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Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson

Walden Dissertations and Doctoral Studies

Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

Photoreception And Eye Regeneration Mechanisms In Planarians, Taylor R. Birkholz

Dissertations

Although humans lack the ability to regenerate complete organs and limbs following amputation or injury, there are many other species (both vertebrates and invertebrates) that can. Significant advances have been made in understanding the genetic mechanisms that regulate organ regeneration in these species, including regeneration of eye tissues such as the lens and retina. Planarians are an established historical model used to study regeneration due to their ability to regenerate any organ, including the eye. With recent advances in molecular genetic analyses, planarians are now an emerging model for the specific study of eye regeneration mechanisms. Furthermore, regeneration of the …

Psychotropic Pharmacogenomic Testing: Effects On Provider Prescribing Patterns And Phq-9 Depression Screening Scores In A Rural Michigan Family Practice, Nicole Madalinski

Doctor of Nursing Practice Scholarly Projects

The rate of depression across the United States is on the rise with over 16.2 million people experiencing a depressive episode per year (Siu & and the US Preventive Services Task Force [USPSTF], 2016). Medications to treat depression typically take weeks or months to see clinical improvement (Uphold & Graham, 2013). If the medication is not effective, a dose or medication change may occur, lengthening the time spent in a depressive state. This scholarly project retrospectively analyzed charts at a rural primary care practice that implemented GeneSight® psychotropic pharmacogenomic testing for treatment resistant depression. This project sought to understand if …

Implementation Of National Pediatric Guidelines To Prevent Chemotherapy Induced Nausea And Vomiting In Children With Cancer, Taryn Sandheinrich

Dissertations

Purpose: The purpose of this study was to assess the use of supplemental, as needed (prn) pharmacologic interventions for uncontrolled acute chemotherapy induced nausea and vomiting (CINV) in children with cancer after implementation of new pediatric CINV prophylaxis guidelines. Description of Project: A retrospective chart review was completed on forty-three children admitted to the hospital for chemotherapy during a 3 month period in 2017 to document the use of medications given for acute breakthrough CINV. The pre-implementation group received anti-emetics based on the institutional standard of care. A second retrospective chart review was completed on thirty-three children admitted to …

The Core Relation Between Hospitality (Philoxenia), Dignity And Vulnerability In Orthodox Christian Bioethics: A Contribution To Global Bioethics, Rabee Toumi

Electronic Theses and Dissertations

In a pluralistic world, reaching consensus in matters of bioethics has proved to be difficult, especially with the political polarization that nurtures inimical differences. This dissertation argues that a middle ground can be identified between the plurality of value systems in contemporary bioethics based on an anthropological approach. This middle ground that reflects commonalities of the human condition can be explored in relation to the foundational principles of Orthodox Christian anthropology. To identify this middle ground the analysis discusses the core relation between hospitality, dignity, and vulnerability as a contribution to global bioethics.

In general, based on Orthodox Christian theology …

Primary Care Provider Attitudes Towards Adoption Of Evidence Based Practice: Indicators Of Acceptance Towards Bibliotherapy, Shannon Scott

Doctor of Nursing Practice Scholarly Projects

The rising prevalence of depression is straining the skeletal mental health systems in rural communities, resulting in a majority of patients receiving management for their depression solely by their primary care providers. However, providers need to be empowered with evidence-based resources to provide adequate care beyond pharmacotherapy exclusively. Bibliotherapy, or the prescription of books for the treatment of disease, is readily used by psychologists but less incorporated into the traditional medical model of patient care. This small pilot study provided primary care providers in a rural area complimentary copies of the self-help text Feeling Good (Burns, 2009) to incorporate into …

Practice Of Ventilation In Middle-Income Countries (Provent-Imic): Rationale And Protocol For A Prospective International Multicentre Observational Study In Intensive Care Units In Asia, Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Reza Hashemian, Madiha Hashmi

Department of Anaesthesia

Introduction: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia.
Methods and Analysis: PRoVENT-iMIC (study of PRactice of VENTilation in Middle-Income Countries) is an international multicentre observational study to be undertaken in approximately 60 ICUs in 11 Asian countries. Consecutive patients aged 18 years or older who …

Analyzing The Differentiation Among State Medical Marijuana Policies By Examining State Policies & Trends, Richard Furlong

Political Science Theses and Capstones

Support for marijuana has been growing nationwide. This increased support has gained a lot of momentum since the late 1990s when California became the first state to legalize marijuana for medical use by enacting Proposition 215, or the Compassionate Use Act. Since the enactment of Proposition 215, 28 more states and the District of Columbia have legalized marijuana for medicinal use. I look into why states have begun to adopt these laws, and what makes these states differ throughout the country in the timeliness of their actions. I assembled data to examine a variety of state policies to attempt to …

