Digital Commons Network^™

Parental Barriers Toward Seeking Mental Healthcare For Saudi Children At Risk Of Adhd, Amani Kappi

Theses and Dissertations--Nursing

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder commonly diagnosed in childhood. Underdiagnosis and undertreatment of ADHD can lead to the development of other mental illnesses and disruptions in social functioning in adulthood. Therefore, parents can play a crucial role in proactively seeking mental healthcare for children who are at risk for or who have a clear diagnosis of ADHD. Studies in the United Kingdom and the United States highlight many barriers that prevent parents from seeking mental healthcare for their children, such as negative attitudes towards the mental healthcare system and stigma towards mental illnesses.

Cultural differences …

Describing And Predicting Preprocedural Anxiety In Patients Scheduled For Advanced Gastrointestinal Endoscopy During The Covid-19 Pandemic, Dawn Profit

Theses and Dissertations--Nursing

Advanced gastrointestinal endoscopy includes a group of specialized procedures and interventions that are being performed more frequently with little attention given to a patient’s preprocedural anxiety issues. Preprocedural anxiety is an anticipated problem with any surgery or invasive procedure and if sustained or experienced excessively, is associated with negative clinical factors and complications.

In the beginning of 2020, the United States was met with a global pandemic caused by the coronavirus SARS-CoV-2, termed COVID-19. There were recommendations to decrease medical procedural case volume in order to slow the spread of the virus, protect staff and patients from getting the virus, …

Development And Psychometric Testing Of An Instrument To Identify Factors That Predict Intentions Related To Post-Mortem Organ Donation Among Saudi Arabian Nurses, Salman Alreshidi

Theses and Dissertations--Nursing

Organ donation shortage is a major international concern. Global data on organ donation and transplantation activities from the World Health Organization indicate that in 2019 organs were available for less than 10% of transplantations needed. In Saudi Arabia alone, the organ donation shortage accounts for 28.8% of deaths annually. Nearly 31% of donated organs are from donors outside of the country because many eligible donors in Saudi Arabia do not donate.

While post-mortem organ donation has the potential to increase available organs for transplantation, in many countries, including Saudi Arabia, hesitancy among candidate donors and their family members can present …

Assessing Patient Engagement With An Mhealth Application For Improving Heart Failure-Related Self-Care In Real-World Settings, Ifeanyi Madujibeya

Theses and Dissertations--Nursing

Consumer-facing mobile health applications (mHealth apps) are being increasingly integrated into routine heart failure (HF)-related self-care. However, there is a dearth of research on patient engagement with mHealth apps in real-world settings and the effect of such engagement on HF outcomes, making it challenging to inform decision-making regarding the use of mHealth apps in real-world settings.

The specific aims of this dissertation were to; 1) examine current evidence on measures of engagement with mHealth interventions in patients with HF; 2) examine the patterns of patient engagement with a consumer-facing mHealth app and the predictors of engagement in real-world settings;3) identify …

Building Tools For Improved Modulation Of The Human Gabaa Receptor, A Central Nervous System Target For The Treatment Of Anxiety, Garrett Edward Zinck

Theses and Dissertations--Pharmacy

In the U.S., anxiety is recognized as an increasing range of mentally and physically debilitating psychiatric health disorders with significant economic repercussions. Over the last 20 years, several novel anti-anxiety therapies have entered the drug development pipeline, but none have made it to market.

The work in this dissertation focused on structurally modifying valerenic acid (VA), a structurally unique carboxylated sesquiterpene acid found in Valeriana officinalis. VA is putatively reported to have allosteric modulatory activity of the human GABA_A receptor, a ligand-gated ion channel responsible for attenuating neurotransmissions. Structural modeling of VA’s GABA_A receptor interaction suggests that …

Analysis Of Potential Facilitators To Use Of Hiv Pre-Exposure Prophylaxis (Prep) In A Young Transgender Population, Noah Dixon

Theses and Dissertations--Pharmacy

Pre-exposure prophylaxis for HIV prevention (PrEP) is heavily under-utilized in transgender youth, a population which experiences high risk factors for contracting HIV and exhibits unique barriers to care. This retrospective study used a secondary data analysis of survey results from transgender youth between 16-and 24-years-old to analyze various exposures for association with PrEP use. It was hypothesized that medical gender affirming therapy, mental health care treatment, and HIV programming would be independently associated with increased use of PrEP in transgender youth. It was found that only HIV prevention services and programming related to HIV or gender identity were associated with …

