Medicine and Health Sciences Commons^™

Differential Effects Of Endocannabinoid Catabolic Inhibitors On Opioid Withdrawal In Mice, Thomas Gamage

Theses and Dissertations

The effects of cannabinoids in reducing somatic signs of opioid withdrawal have been known for some time. In morphine dependent rodents, opioid withdrawal following precipitation with the mu opioid antagonist naloxone elicits robust withdrawal behaviors including jumps, paw flutters, head shakes, diarrhea and weight loss. Delta-9-tetrahydrocannabinol has been shown to reduce this opioid withdrawal in mice via activation of the cannabinoid type-1 (CB1) receptor and recently it has been shown that inhibition of the catabolic enzymes for endocannabinoids also reduce somatic signs of opioid withdrawal. Specifically, inhibition the enzyme fatty acid amide hydrolase (FAAH), the catabolic enzyme for the endocannabinoid …

Outcomes Of An Emotion Word Intervention For Children With Social Communication Impairments, Rebecca Cloward Mansfield

Theses and Dissertations

Children with social communication disorders have been found to exhibit deficits in emotional intelligence, including the ability to identify emotions attributed to facial expressions. The purpose of this thesis was to examine the efficacy of a social communication intervention program designed to increase the accuracy of emotion based word use in three elementary school-aged participants with social communication disorders. The participants took part in a multiple-baseline, 20-session treatment including story enactment, journaling procedures, and supplementary activities. The story enactment portion of the intervention centered on Mercer Mayer's A Boy, A Dog, and A Frog (1967) wordless picture book series. Participants' …

Relationship Between The Experience Of Perceived And Physician Diagnosed Arthritis And The Presence Of Dsm-Iv Criteria-Based Major Depression (Mdd) Among Older, Ryan Neil Schmidt

Theses and Dissertations

BACKGROUND: The purpose of this study was to explore both positive screened MDD and the perception of being depressed (P) and the likelihood of either increasing if the patient suffered from arthritis (P/E), either perceived or evaluated by a physician. The study explored the univariate, bivariate, and multivariate relationships between MDD and depression (P) to better describe influencing characteristics and their prevalence, as related to MDD and depression (P).

METHODS: The study examined a cross section of patients 65 years and older (n=8,205) within the National Epidemiologic Survey on Alcohol Abuse and Alcoholism (NESARC) [2001-02] sponsored by the National Institute …

Exploring Factors That Influence The Choice To Retire From Driving In Older Adults, Debra J. Jenkins

Theses and Dissertations

No

Clostridium Difficile Infection Occurrence In Academic Health Centers: Do Organizational Factors Matter?, Amy Pakyz

Theses and Dissertations

Healthcare-associated infections occur commonly in hospitals and have a major impact on patient well-being. The occurrence of the healthcare-associated infection, Clostridium difficile, has been occurring more frequently among hospitalized patients due to an epidemic strain, and is an important cause of antibiotic-associated diarrhea and colitis. This study examined the impact of several organizational factors on the occurrence of C. difficile infection (CDI) in hospitals using an institutional theory perspective. Administrative claims were utilized from University HealthSystem Consortium hospitals to obtain hospital-level data for the calendar year 2011. Data were available for 89 hospitals. Hospital-level analyses, negative binomial regression models, were …

Tobramycin Disposition In The Lung Following Airway Administration, Min Li

Theses and Dissertations

Tobramycin disposition following airway administration was evaluated by meta-analysis of human data in the literature and, experimentally, using a realistic ex vivo model, the isolated perfused rat lung preparation (IPRL). Pulmonary bioavailability of inhaled tobramycin in published studies was re-evaluated separately for CF and healthy adults, with the drug’s intrinsic pharmacokinetic (PK) parameters obtained from intravenous (IV) studies in the literature. While large variations in tobramycin’s clearance precluded accurate assessment of its bioavailability, the results were indicative of substantial pulmonary absorption, in spite of its hydrophilic and poly cationic properties. To explore its disposition kinetics and mechanisms following airway administration, …

