Digital Commons Network^™

Perceptions Of Missouri School Superintendents And School Resource Officers Regarding Preparedness For Multi-Hazard Events, Jennifer Renae Wheeler Lofton

Dissertations

The purpose of this study was to garner the perceptions of superintendents and school resource officers in regard to district preparedness for multi-hazard events. Nationwide, schools are facing dramatic changes in the area of safety and security due to natural disasters, and more commonly, manmade hazards (Schaffhauser, 2013). Routinely, school personnel do not have the mindset, nor are they equipped, to respond to a major crisis (Trump, 2012). Recent mass murders and natural disasters in the United States have prompted districts to reach beyond the walls of their schools and into local communities for support (Gereluk, Donlevy, & Thompson, 2015). …

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson

Dissertations

Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial

resistance which is a severe threat to the public and an increasing global problem. The

Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses

and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,

2014). The purpose of this quality improvement (QI) project was to evaluate the

effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'

prescribing on viral respiratory tract infections (RTIs) including the common cold,

pharyngitis, and bronchitis.

Methods: This QI project implemented the CDCs Core …

Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery

Dissertations

ABSTRACT

Measurements that Matter: Assessment and Management of the Symptoms of Chronic Illness Using the Integrated Palliative Outcome Scale (IPOS)

Background: The mission of the Advanced Illness Management (AIM) program at the Visiting Nurse Association of Greater St. Louis (VNA) is to relieve the burden of serious illness by providing exceptional care to patients and families through symptom management. A validated symptom tool was needed for holistic assessment.

Purpose: This is a quality-improvement project aimed at enhancing symptom management in patients experiencing advanced illness in a community-based palliative care program. Provider use of the Integrated Palliative Outcome Scale (IPOS) as …

Applications Of Big Knowledge Summarization, Ling Zheng

Dissertations

Advanced technologies have resulted in the generation of large amounts of data ("Big Data"). The Big Knowledge derived from Big Data could be beyond humans' ability of comprehension, which will limit the effective and innovative use of Big Knowledge repository. Biomedical ontologies, which play important roles in biomedical information systems, constitute one kind of Big Knowledge repository. Biomedical ontologies typically consist of domain knowledge assertions expressed by the semantic connections between tens of thousands of concepts. Without some high-level visual representation of Big Knowledge in biomedical ontologies, humans cannot grasp the "big picture" of those ontologies. Such Big Knowledge orientation …

The Effect Of Cobra Training On First Responder Self-Confidence To Work In A Toxic Chemical Or Biological Agent Environment, Robert A. Mann

Dissertations

First responders are our nation’s front line defense against intentional or accidental releases of toxic chemical or biological agents. Self-confidence which is a building block of self-efficacy is hypothesized to be malleable and increased through training. The purpose of this study was to determine the change if any, which first responders undergo during Chemical, Ordnance, Biological, and Radiological (COBRA) training, in their self-confidence to operate in a toxic chemical or biological agent environment. That is to determine if there is a correlation between increased self-confidence and COBRA training. The methodology of this study was based on quantitative methods of analysis …

Cardiovascular Risk Among Patients With Drug-Resistant Tuberculosis And Hiv In South Africa, Erin Rachel Whitehouse

Dissertations

South Africa has the highest incidence of drug resistant-tuberculosis (DR-TB) in sub-Saharan Africa and outcomes are poor. Only 54% of patients successfully complete treatment. The prevalence of HIV co-infection and cardiovascular (CVD) risk factors is also increasing. The purpose of this study was to describe cardiovascular risk in DR-TB patients with and without HIV co-infection and the impact of this risk on 6-month DR-TB negative treatment outcomes among patients co-infected with HIV.