Mechanisms Of Fatigue With Aging: Evidence From The Whole-Limb To The Single Cell In Humans, Christopher W. Sundberg

Dissertations (1934 -)

Aging is accompanied by a loss of muscle mass and increased fatigability of limb muscles making it difficult for old adults to generate the force and power necessary to perform daily activities, such as ascending a flight of stairs. The mechanisms for the age-related increase in fatigability in old and very old adults (≥80 yrs) and whether there are differences between men and women are unknown. The purpose of this dissertation was to determine the mechanisms for the age-related increase in fatigability in men and women by studying fatigue at the level of the whole-limb and within the muscle cells. …

Two Successful Pregnancies Following Fertility Preservation In A Patient With Anaplastic Astrocytoma: A Case Report, A. Peyser, S. L. Bristow, A. Hershlag

Journal Articles

No abstract provided.

Glycemic Control And Type 1 Diabetes Mellitus: Current Standard Treatment Vs. Closed-Loop Insulin Pumps, Kelsey Daley

Physician Assistant Scholarly Project Posters

As of 2015, 9.4% of the US population had a diagnosis of Diabetes Mellitus (DM). Although most of the data sets studied encompass type 1 (T1) and type 2 (T2) DM data in all ages of patients, the focus of this project will be primarily on T1DM.

There are effective methods currently available for the management of T1DM patients. These methods include: closed-loop insulin pumps that integrate a continuous glucose monitor (CGM) and insulin pump into one effective system that calculates the needed insulin doses through complicated algorithms, CGM with self-blood glucose monitoring calibrations (SBGM) and insulin administration, and SBGM …

Breast Cancer Disparities Among African American Women Corresponding To Health Service Barriers, Dianne Jamerson

Walden Dissertations and Doctoral Studies

African American women tend to experience higher health disparities in cancer-related illness than any other female population in the United States. The purpose of this qualitative case study was to identify and examine access-related barriers that play a significant role in the decision-making process of this population when seeking breast cancer health services. The central research question explored the effect that barriers to health care have on African American women in the Southeastern region of the United States. Secondary research questions explored the role the Patient Protection and Affordable Care Act of 2010 has on improving access to affordable, quality …

Classification And Outcome Measures For Psoriatic Arthritis., Ying Ying Leung, Alexis Ogdie, Ana-Maria Orbai, William Tillett, Laura C Coates, Vibeke Strand, Philip Mease, Dafna D Gladman

Articles, Abstracts, and Reports

Psoriatic arthritis (PsA) is an inflammatory arthritis with multiple manifestations: peripheral/axial arthritis, enthesitis, dactylitis, psoriasis, and nail involvement. From having an agreed upon classification criteria in 2006, the assessment of PsA has advanced from uncertainties to development and validation of numerous specific outcome measures. The Group for Research and Assessment of Psoriasis and Psoriatic arthritis (GRAPPA) has spearheaded the development of a core domain set and is now working on a core outcome measurement set to standardize outcome measures for PsA, that will provide guidance for use of instruments in randomized controlled trials (RCTs) and longitudinal observational studies (LOS). This …

The Utility Of Multidisciplinary Rehabilitation As A Treatment Strategy For Circadian Rhythm And Sleep Disturbances In Premanifest Huntington’S Disease, Danielle Megan Bartlett

Theses: Doctorates and Masters

Background: Huntington’s disease (HD) is a rare, neurodegenerative disease caused by an expanded cytosine-adenine-guanine (CAG) sequence in the Huntingtin gene, resulting in the production of an aberrant protein, mutant huntingtin (mHTT). The mHTT protein exhibits a toxic loss and gain in function, leading to degeneration of neurons in the brain. Consequently, the classic triad of motor, cognitive and mood features of the disease develop. Among the earliest features of HD are circadian rhythm and sleep disturbances. These anomalies present many years prior to formal clinical diagnosis of HD and, while it has been postulated that these disturbances arise as a …

Glycemic Control And Type 1 Diabetes Mellitus: Current Standard Treatment Vs. Closed-Loop Insulin Pumps, Kelsey Daley

Physician Assistant Scholarly Project Papers

As of 2015, 9.4% of the US population had a diagnosis of Diabetes Mellitus (DM). Although most of the data sets studied encompass type 1 (T1) and type 2 (T2) DM data in all ages of patients, the focus of this project will be primarily on T1DM patients. A thorough review of the current literature reveals that there are effective methods currently available for the management of T1DM patients. These methods include: closed-loop insulin pumps that integrate a continuous glucose monitor (CGM) and insulin pump into one effective system that calculates the needed insulin doses through complicated algorithms, CGM with …

