Other Medicine and Health Sciences Commons^™

Accessiblehomepro As An Educational Intervention: Preparing Occupational Therapy Students To Perform Home Safety Assessments, Laryn O'Donnell

Theses and Dissertations

The growing aging population of the United States urges occupational therapy practitioners to address the population's home safety needs. However, current occupational therapists need more resources and education to conduct comprehensive home safety evaluations. This study employed a pretest-posttest mixed methods design using occupational therapy students (n=17) to investigate the potential of AccessibleHomePRO as an educational intervention to enhance OT student knowledge of home safety assessments, perceived knowledge, which is known as the belief in your level of knowledge, and self-efficacy, which refers to the confidence in completing a task. AccessibleHomePRO (AHP) is a novel multifaceted assessment that leverages artificial …

Black American Men's Resiliency And Persistence To Grow Old: A Midwest Qualitative Study, Kimberly Ann Walker

Theses and Dissertations

AbstractAs Black American men continue to experience the highest premature morbidity and mortality, few studies have centered on the intersection of class (low-income) and race (middle-aged and older Black men) with multiple morbidity from a critical race approach in the Midwest region of the U.S. Middle-aged Black men have 31% higher death rate than their White counterparts. A qualitative study was conducted by a community health nurse in the spring of 2021 in a metropolitan city. Thirty-one, low-income Black American men were interviewed focusing on their understanding and perceptions of their complex comorbidities, symptom management for quality of life, short …

The Environment Of Interprofessional Education In Graduate Education: Exploring Professional Programs Of Occupational Therapy, Physician Assistant, And Physical Therapy, Allison R. Kaczmarek

Theses and Dissertations

Interprofessional education (IPE) is an educational approach of increasing popularity in professional schools for the preparation of a collaborative ready healthcare workforce. The accrediting bodies of professional education programs in occupational therapy (OT), physician assistant (PA), and physical therapy (PT) have incorporated standards for outcomes addressing IPE. Although they have endorsed the Health Professions Accreditors Collaborative (HPAC) consensus document on quality IPE, we do not have a contemporary snapshot of the IPE environments in the curriculum of their accredited programs. This dissertation, a collection of three distinct inquiries, has two aims: first, to provide a description of IPE as it …

Supplier Performance Scorecard Utilization In The Medical Device Manufacturing Healthcare Supply Chain, Justin Cardisco

Theses and Dissertations

The medical device manufacturing industry has a deficiency in determining how to improve supplier performance for the components and systems they purchase. Many complex medical devices require components from superb suppliers. But how does a medical device manufacturer (MDM) impartially assess supplier performance to know which suppliers to continuing with (or even boost purchase volumes) and which suppliers they should exit? This study describes which supplier-specific metrics are most important to medical device manufacturers (MDMs) so they can utilize this supplier performance scorecard backed by real-world inputs. This research will focus on five categories to measure MDM supplier performance (Quality, …

Multi-Modality Automatic Lung Tumor Segmentation Method Using Deep Learning And Radiomics, Siqiu Wang

Theses and Dissertations

Delineation of the tumor volume is the initial and fundamental step in the radiotherapy planning process. The current clinical practice of manual delineation is time-consuming and suffers from observer variability. This work seeks to develop an effective automatic framework to produce clinically usable lung tumor segmentations. First, to facilitate the development and validation of our methodology, an expansive database of planning CTs, diagnostic PETs, and manual tumor segmentations was curated, and an image registration and preprocessing pipeline was established. Then a deep learning neural network was constructed and optimized to utilize dual-modality PET and CT images for lung tumor segmentation. …

Senior Cohousing: The Social Architecture Of Cohousing, Community Design & Well Being, Michael Mandelman

Theses and Dissertations

The world is facing a situation without precedent, due to the anticipated growth in and increasing longevity of elderly people. Where and how people live is and can be a determinant of health. There is substantial research on inadequate housing for older people and its adverse effects on health. However, less is known about how senior cohousing affects the health of its residents. Further research is needed to improve strategies for senior living environments that promote social interaction and facilitate well-being. This study aims to bolster design and policy strategies by investigating how senior cohousing residents perceive how their living …

Job Stress Effects On Job Satisfaction And Attrition In 9-1-1 Call Centers, Damarys Jaile Gilligan

Theses and Dissertations

In 9-1-1 call centers across the nation the personnel shortage has become a crisis. The nature of the job of a 9-1-1 telecommunicator is stressful due to the high volume of emergency calls. This applied dissertation was designed to learn if there is a relationship between job stress, burnout levels, and job satisfaction in 9-1-1 telecommunicators. This was a nonexperimental quantitative survey research with a correlational approach. The population was a nonprobability convenience sample recruited through the Survey Monkey Audience platform. Data was collected at one point in time. A total of 37 participants took part in the study. All …

The Effects Of Gspt1 Degradation On Serum Calcium, Parathyroid Hormone, And Fibroblast Growth Factor 23 Concentrations In Human Cereblon Knock-In Mice, Kamran Ghoreishi

Theses and Dissertations

Test article CC-325 is a potent oral cereblon (CRBN) modulator that has shown potent G1 to S phase transition 1 (GSPT1) degradation and anti-tumor activity in pre-clinical models. One of the adverse effects associated with CC-325 was dose dependent hypocalcemia, which was determined to be an on-target toxicity.