Studies Toward The Development Of An Improved Countermeasure For Synthetic Opioid Overdose, Sidnee L. Hedrick

Theses and Dissertations--Pharmacy

One of the most prominent opioid analgesics in the United States is the high potency agonist fentanyl. It is used in the treatment of acute and chronic pain and as an anesthetic adjuvant. When used inappropriately, however, ingestion of just a few milligrams of fentanyl or other synthetic opioid can cause opioid-induced respiratory depression (OIRD), often leading to death. Currently, the treatment of choice for OIRD is the opioid receptor antagonist naloxone. Recent reports, however, suggest that higher doses or repeated dosing of naloxone (due to recurrence of respiratory depression) may be required to fully reverse fentanyl-induced respiratory depression, rendering …

Investigating The Physical Stability Of Amorphous Pharmaceutical Formulations, Travis W. Jarrells

Theses and Dissertations--Pharmacy

Amorphous formulations, including amorphous solid dispersions (ASDs), consisting of the active pharmaceutical ingredient (API) intimately mixed in a polymeric matrix, are an attractive formulation approach to improve drug delivery, dissolution, and solubility. However, an amorphous API in an ASD is in a higher energy state compared to the crystalline drug and results in most ASDs being inherently unstable. The polymer helps to stabilize the amorphous drug against crystallization such that the resulting homogenous mixture maintains its solubility advantage relative to the crystalline form. One challenge of ASDs is that the presence of impurities including crystals or residual solvent, variations in …

Response Of Dopaminergic System To Cocaine Exposure, Recovery After Cocaine Abstinence, And Impact Of A Long-Acting Cocaine Hydrolase, Jing Deng

Theses and Dissertations--Pharmacy

Cocaine produces its physiological effects by targeting multiple proteins in the central nervous system, particularly by binding with dopamine transporter (DAT) to block the normal dopamine (DA) recycling process. This process along with the pleasure feeling would wear off shortly after the abstinence from the drug. However, chronic cocaine use is associated with neuroadaptations in the dopaminergic system, including increases in the density of DAT on plasma membrane of dopaminergic neurons. Given the critical role of DAT in neurotransmission, various studies have been carried out on animal models to learn its structure, function, and distribution. Long-standing evidence supports that DAT …

Liposomal Technologies To Improve Gene Delivery, David Nardo Padron

Theses and Dissertations--Pharmacy

Lipid based nanoparticles (LBNs) are used in myriad applications in medicine from small molecule drug delivery to mRNA vaccines. A major contributing factor to the development of the field has been the ongoing development of novel compounds that retain the functionality of natural lipids but expand upon them through inclusion of functional moieties that can be applied to specific scientific and biomedical questions. In the body of this dissertation, an extensive overview of LBNs is provided, focusing primarily on their use in immune modulation. The research presented herein begins with the synthesis of a novel class of lipids based on …

The Relative Contribution Of Liver And Intestine In Reverse Cholesterol Transport, Rupinder Kaur

Theses and Dissertations--Pharmacy

Despite decades of advances in research, death due to cardiometabolic disease remains the largest contributor to mortality in the US. While present therapies oppose “forward cholesterol transport,” and atherosclerotic plaque progression, they do not remove cholesterol from established atherosclerotic plaques. Reverse cholesterol transport (RCT) is the active process of mobilizing peripheral cholesterol for excretion through the hepatobiliary (transhepatic cholesterol elimination, THCE) or intestinal (transintestinal cholesterol elimination, TICE) pathways. Currently, there are no clinically approved therapeutics that target RCT. Elucidation of the mechanisms that govern RCT and TICE, and the subsequent identification of novel targets is of importance. The present work …

Development Of Accurate And Efficient Computational Methodologies For Predicting Protein-Ligand And Protein-Protein Binding Free Energies, Alexander Hamilton Williams