Human Immunodeficiency Virus Disparity In Black Men Who Have Sex With Men, Valencia L. Beckley Hildreth

Walden Dissertations and Doctoral Studies

The HIV/AIDS epidemic continues to be a challenge in the men who have sex with men (MSM) population. Initiatives to decrease rates of new HIV infections have proven less than optimal. Despite evidence-based interventions to curtail the prevalence and incidence rates of HIV infection, Black MSM have been most impacted with increased HIV incidence. The purpose of this quantitative correlational study was to explore the relationship, if any, between age, online and physical venues attended by participants within the last thirty days, neighborhood's perceived social environment, and HIV incidence in the non-Hispanic Black MSM population in a metropolitan statistical area …

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

Aging Well: How Subjective Age, Playfulness, And Depression Influence Quality Of Life Among Older Adults, Yvette Saliba El Habre

Electronic Theses and Dissertations

Given the growing population of aging adults, there is a need for research examining factors that enhance quality of life for older adults (QoL; Colby & Ortman, 2014). Changes in health, relationships, support systems, and social identity are inevitable throughout the lifespan. Therefore, research focused on lessening the negative effects of changes due to aging while also improving QoL is warranted. As such, the aim of the current research study was to examine the extent to which subjective age (SA; how old or young an individual feels), playfulness (PF; "the ability to frame or reframe everyday situations to experience them …

Stasi Brainwashing In The Gdr 1957 - 1990, Jacob H. Solbrig, Jacob Hagen Solbrig

LSU New Orleans Theses and Dissertations

This thesis examines the methods used by the Ministerium für Staatssicherheit (MfS), more commonly known as the Stasi, or East German secret police, for extraction of information from citizens of the German Democratic Republic for the purpose of espionage and covert operations inside East Germany, as it pertains to the deliberate brainwashing of East German citizens. As one of the most efficient intelligence agencies to ever exist, the Stasi’s main purpose was to monitor the population, gather intelligence, and collect or turn informants. They used brainwashing techniques to control the people of the GDR, keeping the populace paralyzed with fear …

Teaching For Epidemiological Literacy: Description, Prescription, And Critical Thinking, Peter J. Taylor

Working Papers on Science in a Changing World

This working paper describes contrasting ideas for a sequence of topics as presented to students in a graduate course on epidemiological literacy. The premise of the pedagogical approach is that researchers develop their epidemiological thinking and practice over time through interactions with other researchers who have a variety of in-practice commitments, such as to kinds of cases and methods of analysis, and not simply to a philosophical framework for explanation. In descriptively teasing out what epidemiologists do in practice through a topic-by-topic presentation, I am prescriptively encouraging discussants to draw purposefully from across the range of topics and contrasting …

Intraoperative Blood Pressure And Effect Of Volatile Anesthetic In Brain Dead Organ Donors, Alison Lynn Karmanian

College of Science and Health Theses and Dissertations

Background: There is a large disparity between the number of people waiting for organ transplants and the number of organs available. Optimal hemodynamic management can influence transplant outcomes, therefore evidence-based hemodynamic management should be practiced to maximize scarce donor organs.

Purpose: The purpose of this study was to examine intraoperative blood pressures and administration of volatile anesthetics during brain dead organ donor procurements. Use of volatile anesthetics was examined to determine how use and dose affected the ability to maintain mean arterial pressure (MAP) between 60 to 90 mmHg.

Design: This study was a retrospective chart review.

Results: Twenty-eight cases …

The Social And Historical Subject In Sartre And Foucault And Its Implications For Healthcare Ethics, Kimberly Siobhan Engels

Dissertations (1934 -)

This dissertation explores Jean Paul Sartre’s and Michel Foucault’s view that subjectivity is socially and historically constituted. Additionally, it explores their corresponding ethical thought and how these viewpoints can be applied to ethical issues in the delivery of healthcare. Sartre and Foucault both hold the view that human beings as subjects are not just participants or spectators in social practices, rather, they become subjects with ontological possibilities through their interaction with these practices. In Chapter One, I trace Sartre’s views on subjectivity in his two major works Being and Nothingness and The Critique of Dialectical Reason, Volume 1, showing how …

Emerging Roles Of Xenobiotic Detoxification Enzymes In Metabolic Diseases, Michael C. Petriello, Jessie B. Hoffman, Andrew J. Morris, Bernhard Hennig

