Medicine and Health Sciences Commons^™

Virtual Reality Aided Mobile C-Arm Positioning For Image-Guided Surgery, Zhenzhou Shao

Doctoral Dissertations

Image-guided surgery (IGS) is the minimally invasive procedure based on the pre-operative volume in conjunction with intra-operative X-ray images which are commonly captured by mobile C-arms for the confirmation of surgical outcomes. Although currently some commercial navigation systems are employed, one critical issue of such systems is the neglect regarding the radiation exposure to the patient and surgeons. In practice, when one surgical stage is finished, several X-ray images have to be acquired repeatedly by the mobile C-arm to obtain the desired image. Excessive radiation exposure may increase the risk of some complications. Therefore, it is necessary to develop a …

Effects Of Non-Steroidal Anti-Inflammatory Drugs On Cellular Structure And Adhesion Proteins In Human Colorectal Cancer, Jason Lee Liggett

Doctoral Dissertations

This dissertation explores the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on human colorectal cancer (CRC) cell proteins related to cellular structure and adhesion. NSAIDs are extensively used not only to treat inflammatory diseases but also to prevent cancer among high-risk groups. Their mechanisms are not fully understood, but both cyclooxygenase (COX) dependent and independent pathways play a role in NSAID-induced anti-tumorigenesis. Our lab previously reported that NSAIDs induce other anti-tumorigenic genes in a COX-independent manner (Chapter 1). Human CRC cells treated with the NSAID sulindac sulfide (SS) showed dramatic morphological changes under differential interference contrast and fluorescent microscopy, as well …

Exploring Neonatal Intensive Care Nurses’ Affective Responses To Providing End-Of-Life Care, Stephanie Lynn Lewis

Doctoral Dissertations

Significance. The Joint Commission established standards to evaluate comprehensive end-of-life infant care and the positive outcomes of such care are well documented. However, findings from multiple studies conducted over the last decade indicate that end-of-life care in the neonatal intensive care unit is not provided consistently or holistically to all dying infants. Because nurses are the healthcare professionals most often responsible for providing this care, anything that detracts from their ability to provide it, including their own affective responses, needs to be addressed.

Aim. The purpose of this study was to explore—through lived and told stories—the affective, interactional, and …

Design And Synthesis Of Novel Sultams As Non-Nucleoside Inhibitors Of Hiv Reverse Transcriptase, Brian Chadwick Lecroix

Doctoral Dissertations

The compound 2-methyl-3-phenyl-2,3-dihydro-1,2-benzisothiazole 1,1-dioxide (NSC 108406) was identified as an HIV-1 reverse transcriptase inhibitor by the National Cancer Institute. Using this lead, the Baker group has developed a series of analogues with various groups at the 3-position that show a spectrum of biological activities. In the end, the substituents used could not compare to the biological activity of the inhibitor efavirenz (Sustiva^® [trademark]), and so it was decided to synthesize sultams with alkylethynyl substituents at the 3-position of the sultams in an attempt to mimic the activity of efavirenz.

Previous research analyzed the proposed novel sultams in the modeling …

Safety And Immunoreactivity Of A Xenogeneic Dna Plasmid Vaccine Expressing Human Tyrosinase In Tumor-Bearing Horses, Luis Miguel Lembcke Perez Prieto

Doctoral Dissertations

Melanomas are among the most common skin tumors in horses (second only to sarcoids), with prevalence rates reaching as high as 80% in adult gray horses. Despite the wide availability of measures of local control, there are currently no systemic therapies that can effectively prevent spread, or treat metastatic or locally advanced/non-resectable melanoma in horses. A form of gene immunotherapy based on a plasmid DNA construct containing a xenogeneic form of the antigen tyrosinase have been developed and optimized for targeting cancer in both humans and dogs; and have demonstrated significant immunoreactivity and clinical benefit in the treatment of melanocytic …

Association Between Iliotibial Band Syndrome Status And Running Biomechanics In Women, Eric Henri Foch

Doctoral Dissertations

Iliotibial band syndrome (ITBS) is common knee overuse injury that is twice as likely to afflict women compared to men. Etiological factors associated with ITBS include atypical biomechanics during running, as well as iliotibial band flexibility and hip abductor muscle weakness. This dissertation implemented a combination of discrete and continuous analyses to identify lower-extremity and trunk movement patterns that may be associated with ITBS injury status in female runners with current ITBS, previous ITBS, and controls. Three studies were conducted. Study 1 examined discrete joint and segment biomechanics during running, iliotibial band mechanics via musculoskeletal modeling and dynamic simulation, and …

Geographic And Socioeconomic Risk Factors For Sporadic Cryptosdporidiosis And E. Coli Infection In East Tennessee, Ingrid Elizabeth Luffman

