Digital Commons Network^™

Study Of Rickettsia Parkeri Colonization And Proliferation In The Tick Host Amblyomma Maculatum (Acari: Ixodidae), Khemraj Budachetri

Dissertations

Amblyomma maculatum (Gulf coast tick) ticks are prevalent across the Atlantic to Gulf Coast region of United States. These ticks are recognized vectors of Rickettsia parkeri, a spotted fever group of Rickettsia (SFGR) known to cause American boutonneuse fever associated with fever and eschar rashes localized to the site of bites. We hypothesized that Rickettsia parkeri colonization and proliferation in the tick vector involve pathogen-symbiont dynamics and tick-pathogen interactions, which influence rickettsial transmission to the victims after tick bites. The rickettsial infection is maintained across the tick life cycle for many generations due to transovarial and transstadial transmission of …

Implementation Of A Daily Checklist To Improve Patient Safety And Quality Of Care In A Pediatric Intensive Care Unit, Catherine Reese

Dissertations

Background

Multiple industries have demonstrated checklists to be of great value in reducing errors of omission and improving communication. In healthcare, checklists have been shown to ensure patients receive evidence-based, safe care. In a fast paced environment of a critical care unit, adverse events are common and can have significant consequences on patient outcome. Safety guardrails are necessary to minimize naturally occurring human error. Safety checklists help support best practices to standardize care and support processes to improve outcome.

Objectives

To develop and implement a daily safety checklist in a pediatric intensive care unit (PICU) to enhance clinical care and …

Parasitism Of Free-Ranging Neotropical Primates: Examining Parasite-Host And Parasite-Parasite Relationships, Gideon A. Erkenswick

Dissertations

Parasites are infectious agents that require resources from host organisms to complete all or part of their lifecycles. It is customary for wild animals to acquire and maintain multiple parasitic infections during their lifetime. The effects of parasites on hosts vary across demographic and environmental variables, and in relation to each other. Moreover, the propensity for a host animal to acquire an infection can be influenced by other host species in the area that are susceptible to the same parasites. This dissertation describes and explores the natural parasite assemblage of a free-ranging community of nonhuman primates in the Peruvian Amazon …

The Influence Of Culture On The Use Of Healthcare Services By Refugees In Southcentral Kentucky: A Mixed Study, Chika N. Ejike

Dissertations

The world as a global village has become a ubiquitous trope in the popular discourse, and Bowling Green, Kentucky, with its substantial immigrant population, may be considered an exemplar of this idealized community. It has become an ideal location for research regarding the challenges faced by immigrants. Due to the diverse cultural identities of the refugee/immigrant population, it is particularly well suited for studies into complex culturally dependent healthcare utilization patterns.

The central research question for the study was as follows: What are the healthcare-seeking behavioral patterns (as influenced by culture) among refugees at their nearest healthcare facilities? This mixed …

Assessing A Punching Bag Feedback Performance Device, Neil Deochand

Dissertations

Physical exercise has been integrated into treatment efforts in reversing the number of overweight and obese individuals. Furthermore, exercise extends mortality, enhances general quality of life, and it is a protective health factor for preventing the progression some mental health disorders. Electronic athletic training equipment easily allows monitoring of real-time physical activity, and enables tracking of progress made toward individualized performance goals. There are limitations to only using visual feedback (e.g., visual depictions of heart rate, speed, distance traveled, or calories burned etc.) to track and improve exercise and athletic performance, especially for some sports, such as boxing. This issue …

Development Of A Comprehensive Safety And Preparedness Plan For Pregnancy Shelter Center, Catherine A. Marcum

Dissertations

Disaster has almost become a household word in America and around the world. Disaster Preparedness provides some since of control over the effects of disaster, however small that may be. The National Response Framework provides the structure under which all disasters are managed domesticallly (Veenema, 2013). It is scalable and flexible - having the ability to accomodate any disaster, from the smallest incident to a disaster of national proportions (http://emilms.fema.gov//IS700aNEW/index.htm; http://emilms.fema.gov/IS800Bindex.htm). Preparedness determines the degree of service disruption regardless of the nature of the disaster. The goal of preparedness within any entity is to expect the unexpected, …

Social Ecological Factors Associated With Parental Vaccination Decisions And Perceptions Of Barriers To Childhood Immunizations, Catherine A. Ferris