To investigate the mechanism of hypocalcemia, we conducted a toxicity study in human cereblon (huCRBN) knock-in (KI) mice with CC-325. The huCRBN KI mice are transgenic mice engineered to express human cereblon that is capable of binding to CRBN and degrading GSPT1. Four groups of mice were treated with vehicle (0 mg/kg), …

Memory-Based Viewing: A Potential Marker Of Pathological Aging, Jenna Blujus

Theses and Dissertations

Markers of cognitive impairment are needed to distinguish normal from pathological aging prior to the onset of clinical symptomology to improve Alzheimer’s disease (AD) treatment or prevention efforts. AD pathology is believed to develop years or even decades prior to diagnosis in medial temporal lobe subregions that provide input to the hippocampus (Braak & Braak, 1991), disrupting the ability of the hippocampus to bind individual elements of an experience to form cohesive memory representations. Eye movement behavior is a sensitive index of learning and effects of memory on eye movements have been shown to emerge rapidly (within 500-750ms of stimuli …

Memory-Based Viewing: A Potential Marker Of Pathological Aging, Jenna Blujus

Theses and Dissertations

Markers of cognitive impairment are needed to distinguish normal from pathological aging prior to the onset of clinical symptomology to improve Alzheimer’s disease (AD) treatment or prevention efforts. AD pathology is believed to develop years or even decades prior to diagnosis in medial temporal lobe subregions that provide input to the hippocampus (Braak & Braak, 1991), disrupting the ability of the hippocampus to bind individual elements of an experience to form cohesive memory representations. Eye movement behavior is a sensitive index of learning and effects of memory on eye movements have been shown to emerge rapidly (within 500-750ms of stimuli …

Replacing Sedentary Behavior With A Light Intensity Physical Activity In The Homes Of Older Adults, Nicholas Louis Lerma

Theses and Dissertations

Aging is positively correlated with time spent in sedentary behavior (SB), which has been found to be linked to premature mortality, cardiovascular disease risk, and functional limitations. Moderate-to-vigorous-intensity physical activity (MVPA) is a potent stimulus for preventing and improving functional limitations in older adults, but less than 17% of the older adult population meets the recommended PA guidelines. While increased time spent in SB is detrimental to health in all, the impact among those that are physically inactive appear to be most pronounced. Recent evidence suggests increasing light-intensity physical activity (LPA) in these populations may provide health benefits and could …

The Association Between Physiologic Sources Of Pain And Sleep Quality In Older Adults And People With Dementia, Crystal-Rae Evans

Theses and Dissertations

The association between physiologic sources of pain and sleep quality in older adults and people with dementia was examined in this dissertation. Previous research illustrates multiple factors contribute to sleep quality outcomes. Musculoskeletal pain, respiratory distress, gastrointestinal discomfort, and genitourinary pain were examined in relation to sleep quality in older adults and people with dementia. No theory currently exists to guide this nursing research, therefore an illustration of pain and sleep quality in older adults and people with dementia was utilized. Descriptive data analysis and logistic regression were used to address the study aims. The findings from this research illustrate …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

The Correlation Of Size Of Core Network And Frequency Of Contacts With Agitation And Positive Affect In Elderly With Dementia, Amal Ali Al Ghassani

Theses and Dissertations

In the country of Oman, care needs of older adults are primarily provided by family members in the home. The study was guided by socioemotional selectivity theory, the environmental vulnerability hypothesis, and the need-driven dementia-compromised behavior theories. The central premise was that the size of the person’s activities of daily living (ADL) core network and frequency of contact with the ADL core network would predict agitation and affect. A smaller core network with a higher frequency of contact may be better at identifying and treating the person’s unmet needs. A secondary premise was that the emotional closeness of the core …

Housing Adjustment Behaviors Of Korean Elderly Immigrants Residing In Affordable Housing: The Cultural Aspects Of Residential Experiences, Myounghee Jorn

Theses and Dissertations

The present study is an explorative study that employs mixed methods for examining the daily life patterns and housing adjustment behaviors of low-income elderly Korean immigrants residing in public housing in the Chicago metropolitan area. It particularly focuses on identifying the cultural practices of research participants and the influence of those cultural practices on using residential features, evaluating them, and developing coping responses to satisfy dwelling needs.

