberly Mitchell-Ryan

Wayne State University Dissertations

Ovarian Cancer is the fifth leading cause of cancer-related death of women in the United States. Epithelial Ovarian Cancer (EOC) constitutes 85-90% of malignancies within the ovary, with an alarming majority of these cases diagnosed at advanced stage. While most patients are initially highly responsive to the current treatment standard, there is a very high probability that they will recur with a drug resistant fatal disease. Currently there is no validated comprehensive model of disease progression for ovarian cancer, although tremendous progress has been made in understanding the origin of this disease and a putative precursor lesion has been identified …

Online Communities For People Who Stutter: An Ethnographic Study Of A Facebook Social Networking Support Group, Erik X. Raj

Wayne State University Dissertations

The purpose of this study was to explore the experiences of people who stutter who digitally connect and share with other people who stutter on a social networking site, specifically Facebook. This study used a qualitative, ethnographic approach to gain insight from members of a private Facebook group for people who stutter and to collect their opinions as to whether an online community was a beneficial means of obtaining psychosocial support from other people who stutter. The primary investigator collected textual data and artifacts from 3 months of Facebook group postings, semi-structured interviews with 7 of the Facebook group members, …

Neural Alterations Influencing Skilled Reading In Adhd: A Task-Based Fmri Study, Brianne Mohl

Wayne State University Dissertations

Attention-Deficit/Hyperactivity Disorder (ADHD) is a heterogeneous, neurodevelopmental disorder which co-occurs often with Reading Disability (RD). ADHD with and without RD consistently have higher inattentive ratings compared with typically developing controls, with co-occurring ADHD and RD (ADHD/+RD) also demonstrating impaired phonological processing. Accordingly, inattention has been associated with greater phonological impairment, though neither the neural correlates of the co-occurring disorders nor the association are well understood from a functional neuroimaging perspective. The goal was to assess to what extent ADHD/+RD differ from ADHD without RD (ADHD/-RD) and typically developing controls (TDC) in functional activation of attention- and reading-related areas during various …

Modeling And Optimization Of Non-Profit Hospital Call Centers With Service Blending, Yanli Zhao

Wayne State University Dissertations

This dissertation focuses on the operations problems in non-profit hospital call centers with inbound and outbound calls service blending.

First, the routing policy for inbound and outbound calls is considered. The objective is to improve the system utilization under constraints of service quality and operators' quantity. A collection of practical staffing assignment methods, separating and mixing staffing policy are evaluated. Erlang C queuing model is used to decide the minimum number of operators required by inbound calls. Theoretical analysis and numerical experiments illustrate that through dynamically assigning the inbound and outbound calls to operators under optimal threshold policy, mixing staffing …

Evidence Of Distinctive Structural Alterations That Differentiate Adhd Boys With And Without A Comorbid Reading Disability, Dhruman Dilip Goradia

Wayne State University Dissertations

Attention deficit hyperactivity disorder (ADHD) and reading disability (RD) are neurodevelopmental disorders that often co-occur. Children with ADHD and co-occurring RD (ADHD/+RD) tend to show greater cognitive deficits than children with ADHD alone (ADHD/-RD). However, the extents to which comorbid RD impact structural alteration in children with ADHD have never been investigated. The overall goal of this study was to assess structural alterations in the subcortical, cortical and white matter that may differentiate ADHD/-RD from ADHD/+RD. The general hypothesis was that ADHD/+RD would show extensive alterations in regions implicated in ADHD than ADHD/-RD as well as show additional abnormalities in …

Agency And Resistance Strategies Among Black Primary Care Patients, Janella Nicole Hudson

Wayne State University Dissertations

Research has identified marginalized and minority patients as displaying fewer participatory behaviors during the clinical interaction. Using a culture-centered framework, this study examines the process by which patients with a previous history of discrimination employed agency and resistance strategies in order to influence the outcome of their clinical interactions. This study conducted a secondary analysis of the video taped interactions of 25 black primary care patients in an urban low-income clinic. Using qualitative content analysis, I identified five emergent themes for patient agency: interrupting the physician, stating observations of care, expressing needs and desires, constructing identity, and agenda/goal management. Participants …