Doctoral Dissertations

This research examines risk factors for sporadic cryptosporidiosis and Escherichia coli (E. coli) O157 infection in East Tennessee, using case-control and retrospective ecological approaches. Multiple models and approaches are used to identify risk factors for the two diseases, and to examine the effect of scale on risk for disease in the individual and in the population. Risk factors examined are animal density, land use, geology, surface water impairment, poverty rate and availability of private water supply. The research objectives are, first, to identify risk factors for E. coli O157 and cryptosporidiosis in East Tennessee by relating disease data …

Living With The Choice: A Grounded Theory Of Iraqi Refugee Resettlement To The U.S., Lisa Ann Davenport

Doctoral Dissertations

Though the United States has become a place of increasing resettlement for refugees, particularly Iraqi refugees who have been forced to flee their homeland due to violence, persecution and civil unrest, little is known about Iraqi refugee resettlement in the United States, or the way in which resettlement impacts health and adjustment. A grounded theory study was conducted to develop a substantive theory of Iraqi refugee resettlement. Participants in the qualitative study included 29 Iraqi refugees and 2 community partners who participated in face-to face interviews. Data analysis and interpretation revealed fundamental concepts related to Iraqi refugee resettlement. Results of …

Effects Of Lateral Shoe Wedges And Toe-In Foot Progression Angles On The Biomechanics Of Knee Osteoarthritis During Stationary Cycling, Jacob Kale Gardner

Doctoral Dissertations

Exercise is important for individuals with knee osteoarthritis (OA) but certain activities can be painful and discourage participation. Cycling is commonly prescribed for OA but practically no previous literature exists. Due to their altered knee kinematics, OA patients may be at greater risk of OA progression or other knee injuries during cycling. The purpose of Study One was to investigate the effects of lateral wedges on knee joint biomechanics and pain in patients with medial compartment knee OA. The purpose of Study Two was to investigate the effects of toe-in foot progression angles on the same variables. Thirteen OA subjects …

Exploration Of Breastfeeding Concepts Among Current And Future Parents: Results Of Questionnaires Administered To Chinese And Us University Students And To New Mothers In China, Zixin Lou

Doctoral Dissertations

The objectives were to explore breastfeeding knowledge, attitudes, and intention of future parents, and to investigate indicators and causes of perceived insufficient milk (PIM) supply among Chinese mothers. Objectives were accomplished using a cross-sectional study design. Two questionnaires were developed, one targeting Chinese and US undergraduates, and a second targeting Chinese mothers. In total, 597 undergraduates (395 Chinese; 202 US) and 392 Chinese mothers participated in the study. Data cleaning resulted in a final sample size of 572 for undergraduates (383 Chinese; 189 US) and 341 for Chinese mothers. Results showed that undergraduates in both countries possessed some breastfeeding knowledge …

Functional Analysis Of Corazonin And Its Receptor In Drosophila Melanogaster, Kai Sha

Doctoral Dissertations

Corazonin (Crz) is an amidated undecapeptide originally isolated from the American cockroach. It has been shown to affect diverse physiological functions in a species-specific manner. However, the functionality of Crz in Drosophila melanogaster has not yet been determined. To gain insight into the role of Crz signaling in vivo, Crz and CrzR null alleles were obtained by transposable element mobilization. Flies carrying a deficiency uncovering Crz and pr-set7 loci were generated via P-element excision, and the latter was rescued by wild-type pr-set7 transgene. A mutation of Crz receptor (CrzR) was generated by Minos-element mobilization from …

The Lived Experience Of Transitioning From The Foster Care System To Adulthood, Carla Renee Parker

Doctoral Dissertations

Approximately 408,000 children were in foster care in the United States at the end of fiscal year 2010 (U.S. Department of Health and Human Services, 2012). Some children return to their families of origin; however, some children remain in the foster care system until they reach age 18 or 21 and must leave, which is called “emancipation” or “aging out” (U.S. Department of Health and Human Services, 2012). Transitioning foster youth are at risk for many negative consequences including poverty and homelessness. These negative consequences are associated with significant health implications, such as mental health problems and risky sexual behaviors. …

Geographic And Temporal Epidemiology Of Campylobacteriosis, Jennifer Weisent

Doctoral Dissertations

Campylobacteriosis is a leading cause of gastroenteritis in the United States. The focus of this research was to (i) analyze and predict spatial and temporal patterns and associations for campylobacteriosis risk and (ii) compare the utility of advanced modeling methods. Laboratory-confirmed Campylobacter case data, obtained from the Foodborne Diseases Active Surveillance Network were used in all investigations.

