Digital Commons Network^™

Examining Effective And Realized Healthcare Access In The West South Central Division., Katherine Cameron

Electronic Theses and Dissertations

This study explores realized and effective access domains outlined by Andersen’s Behavioral Model of Health Services Use. Exploring other domains of access is critical to understanding how the healthcare system functions (Kirby & Yabroff, 2020). This study evaluates rural-urban and racial/ethnic differences in access to care using two underresearched domains of healthcare access. It also allows for exploring access disparities within rural communities amongst minority populations. This dissertation is divided into five chapters. Chapter One provides an overview of health disparities and inequities and a brief overview of the study. Chapter Two details a high-level history of racism and its …

The Impact Of Pegylation On Cellular Uptake And In Vivo Biodistribution Of Gold Nanoparticle Mri Contrast Agents., Nagwa El-Baz

Electronic Theses and Dissertations

Gold nanoparticles (GNPs) have become a pivotal platform for the delivery of pharmaceutical and diagnostic agents as well as for general therapeutic purposes. Despite their potential for use in biomedicine, their interaction with serum proteins is crucial as it could change their biological profile due to the formation of a protein corona, which can affect their delivery to target tissues in the body. Grafting the GNPs with polyethylene glycol (PEG) is widely used in research to decrease opsonization of the particles by serum proteins and decrease the uptake by the reticuloendothelial system. Here in this dissertation, we have developed a …

Changing Public Perception Of Dementia: The Effect And Credibility Of Three Informational Models., Diana Hedrick

Electronic Theses and Dissertations

Background: Since the 1970s, Alzheimer’s disease and dementia have been portrayed in a medicalized, symptom-focused manner to help spread awareness, improve diagnosis, and push for treatment research. In recent decades, there has been movement towards a biopsychosocial, person-centered approach that considers social and psychological factors that interact with biological diseases processes. Common biopsychosocial approaches retain an emphasis on deficits and symptoms. New research has integrated positive psychology constructs and dementia. This integration of positive psychology principles and dementia care and research has the potential to more accurately capture the experience of having dementia. Objectives: This dissertation tested how the portrayal …

The Mechanisms Of Mitochondrial Dysfunction In T Cell Aging During Chronic Viral Infection, Madison B. Schank

Electronic Theses and Dissertations

Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections induce a myriad of disturbances to CD4 T cell functions, including mitochondrial compromise, excessive inflammation, increased telomeric DNA damage and attrition, cellular exhaustion and senescence, and accelerated aging. In this dissertation, the mechanisms underlying metabolic failure, accelerated aging, and cellular dysfunctions were evaluated in CD4 T cells from healthy subjects (HS) treated with a telomere-targeting drug (KML001) or HCV-infected individuals or people living with HIV (PLHIV) compared to HS. We observed that KML001-induced telomere injury resulted in mitochondrial swelling and decreased mitochondrial membrane potential, cellular respiration, mitochondrial DNA (mtDNA) copy …

The Effect Of Volatile Organic Compounds On Endothelial Function And Atherogenesis., Samantha Mcfall

Electronic Theses and Dissertations

Volatile organic compounds (VOCs) are a group of pervasive air pollutants that are released into the atmosphere from both anthropogenic and environmental sources. Recent epidemiological studies suggest that exposure to various VOCs is associated with an increased risk of cardiovascular disease. However, the relationship between VOCs and cardiovascular disease is not well-studied. Using animal models and three select VOCs, benzene, xylene, and trichloroethylene, we studied the effects of VOCs on endothelial injury and benzene-induced atherogenesis. We found that exposure to benzene and xylene increased circulating endothelial microparticles, depleted progenitor cells, and increased platelet activation. Following the exposure to the representative …

Hgf-Mediated C-Met Signaling In Human Corneal Epithelial Cells., Kate Tarvestad

Electronic Theses and Dissertations

Vision is often regarded as the primary sense of humans. The cornea is the main refractive tissue that permits light through to the retina, allowing a clear image. When the cornea sustains damage, it opens a pathway for infection and blindness through fibrotic processes. Healing the corneal tissue is critical for vision restoration and pain alleviation. Growth factors and their cognate receptors are currently under investigation as tools to restore proper corneal physiology. We hypothesize that manipulating the hepatocyte growth factor (HGF)/ c-Met signaling pathway is one route to promote quality corneal healing. This thesis investigates the signaling, trafficking, and …