The Influence Of Manual And Hydraulic Stretchers On Recruitment, Retention, And Turnover In The Emergency Medical Services Workforce, Gregory Cole

Dissertations

The Department of Labor predicts an increase in demand for Emergency Medical Services (EMS) as the United States’ population grows older. The leaders of EMS must confront the difficulties surrounding recruitment, retention, and employment turnover of the EMS workforce to ensure a solvent employment pipeline to meet the predicted service demands. Previous researchers found that hydraulic stretchers reduced the number of occupationally acquired injuries among the EMS workforce. Grounded in human capital development and corporate social responsibility theories, this study extended from the work of Brice et al. (2012), Fredericks, Butt, and Hovenkamp (2009), and Studnek, Crawford, & Fernandez, (2011) …

Investigating The Construct Of Health Literacy Assessment: A Cross-Validation Approach, Bethany Miller

Dissertations

According to researchers, low health literacy is considered a worldwide health threat (Lee, Tsai-Tzul, Tsai, & Kuo, 2010). With the recent emphasis on healthcare and improving health status, knowledge has proven vital in the struggle for improved health status and health prevention. The purpose of this study was to investigate the measurement of health literacy utilizing a cross-validation approach. Health literacy measurement has been assessed using three health literacy instruments that are currently available: Short Test of Functional Health Literacy in Adults (STOFHLA), Newest Vital Sign (NVS), and Health Literacy Skills Instrument (HLSI). This study used an exploratory research design. …

Identification Of Young Children With Visual Impairments Including Unique Characteristics And Factors Related To Responsive Services, Deette L. Snyder

Dissertations

In order to truly meet the unique learning needs of young children with blindness and visual impairment (BVI), it is critical to accurately define the population to create and implement quality and responsive support services. The current analysis utilized existing data gathered from the Babies Count database to examine the defining characteristics of a sample of 588 young children, aged birth to three, with BVI and then used these characteristics to predict the influence of potential barriers to early referral. This study also examined the multiple variables through descriptive statistics and then utilized a multiple regression procedure to determine which …

The Ecology And Feeding Behavior Of Mosquitoes In The Galapagos Islands, Samoa S. Asigau

Dissertations

Mosquitoes remain important vectors in transmitting wildlife diseases. This dissertation aims to understand the role that mosquitoes play in transmitting wildlife diseases such as avian malaria, a protozoan parasite belonging to the genus Plasmodium. Using data from wild-caught mosquitoes captured in multiple years and across multiple islands on the Galapagos Archipelago, we describe distributional patterns of mosquitoes, their range limits and assess whether there exists a disease-free refuge as occurs in Hawaii. We show that altitudinal ranges for disease transmission of avian malaria may not be bounded by a stable disease-free refuge, since mosquitoes are found at all elevations, …

Interactions And Pathogen Transmission Between Carnivores In Madagascar, Fidisoa Rasambainarivo

Dissertations

Introduced carnivores exert considerable pressure on native predators through predation, competition and disease transmission. Improved understanding of determinant factors of interactions and pathogen transmission between introduced and endemic wildlife may help to predict disease emergence, avoid pathogen spillover and help control outbreaks. Using non-invasive camera traps, I identified areas where transmission of pathogens might happen through records of shared space-use within a protected area in Eastern Madagascar. I showed that indirect interactions between animals were more likely to occur near the research station which may constitute a disease transmission hotspot for carnivores in the landscape. Secondly, I investigated the associations …

Chemical Synthesis Of Staphylococcal Oligosaccharides, Satsawat Visansirikul

Dissertations

The Gram positive, cluster forming bacteria Staphylococcus aureus belongs to the family of opportunistic pathogens that may cause blood stream infections when the integrity of skin is broken and the immune system can no longer fight the infection. S. aureus has become one of the most frequent causes of infections in newborns, surgical patients, trauma and burn patients, patients receiving an implant, and dialysis patients with high mortality rates. As a matter of fact, S. aureus has become one of the largest public health and economic impacts amongst all bacterial infectious diseases worldwide. This situation is further complicated by the …

Haemosporidian Parasites And Host Immune Function Of Galapagos Avifauna, Maricruz Jaramillo