We compared the accuracy of forecasting techniques for campylobacteriosis risk in Minnesota, Oregon and Georgia and found that time series regression, decomposition, and Box-Jenkins Autoregressive Integrated Moving Averages reliably predict monthly risk of infection for campylobacteriosis. Decomposition provided the fastest, most accurate, user-friendly …

Kinetic And Kinematic Evaluation Of Compensatory Movements Of The Head, Pelvis And Thoraco-Lumbar Spine Associated With Asymmetrical Weight Bearing Of The Pelvic Limbs In Dogs, David Alan Hicks

Doctoral Dissertations

The purposes of this dissertation were to 1) determine ground reaction forces of dogs with mild asymmetrical weight-bearing of the pelvic limbs while trotting and 2) use three-dimensional motion analysis to identify compensatory vertical motion of the head and pelvis, and lateral motion of the thoraco-lumbar spine in dogs with mild asymmetrical weight-bearing of the pelvic limbs while trotting, and 3) use this information to introduce a subjective grading system for the pelvic limbs in dogs. Our hypotheses were that dogs with asymmetric weight bearing demonstrate compensatory motions of the head, pelvis and thoraco-lumbar spine while trotting, and that these …

The Lived Experience Of Female Doctor Shoppers, Julie Ann Worley

Doctoral Dissertations

Prescription drug abuse is a significant problem in the United States with huge societal and financial cost. The 2010 National Survey on Drug Use and Health indicated that in 2009 there were 12.4 million non-medical users of prescription opioids, indicating a 10% increase from 2002. According to the Drug Enforcement Administration (DEA), the financial cost of prescription drug diversion is approximately $72 billion per year. According to the Department of Justice, doctor shopping is the primary method of diversion of prescription drugs. Doctor shopping occurs when patients visit numerous prescribers and pharmacies to obtain prescriptions for controlled drugs for illicit …

Cyberathletes’ Lived Experience Of Video Game Tournaments, Samuel Joseph Whalen

Doctoral Dissertations

Increased interest in video games has led to the emergence of competitive video game leagues and organizations known as e-Sport (Hutchins, 2008; Wagner, 2006). Much of the research on video games has focused on negative aspects of gamers’ behavior, such as aggression (Ferguson, 2007) and addiction (Kuss & Griffiths, 2012). The majority of studies have examined video game performance from a third-person perspective using video analysis (Reeves, Brown, & Laurier, 2009) or behavioral observation when examining high-level video game play (Jansz & Martens, 2005). Prior to the present study, there had been very little attention devoted to gamers’ experience of …

Enhancing Critical Thinking Disposition And Clinical Judgment Skills In Senior Bsn Students Via Electronic Interactive Simulation, Deborah Lynne Weatherspoon

Doctoral Dissertations

Problem
The problem investigated in this study was the lack of empirical evidence available regarding the effectiveness of electronic interactive simulation (EIS) for developing critical thinking disposition and clinical judgment skills in the senior baccalaureate nursing student.

Aim
The aim of this study was to identify an effective method of experiential learning simulation that may be independently accessed by the learner with a goal of enhancing critical thinking disposition and clinical judgment skills of senior baccalaureate student nurses (BSN).

Purpose
The purpose of this experimental study was to compare the effects of EIS to traditional paper case studies on the …

Generational Differences In Empowerment, Professional Practice Environment, Incivility, Authentic Leadership, Job Satisfaction, Engagement And Intent To Leave In Acute Care Nurses, Lisa Marie Haddad

Doctoral Dissertations

Aim. The aim of this study was to examine generational differences among acute care nurses on empowerment, professional practice, authentic leadership, incivility, job satisfaction, engagement and intent to leave the current job.

Background. Empowerment in nursing is a well-studied subject. Perceptions of professional practice environments, authentic leadership and incivility are related to empowerment. An increase in empowerment has been linked to job satisfaction and the likelihood of leaving one’s job or the profession. The nursing shortage forces attention to job satisfaction and keeping the professionals we currently have in the profession. Generational differences exist within different cohorts of nurses and …

Modulating T Cell Responses To Control Stromal Keratitis, Tamara Antia Veiga Parga

Doctoral Dissertations

Herpetic stromal keratitis (SK) is an immunoinflammatory corneal lesion caused by herpes simplex virus (HSV) infection. This infection, in some cases, can result in a chronic immunoinflammatory lesion that is the most common cause of infectious blindness in the developed world. Studies in animal models have revealed that SK lesions are orchestrated mainly by IFN-gamma producing CD4+ T cells (Th1) and neutrophils that infiltrate the corneal stroma.