Transcriptional Crosstalk Between Helper Bacteriophages And Staphylococcal Aureus Pathogenicity Islands, Kristin Lane

Theses and Dissertations

Acquisition of a superantigen pathogenicity island (SaPI) significantly increases virulence in Staphylococcus aureus. Horizontal transfer of SaPIs occurs at high frequency and depends upon a helper bacteriophage, either through direct infection or SOS-mediated induction of a lysogen. SaPIs hijack the packaging machinery of the helper phage, leading to the formation of SaPI-containing transducing particles that can introduce the pathogenicity island into neighboring SaPI-negative cells. All SaPIs contain a conserved core of genes, some of which are co-transcribed as an operon and encode functions involved in helper exploitation. The goal of this study was to more fully understand the intricate relationships …

Effects Of Thoracic Spinal Manipulative Therapy On Thoracic Spine And Shoulder Kinematics, Thoracic Spine Flexion/Extension Excursion, And Pressure Pain Sensitivity In Patients With Subacromial Pain Syndrome, Joseph Kardouni

Theses and Dissertations

EFFECTS OF THORACIC SPINAL MANIPULATIVE THERAPY ON THORACIC SPINE AND SHOULDER KINEMATICS, THORACIC SPINE FLEXION/EXTENSION EXCURSION, AND PRESSURE PAIN SENSITIVITY IN PATIENTS WITH SUBACROMIAL PAIN SYNDROME By Joseph R. Kardouni, Ph.D., PT A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, at Virginia Commonwealth University. Virginia Commonwealth University, 2013. Major Director: Lori A. Michener, PhD, PT, ATC, Professor, Department of Physical Therapy In patients with shoulder pain, the use of manual therapy directed at the spine and shoulder have been reported to provide superior outcomes to exercise based interventions or usual care without …

Hybrid Pet/Mri Nanoparticle Development And Multi-Modal Imaging, David Hoffman

Theses and Dissertations

The development of hybrid PET/MRI imaging systems needs to be paralleled with the development of a hybrid intrinsic PET/MRI probes. The aim of this work was to develop and validate a novel radio-superparamagnetic nanoparticle (r-SPNP) for hybrid PET/MRI imaging. This was achieved with the synthesis of superparamagnetic iron oxide nanoparticles (SPIONs) that intrinsically incorporated 59Fe and manganese iron oxide nanoparticles (MIONs) that intrinsically incorporated 52Mn. Both [59Fe]-SPIONs and [52Mn]-MIONs were produced through thermal decomposition synthesis. The physiochemical characteristics of the r-SPNPs were assessed with TEM, DLS, and zeta-potential measurements, as well as in imaging phantom studies. The [59Fe]-SPIONs were evaluated …

Transcending Microbial Source Tracking Techniques Across Geographic Borders: An Examination Of Human And Animal Microbiomes And The Integration Of Molecular Approaches In Pathogen Surveillance In Brazil And The United States, Amber Mae Koskey

Theses and Dissertations

Waterborne illnesses, attributed to the ingestion or contact with contaminated water, present a significant global health concern. Surface water sources can be impacted by wide array of pollution inputs, but fecal pollution generates the most significant and acute threat to human health. Therefore, the detection of fecal bacteria in surface water sources remains an important public health objective. Current surface water monitoring employs the use of fecal indicator bacteria (FIB) including E. coli and enterococci as proxies for pathogenic organisms carried in fecal pollution. These traditional indicators, detected by culture-based microbiological methods, do not discriminate fecal sources from another. New …

Integration And Impact Of Stress Management And Resiliency Training (Smart) In A Nurse Residency Program: A Feasibility Study, Sherry Chesak

Theses and Dissertations

Nursing is recognized widely as a highly stressful profession, and the time of orientation is identified as the most stressful time in a nurse's career. Innovative strategies are needed to assist new registered nurses in the management and prevention of stress as a result of transitioning into the complex and challenging healthcare environment. The purpose of this study was to assess the feasibility and impact of integrating a Stress Management and Resiliency Training (SMART) program within a nurse residency program for new nurses at an academic medical center. Additional aims were to assess the effects of the program on participants' …