Dissertations

The large number of emergent infectious diseases witnessed in the past few decades has increased interest in the ecology and distribution of potentially threatening pathogens worldwide. Island species are often considered more vulnerable to parasites due to their impoverished parasite communities, long isolation from disease and low genetic diversity. Avian surveys done by our group on the Galapagos Islands have found various pathogens infecting their endemic avifauna, including haemosporidian parasites of the genera Plasmodium and Haemoproteus. My research seeks to understand the relationships between two haemosporidian parasites (blood parasites) and their multiple bird hosts in Galapagos and to explore …

Understanding And Describing The Impact Of Self-Concept On Weight Loss As Perceived By African American Women, Tchicaya Missamou

Dissertations

Purpose. The purpose of this mixed-method study was to understand and describe the impact of Bracken’s (1992) six domains of self-concept (affect, academic, competence, family, physical, and social) on weight loss as perceived by African American women.

Methods. This study employed a sequential mixed-methods exploratory design. A web-based survey was administered with 66 respondents, followed by in-person interviews with 10 participants. Data were collected from African American women who participated in a fitness and weight loss challenge and lived in the greater Los Angeles Area.

Findings. The extent to which each domain affected participants’ ability to lose …

A Psychometric Investigation Of The Short Interpersonal Reactions Inventory: An Exploratory Factor Analysis Of The Short Interpersonal Reactions Inventory And An Assessment Of The Validity Of The Type 1 (Cancer-Prone) Personality Category, Jason Taller

Dissertations

Purpose

The purpose of this study was to determine if the 6 personality Types, as measured by Grossarth-Maticek and Eysenck’s (1990) Short Interpersonal Reactions Inventory (SIRI), were present in a sample of cancer and cancer-free individuals and to examine if the Type 1 personality category (cancer-prone personality) could significantly differentiate cancer from cancer-free subjects. Using an ex post facto research design and a sample of 648 English speaking adults selected from North America, overall findings from a confirmatory factor analysis suggested that contrary to results from some prior studies which validated the 6-personality factor structure of the SIRI, the six …

The Enzymatic Activity And Inhibition Of Dape Encoded N-Succinyl-L,L-Diaminopimelic Acid Dessucinylase, Tahirah Heath

Dissertations

The bacterial enzyme DapE is a hydrolase in the late stage of the mDAP/lysine biosynthetic pathway that catalyzes the hydrolysis of N-succinyl-L,L-diaminopimelic acid (L,L-SDAP) to succinic acid and L,L-diaminopimelate (DAP). The product DAP is ultimately converted to m-DAP and then to lysine which is used in the construction of proteins, whereas for humans, lysine is an essential amino acid obtained through diet. DapE has been shown to be conserved across many strains of bacteria. The m-DAP produced through the succinylase pathway is used by both gram negative and gram-positive bacteria in the construction of the essential peptidoglycan cell wall. Because …

Uncovering The Mechanisms Underlying The Immunogenicity Of Adenovirus Vaccine Vectors, Natalie Nidetz

Dissertations

Vaccination is historically the most effective tool for preventing infectious disease but current vaccine strategies fail to generate robust immunity to major infectious diseases such as HIV and malaria. Therefore, newer vaccine approaches are needed. Vaccines generated from viral, adenovirus based, vectors (AdVs) have proven highly immunogenic in multiple disease models. However, the clinical use of many AdVs is limited by the presence of pre-existing antibodies in human populations, which prevent expression of antigenic genes during immunization with AdVs based on common adenovirus (Ad) serotypes, such as HAdV-5C. Immunization with rare serotype based AdVs, such as HAdV-28D, are not affected …

A Mixed-Methods Study: An Examination Of The Relationship Between Private Social Media Participation And Accountability, Adherence, And Social Connectedness In, Diana A. Cabori

Dissertations

Purpose: The purpose of this mixed-methods sequential explanatory study was to examine the influence of private social media usage on accountability, adherence, and social connectedness in weight loss and fitness program participants.