Superfund Research Center Faculty Publications

Mammalian systems have developed extensive molecular mechanisms to protect against the toxicity of many exogenous xenobiotic compounds. Interestingly, many detoxification enzymes, including cytochrome P450s and flavin-containing monooxygenases, and their associated transcriptional activators [e.g. the aryl hydrocarbon receptor (AhR)], have now been shown to have endogenous roles in normal physiology and the pathology of metabolic diseases. This mini-review will focus on two such instances: the role of flavin-containing monooxygenase 3 (FMO3) in the formation of the cardiometabolic disease biomarker trimethylamine-N-oxide (TMAO) and the role of AhR as a sensor of endogenous ligands such as those generated by the gut microbiota. Understanding …

Implications For Delayed Versus Immediate Umbilical Cord Clamping, Laura Ann Shaver

All Electronic Theses and Dissertations

Purpose: The purpose of the critical review of literature was to identify and analyze benefits of delayed umbilical cord clamping in full term and preterm infants with a focus on iron stores, hemoglobin, hematocrit, and hyperbilirubinemia. Methods: Twenty-two articles were included in the critical literature review with the purpose of determining whether delayed umbilical cord clamping caused increases in iron stores, hemoglobin and hematocrit, or had no clinical significant increases in hyperbilirubinemia causing neonatal jaundice and the need for phototherapy treatment. Results/Conclusion: Delayed umbilical cord clamping is a low risk, cost effective intervention that is safe and has many benefits …

Online Health Information Gathering And Health Service Utilization By Emergency Department Patients With Acute, Non-Urgent Illness Symptoms, Joanne Yastik

Wayne State University Dissertations

ABSTRACT

ONLINE HEALTH INFORMATION GATHERING AND HEALTH SERVICE UTILIZATION BY EMERGENCY DEPARTMENT PATIENTS WITH ACUTE, NON-URGENT ILLNESS SYMPTOMS

by

JOANNE M. YASTIK

May 2017

Advisor: Dr. Deborah Schutte

Major: Nursing

Degree: Doctor of Philosophy

Statement of the Problem: The influence of the Internet on our global society cannot be overstated. One of the most utilized areas on the Internet is the quest for health information (Bouche & Migeot, 2008; Goldman & Macpherson, 2006; Warner & Procaccino, 2007, Seckin, 2014). To date, little is known on how this information is being used or whether there is a link between online health …

Backward Masking With Simultaneous Early, Middle And Late Evoked Potentials, Silas Smith

Graduate Student Theses, Dissertations, & Professional Papers

Auditory processing disorders (APDs) affect a diverse range of people. These types of disorders impair auditory function, despite the outer, middle and inner ear maintaining proper function and health. APD is not necessarily related to auditory thresholds. When people with APD have difficulty discriminating sounds in connected speech, it may be due in part to an effect called Backward Masking (BM). Masking occurs when one stimulus inhibits another, which can lead to a variety of impairments. The neural locus of APDs is for the most part unknown, including the specific conditions which cause BM. A better understanding of these processes …

Phylogeny, Psychology, And The Vicissitudes Of Human Development: The Anxiety Of Atavism, Frank Pittenger

Electronic Theses and Dissertations

This cross-disciplinary dissertation provides a missing intellectual history of an ostensibly dead idea. Once widely held and no less elegant for its obsolescence, the principle of biogenetic recapitulation is best remembered by its defining mantra, “ontogeny recapitulates phylogeny.” Among psychologists and sociologists as well as embryologists, the notion that the development of any individual organism repeats in compressed, miniaturized form the entire history of its species enjoyed broad (if not uncontested) acceptance through the early twentieth century. The author reexamines the origins of this theory in the work of Charles Darwin and Ernst Haeckel, and traces its influence in psychology …

Use Of Steroids For Early Stage Ards In Icu Patients, Jasmine Coatie Pharmd, Michael Todt Pharmd, Megan Straub Pharmd

Parkview Pharmacy Department

2017 ASHP Midyear Clinical Meeting / Orlando, FL / Poster #10-085

Poster Presentation

Compare outcomes in patients treated with high-dose and low-dose corticosteroids in the early stage of Acute Respiratory Distress Syndrome (ARDS).

Resources And Well-Being In Amyotrophic Lateral Sclerosis Patients And Caregivers: A Longitudinal, Dyadic Analysis, Suzanne C. Segerstrom

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Socioemotional selectivity theory predicts that as the end of life approaches, resources that provide immediate, hedonic reward become more important and resources that provide delayed rewards become less important. The present study tested the theory in the context of marital dyads in which one partner had been diagnosed with amyotrophic lateral sclerosis (ALS), a terminal disease. ALS patients (N = 102) and their spouses (N = 100) reported their loneliness, financial worry, and psychological health every 3 months for up to 18 months. In multilevel dyadic models, patients and spouses had similar levels of financial worry and loneliness, but spouses’ …