Dissertations

The success of childhood immunizations has led to a decrease in the visibility of the morbidity and mortality of vaccine-preventable diseases. Parents are questioning the validity and safety of vaccines resulting in significantly increasing numbers of underimmunized and unvaccinated children throughout the country. The purpose of this dissertation was to explore the perceptions of barriers to immunizations in parents with children, birth to 12 months of age presenting for a well-child or vaccinations-only visit to one of two pediatric primary care clinics located in San Diego County. The social ecological model was used to guide this dissertation. A cross-sectional, descriptive …

Healthcare Use Self-Efficacy In Adults Who Are Homeless, Jared Ian Israel

Dissertations

The physical and mental health care needs of homeless adults are extensive. However, these needs regularly go unmet. Healthcare use behavior is complex and involves a range of obstacles. As such, self-efficacy, an individual’s belief in his or her ability to perform a given behavior, appears to be a relevant factor in healthcare use. While current theory supports this notion and research has confirmed the role of self-efficacy in health behavior generally, a validated measure of healthcare use self-efficacy has not previously existed. The aim of this study was to develop and validate the Healthcare Use Self-Efficacy List (HUSEL) in …

Evaluation Of Shared Medical Appointments For Opioid Relapse Prevention In Patients Receiving Medication-Assisted Treatment In A Rural Health Clinic, Ashley M. Koch

Dissertations

The United States is facing an opioid epidemic. Access to medication-assisted treatment (MAT) is recognized as one crucial strategy in decreasing opioid abuse rates and improving population health through mitigation of infectious disease and overdose deaths. However, it has been reported that individuals suffering from opioid-use disorders have limited access to MAT. A synthesis of evidence supported project implementation of shared medical appointments (SMAs) for opioid relapse prevention as a means to support implementation of MAT, increase patient access to treatment, and promote social support in opioid abuse recovery. Accordingly, this project aimed to develop, implement, and evaluate a SMA …

Role Of The Interleukin-22 And Stat3 Signaling Pathway In Gut Barrier Maintenance Following Intoxication And Burn Injury, Adam M. Hammer

Dissertations

More than half of patients admitted to burn centers for treatment have measurable alcohol levels in their blood. Intoxication that precedes a traumatic burn injury leads to worsened patient outcomes, including higher rates of infection and sepsis. The intestines harbor the largest concentration of bacteria in the human host. Any disruption of the intestinal barrier as a result of intoxication and burn injury could contribute to infection and/or sepsis from gut-derived microbes. Previous work has demonstrated that the intestinal barrier becomes leaky, and that administration of interleukin-22 (IL-22) significantly reduces gut barrier leakiness following alcohol and burn injury. However, the …

Endocytic Vesicle Rupture In The Pathogenesis And Propagation Of Neurodegenerative Proteinopathies, William P. Flavin

Dissertations

Numerous pathological amyloid proteins spread from cell-to-cell during neurodegenerative disease, facilitating the propagation of cellular pathology and disease progression. Understanding the mechanism by which disease-associated amyloid protein assemblies enter target cells and induce cellular dysfunction is therefore key to understanding the progressive nature of such neurodegenerative proteinopathies. In this study, we utilized an imaging-based assay to monitor the ability of disease-associated amyloid assemblies to induce the rupture of intracellular vesicles following endocytosis, as well as to elucidate the cellular consequences of this damaging mechanism of invasion. We observed that the ability to induce vesicle rupture is a conserved feature of …

The Female Urogynecological Microbiome: Determining Niche Specificity, Krystal Thomas-White

Dissertations

Contrary to dogma, urine is not sterile. Recent discoveries show that the female urinary bladder contains a unique microbiome,with differences in healthy and disease states. This female urinary microbiome (FUM) is distinguishable from vulvo-vaginal contamination; yet, only the few centimeters of the urethra separate these two niches. Recent studies show that the most common bladder organisms are Lactobacillus, Gardnerella, Streptococcus, Corynebacterium, and a diverse group of anaerobes, the same genera commonly found in the vagina. Thus, we asked if the bladder and vaginal microbiomes are interconnected.