The study develops upon Canter’s theories of place (1977; 1991; 1997) and Weisman’s model of place (2001), and integrates Rapoport’s concepts of culture (1980; 2008) for exploring the residential experiences of elderly Korean …

Exploring The Costs And Values Of The Household Model In Long Term Care, Mark Alan Proffitt

Theses and Dissertations

As part of the culture change movement in long term care, nursing homes are transforming into person centered living settings that reject the previous medical emphasis that dominated the industry. The household model is one approach to achieve this goal by systemically altering the traditional nursing home’s organization, routines and physical setting with an emphasis on recreating familiar, domestic places for its residents. The household model is hallmarked by three key characteristics: 1) the creation of a smaller functional group of residents within the nursing home that is delineated by the environment (24 residents or less) with the 2) intent …

Effectiveness Of Pictorial Health Warning Labels For Indonesia's Cigarette Packages, Dien Anshari

Theses and Dissertations

Pictorial health warning labels (PHWL) on cigarette packaging is a key way to communicate with consumers about the harms from tobacco, particularly in the low- and middle-income countries that do not have the resources for effective mass media campaigns. Research is needed to determine the most effective PHWL content for Indonesia, a country with one of the largest populations of smokers in the world and amongst the weakest tobacco policy environments. This research aimed to determine the most effective PHWL content for Indonesia’s cigarette packages, including the social and psychological factors that may influence PHWL effects.

Data for this study …

A Targeted Approach To Increasing The African American Blood Donor Pool, Arnethea L. Sutton

Theses and Dissertations

A continuous need for blood products, specifically for those who require frequent transfusions, such as individuals with sickle cell disease, warrants the need for targeted interventions to increase blood donations from underrepresented populations. One population in particular, African Americans, only account for 1% of blood donors in the United States. Literature indicates numerous reasons why this population is underrepresented amongst donors, including fear, lack of knowledge about the blood donation, and specific to this population, lack of trust in the medical community. This study involves the development, implementation, and assessment of a targeted educational approach, incorporating the Theory of Planned …

The Experiences And Perceptions Of Behavioral Factors That Contribute To Successful Weight Loss In Male Bariatric Patients, Stephen P. Sowulewski

Theses and Dissertations

The purpose of this study was to examine the experiences and perceptions of behavioral factors that contribute to successful weight loss in male bariatric patients. By analyzing participant experiences and perceptions, this study contributes to a better understanding of which factors are most important in the postoperative phase of gastric bypass in males owing to successful weight loss. Although there is a tremendous amount of quantitative research within the bariatric population, there is a significant gap within the qualitative literature as it relates to male outcomes. As such, by conducting interviews with 10 postoperative male gastric bypass patients, this study …

Hemodynamic Regulation Of Cardiac Valve Development, Vinal Menon

Theses and Dissertations

It is well established that valvulogenesis is a result of a complex interplay between genetic and environmental factors. Hemodynamics is one such environmental stimulus that is well documented to influence the development of heart valves. Using advanced imaging modalities, such as optical coherence tomography, investigators have better understood the effects of altering hemodynamic loads in the embryonic (avian) heart. However, the field of valvulogenesis is currently stagnant with a paucity of studies aiming to understand the molecular mechanisms influenced/affected by hemodynamic stimuli. Deciphering these pathways is critical from a valve development perspective, but also becomes vital as potential therapeutic targets, …

Prospective Assessment Of Health Disparities And Injury Risk Factors At Basic Combat Training At Ft. Jackson, Kristin Lescalleet

Theses and Dissertations

Numerous recruits for Basic Combat Training (BCT) for the Army fail to complete the course due to injury and time lost. This study was designed to provide a more thorough list of risk factors involved in injury and attrition through real-time data analysis throughout a cycle of BCT. Throughout BCT, a researcher was placed in the Battalion Aid Station (BAS) and recorded the reason for the visit, whether it was a new or existing condition, injury location, medical history, and how long this injury has been an issue. Several risk factors were tested: sex, age, and ethnicity/race. It was found …

Transcriptional And Post-Transcriptional Regulation Of Nrf2 In The Heart By The Deubiquitinase Cyld, Bryan J. Mathis

Theses and Dissertations

The cylindromatosis (CYLD) is a K63-linked deubiquitinase (DUB) that has been linked to the regulation of multiple physiological or pathological processes, such as neural development, inflammation and fibrosis. However, a novel paradigm for CYLD has been recently postulated; namely that of CYLD as a mediator of cardiac disease. Nuclear factor, erythroid-2 related factor 2 (Nrf2), a master antioxidant transcription factor, has been shown to suppress cardiac pathological remodeling and dysfunction via downregulation of reactive oxygen species formation (ROS). It is normally regulated by Kelch-like ECH associated protein 1 (Keap1). However, the regulatory link between CYLD and Nrf2 in the diseased …