Patient-Oriented Evidence-Based Treatment Decision Support System (Treatquest®) For Lung Cancer, Danqing Hu

Theses and Dissertations

Involving patients in healthcare decisions makes a significant and enduring difference to healthcare outcomes. One challenge for patients is the lack of evidence-based information and tools to support their decision making. Although patients have access to significant information through internet and other sources, it is not personalized for their specific situation. This dissertation attempts to help patients acquire evidence-based information relevant to their own situation, so they can make a more informed decision in co-operation with their physicians. Lung cancer has been selected as a focus for this study because lung cancer presents very complex decision making situation and is …

Representing And Retrieving Patients' Falls Risk Factors And Risk For Falls Among Adults In Acute Care Through The Electronic Health Record, Jann Pfaff

Theses and Dissertations

Defining fall risk factors and predicting fall risk status among patients in acute care has been a topic of research for decades. With increasing pressure on hospitals to provide quality care and prevent hospital-acquired conditions, the search for effective fall prevention interventions continues. Hundreds of risk factors for falls in acute care have been described in the literature. However, due to variations in the terms utilized to represent each fall risk factor, an effort to compare findings across settings and replicate research is hampered. As the expectations for the effective use of electronic health records increase, an opportunity exists to …

The Experiences Of Women Entering Methadone Treatment For Opioid Use: An Interpretive Phenomenological Inquiry, Melissa Mae Rubio

Theses and Dissertations

The United States is facing a momentous public health problem of prescription and illicit opioid use among women. Traditionally in health literature women have received less attention than men and this is especially true with regard to drug use. In terms of recovery from opioid use, treatment centers that use methadone as a pharmaceutical replacement for illicit opioids have been present in the US for decades, and women have been enrolling in treatment since its inception. However, there is little in the literature about the characteristics of these women, why they choose methadone treatment, and what their experiences are while …

Trends In Work-Related Injury Rates And The Associated Incurred Costs In Long-Term Care Centers, Darcie Lange Olson

Theses and Dissertations

Background. Nursing assistants, working in long-term care facilities, have consistently been among the top occupational groups experiencing work-related musculoskeletal injuries. These injuries have been attributed the physical demands of lifting and moving the individuals in their care. Great strides in research have identified successful risk reduction strategies such as the implementation safe patient handling and mobility programs. The benefits of these programs have been advocated over the last two decades, but the rate of injuries among nursing assistants continues to be more than double the national average for all other industries. The purpose of this study was to investigate the …

New Graduate Nurses' Experiences Of Transition During Orientation Into Critical Care, Mari Beth St Clair

Theses and Dissertations

The concept of new graduate nurses working in critical care for some healthcare systems remains a fairly new concept. Often new graduate nurses begin their orientation in critical care with minimal to no critical care experience. Orientation for the new graduate nurses can be challenging as for years new graduate nurses were not allowed to work in critical care until they had a minimum of one year of nursing experience. Currently new graduate nurses beginning employment in critical care are faced with revisiting basic nursing and learning critical care nursing at the same time. In order for critical care units …

Simulation Design Characteristics: Perspectives Held By Nurse Educators And Nursing Students, Jane Brekke Paige

Theses and Dissertations

Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. …

Communication During Palliative Care And End Of Life: Perceptions Of Experienced Pediatric Oncology Nurses, Kathleen Montgomery

Theses and Dissertations

Advances in cancer and supportive therapy have led to improved outcomes for children with cancer. Despite progress, children still die from complications of cancer therapy or their disease. Communication during palliative care and end of life is essential to successful navigation through the end of life continuum. Nurse communication during palliative care and end of life is a phenomenon with limited research, and it is unclear how the level of nursing experience influences the perspectives of nurses communicating during end of life. The purpose of this dissertation study was to describe the commonalities of nurses' experiences of communicating palliative care …

Perceived Needs And Coping Resources Of Newly Hired Nurses In Transition, Catherine A. Schmitt

