Medicine and Health Sciences Commons^™

Development And Feasibility Studies Of Ai-Powered Socially Assistive Robotics To Promote Wellbeing Of Persons With Alzheimer’S Disease And Related Dementias, Fengpei Yuan

Doctoral Dissertations

The number of persons living with Alzheimer's Disease and Related Dementias (PLWDs) has been keeping growing. In 2024, it is estimated that there will be approximately 6.7 million individuals living with Alzheimer's Dementia. This number will increase to about 14 million in 2060. Due to the damage in neurons, the capabilities of memory, thinking, and language will decline as the disease progress. As a result, persons with dementia will gradually withdraw from their social activities and become more dependent on others during their activities of daily living. Making it worse, our society is not ready for the increasing requirements of …

The Voices Of Veteran Women Shared With The World: Experiences Of Military Sexual Trauma, Kerri Alaine Qualls

Doctoral Dissertations

Through the cumulative work of this dissertation, I sought to provide a new perspective on the experience of Military Sexual Trauma (MST) through the voices of veteran women who shared their stories with the world through the internet. This approach had three sequential segments: (a) an integrative literature review, (b) an innovative methodology approach involving the application of the netnographic method, and (c) a qualitative research study. First, I present an integrative review of current MST literature. After the evaluation of thirteen studies common findings were the numerous barriers to disclosure that women veterans encountered, as well as the negative …

Farm Animal Assisted Therapy Intervention With Ducks For Persons With Traumatic Brain Injury, Arshak Alex Sargsyan

Doctoral Dissertations

Interaction with animals may offer numerous benefits for human health. In addition to benefits for physical health, Animal Assisted Therapies (AAT) interactions are beneficial for mental health. In particular, animal interactions may offer improvement in patients with depression and anxiety. While the majority of AAT research focuses on pets, animal assisted therapies with farm animals (AATF) also have been found to be beneficial.

AATF is a component of the Green Care therapeutic approach. Green Care is described as a cluster of nature-based therapeutic interventions to promote health in humans. AATF like AAT has undeniable benefits for people who suffer from …

A Pattern Matching Algorithm For Self-Adjusting Basal Rates In Insulin Pump Systems, Lauren Smith

Doctoral Dissertations

In a Type 1 Diabetic, Insulin can be administered in a pump system. There are two types of insulin that must be given: basal and bolus. Basal insulin is a long-acting form of insulin that works in the background while fasting, while Bolus insulin is rapid/short acting given in response to food to immediately begin working to lower blood sugar.

Modeling in Diabetes can be represented by algorithmic approaches ranging from simple autoregressive models of the Continuous Glucose Monitor time series to multivariate nonlinear regression techniques of machine learning. Other examples of modeling in Diabetes include prediction models of hypoglycemia …

Discriminative Nursing Care Practices Towards Patients With Opioid Use Disorder In The Hospital Setting: How Knowledge And Social Attitudes Impact Care Delivery, Jeanne Adam Bernier

Doctoral Dissertations

Discriminative nursing care (DNC) practices towards patients with opioid use disorder (OUD) is a current phenomenon negatively affecting patient care and patient outcomes. It leads to delays in care, insufficient pain control, and feelings of guilt and shame, and it is linked to self-isolation, social isolation, social rejection, and even unemployment and housing disruption which perpetuate a dangerous cycle of inequity that is hard to overcome. In some cases, OUD stigmatization even increases morbidity and mortality rates. OUD stigmatization and discrimination are real problems in today’s health care climate due to the vast number of people affected by OUD and …

Physical Activity On Multiuse Trails And In A Novel Bike Park Within An Urban Wilderness, Douglas Gregory

Doctoral Dissertations

Research has shown that the presence of, access to, and use of parks and trails is associated with increased levels of PA. However, little research exists on nature-based, recreational multiuse trails and bike-specific amenities within parks and their impact on PA. Therefore, to explore the effect trails and bike parks have on PA, this dissertation conducted three investigations to: 1) determine the impact of trail/greenway interventions on PA, 2) investigate how seasonality and weather influence nature-based recreational trail use, and 3) develop a demographic and PA profile of bike park users.