Theses and Dissertations--Pharmacy

Computational modeling is an invaluable tool in the drug discovery process either for small ligand or protein therapeutics. The widespread availability of protein X-Ray Crystal and Cryo-Electron Microscopy (Cryo-EM) structures has allowed for more accurate molecular dynamics (MD) simulations that are not reliant on methods such as homology modeling, which may produce structures that require significant computational time to demonstrate their stability. In this thesis we describe several novel methodologies for the computationally efficient modeling of protein/ligand and protein/protein complexes that may be employed within both large-scale virtual screenings and lead compound optimization. These methodologies may also be utilized in …

Development Of Zafirlukast Derivatives Active Against Porphyromonas Gingivalis, Kaitlind C. Howard

Theses and Dissertations--Pharmacy

Periodontal diseases are inflammatory diseases that can lead to damage of the soft tissue and bone supporting the teeth. Gingivitis is the reversible early stage of gum disease, which consist of gums that bleed when brushing or flossing teeth. When left untreated, the preventable but irreversible late stage of periodontal disease, periodontitis, can lead teeth to loosen or even fall out. Oral bacterial species, such as the Gram-negative anaerobic pathogen Porphyromonas gingivalis trigger these inflammatory diseases through oral dysbiosis. P. gingivalis is a keystone pathogen, meaning that the damage caused by P. gingivalis is not proportional to its abundance. Treatment …

Addressing Ascertainment Bias In The Study Of Cardiovascular Disease Burden In Opioid Use Disorders - Application Of Natural Language Processing Of Electronic Health Records, Jade Huang Singleton

Theses and Dissertations--Epidemiology and Biostatistics

In the United States, the prevalence of long-term exposure to opioid drugs, for both medically and nonmedically indicated purposes, has increased considerably since the mid-1990’s. Concerns have emerged about the potential health effects of opioid use. There is also growing interest in other possible connections with opioid use including cardiovascular disease. Electronic health records (EHR) contain information about patient care in the form of structured codes and unstructured notes. Natural language processing (NLP) provides a tool for processing unstructured textual data in EHR clinical notes and extracts useful information for research with structured formats. The purpose of this dissertation was …

Opioid Use Disorder Treatment With Buprenorphine: Analysis Of Treatment Utilization And Associated Outcomes In Kentucky, Feitong Lei

Theses and Dissertations--Epidemiology and Biostatistics

Opioid use disorder (OUD) is chronic opioid use that results in clinically significant suffering, impairment, or even death. The opioid epidemic in the United States has become a public health and economic crisis, affecting patients' well-being and the nation's overall health and welfare. Eastern Kentucky was among the first regions affected by the opioid crisis, and Kentucky has historically ranked among the top five states for age-adjusted drug overdose mortality rate.

There are three medications (buprenorphine, methadone, naltrexone) approved by the U.S. Food and Drug Administration to treat OUD. As a partial opioid agonist, buprenorphine is a safe medication for …

The Influence Of Distance Learning On Undergraduate Social Work Competency: An Exploratory Study At A Private University, Christine K. Fulmer

Theses and Dissertations--Social Work

This is an exploratory study of undergraduate social work education at a private faith-based university. The university offers both online and residential program options. The purpose of the study was to examine the influence of distance education and program option on the educational outcomes of graduates in a newly developed social work program. The program started in 2015 with its first graduating class in 2017. The sample (N = 262) consists of students graduating in 2017, 2018, and 2019. Students could take classes across program options and each student in the sample completed both traditional and online social work courses. …

Development Of Univariate And Multivariate Forecasting Models For Methane Gas Emissions In Underground Coal Mines, Juan Diaz

Theses and Dissertations--Mining Engineering

Methane gas management continues to be a challenge concerning underground coal mine safety and productivity worldwide despite the extraordinary effort of the mining industry, governmental agencies, and academia to develop new technologies to monitor and control methane gas emissions more efficiently. The risk of hazardous methane gas concentrations in underground environments cannot be underestimated. Statistical data for the last 100 years indicate that around 80% of the accidents and 90% of the fatalities in the underground coal mining industry in the US were related to methane gas explosions.

