Medicine and Health Sciences Commons^™

Perception Of Pediatric Readiness Across A Health System's Emergency Departments, Rebekah L. Sabo

Doctoral Dissertations

The recent pandemic and pediatric respiratory syncytial virus surge have reinvigorated pediatric care readiness conversations. National strategies and associations exist to guide health systems in improving the quality of emergency care offered to pediatric populations by first assessing readiness for care. These research strategies center on survey implementation and staff engagement in general emergency departments with the goal to improve staff readiness to care for pediatric patients that may present for treatment. What impact would developing a consolidated pediatric readiness program that includes: pediatric emergency care coordinator designation for each emergency department, pediatric readiness education and committee engagement have on …

Deprescribing Proton Pump Inhibitors In A Rural Health Clinic, Jason Thomas Barney

Doctoral Dissertations

Background: Proton pump inhibitors (PPIs) have been extensively prescribed for gastrointestinal pathologies, contributing to $14 billion in annual expenditure in the United States alone. Inappropriate PPI prescriptions, affecting 48% of adults, raise concerns about prolonged usage and associated health risks. Addressing these issues is vital, considering the significant impact of PPIs on patient health and healthcare costs.

Local Problem: A Midwestern clinic grapples with inappropriate and unnecessary PPI use among patients. In response, a comprehensive deprescribing intervention combining a provider algorithm with patient education was implemented to reduce PPI usage that was medically unnecessary.

Methods: A literature …

Selective Targeting Of Microglia By Quantum Dots And Green Synthesis Of Metal Organic Biohybrids; Applications In Dynamic Cell And Assay Systems, Navya Uppu

Doctoral Dissertations

Neurological disorders are the leading cause of physical and cognitive disability across the globe, currently affecting approximately 15% of the worldwide population. Part of the glioma microenvironment are microglia, resident immune cells of the CNS that were thought to be involved in the pathogenesis of diverse neurodegenerative diseases. Though it remains uncertain what triggers microglial activation in these disorders, targeting and tracking microglial functions using nanotools like Quantum Dots (QDs) could help us elucidate them in such neurological diseases. This research focuses on the comparative study of different QDs formulations and their selective uptake by brain microglia in primary cultures …

Experiences Of Black American Millennials: A Qualitative Study Of Internalized And Externalized Coping In The Face Of Racial Trauma, Natalia Angelique Giles

Doctoral Dissertations

The experiences Black Americans have faced when standing against racial trauma have impacted the Black community for generations. Though previous generations faced overt styles of racism throughout the eras of slavery and Jim Crow, the invalidation and discrimination have remained consistent within the experiences of the Black American millennial (BAM) generation. Current experiences BAMs face are a combination of both overt and covert styles of racism, which increase mental exhaustion, reduce motivation, and leave the individual psychologically defenseless. The purpose of this qualitative study was to examine the experiences of BAMs in the face of racial trauma. This qualitative research …

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 …

Reactive Chemistries For Protein Labeling, Degradation, And Stimuli Responsive Delivery, Myrat Kurbanov

Doctoral Dissertations

Reactive chemistries for protein chemical modification play an instrumental role in chemical biology, proteomics, and therapeutics. Depending on the application, the selectivity of these modifications can range from precise modification of an amino acid sequence by genetic manipulation of protein expression machinery to a stochastic modification of lysine residues on the protein surface. Ligand-Directed (LD) chemistry is one of the few methods for targeted modification of endogenous proteins without genetic engineering. However, current LD strategies are limited by stringent amino acid selectivity. To bridge this gap, this thesis focuses on the development of highly reactive LD Triggerable Michael Acceptors (LD-TMAcs) …

Chemical Modification And Evaluation Of Cells Towards Use As Delivery Tools, Bishnu Prasad Joshi

Doctoral Dissertations

CHEMICAL MODIFICATION AND EVALUATION OF CELLS TOWARDS USE AS DELIVERY TOOLS SEPTEMBER 2023 BISHNU PRASAD JOSHI M.S., SRI SATHYA SAI INSTITUTE OF HIGHER LEARNING Ph.D., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Professor Michelle E. Farkas Endogenous cells are being studied for use in various applications, such as next generation therapeutics and drug delivery vehicles. This is on account of their biocompatibility, amenable distribution profiles, and in many instances, recruitment to and localization of diseased tissues. Multiple cell types have been employed, including macrophages, stem cells, red blood cells, and T cells. Most examples of cell-based delivery utilize phagocytosed entities as …

Exploring The Associations Between Sexism, Physical Behaviors, And Psychosocial Correlates Of Physical Activity In Young Women, Melanna Cox