Toward Enhancing Treatment For Pregnant Smokers: Laying The Groundwork For The Use Of Complementary And Alternative Medicine Approaches, Amy Michele Loree

Wayne State University Dissertations

Tobacco is the most widely used drug of abuse during pregnancy. Despite efforts to reduce perinatal tobacco use, its prevalence has remained steady over at least the past decade, suggesting that efforts to reduce smoking prevalence before and during pregnancy have not been effective. Although a range of effective treatments exist, most pregnant smokers neither seek nor receive any kind of treatment. Complementary and alternative medicine (CAM) treatments may be ideal as alternative, low-cost approaches capable of reaching and assisting a greater proportion of pregnant women with smoking cessation. This study examined characteristics and treatment utilization practices of pregnant smokers …

Engagement In Activities And Cognitive Functioning Among Older Adults In The Health And Retirement Study, Pamela Emily May

Wayne State University Dissertations

The goal of this dissertation is to examine the effect of cognitive and social activities on cognitive performance and health conditions in a national sample of older adults from the Health and Retirement Study (HRS). This dissertation first aimed to identify longitudinal relations between activity frequency and cognitive functioning. Two hypotheses were tested, baseline activity frequency predicts change in cognitive functioning over time, and baseline cognitive performance predicts change in activity frequency over time. The dissertation’s second aim was to identify links between activity frequency and cognitive trajectories. The third aim was to identify longitudinal relations between activity frequency and …

The Experiences Of Black American Older Adults Managing Pain: A Nursing Ethnography, Sheria Grice Robinson

Wayne State University Dissertations

Introduction: Pain can negatively affect quality of life for Black elders. They are less likely to report pain concerns and have voiced pain needs adequately met. To better understand the pain management experiences and concerns of Black elders, an ethnographic study was completed within an urban, low-income, elder housing facility. Methods: 106 participants completed a questionnaire comprised of a demographic tool, the PROMIS Global Health Scale (PROMIS), the Brief Pain Inventory (BPI), and the Psychological Stress Measure (PSM-9). Additionally, participant observation, informal interviews, and 20 formal recorded interviews with individuals identified as having pain were completed. Qualitative and frequency analysis …

Investigation Of Whether Sedentary And Physically Active Conditions Lead To Altered Gabaergic Signaling In The Rvlm, Maryetta Donna Dombrowski

Wayne State University Dissertations

Investigation of whether sedentary and physically active conditions lead to altered GABAergic signaling in the RVLM

MD Dombrowski, and PJ Mueller

Department of Physiology, Wayne State University, School of Medicine, Detroit, MI

A sedentary lifestyle is a major risk for cardiovascular disease. Cardiovascular disease has been associated with elevated basal sympathetic nerve activity. The rostral ventrolateral medulla is a bilateral brainstem region that is an important for the control of resting and reflex control of sympathetic nerve activity and blood pressure. The activity of these neurons in this region is tonically inhibited by the neurotransmitter γ-butyric amino acid (GABA). Interestingly, …

Evaluating The Relationship Between Diadochokinesis And Severity Of Dysphagia As It Relates To Forced Vital Capacity In Individuals With Amyotrophic Lateral Sclerosis, Arthur Franklin Knack

Wayne State University Dissertations

Purpose: To determine if the severity of dysphagia, as determine by Penetration Aspiration Scale (PAS) ratings and pharyngeal residue scale ratings in individuals with ALS, can be predicted through performance on diadochokinesis (DDK) and force vital capacity (FVC) measures.