Investigation 1 (Chapter 4) systematically reviewed the literature specific …

Effects Of The U.S. Veterinary Feed Directive Final Rule On The Prevalence Of Violative Antibiotic Residues And Antibiotic-Resistant Bacteria In Animal Products, Md Shamim Sarkar

Doctoral Dissertations

Antibiotic-resistant is a public health concern. The dissertation objective was to assess the effect of the implementation of the Veterinary Feed Directive (VFD) rule changes on the prevalence of violative antibiotic residues and antibiotic-resistant bacteria in food-animal tissues, retail meats, and cecal samples from food animals compared to the pre-VFD rule change period in the U.S. To understand the effect of implemented VFD rule changes on violative antibiotic residues in food-animal tissues, inspector-generated sampling (IGS) data from the U.S. National Residue Surveillance Program (NRP) was analyzed. An important observation was that implementing VFD rule changes was associated with the decreased …

Ethyl Pyruvate Failed To Reduce Pro-Inflammatory Cytokines Release Following In Vitro Stimulation In Dairy Calves' Whole Blood., Vincent Dore

Doctoral Dissertations

Recent developments in sepsis treatment showed that control of the late mediator of inflammation, High Mobility Box group-1 (HMGB1), improves survival in animal models of endotoxemia. Ethyl pyruvate is a small-molecule inhibitor that has been shown to reduce the systemic release of HMGB1 during experimental treatment of systemic inflammation in different species. The objectives of this body of work were 1) to explore ethyl pyruvate's ability to modulate early pro-inflammatory cytokines production and immune effector function in treated calves, 2) to evaluate the safety of an administration of ethyl pyruvate infusion in neonatal calves, and 3) to explore ethyl pyruvate's …

Tiktok Use And Body Dissatisfaction: Examining Direct, Indirect, And Moderated Relations, Danielle Leigh Mink

Doctoral Dissertations

In this study, we examined potential indirect and moderated effects in the relations between the use of TikTok, a video-based appearance-related social networking site, and body dissatisfaction among a sample of approximately 475 United States’ young adult college women residing in the Southeast. We hypothesized that TikTok use would be directly and indirectly related to body dissatisfaction through more upward appearance comparison and more body surveillance in serial. We also hypothesized that exposure to body positive media and social media literacy (both commercial and peer) would moderate or buffer both the direct and indirect links between TikTok use and body …

Acceleration Profiles Of Adolescent Soccer Players Across A Season, Jake A. Melaro

Doctoral Dissertations

The injury risk inherent to soccer can be affected by external training loads and intrinsic factors. These intrinsic factors (sex, mass, strength, coordination, etc.) in young athletes can be rapidly altered the near their peak height velocity (PHV) during puberty, modifying their movement complexity and, potentially, their injury risk. While quantification of movement complexity through multiscale entropy analysis have been used in past biomechanical investigations, no studies have incorporated this analysis on tibial accelerometry signals collected in these maturing athletes. The purpose of this study is to collect tibial acceleration data from youth soccer athletes during several discrete drills and …

Investigating The Transfer Of Learning, Psychological, And Neural Effects In Immersive Virtual Reality, Logan Taylor Markwell

Doctoral Dissertations

Achieving mastery or expertise requires a substantial amount of quality practice. Recent technological developments have introduced a novel approach to practice, virtual reality. Specifically, virtual reality offers a low-cost, customizable opportunity to practice while minimizing the risk of the individual. Given that some types of practice may not lead to the acquisition of a motor skill, or worse, lead to detriments of that skill, understanding the developing science of motor behavior in relation to virtual reality is imperative. The following literature review will begin with a brief historical account of the evolution of virtual reality. Next, some terms of virtual …

Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan

Doctoral Dissertations

The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.

Behavioral Risk Factor Surveillance System and …

Advanced Air Quality Management With Machine Learning, Cheng-Pin Kuo

Doctoral Dissertations

Air pollution has been a significant health risk factor at a regional and global scale. Although the present method can provide assessment indices like exposure risks or air pollutant concentrations for air quality management, the modeling estimations still remain non-negligible bias which could deviate from reality and limit the effectiveness of emission control strategies to reduce air pollution and derive health benefits. The current development in air quality management is still impeded by two major obstacles: (1) biased air quality concentrations from air quality models and (2) inaccurate exposure risk estimations

Inspired by more available and overwhelming data, machine learning …

Translational Models For Advancement Of Regenerative Medicine And Tissue Engineering, Kristin Marie Bowers

Doctoral Dissertations

At the root of each regenerative medicine or tissue engineering breakthrough is a simple goal, to improve quality of healing, thus improving a patient’s quality of life. Each tissue presents its own complexities and limitations to healing, whether it is the scarring nature of tendon healing or the mechanical complexity driving bone regeneration. Preclinical, translational models aim to reflect these complexities and limitations, allowing for effective development and refinement of tissue engineered therapeutics for human use. The following body of work explores several of these translational models, both utilizing them for tissue regenerative therapy development and evaluating the benefits and …

Utilizing Ultra-Performance Chromatography High-Resolution Mass Spectrometry To Investigate Fatty Acid Mediated Antibiotic Tolerance, Brittni Woodall