Doctoral Dissertations

Physical behaviors (PB), defined as physical activity (PA) and sedentary behavior (SB), tend to be less favorable in women than in men. Low self-efficacy (SE) and social support (SS), and gender norms hinder women’s PB. Benevolent sexism, a theory on gender norms, could explain the gender disparity. PURPOSE: To 1) assess the associations among benevolent sexism endorsement (BSEN), experiences with benevolent sexism (EBS), PB, SE, and SS, 2) evaluate if BSEN or SE mediate the relationship between EBS and PB, and 3) develop a questionnaire that measures a woman’s sexist experiences in PA. METHODS: Study 1: Women (N=186) completed a …

Impact Of Child/Parent Characteristics On Ultra-Processed Food Intake In Preschool-Aged Children, A Latent Class Analysis Of Obesity-Related Factors And Obesity Risk, And The Qualitative Impact Of 9-11 Year Old's Perception Of Unhealthy Food Marketing, Jennifer E. Carroll

Doctoral Dissertations

Childhood overweight/obesity is an epidemic in the US. Modifiable risk factors, such as intake of foods that are highly processed, are heavily marketed to children. Exposure to food advertisements, along with home environment factors, family meal styles, and digital media habits shapes children’s preferences, tastes, and habits. Predictors of ultra-processed food (UPF) intake in children are unclear and the potential effect of ad exposure on UPF intake is unknown. It is also unknown if there are distinct response patterns among a collection of potentially obesity-related factors, and if distinct groups affect child BMI. Additionally, more qualitative research is needed to …

A Grounded Theory Of Patient Flow Management Within The Emergency Department, Ellen Benjamin

Doctoral Dissertations

Background: Emergency department (ED) crowding is an urgent threat to patient safety and negatively impacts healthcare staff and institutions. Patient flow researchers have employed a range of methods to address this crisis, including an increase in the use of operations research and operations management strategies. However, identified patient flow solutions are inadequate. Research describing the complexities of patient flow processes and investigating the work and contributions of ED nurses is needed. Purposes: The purposes of this study were to explore how ED nurses perform patient flow management and to develop a constructivist grounded theory of patient flow management within the …

The Meanings Of Daily Activities And Attitudes Of Older Breast Cancer Survivors: A Case Study Research, Wadha Alquraini

Doctoral Dissertations

Objectives: The aim of the study was to explore how older breast cancer survivors made meaning from daily activities and their attitudes to life and behaviors in it. Method: Secondary data was analyzed from nine older women with breast cancer. Data on living women was used to elicit the influence of breast cancer on survivors' attitudes and behaviors. Results: Eight significant themes were identified that were related to breast cancer meanings, attitudes to it, and behaviors that impact participants' survivorship; breast cancer means death or being close to death, survivor-provider relationships, social support, the meaning of dignity or …

Head Stabilization And Cortical Activation In Contact Sport Athletes During Walking Under Different Visual Task Constraints, Sam Zeff

Doctoral Dissertations

Contact sport participation exposes athletes to repetitive sub-concussive head impacts, which have been shown to elicit cortical neurophysiologic, cognitive, and motor performance alterations that have the potential to disrupt visual perception. Despite the growing concern regarding sub-concussive impacts, our understanding of their implications on motor performance and risk for further injury is limited. A stable head provides a consistent perceptual platform for the visual and vestibular sensory systems, but the effects of contact sport participation on head stability and visual perception remain poorly understood. The goal of this dissertation was to understand whether contact sport participation modifies athletes’ ability to …

Weight Bias In Pre-Professional Health Students, Heather A. Wemhoener

Doctoral Dissertations

Weight bias includes negative attitudes or judgements towards people in larger bodies. It is associated with poor health outcomes. Weight bias is highly common in the United States, and pre-professional health students are known to exhibit it. Given its impact, finding effective interventions to reduce weight bias is important. The first paper reviewed literature on existing interventions for weight bias reduction. The search revealed three main intervention types: targeting attributions, increasing empathy, and targeting social consensus. Interventions, regardless of strategy, yielded mixed results for weight bias reduction, and, in some cases, increased bias. The second paper tested a novel intervention …

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

Transition Metal Catalyst (Tmc)-Embedded Bioorthogonal Nanozymes For Anticancer Therapeutics, Xianzhi Zhang