Methodology: This study utilized a mixed-methods sequential explanatory research design comprised of a multi-state quantitative survey of weight loss and fitness participants and subsequent qualitative interviews to elucidate the influence of private social media on weight loss and fitness program participants regarding program accountability and adherence, and social connectedness to others. The population included 3,000 participants of The Camp Transformation Center and 1,000 participants of Warrior Fitness and …

Climate Change Impact On Urban Stormwater System And Use Of Green Infrastructure For Adaptation: An Investigation On Technology, Policy, And Governance, Krishna Prasad Dhakal

Dissertations

The world is urbanizing at an unprecedented rate, and cities are dominantly and increasingly becoming hubs for agglomerations of human population and economic activities, as well as major sources of environmental problems. Accordingly, humanity′s pursuit of global sustainability is becoming increasingly reliant on urban sustainability. Unfortunately, the traditional approaches of urbanization and urban stormwater management are inappropriate from the sustainability standpoint. By removing vegetation and topsoil and creating impervious structures, urbanization destroys natural biodiversity and hydrological processes. As a result, urban societies are disconnected from nature and deprived of ecosystem services including flood control, fresh air, clean water, and natural …

Aerosol Transport By Coughing In A Depressurized And Air-Conditioned Chamber, Bo Zhang

Dissertations

Expiratory droplets from human coughing in an air-conditioned environment have always been considered to be potential carriers of pathogens, responsible for respiratory disease transmission. The air movement/circulation and ambient conditions such as pressure and temperature are all key factors of aerosol transport. To study the transmission of disease by human coughing in a depressurized air-conditioned chamber, there are many technical challenges, including the following: 1) the study of simulating human coughing; 2) the collection of aerosol generated by coughing; 3) the CFD simulation of coughing-induced aerosol transport in an air-conditioned chamber; 4) the validation of such a CFD simulation by …

Taxonomy And Systematics Of Plagioporus (Trematoda), With Descriptions Of 10 New Species From Freshwater Fishes Of The Nearctic, Thomas John Fayton

Dissertations

The Opecoelidae Ozaki, 1925 is one of the largest families of digenetic trematodes of fishes. While the family is mostly marine/estuarine, invasion of freshwater hosts has occurred at least two times. The only representative freshwater plagioporine sequenced to date is Plagiocirrus loboides Curran, Overstreet, & Tkach, 2007, which previous phylogenetic analyses resolved as being related to deep water marine opecoelids. The taxonomy of the freshwater plagioporines, particularly Plagioporus, has long been confused; homoplasy is rife within the family and has complicated the delineation of species and genera, and the freshwater species from marine forms. Here, I hypothesize that the …

A Qualitative Study Investigating Facility Managers’ Perceptions Of The Classroom Learning Environment, Eric Shannon Parr

Dissertations

Facility managers have the challenge of adhering to community college policies and procedures while fulfilling requirements of administration, students, and teachers concerning specific needs of classroom aesthetics. The role of facility manager and how specific entities affect perceptions of the design and implementation of classroom aesthetics were presented in this study in an attempt to further clarify present classroom design practices and future aesthetic possibilities. The purpose of this study was to explore and compare a facility manager’s perceptions of classroom learning environments, and a student’s learning environment aesthetic needs. A qualitative research design was utilized within the theoretical framework …

Age Appropriate Treatment Of Drug-Resistant Tuberculosis In South Africa, Brittney Jayne Sullivan

Dissertations

The purpose of this study was to describe the time from DR-TB diagnosis to treatment initiation for people in South Africa with DR-TB with and without HIV and to evaluate the influence of age on the timing of treatment initiation after controlling for patient and health system characteristics. It was hypothesized that younger patients would have a greater number of days from DR-TB diagnosis to DR-TB treatment initiation. Additionally, we address the knowledge gaps pertaining to prescription of guideline-based treatment for DR-TB at treatment initiation and the influence of individual and health system factors on prescribed treatment for youth and …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