Non-Steroidal Anti-Inflammatory Drug Effects On Core Temperature, Hydration, Gastrointestinal Distress, And Performance In Exercising Humans, Dawn Marie Emerson

Theses and Dissertations

Naproxen is a commonly used non-steroidal anti-inflammatory drug designed to relieve pain and inflammation. Due to potentially adverse effects on the gastrointestinal (GI) tract, cardiovascular and immune system, and renal function, naproxen may negatively affect thermoregulation, fluid and electrolyte balance, and performance during exercise, particularly in the heat. Therefore, the purpose of this study was to determine the effects of naproxen on core temperature (Tc), inflammation, hydration, GI distress, and performance during cycling in a hot environment. We utilized a double-blind, randomized and counterbalanced, cross-over design to determine the effects of naproxen (dose = 3 220 mg naproxen sodium pills) …

Age-Associated B Cell And T Helper Cell Dysfunction In Rhesus Macaques, Evan Knox Stalvig

Theses and Dissertations

The immune system undergoes drastic changes as we age, known as immunosenescence. An example of this is the dysfunction and subpopulation distribution changes of immune cells. Due to immunosenescence, the elderly have a higher risk of complications and rapid progression of new challenges to the immune system, including human immunodeficiency virus (HIV). In an effort to determine the mechanism of dysfunction of humoral immunity due to age, I compared B cell and T cell responses to non-specific, mitogenic stimuli between aged and young adult rhesus macaque peripheral blood mononuclear cells (PBMCs). Analysis by flow cytometry revealed several differences in B …

Markerless Lung Tumor Trajectory Estimation From Rotating Cone Beam Computed Tomography Projections, Shufei Chen

Theses and Dissertations

Respiration introduces large tumor motion in the thoracic region which influences treatment outcome for lung cancer patients. Tumor motion management techniques require characterization of temporal tumor motions because tumor motion varies patient to patient, day to day and cycle to cycle. This work develops a markerless algorithm to estimate 3 dimensional (3D) lung-tumor trajectories on free breathing cone beam computed tomography (CBCT) projections, which are 2 dimensional (2D) sequential images rotating about an axis and are used to reconstruct 3D CBCT images.

A gold standard tumor trajectory is required to guide the algorithm development and estimate the tumor detection accuracy …

Comparison Of The Effects Of Energy Flux On Metabolic Conditions And Satiety In Young Adults, Molly Madison Demello

Theses and Dissertations

Within the United States, 68% of all adults have been classified as overweight to obese, as defined by 25 kg/m2 ≤ BMI ≤ 35 kg/m2. Research has shown that overweight/obese individuals can still gain health benefits through participation in aerobic activity without losing weight. These improvements include improved glucose control, CRF, HDL and quality of life. More research is necessary to understand the health benefits associated with a chronic aerobic intervention under weight stable conditions. We therefore examined the health benefits of an aerobic 6-month intervention under weight stable conditions on body composition, cholesterol and measurements of appetite and satiety …

Family Connections: The Impact Of Self-Disclosure, Solidarity, And Stereotyping On Relational Satisfaction In Grandparent-Adult Grandchild Dyads, Deanne Priddis

Theses and Dissertations

As life expectancy increases, the length of time in both the grandparent and adult grandchild role increase. The grandparent-adult grandchild relationship is integral to the health and preservation of the family system. The sample for this quantitative study included 62 grandparent-adult grandchild dyads, 124 individuals. Findings indicate that both the grandparents and the adult grandchildren experienced meaning and burden in the grandparent-adult grandchild relationship. The six different types of solidarity (affectual, consensual, structural, associational, functional, and normative) had varying associations with relational satisfaction for the grandparents and adult grandchildren. Although there are several self-disclosures in a close grandparent-adult grandchild relationship, …

Use Of Photobiomodulation In Osteoclast Formation: Possible Intervention For The Treatment Of Osteoporosis, Lisa Lauren Anderson-Antle

Theses and Dissertations

After critically examining the literature to gain a robust understanding for the pathogenesis of bone loss, specifically osteoporosis, the development of a possible new intervention to prevent or treat osteoporosis was explored. The purpose of this dissertation was to pilot test a new protocol designed to answer the broad research question: Does Near-Infrared Light Emitting Diode (NIR-LED) treatment affect Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) induced osteoclastogenesis in a cell culture model?

Osteoporosis is defined as a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to …