Doctoral Dissertations

Bioorthogonal chemistry offers versatile strategies for monitoring and modulating biomolecules in their native environments through abiotic chemical reactions. Bioorthogonal catalysis via transition metal catalysts (TMCs) provides the controlled activation of anticancer therapeutics, which mimics the enzymatic amplifications. However, the direct use of TMCs in living systems faces challenges such as instability, poor solubility, and low biocompatibility. Engineering the structure of TMCs can partially solve the problems, but the rapid clearance of small molecules hurdles the in vivo applications. Therefore, embedding TMCs in/onto nanomaterials to obtain bioorthogonal nanozymes enhances stability, solubility, biocompatibility, and the presence of the catalysts in biological environments …

"The Land That Feminism Forgot": Birthzillas, Madwives, And The Politics Of Chilbirth, Amber Vayo

Doctoral Dissertations

“The Land that Feminism Forgot” is an in-depth exploration of the politics of childbirth that draws together qualitative and quantitative evidence to theorize the connections between treatment in childbirth and maternal mortality. Situating the qualitative research in the larger national context, the second chapter offers a State Reproductive Autonomy Index that provides an overview of the reproductive policy landscape at the national level. The dissertation then explores the role of institutionalized childbirth, medical mistrust, and obstetric violence in the U.S.’s longstanding maternal mortality crisis and offers policy suggestions in key public health areas. Through 120 qualitative interviews with people who …

Role Of Fat Content On The Structure And Function Of Human Skeletal Muscle, Joseph A. Gordon Iii

Doctoral Dissertations

Muscle size does not fully explain variations in muscle strength. Fat content has been implicated in muscle weakness, though this relationship remains unclear. The relationship between fat and strength may vary between scales (e.g., cellular, organ, and organism). The goal of this dissertation was to clarify the role of fat in the structure and function of muscle using in vitro and in vivo techniques across multiple scales in adults 21-45 years old. Study 1 tested the agreement of intramyocellular lipid (IMCL) content between oil red o (ORO) and magnetic resonance spectroscopy (MRS) techniques. These measures of IMCL were also compared …

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 …

Reducing Medical Errors For Patients With Substance Use Disorders With A Medical Information Card, Michael V. Hughes

Doctoral Dissertations

Background

Approximately 98,000 Americans perish annually due to medical errors and adverse events associated with the limited access to or incomplete pertinent patient health information (Centers for Disease Control and Prevention [CDC], 2022; Obrien et al., 2021). Pertinent patient health information includes patients’ allergies, current medications, current medical diagnosis, blood type, insurance, and emergency contact. The purpose of this project was to examine the efficacy in using File of Life cards in reducing medical errors among patients with substance use disorders (SUDs), and the perception of patients and healthcare providers ease of use, satisfaction of using the File of Life …

Improving Adherence To Annual Retinal Screening Among Adult Diabetics In Rural Midwest, Sarah Hunger

Doctoral Dissertations

Background: Diabetic retinopathy (DR) affects millions of people worldwide and is a main cause of preventable blindness. Experts recommend annual retinal screenings on all diabetic patients. Studies show continuing trends of non-adherence, as well as significant barriers to screenings. Recommendations to overcome barriers and methods to improve adherence among diabetics are topics of interest among healthcare providers. The purpose of this project was to increase annual retinal screening adherence among adult diabetics at a privately owned primary care practice in the rural Midwest.

Methods: Staff and 59 patients, chosen through convenience sampling were involved. Pre- and post- implementation surveys were …

Evaluating The Efficacy Of An Acuity Stratification Tool In Community Based Palliative Care, Madison K. Niederer

Doctoral Dissertations

Background: Community-based palliative (CBPC) care teams strive to optimize the quality of life of patients living with serious illness while also providing value-based care. An acuity tool was previously implemented at a CBPC site to promote resource allocation and improve follow-up care. Initial implementation failed, and re-implementation was undertaken.

Objective: Address barriers to acuity tool uptake and provide education on correct acuity tool documentation to improve the number of patients that receive prescribed follow-up care.

Setting/Subjects: An urban CBPC service in the Midwestern United States with a patient panel of 443 patients. Subjects include nurses, social workers, providers, and patients. …

Mechanism-Driven Approaches And Novel Constructs For High Purity Rna Synthesis, Kithmie Malagodapathiranage

Doctoral Dissertations

RNA is poised to revolutionize medicine. By simply changing the sequence, one therapeutic can be converted into a wholly new one, with little or no change in manufacturing and formulation. While a single mRNA vaccine produced at massive scale can treat billions, the re-codability of RNA will also enable the widespread growth of personalized medicines. T7 RNA polymerase is highly efficient at the synthesis of therapeutic RNA, but is known to produce unintended RNA impurities during synthesis. These products arise from the encoded RNA rebinding the enzyme such that its 3’ end serves as a primer for extension. This leads …