Doctoral Dissertations

The lipid membrane is the first component necessary to sustain life. To maintain homeostasis, segregate cellular machinery, provide protection from the environment, and reproduce, an organism must establish a boundary in which the processes can occur. Throughout the last two decades, research has propelled our knowledge of lipid membranes much beyond original hypotheses. Once thought of to be static and uniform, the understanding of the lipid membrane has evolved to encompass a structure that is responsive, unique, and intricately constructed by the organism itself. By chance or by choice, organisms adapt the lipid membrane according to the environment for which …

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …

Evaluation Of Treatment Options And Investigation Of Pathogenesis Of Chytridiomycosis In North American Salamanders, Anastasia Elaine Towe

Doctoral Dissertations

Chytridiomycosis, a cutaneous fungal disease caused by two related fungi, Batrachochytrium dendrobatidis (Bd) and Batrachochytrium salamandrivorans (Bsal), is a major cause of amphibian population declines worldwide. Bd has a broad distribution, covering every continent except for Antarctica. Meanwhile, Bsal is currently restricted to Europe and Asia. Treatment options for both Bd and Bsal remain a major area of concern for wild populations. Recently, implants for long-term, parenteral antifungal drug administration have shown some promise in fungal diseases in wildlife. We investigated the safety and efficacy of an intracoelomic implant of the antifungal drug terbinafine in greater …

Development Of Surface-Modified Liposomes For Drug Delivery Applications, Megan Louise Qualls

Doctoral Dissertations

Liposomes are spherical vesicles composed of a lipid bilayer membrane that assembles around an internal aqueous core. This duality gives liposomes the ability to encapsulate both hydrophobic cargo within the lipid bilayer and hydrophilic cargo in the aqueous core, making them versatile molecular carriers for drug delivery. Liposome platforms have many advantages and are promising drug delivery carriers, and research is ongoing to improve their designs for continued clinical applications. Many liposome types have been developed, but further work is needed to improve surface modification, site-specific targeting, and triggered cargo release in order to further the therapeutic applications of these …

Intra-Skeletal Variation In Stable Isotopes Through Non-Destructive Approaches: Applications Of The Patterns Of Skeletal Remodeling To Biological Anthropology, Armando Anzellini

Doctoral Dissertations

Stable isotope analysis is a well-established method in biological anthropology used to deliver data on residence, diet, and life history. Samples for these analyses are often collected from the diaphyses of long bones with an assumption of an expected rate of turnover between five and ten years, depending on the skeletal element. However, the biological foundations of this assumption are still uncertain, especially concerning the intra-skeletal and intra-element variation of isotopic signatures that may relate to patterns of remodeling. Exploring these gaps in intra-element isotopic variation requires fine-grained work using multiple bones from multiple individuals, but such work is limited …

Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell

Doctoral Dissertations

South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall …

Perinatal Health In North Dakota: Emerging Issues, Grace N. Njau

Doctoral Dissertations

Preterm birth, newborn screening refusal, and postpartum depression represent three emerging areas of concern that have not been previously investigated in North Dakota. Their potential impact creates significant social, behavioral, and economic burdens. Although various studies have investigated preterm birth and postpartum depression, to the best of my knowledge, newborn screening refusal in the United States has not been previously investigated. In alignment with the role of Title V of the Social Security Act (Maternal and Child Health) Programs to conduct ongoing statewide needs assessments, the objectives of this study was to investigate and identify predictors of preterm birth, newborn …

Sphenoidal Sinuses And Spherical Harmonics: Variation And Covariation Of The Most Morphologically Diverse And Least Understood Paranasal Sinus, Katharine Grace Josephine Ryan

Doctoral Dissertations

Understanding the shape variation of the human sphenoidal sinus is important to several areas of research. This includes clinical investigation (sinus pathology and safe endoscopic endonasal surgical practice) and paranasal sinus evolution (for which there is still no consensus). Yet, the sphenoidal sinus has high morphological variation, prohibiting its quantification through traditional geometric morphometric landmarking methods. The sphenoid body, and thus also the sinus contained within, is located directly at the developmental center of the basicranium in humans, where the three cranial fossae meet at the midline, and adjacent to the three synchondroses which are the sites of cranial base …

The Lived Experience Of Losing Employment After Diagnosis With Dementia: A Phenomenological Analysis, Susan K. Blaine

Doctoral Dissertations

The purpose of this study was describing the experiences of people with dementia (PWD) who lose their employment after diagnosis with dementia, but sooner than originally planned. A phenomenological approach based on tenets of Maurice Merleau-Ponty was used. Six telephone interviews were conducted, with participants sharing their experiences. Transcripts were transcribed verbatim, and subsequently analyzed via a hermeneutical analysis approach. Themes were identified within and between transcripts, considering the contextual grounds of Merleau-Ponty’s phenomenology: body, others, time, and world, and the contextual ground of participants’ experience: the stigma of dementia. An overarching, central theme of “still working” was identified across …