Previous work suggests a link between these two niches. The vaginal tract of reproductive …

Discrete Time Structured Models And Their Dynamics For Interactive Wild And Sterile Mosquitoes And Malaria Transmissions, Yang Li

Dissertations

Mosquito-borne diseases, including malaria, transmitted between human beings by blood-feeding mosquitoes, have been big concerns for the public health. No vaccines are available. An effective way to prevent such diseases is to control the amount of mosquitoes. The Sterile Insect Technique (SIT) is indeed a method of biological control. Mathematical models have proven useful in gaining insights into challenging questions in population dynamics and epidemiology. The objectives in this dissertation is to formulate new models for interactive wild and sterile mosquitoes so that the dynamics are relatively simpler and mathematically more tractable, but the fundamental model features are snatched. Instead …

Correlation Of The Boost Risk Stratification Tool As A Predictor Of Unplanned 30-Day Readmission In Elderly Patients, Carol K. Sieck

Dissertations

Carol K. Sieck

Loyola University Chicago

CORRELATION OF THE BOOST RISK STRATIFICATION TOOL AS A PREDICTOR OF UNPLANNED 30-DAY REAMDISSION IN ELDERLY PATIENTS

Risk stratification tools can identify patients at risk for 30-day readmission but available tools lack predictive strength. While physical, functional and social determinants of health have demonstrated an association with readmission, available risk stratification tools have been inconsistent in their use of variables to predict readmission. The Better Outcomes by Optimizing Safe Transitions (BOOST) 8 P's tool is a risk stratification tool developed by the Society of Hospital Medicine but has no published validation studies. The theoretical …

Investigating Novel Methods Of Interaction With Pharmaceutically Relevant Enzymes, Cory T. Reidl

Dissertations

Metalloproteins requiring one or more metal ions for normal function make up 30% of all known proteins, and many critical biological pathways contain at least one metallo-enzyme. Di-nuclear metallo-proteins constitute a large class of these proteins yet we currently lack effective methods of inhibiting these enzymes for the development of new medical therapies, particularly for the discovery of new antibiotics. Our work has focused on developing novel functionalities that selectively interact with di-nuclear catalytic centers, and we are targeting three separate di-zinc-metallo-enzymes that are unique to bacteria and play key roles in their growth and development. These enzymes are DapE, …

Anthropogenic Disturbance Modulates Mammal Community Diversity, Assembly, & Abundance: Emerging Infectious Disease Risk In The Greater Yellowstone Ecosystem, Leticia Andrea Gutiérrez Jiménez

Dissertations

This dissertation examines the role of mammalian biodiversity in maintaining overall ecosystem health in the Greater Yellowstone Ecosystem (GYE). The study explores the pathways by which anthropogenic disturbance prevents or promotes the emergence of human infectious diseases. I studied two paramount research questions: Question 1: What are the direct effects of anthropogenic disturbance on rodent community assemblages and the consequent indirect effects on public health? I first surveyed the GYE rodent community and their pathogens by using land use as a measure of anthropogenic disturbance (e.g., human settlements, horseback ranches, pastures, undisturbed). I identified pathogens in rodent blood samples by …

Synthetic Ion Channels: A New Class Of Membrane Disruptor And Efflux Pump Inhibitor For The Recovery Of Antibiotic Potency, Mohit Bharatkumar Patel

Dissertations

Antibiotic resistance has become a world-wide health care crisis. In 2013 there were 50,000 deaths in U.S. and EU, associated with hospital acquired bacterial infections. This problem is exacerbated by the lack of new antibiotics in development. Here, we report that synthetic amphiphiles represent a new class of adjuvants that rescue antibiotic potency against multidrug resistant bacteria. Hydraphiles are amphiphiles, designed and synthesized in Gokel lab, that show many of the same properties as protein ion channels. Hydraphiles were previously shown to have antimicrobial activity against Escherichia coli, Bacillus subtilis and Saccharomyces cerevisiae. Here, we report that hydraphiles recover the …

Historical Biogeography, Spatial Distribution, And Within-Host Interactions Of Avian Haemosporidian Parasites (Apicomplexa, Haemosporida), Leticia De Souza Soares

Dissertations

This dissertation addresses several aspects of the biogeography and evolution of avian malarial parasites (Haemosporida: Plasmodium and Haemoproteus), and the interactions of these pathogens with their hosts and other avian blood parasites. In Chapter 1, I investigate change in haemosporidian assemblages on the West Indies over millennial time scales, taking advantage of the historical isolation of islands by postglacial rising sea levels. I found that, the prevalence of parasite lineages is highly dynamic over periods from decades to thousands of years. Turnover of lineages requires more time than variation in lineage prevalence, suggesting that competitive exclusion of parasite lineages, likely …