Theses and Dissertations

Newly hired nurses who do not transition well often leave their first nursing position or nursing prematurely, at great cost to themselves, the profession, the hiring organization and patients. The purpose of this secondary analysis study was to better understand the experience of new graduate nurses (NGNs) and experienced nurses as each group transitions to a new setting in nursing practice and the contribution the preceptor role plays in that transition. Schlossberg's Transition Theory was the framework that guided the study. The original data were collected from 118 newly hired nurses who were predominantly female and Caucasian with the majority …

Walk It Off!: The Relationship Between Physically Active And Passive Coping Style And Perseverative Cognition, Michelle Rosalie Di Paolo

Theses and Dissertations

ABSTRACT

WALK IT OFF!: THE RELATIONSHIP BETWEEN PHYSICALLY ACTIVE AND PASSIVE COPING STYLE AND PERSEVERATIVE COGNITION

by

Michelle R. Di Paolo

The University of Wisconsin-Milwaukee, 2013

Under the Supervision of Professor Marcellus Merritt

The main aim of the current study is to assess if a relationship exists between self-selected coping styles and levels of perseverative cognition (PC). Recent pilot studies have revealed a relative distinction between the coping styles people choose when coping with stress, i.e., those that are physically active (PAC) like going for a walk, jogging, or lifting weights, and those that are physically passive (PPC) like reading …

The Influence Of Position Type And Generational Grouping On Job Satisfaction Of Milwaukee County's Public Health Workforce, Jeanette L. Kowalik

Theses and Dissertations

Nationally, the public health workforce (PHW) consists of 155,000 staff (NACCHO, 2010). It is projected that half of the PHW will soon retire. Health departments must find ways to retain its diverse workforce.

Job Satisfaction is a critical variable that impacts a sustained PHW. Job Satisfaction assessments can promote sustainability of the workforce because the data assembled from the assessments can inform research, policy, and practice. Public health workers that report high Job Satisfaction are less likely to quit as well as delay retirement (RWJF, 2013).

The purpose of this study is to examine the influence of position type and …

Evaluation Of Vdr-Coactivator Inhibitors Using Biochemical And Cell-Based Assays, Athena Marie Baranowski

Theses and Dissertations

ABSTRACT

EVALUATION OF VDR–COACTIVATOR INHIBITORS USING BIOCHEMICAL AND CELL–BASED ASSAYS

by

Athena Baranowski

The University of Wisconsin–Milwaukee, 2013

Under the Supervision of Dr. Alexander Arnold

The vitamin D receptor (VDR) is a ligand–dependent transcription factor, which belongs to the nuclear receptor superfamily. VDR–mediated gene regulation is governed by coregulators (coactivators and corepressors). VDR coregulator binding inhibitors (CBIs), which were discovered using high throughput screening (HTS), were evaluated using cell–based assays and biochemical assays to determine their ability to inhibit the interaction between VDR and steroid receptor coactivator–2 (SRC–2). Determining their ability to inhibit the VDR–SRC–2 interaction can lead to the …

Effects On Volunteer Peer Leaders Participating In A Health Promotion Program For U.S. Veterans, Leslie A. Patterson

Theses and Dissertations

Health-focused peer-led interventions demonstrate success in reducing risk-related behaviors among participants with chronic illnesses, yet few researchers have explored the effects of such interventions on the health of volunteer peer leaders who participate in the interventions. Using data from the project entitled, An RCT of a Peer Support Intervention to Improve Hypertension, this study explored volunteer peer leaders' self-care behaviors that contribute to blood pressure control in two hypertension interventions for U.S. veterans. Inspection of the study's findings demonstrated that volunteer peer leaders improved their health habits and hypertension knowledge significantly more than the peer groups they served. Findings revealed …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Modulation Of Interleukin-17 By Tumor Necrosis Factor Alpha During The Immune Response To Borrelia Burgdorferi, Velinka Medic

Theses and Dissertations

Arthritis is one of the main complications of late-stage Lyme borreliosis. Cytokines play an important role in the persistent inflammation that is elicited by the causative agent of disease, Borrelia burgdorferi. Tumor necrosis factor alpha (TNF-alpha) is a pro-inflammatory cytokine that is induced by B. burgdorferi and that has been implicated in development of arthritis. However, in a mouse model of Lyme arthritis, treatment with anti-TNF-alpha; antibodies increased the severity of disease. By contrast, injection of recombinant TNF-alpha; ameliorated arthritis in this model. These findings suggested that other factors might be involved during the development of Lyme arthritis. One possible …