Modern underground mine operations monitor and evaluate atmospheric parameters such as barometric …

Laptop Recycling Case Study: Estimating The Contained Value And Value Recovery Process Feasibility Of End-Of-Life Consumer Electronics, Zebulon Hart

Theses and Dissertations--Mining Engineering

Work has been done to establish, through the development and use of novel assay techniques and analysis metrics, the contained value of a sampling of laptop computers (as an analog for myriad e-waste sources). This work has conceptualized e-waste as an alternative to geologic-origin complex metallic ores and has likewise evaluated the feasibility of value recovery from e-waste sources in a similar manner to an ore. The application of conventional and novel mineral separation techniques to e-waste recycling processes has been evaluated and positive results are demonstrated. Further, this work has demonstrated the ability to identify the presence of base …

Parametric Numerical Analysis Of Inclined Coal Pillars, Robin Flattery

Theses and Dissertations--Mining Engineering

Pillars are used as the primary support structures for underground mining to maintain stability by supporting the over laying strata. In the case of horizontal seams, the pillars are typically subjected to axial loading due to the weight of the overburden and/or abutment stresses, while in the case of inclined seams they are subjected to oblique loading due to both the vertical and horizontal in-situ stress. Over the years numerous studies have been completed on square and rectangular pillars in horizontal seams that have resulted in several pillar stability equations and criteria. However very few studies are available with respect …

Investigation Into, & Analysis Of Temperature & Strain Data For Coal Mine Seal Material During Curing, Stephanus Jaco Van Den Berg

Theses and Dissertations--Mining Engineering

On Monday, January 2, 2006, an underground explosion occurred at the Sago Mine WV, resulting in the death of 12 miners and seriously injury to one miner. On Saturday, May 20, 2006, an underground explosion occurred at the Darby Mine No.1 KY, resulting in five miner’s deaths and one miner’s injury.

The explosion of methane gas and coal dust result in many fatalities in the coal mining industry.

The coal mining industry uses mine seals to optimize the ventilation network. Those structures are designed not only to direct the air appropriately, but also, they should be capable of withstanding some …

Development Of Univariate And Multivariate Forecasting Models For Methane Gas Emissions In Underground Coal Mines, Juan Diaz

Theses and Dissertations--Mining Engineering

Methane gas management continues to be a challenge concerning underground coal mine safety and productivity worldwide despite the extraordinary effort of the mining industry, governmental agencies, and academia to develop new technologies to monitor and control methane gas emissions more efficiently. The risk of hazardous methane gas concentrations in underground environments cannot be underestimated. Statistical data for the last 100 years indicate that around 80% of the accidents and 90% of the fatalities in the underground coal mining industry in the US were related to methane gas explosions.

Modern underground mine operations monitor and evaluate atmospheric parameters such as barometric …

Numerical Investigation Of An Oxyacetylene Torch With Regards To An Ablative Material, Luke Fortner

Theses and Dissertations--Mechanical and Aerospace Engineering

A computational fluid dynamic (CFD) software is used to model an oxyacetylene torch used as a screening facility for high temperature material testing. First, a published test-case is used to verify the CFD approach. The model that was produced falls within 5% of the Marra et al. [15] work in regards to heat flux and front face temperature, with a one step reaction mechanism that is computationally cheap. Then, the approach is used to model an existing experimental facility.

Modeling Human Control Behavior In Command-Following Tasks, Sajad Koushkbaghi

Theses and Dissertations--Mechanical and Aerospace Engineering

Humans interact with a variety of complex dynamic systems on a daily basis. However, they are often the lesser understood component of human-in-the-loop (HITL) systems. In this dissertation, we present the results of two HITL experiments to investigate the control strategies that humans use when performing command-following tasks. The first experiment is designed to investigate the control strategies that humans use to interact with nonlinear dynamic systems. Two groups of human subjects interact with a dynamic system and perform a command-following task. One group interacts with a linear time-invariant (LTI) dynamic system and the other group interacts with a Wiener …

Energy And Economic Modeling Of Stillage Dewatering Processes In Kentucky Bourbon Distilleries, William Brennan

Theses and Dissertations--Mechanical and Aerospace Engineering

Stillage is a byproduct of alcohol distillation and must be managed in all distilleries to sustain operations. In the United States, fuel ethanol plants typically convert all stillage into Dried Distillers’ Grains with Solubles (DDGS). This process and its variations are well known. Typical stillage management approaches are not well known, however, for the Kentucky bourbon industry. A survey of stillage management approaches in operational bourbon distilleries was conducted. Process modeling was performed to evaluate the energy and economic considerations of the available stillage dewatering methods for a 7 Million Original Proof Gallon (MMOPG) distillery. Monte Carlo simulations were performed …