Epidemiology Of White Spot Syndrome Virus In The Daggerblade Grass Shrimp (Palaemonetes Pugio) And The Gulf Sand Fiddler Crab (Uca Panacea), Muhammad

Dissertations

Ever since the first outbreaks of White spot syndrome virus (WSSV), which causes White Spot Disease (WSD), in Asia in the early 1990s, the pathogen has been a major constraint to the profitability of the shrimp aquaculture industry across the globe. WSSV has a broad host range and is routinely detected in wild decapod crustaceans. In the present study, two common species in the tidal salt marsh along the northern coast of the Gulf of Mexico, the daggerblade grass shrimp (Palaemonetes pugio) and the Gulf sand fiddler crab (Uca panacea), were investigated for their role as …

A Microbiomic Approach To The Characterization Of The Impacts And Influences Of Viral, Bacterial, And Harmful Algal Bloom Toxins On The Bottlenose Dolphin, Corey David Russo

Dissertations

As apex predators that display high site fidelity Tursiops truncatus (bottlenose dolphin) are indicators of marine ecosystem health. Bottlenose dolphins, additionally, display pathogenesis and immune response similar to that of humans. Humans and coastal bottlenose dolphins, in particular, are constantly exposed to the same industrial, agricultural and domestic toxins and pathogens, contaminants and pollutants. Thus, studies on the bottlenose dolphin are also valuable in bridging the gap between ocean and human health. Bottlenose dolphins are susceptible to viral bacterial and toxin infection. Infection in the bottlenose dolphin manifests itself in the form of mass stranding events, unusual mortality events, chronic …

In Vivo And In Vitro Studies Of Polyamides That Are Active Antiviral Agents Against Hpv16, Edith Csiki-Fejer

Dissertations

Long-term, persistent infection with high-risk strains of human papillomavirus (HPV) is the precursor of most cervical cancers and an increasing number of the head and neck cancers. While HPV vaccines can protect patients under twenty-five years old from possible infections, no HPV antiviral drugs are available for the definitive treatment of preexisting or future viral infections. To treat current or future HPV infections, drugs that selectively block virus-specific processes, but do not damage the host cells, are needed. The compounds developed in our group are unique Imidazole-pyrrole polyamides, analogs of natural products Distamycin A and Netropsin that function by interfering …

“Mind The Gap”: The Standardization Of Master-Level Education Competencies Among Humanitarian And International Development Professionals, Polina Kadatska

Dissertations

Quality education of international development/humanitarian professionals is of high importance due to increased donor demands for projects’ transparency, accountability, and efficiency. However, there is a lack of standardization of learning outcomes among the educational institutions that train the workforce for the non-profit sector. The purpose of this quantitative survey study was to describe how humanitarian professional alumni think their Master’s program aligned with the Core Humanitarian Competencies Framework (CHCF) and how these competencies assisted them in their current work. Additionally, the study explored what NGO employers think of applicability of the Framework’s competencies in their organizations and the preparedness of …

Synthesis And Characterization Of Amphiphiles For Mammalian Cell Transfection And Antimicrobial Activity, Joseph William Meisel

Dissertations

Amphiphiles are molecules that contain both water-soluble and water-insoluble components. The dual nature of these molecules engenders remarkable properties including the ability to self-assemble into ordered structures. Cell membranes are composed of amphiphilic phospholipids that organize into a bilayer motif. Synthetic amphiphiles can interact with natural membranes and influence the transport of molecules across the cell membrane. The work elaborated in this report employs amphiphiles to co-assemble with DNA and transport the genetic material across cell membranes. First, a simplified method for interacting DNA with amphiphiles was developed. Second, a series of known ion-transporting compounds were assayed for their interaction …

Improving Veteran Access To Heart Failure Specialty Care: A Change Model Project, Mark Bird Whelchel

Dissertations

Background: Many Veterans Health Administration (VHA) facilities have cardiac services, but not all VHA centers offer heart failure care. Viable alternative models exist to traditional outpatient treatment by physicians, such as Tele-medicine consultations, the use of nurse practitioner run clinics, and the use of models such as Specialty Care Access Network-Extension for Community (SCAN-ECHO) and site specific contracted physician services models. These have the potential to improve Veteran access to care. Objective: The purpose of this change project was to conduct a needs assessment survey, in joint effort with the Hershey Medical Center Heart and Vascular Institute, to identify barriers …