Life After Adhesion: L-Selectin Throughout The T Cell Lifespan, Abner Garcia Fernandez

Theses and Dissertations

Lymphocytes require antigenic encounter to activate and proliferate, eventually clearing the source of antigenic challenge. The peripheral lymph nodes (PLN) are the primary sites of antigenic encounter and thus the ability of lymphocytes to migrate to this tissue is a requirement for mounting effective immune responses. The process of lymphocyte migration to the PLN is known as the "adhesion cascade". Specifically, lymphocytes are captured from the blood through the adhesion molecule, L-selectin, followed by CC chemokine receptor 7 (CCR7)-mediated integrin activation, which ultimately results in cell transmigration into the PLN. Because the PLN is the site where antigenic encounter is …

Potential Benefits And Withdrawal Effects Of Cranial Nerve Non-Invasive Neuromodulation On Functional Mobility For Individuals With Traumatic Brain Injury, Kati P. Liegl

Theses and Dissertations

Objective: Document and describe benefits and withdrawal effects of the Cranial Nerve Non-Invasive Neuromodulation (CN-NINM) intervention.

Background: Neuromodulation techniques can be used for the treatment of many diagnoses and conditions. Many current neuromodulation techniques have or can have negative consequences such as high cost, risk of surgical complications or infections, effects not lasting without the drug or stimulation presence, and need for medical experts' direct oversight. A new rehabilitation intervention called CN-NINM may eliminate these negative factors, making it a promising tool for clinicians and participants. CN-NINM combines targeted training activities with mild, portable, electrical stimulation of the tongue to …

Brain Mapping Of The Mismatch Negativity Response To Vowel Variances Of Natural And Synthetic Phonemes, Lyndsy Marie Smith

Theses and Dissertations

The mismatch negativity (MMN) is a specific event-related potential (ERP) component used frequently in the observation of auditory processing. The MMN is elicited by a deviant stimulus randomly presented in the presence of repeating stimuli. The current study utilized the MMN response in order to determine the temporal (timing) and linguistic processing of natural and synthetic vowel stimuli. It was hypothesized that a significant MMN response would be elicited by natural and synthetic vowel stimuli. Brain mapping of the MMN response was hypothesized to yield temporal resolution information, which would provide detail regarding the sequential processing differences between natural and …

Analysis Of Plasminogen Binding To Treponema Denticola, A Key Periopathogen, Brittney Tegels

Theses and Dissertations

Periodontitis is a chronic inflammatory disease that affects over 116 million adults in the United States. A shift in the normal microflora occurs as periodontal disease develops resulting in a larger number of Gram-negative anaerobes and spirochetes. An increase in the oral spirochete, Treponema denticola, is highly correlated with periodontal disease progression and severity. The ability of this periopathogen to thrive in the subgingival crevice is dependent on complement evasion mechanisms. Earlier analyses demonstrated that the primary mechanism of T. denticola serum resistance is binding of the human complement regulatory protein, Factor H (FH), to the factor H-binding protein (FhbB). …

Sirt6 And Premature Aging Of Hutchinson-Gilford Progeria Syndrome Fibroblasts., Helal Endisha

Theses and Dissertations

The genetic disease Hutchinson-Gilford Progeria Syndrome (HGPS) arises from a de novo single nucleotide mutation (1824CàT) in the LMNA gene. As a result, the mutated lamin A protein (progerin) remains farnesylated and permanently attached to the nuclear membrane. Progerin accumulates and deforms the nuclear membrane leading to an array of cellular abnormalities driving the cells to enter a state of permanent cell-cycle arrest early on in replicative age i.e. premature cellular senescence. Cellular senescence has been extensively studied as one of the contributing factors to aging in HGPS patients and other age-related diseases. There has also been evidence to show …