Quantitative Methods For Total Lifecycle Risk Likelihood And Impact Assessment In Sustainable Product Design Decision Making, Christian Enyoghasi

Theses and Dissertations--Mechanical and Aerospace Engineering

Sustainable products promise significant economic, environmental, and societal benefits. Numerous methods are available for use during the new product development process to identify alternate product designs that optimize sustainability performance. Once any such design is selected and the product is launched, many uncertainties are likely to affect its performance over the total lifecycle. Such uncertainties give rise to risks that can influence the overall product sustainability performance. However, comprehensive quantitative methods to evaluate the likelihood or the impact of different risks to enable sustainable product design decision making are lacking.

This research aims to address this gap by developing a …

In-Situ Characterization Of Surface Quality In Γ-Tial Aerospace Alloy Machining, David Adeniji

Theses and Dissertations--Mechanical and Aerospace Engineering

The functional performance of critical aerospace components such as low-pressure turbine blades is highly dependent on both the material property and machining induced surface integrity. Many resources have been invested in developing novel metallic, ceramic, and composite materials, such as gamma-titanium aluminide (γ-TiAl), capable of improved product and process performance. However, while γ-TiAl is known for its excellent performance in high-temperature operating environments, it lacks the manufacturing science necessary to process them efficiently under manufacturing-specific thermomechanical regimes. Current finish machining efforts have resulted in poor surface integrity of the machined component with defects such as surface cracks, …

Radiative Conductivity Estimation Using Direct Approach For Fibrous Materials, Mohammad Khaleel

Theses and Dissertations--Mechanical and Aerospace Engineering

During planetary entry, space vehicles encounter high loads of thermal energy which requires a thermal protection system. Ablative thermal protection systems are usually made out of fibrous materials that exhibit internal radiation. In order to model the internal radiation response of a thermal protection system one should obtain proper radiative properties as well as thermal properties. The objective of this work is to provide a method that solves for the solid/gas thermal conductivity. Which can be used in coupled detailed radiative analysis.

Keywords: radiative conductivity, fibrous materials, radiative transfer, thermal protection system, P1 approximation, Finite Volume method.

A Decoupled Engineering Methodology For Accurate Prediction Of Ablative Surface Boundary Conditions In Thermal Protection Systems, Justin Cooper

Theses and Dissertations--Mechanical and Aerospace Engineering

The main objective of the present work is to demonstrate a method for prediction of aerothermal environments in the engineering design of hypersonic vehicles as an alternative to the current heritage method. Flat plate and stagnation point boundary layer theory require multiple assumptions to establish the current engineering paradigm. Chief among these assumptions is the similarity between mass and heat transfer. Origins of these assumptions are demonstrated and their relationship to conservative engineering design is analyzed, as well as conditions where they possibly break down. An alternative approach for assessing aerothermal environments from the fluid domain is presented, which permits …

Formation Control With Bounded Controls And Collision Avoidance: Theory And Application To Quadrotor Unmanned Air Vehicles, Zachary S. Lippay

Theses and Dissertations--Mechanical and Aerospace Engineering

This dissertation presents new results on multi-agent formation control and applies the new control algorithms to quadrotor unmanned air vehicles. First, this dissertation presents a formation control algorithm for double-integrator agents, where the formation is time varying and the agents’ controls satisfy a priori bounds (e.g., the controls accommodate actuator saturation). The main analytic results provide sufficient conditions such that all agents converge to the desired time-varying relative positions with one another and the leader, and have a priori bounded controls (if applicable). We also present results from rotorcraft experiments that demonstrate the algorithm with time-varying formations and bounded controls. …

The Effects Of Reference-Command Preview On The Strategies That Humans Use In Command-Following Tasks, Amelia J. S. Sheffler

Theses and Dissertations--Mechanical and Aerospace Engineering

This thesis presents results from an experiment in which 22 human subjects each interact with a dynamic system 40 times over a one-week period. For each interaction, a subject performs a command-following task, where the reference command is the same for all 22 subjects but different on each trial. The subjects are divided into 2 groups of 11 subjects. One group performs the command-following task without reference-command preview. The other group is provided with 1-s preview of the reference command. The experimental results are used to examine the effects of reference-command preview. For the group with 1-s reference-command preview, the …