N-Terminal Domains Of Copper Atpases In Plasmodium Falciparum, Dictyostelium Dicsoideum, Human Atp7b And A Chimera Of Atox1 With Metal Binding Domain Four Of Atp7b, Javan Kilango Kisaka

Dissertations

Copper transporting ATPases (Cu-ATPases) are essential for mediating copper uptake, maintaining cellular copper levels and prevention of accumulation of toxic copper. The most studied copper ATPases are the Menkes and Wilson proteins in eukaryotes, CopA and CopB found in bacteria. The precise interaction of the metal binding domains with their copper donor, the association of each metal binding domain within the N-terminal portion of the protein, how they communicate with each other, and the eventual metal ion translocation across the membrane, is little known. The variation in number of the cytosolic metal binding domains may also offer clues on the …

Patterns Of Olfactory Neurogenesis And Immune Response In Adult Zebrafish Following Damage Of The Olfactory Bulb, Darcy M. Trimpe

Dissertations

The adult zebrafish olfactory system, with its persistent neuronal turnover and abundant regenerative capacity, is an excellent model system for studies of adult brain plasticity. Reversible deafferentation, achieved by repeated intranasal irrigation with detergent, reduces bulbar innervation and affects bulb structure and function, while cessation of treatment permits reinnervation and recovery of bulb volume. Alterations in cell genesis may account for this phenomenon. This study focuses on adult neurogenesis in the zebrafish olfactory system following reversible deafferentation and direct olfactory bulb injury.

Potential alterations in cell proliferation, differentiation, migration, and survival in the olfactory bulb following single and repeated intranasal …

Emotional Intelligence And Self-Efficacy In Military Leaders, Kelly A. Hudson

Dissertations

\Purpose: This quantitative study was conducted for the purpose of determining the relationship between emotional intelligence and self-efficacy in military leaders.

Methodology: This quantitative, correlational study measured emotional intelligence and self-efficacy in military leaders to determine the relationship between them. The study involved differentiating between non-commissioned officers and commissioned officers in order to determine if a difference exists between the types of leaders in the military.

Findings: The findings from this research illustrate that there is a relationship between the leaders’ emotional intelligence and self-efficacy.

Conclusions: The study supported the hypothesis that the higher a leader’s emotional intelligence, the higher …

Inhibition Of B Lymphopoiesis By Adipocytes And Myeloid-Derived Suppressor Cells, Domenick Kennedy

Dissertations

B lymphopoiesis declines with age in humans, mice, and rabbits. Impaired B lymphopoiesis correlates with increased fat in the bone marrow (BM), suggesting that adipocytes negatively regulate this process. In fact, adipocyte factors were found to inhibit B cell development in BM cultures.

Our goal was to understand the mechanism by which adipocytes inhibit B cell development. Through culturing mouse BM cells on OP9 stromal cells in the presence of adipocyte-conditioned medium (ACM), we found that adipocytes promote the accumulation of CD11b+Gr1+ myeloid-derived suppressor cells (MDSCs). These cells were not simply bystanders, as we report for the first time that …

Monocyte-Induced Regulatory T Cell Differentiation, Jessica Genevieve Lee

Dissertations

Immediately after birth, thousands of foreign antigens challenge the newborn immune system. Many of the invaders are harmless, such as food, pollen, and beneficial bacteria. Newborns have a tolerant immune system that keeps them from developing inflammation or allergies to these new antigens. In utero, this immunoregulatory tendency is important for establishing tolerance to self and maternal antigens. Multiple processes contribute to fetal tolerance, including clonal deletion, anergy, changes in antigen presenting cells (APCs), and the generation of regulatory T cells (Tregs). However, the mechanism(s) of fetal Treg differentiation and the specific APCs required are unknown.

Our lab has previously …

The Responsibility To Protect And United States Intervention In The Libyan Civil War (2011), Paul Tang Abomo

Dissertations

ABSTRACT

On April 6, 1994, Rwandan president Juvenal Habyarimana’s plane was shot down. Soon after, there were reports that massive ethnic-based violence was unfolding, and the only way to stop it was the presence of an outside military force. The Clinton administration knew Rwanda was being engulfed by genocide but ignored the information to justify its inaction. Seventeen years later, on 15 February 2011, the arrest of Mr. Fathi Terbil, a well-known lawyer and human rights defender by the Libyan internal security forces (Jihaz al-Amn al-Dakhili) sparked a mass protest in Benghazi, Libya. When demonstrations began the Gaddafi government responded …