Neuroimaging And Cognitive Outcomes In Adults With Human Immunodeficiency Virus And Early Life Stress, Laurie M. Baker

Dissertations

Brain abnormalities persist in individuals with human immunodeficiency virus (HIV) despite the use of highly active antiretroviral therapy (HAART). To date, limited work has focused on the association between early life stress (ELS) and brain integrity in individuals with HIV, although ELS is highly prevalent in this population. The present study was conducted to determine whether ELS corresponds to the expression of persistent HIV–related neuroimaging abnormalities and cognitive dysfunction. A total of 130 HIV+ individuals on HAART and 76 HIV– individuals underwent 3T structural magnetic resonance imaging, diffusion tensor imaging, and neuropsychological assessment. Individuals were free of major psychiatric illness …

Spatial Analysis Of Time Between Two Consecutive Dental And Two Consecutive Well-Child Visits For Foster Care Youth, Chenyang Shi

Dissertations

Foster care youth is a medically vulnerable population. Poor dental health and irregular well-child visits may cause serious health-related issues, such as mental disorder, nutrition imbalance, tooth damage, etc. Michigan requires all youth in foster care to receive annual dental and well-child visits. Usually, the study of foster care well-child and dental visits include two parts: time between two consecutive visits (gap time) and number of visits. For this study, a longitudinal-spatial model that has the flexibility to analyze the well-child/dental gap times and number of visits was developed. The longitudinal data (2009-2012) on Michigan foster care youth from 10 …

The Lived Experience Of Registered Nurses Caring For Patient Living With Hiv/Aids In Broward County, Florida: A Phenomenological Inquiry, Archimore Alexander Wright

Dissertations

Vulnerability, opportunistic infections, and infection-related illnesses, caused by the human immunodeficiency virus (HIF), progressively overwhelms the human immune system resulting in acquired immunodeficiency syndrome (AIDS). The HIV/AIDS epidemic continues to slowly and non-discriminately spread continentally with dramatic consequences on the life expectancy of anyone who develops this pervasive illness/disease. The virus, HIV, is well documented and is commonly transmitted through risky behaviors of human contact, and if left unattended and untreated, leaves a path of destruction an devastation of monumental proportions. HIV/AIDS dramatically leads to long struggles and concerns for human rights and end-of-life (EOL) care.

The purpose of this …

A Novel Role For Osteopontin In Facilitating West Nile Virus Neuroinvasion, Amber M. Paul

Dissertations

West Nile virus (WNV) is a positive-sensed, single-stranded RNA flavivirus that can cause human neuroinvasive diseases, including encephalitis, meningitis, and flaccid paralysis. The mechanisms by which WNV enters the central nervous system and the host-factors that are involved in WNV-neuroinvasiveness are not completely understood. Osteopontin (OPN), a multifunctional glycoprotein, has been implicated as a bio-marker for a number of neuroinflammatory diseases. In particular, secreted (s)OPN has been implicated to participate in recruitment of polymorphonuclear neutrophils (PMN) to sites of its expression, while PMNs have been suggested to act as WNV reservoirs. Therefore, sOPN recruitment of PMNs may contribute to neuroinvasive …

Elucidating The Role Of Interleukin-17a In West Nile Virus Infection, Dhiraj Acharya

Dissertations

West Nile virus (WNV) is a neurotropic flavivirus of significant public health importance for which no therapeutics and vaccine are currently available. Interleukin-17A (IL-17A) is an inflammatory cytokine that regulates diverse immune functions, while its role is unclear in host’s immune response to WNV. Furthermore, CD8⁺ T cells are crucial components of immunity and play a vital role in recovery from WNV infection. Here, we report a previously unrecognized function of IL-17A in regulating CD8⁺ T cell cytotoxicity. We show that WNV induces the expression of IL-17A in both mouse splenocytes and human peripheral blood mononuclear cells cultured …