This study was designed to evaluate differences in performance of clinical measures and objective swallowing severity ratings between individuals with ALS and a Control group of similar age. The goal of this study was to attempt to develop a clinical assessment battery that can predict swallowing impairment in ALS patients. In addition, potential predictive relationships between dysphagia ratings and other commonly …

College Student Adjustment: Examination Of Personal And Environmental Characteristics, Aleksandra M. Stoklosa

Wayne State University Dissertations

This study used a multi-dimensional model of college adjustment to examine the relationships between multiple layers of personal influences and college adjustment (academic, social, personal/emotional, attachment to the institution, and overall adjustment) among emerging adults in a large urban university. The sample included 177 undergraduate students, ages 18-25, attending Wayne State University, who completed on-line questionnaires. Race and cumulative college GPA were related to academic adjustment. Being Arabic/Middle-Eastern was a consistent predictor of college adjustment. It was found that higher college GPA and being White was related to higher academic adjustment, while being Arabic/Middle-Eastern was related to lower academic adjustment. …

Using A Novel Optogenetic Approach To Directly Assess 5-Ht1a Somatodendritic Autoreceptor Function In Response To Chronic Selective Serotonin Reuptake Inhibitor Treatment, Kelly Marie Mcgregor

Wayne State University Dissertations

Antidepressant drugs are widely used but their mechanism of action remains only partially understood. One leading hypothesis holds that a key effect of chronic treatment with a Selective Serotonin Reuptake Inhibitor (SSRI) is loss of somatodendritic 5-HT1A receptor-mediated autoinhibition in serotonergic neurons of the dorsal raphe nucleus (DRN). However, technical limitations have prevented direct testing of this hypothesis. In the current study we took advantage of optogenetic strategies to assess the effects of the classic SSRI fluoxetine on 5-HT1A receptor-mediated autoinhibition. We conducted these experiments in mice expressing the light-sensitive ion channel Channelrhodopsin (ChR) in 5-HT neurons to facilitate their …

Photodynamic Therapy As An Effective Therapeutic Approach In Mame Models Of Triple Negative And Inflammatory Breast Cancers, Neha Aggarwal

Wayne State University Dissertations

Introduction: Photodynamic therapy (PDT) is a minimally invasive, FDA approved therapy for

treatment of several indications including endobronchial and esophageal cancers that are

accessible to light. Triple negative breast cancer (TNBC) and inflammatory breast cancer (IBC)

are aggressive and lethal subtypes of breast cancer that spread to chest wall and dermal

lymphatics, respectively, sites that would be accessible to light. Both TNBC and IBC patients

have a relatively poor survival rate due to lack of targeted therapies. Use of PDT is

underexplored for breast cancers but has been proposed for treatment of subtypes for which a

targeted therapy is unavailable. …

An Investigation Of The Relationship Between Axonal Injury, Biomarker Expression And Mechanical Response In A Rodent Head Impact Acceleration Model, Yan Li

Wayne State University Dissertations

In the United States 1.4 million people sustain traumatic brain injury (TBI) each year, resulting in 235,000 hospitalizations and 50,000 fatalities annually. Traumatic axonal injury (TAI) is a serious outcome of TBI that accounts for 40-50% of hospitalizations due to head injury and one third of the mortality due to TBI, and it is difficult to diagnose and evaluate. The purpose of this dissertation is to determine mechanical injury predictors for TAI and identify potential biomarkers to evaluate TAI.

In this dissertation, a modified Marmarou impact acceleration injury model was developed to allow the monitoring of velocity of the impactor …

Novel Incorportation Of Biomedical Engineering Algorithms (Bispectral Index Guided Or Anesthetic Concentration Guided) In Real-Time Decision Support To Prevent Intraoperative Awareness Using An Electronic Anesthesia Information Mananagement System, Amy Melanie Shanks

Wayne State University Dissertations

Background: Intraoperative awareness with explicit recall (AWR) is a feared complication of surgery that can lead to significant psychological distress. Several large prospective trials have been completed comparing two methods of monitoring anesthetic depth [minimum alveolar concentration (MAC) or electroencephalography (EEG) monitoring using the bispectral index (BIS)] for the prevention of AWR. However, these trials were conducted in high risk populations, limiting generalizability.

Research Hypothesis: Real-time decision support with Anesthesia Information Management System alerts based on a novel anesthetic concentration algorithm (incorporating the use of intravenous anesthetics) or an EEG-guided algorithm will reduce the known incidence of AWR.

Methods: First, …