The first part of this dissertation (I) reviews literature on HSV induced corneal SK immunopathology and the role of Tregs in viral infections. It also focuses on the understanding of HSV-1 induced immunoinflammatory …

Low Soluble Drug Encapsulation Based On Architecture Of Layer-By-Layer Assembly For Longer Circulation Time And Targeted Therapy, Pravin Pattekari

Doctoral Dissertations

A combined effect of sonication and layer-by-layer assembly (LbL) enhances the solubility of many poorly soluble inorganic and organic materials by forming stable particles with ca. 200 nm size and up to 90 wt% of loading. The entire method is reproducible, easy-to-handle, and flexible for varying surface properties according to the application of the materials. The method develops good colloidal stability of materials in buffers and maintains architecture for future improvement. A top-down approach, with a combined effect of sonication and LbL assembly, ruptures the material and allows adsorption of oppositely charged polyelectrolytes simultaneously. Thus, the approach is applicable for …

The Effect Of Network Transitions On Spontaneous Activity And Sycnhrony In Devloping Neural Networks, Jude P. J. Savarraj

Doctoral Dissertations

Connectivity patterns of developing neural circuits and the effects of its dynamics on network behavior, particularly the emergence of spontaneous activity and synchrony, are not clear. We attempt to quantify anatomical connectivity patterns of rat cortical cultures during different stages of development. By culturing the networks on dishes embedded with micro electrode arrays, we simultaneously record electrical activity from multiple regions of the developing network and monitor its electrical behavior, particularly its tendency to fire spontaneously and to synchronize under certain conditions. We investigate possible correlations between changes in the network connectivity patterns and spontaneous electrical activity and synchrony. Cocultures …

The Measurement Of Auditory Interhemispheric Transfer Time (Ihtt) In Children With Normal Auditory Processing Abilities, Brittany Suzanne Keahey

Doctoral Dissertations

Interhemispheric transfer time (IHTT) is the time it takes for information to be transmitted from one hemisphere to the other. The goal of this study was to determine if differences existed in the IHTT of children 6 to 9 years of age with normal auditory processing abilities by the use of an objective measure (auditory late evoked potentials [ALEPs]), specifically waves P1, N1 and P2. It was hypothesized that there would be no difference in IHTT between the groups due to the age range of participants being tested. The 16 participants were divided into two groups based on age and …

Asymmetrical Speech In Noise Assessment For Children With (Central) Auditory Processing Disorders, Jessica Vaughn

Doctoral Dissertations

The primary purpose of this investigation was to determine if children with (Central) Auditory Processing Disorder have better word recognition abilities for monosyllabic words under monaural speech-in-noise conditions than binaural speech-in-noise conditions. Fifteen participants, five females and ten males, ages 8-10 years, were included in this study. There were 7 children placed in the experimental group with a diagnosis of (C) APD identified from the Louisiana Tech University Speech and Hearing Center. There were 8 typically developing children placed in the control group. Each participant had pure-tone thresholds of 0-20 dB HL for 250-8000 Hz bilaterally. The SCAN-3 for children, …

Effects Of Untrained Earmold Impression Taking On Custom Hearing Protector Device Performance, Kelly R. Pack

Doctoral Dissertations

Today's consumer is increasingly turning to the internet for both healthcare information as well as the purchase of custom hearing protection devices (HPDs). These HPDs are often cast from do-it-yourself home ear impression kits that include a syringe and silicone earmold impression material to be injected into the ear canal. Although not required by law, earmold impressions have typically been taken by medical professionals and other individuals formally trained in the procedures and safety measures of effective earmold impression taking. The main purpose of this study was to determine if do-it-yourself earmold impressions produce HPD's with lower attenuation levels than …

Ultrasonication Assisted Layer-By-Layer Technology For The Preparation Of Multi-Functional Anticancer Drugs Paclitaxel And Lapatinib, Xingcai Zhang

Doctoral Dissertations

In this dissertation, ultrasonication assisted Layer-by-Layer (LbL) technology for the preparation of multifunctional poorly water-soluble anticancer drug nanoparticles, paclitaxel and lapatinib, has been developed. Many FDA approved drugs are very low soluble in water; therefore, it is very difficult to load and control their release and targeting efficiently, which greatly confines their application. The development of this method will pave the way for the development and application of those low soluble anticancer drugs.

In the first part of this dissertation, the first approach for powerful ultrasonication, the top-down approach (sonicating bulk drug crystals in polyelectrolyte solution), was successfully applied for …

A Comparison Of Two Teaching Methods For Pediatric Medication Administration: Multimedia And Text-Based Modules, Renee Granados

Doctoral Dissertations

A Comparison of Two Teaching Methods for Pediatrics: Multimedia and Text-based Modules to Teach Pediatric Medication Administration

Nurse educators are in a position to design and develop effective methods that consider the cognitive structures and how the mind processes information to teach pediatric medication content to nursing students. The majority of methods teaching medication administration use only one mode: the visual mode. One mode to present leaning material does not take advantage of the additive effects of using two modes to present learning material.

The purpose of the study was to compare the effectiveness of two teaching methods to present …