Identification Of The Type Eleven Secretion System (T11ss) And Characterization Of T11ss-Dependent Effector Proteins, Alex S. Grossman

Doctoral Dissertations

Host-associated microbes live in dangerous environments as a result of host immune killing, nutrient provisioning, and physiological conditions. Bacteria have evolved a host of surface and secreted proteins to help interact with this host environment and overcome nutrient limitation. The studies included within this dissertation describe the identification of a novel bacterial secretion system which has evolved to transport these symbiosis mediating proteins. This system, termed the type eleven secretion system (T11SS), is present throughout the Gram negative phylum Proteobacteria, including many human pathogens such as Neisseria meningitidis, Acinetobacter baumanii, Haemophilus haemolyticus, and Proteus vulgaris. Furthermore, …

Evaluation Of Ocelot And Bobcat General And Reproductive Health In South Texas And Assessment Of Assisted Reproductive Techniques For Wild Felid Conservation, Ashley Reeves

Doctoral Dissertations

Recent studies of wild felid populations in southern Texas have shown loss of genetic variability and inbreeding depression over time, increasing the risk of reduced reproductive and immune fitness leading to an overall decrease in reproductive success, increase in disease susceptibility, and further population demise. Assessment of general health, pathogen exposure, and reproductive health can provide documentation of the possible effects of inbreeding and inform the development of conservation strategies. Assisted reproductive technologies have been used in many other species and can address behavioral or physical incompatibilities among breeding pairs, connect distant populations by transporting frozen gametes, preserve genetic diversity …

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …

Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert

Doctoral Dissertations

Interpretation of electronic fetal monitor (EFM) tracings is a critical clinical practice skill nurses and physicians perform during the intrapartum stage of pregnancy. However, if performed inaccurately can potentially jeopardize the well-being of the neonate. This risk is present because if concerning EFM tracings are not interpreted accurately, preventative care interventions to promote the well-being of the unborn child do not occur. The project was initiated by completing a scoping literature review on the methods for training and evaluating EFM interpretation competence, which revealed current EFM interpretation training and evaluation methods are lacking. A concept analysis defined nurse competence in …

Implantable Medical Devices For Local Drug Delivery And Tissue Regeneration To Combat Chronic Bacterial Infection, Caroline J. Billings

Doctoral Dissertations

Local drug delivery has been an area of exceptional interest in the treatment of chronic bacterial infections, particularly in areas where there are medical implants placed. Medical implants are widely utilized and are becoming increasingly popular with time. With the increasing use of medical implants, concomitant bacterial infection is also increasing, and this type of bacterial infection can be exceedingly difficult to clear. The following body of work focuses on implant-associated bacterial infection, with an emphasis on chronic Staphylococcus aureus (S. aureus) infection, particularly osteomyelitis. Specifically, this work is focused within the scope of utilizing locally implantable medical …

Investigating Person-Specific Profiles Of Readiness-To-Exercise: Exploring Associations With Hypothetical Experiential Outcomes And Perceived Relevance, Cory Beaumont

Doctoral Dissertations

Autoregulation is a person-adaptive strategy wherein exercise workloads are adjusted to match one’s readiness (e.g., acute mental, physical, perceptual state). Prior work demonstrated that structural features of readiness profiles (i.e., which factor(s) are most important) differ across individuals. As this work relied on mathematical modeling, research is needed to understand the informational utility of person-specific profiles (PSPs) of readiness. Purpose: Model heterogeneity in PSPs of readiness (Aim 1), explore associations between PSP factor scores and forecasted experiences to hypothetical muscle-strengthening exercise (Aim 2), and explore participants’ perceptions of relevance and utility regarding their PSP (Aim 3). Methods: For …

Role Of Temperature, Transmission Pathways, And Pathogen Load In Batrachochytrium Salamandrivorans Epidemiology, Edward Davis Carter

Doctoral Dissertations

Amphibian populations are experiencing dramatic population declines. Amphibian diseases are one of the major reasons for these declines. A newly described fungal pathogen, Batrachochytrium salamandrivorans (Bsal), has been recently introduced to Europe and is currently decimating European salamander populations. Sampling efforts have not detected Bsal yet in the United States in captive or wild populations. Disease management hinges on knowing how environmental, host, and pathogen interactions influence disease occurrence and severity. Understanding routes of pathogen transmission is also critical as knowledge of these routes can elucidate management strategies. In Chapter I of my dissertation, I measured how environmental …