Investigating The Pi3k/Akt/Atm Pathway, Telomeric Dna Damage, T Cell Death, And Crispr/Cas9-Mediated Gene Editing During Acute And Chronic Hiv Infection, Sushant Khanal

Electronic Theses and Dissertations

Human Immunodeficiency Virus (HIV) infection initiates major metabolic and cell- survival complications. Anti-retroviral therapy (ART) is the current approach to suppress active HIV replication to a level of undetected viral load, but it is not a curative approach. Newer and sophisticated gene editing technologies could indeed be a potent antiviral therapy to achieve a clinical sterilization/cure of HIV infection. Chronic HIV patients, even under a successful ART regimen, exhibit a low-grade inflammation, immune senescence, premature aging, telomeric DNA attrition, T cell apoptosis, and cellular homeostasis. In this dissertation, we investigated CD4 T cell homeostasis, degree of T cell apoptosis, an …

Correctional Career Pathways: A Reentry Program For Incarceration, Taylor M. Dula

Electronic Theses and Dissertations

For the past several decades, the United States led the world in incarceration rates. With nearly 2.3 million people being held in state or federal prisons or local jails in 2019, incarceration rates in the United States are over four times higher than in other developed countries. Disparities exist by gender, race, ethnicity, and other special populations. Males are 13 times more likely to be incarcerated than females. Additionally, black males are 5.7 times and Hispanic males are 2.8 times more likely to be incarcerated than white males. Individuals who experience incarceration have poorer mental and physical health outcomes. People …

A Functional Study Of Topological Dna Problem In Human T Cells During Chronic Viral Infection, Xindi Dang

Electronic Theses and Dissertations

T cells play an important role in adaptive immune system against viral infections, while premature aging and dysfunction of T cells induced by unrepaired DNA damages are always non-negligible snags during the long-term of fighting with chronic viral infections, such as Hepatitis B virus (HBV), Hepatitis C virus (HCV) or Human Immunodeficiency Virus (HIV) infection. In this dissertation, we investigated the role of topological DNA damage in reprogramming telomeric DNA damage responses (DDR), mitochondrial metabolisms, and T cell functions using CD4+ T cells derived from individuals with chronic viral infections or healthy subjects treated with topoisomerase inhibitors. The healthy human …

A Comparison Of The Mental Health Of Police Officers And Correctional Officers In Rural Appalachia, Sierra Thomas

Electronic Theses and Dissertations

The purpose of this study was to explore perceptions of mental health among police officers and correctional officers within rural Appalachia. The main goal of this research was to better understand how the occupational demands of working in the criminal justice field can impact one’s mental health over time. Several research questions were explored, including the prevalence of various mental health problems, associated stressors, the structure of support among officers, and the perceptions of mental health treatment services. Data were gathered through semi-structured interviews with 21 police and correctional officers located in rural Appalachia. Results provided a better understanding of …

The Acceptance Of Learning Management Systems By Higher Education Faculty In An Educational Landscape Influenced By A Global Pandemic, Stephen Mark Rektenwald

Electronic Theses and Dissertations

This quantitative study investigated the perceptions of higher education faculty with respect to their behavioral intentions to use learning management systems and the perceived effect of COVID-19 on those intentions. An online survey was administered through private Facebook groups to faculty in higher education and listservs focused on technology in higher education. The sample size initially included 137 participants but participants were reduced to 121 due to incomplete responses on some surveys or not meeting the selection criteria for the research. The theoretical framework for this research was the intersection of the technology acceptance model and digital transformations. The data …

Investigating Host Defenses Of North American Salamanders Against The Recently Emerged Chytrid Pathogen, Batrachochytrium Salamandrivorans, Kenzie Pereira

Electronic Theses and Dissertations

A recently emerged chytrid fungal pathogen, Batrachochytrium salamandrivorans (Bsal) threatens salamander biodiversity. Bsal susceptibility varies between and within salamander species, but little is known about the mechanisms underlying these differences. Susceptibility is likely influenced by numerous interacting factors, but my dissertation studied the role of host immune responses.

My first aim investigated between species differences by studying the bioactive properties of salamander skin peptides against Bsal and the related pathogen, B. dendrobatidis (Bd). Skin peptides were collected from five salamander species, used for in vitro assays, and analyzed by RP-HPLC. While skin peptides from one …

Exploring Cultural Values, Beliefs, And Perceptions Of Human Papillomavirus Vaccine Acceptance In African American Men, Rashida Henderson

Electronic Theses and Dissertations

Introduction: African American (AA) /Black men have a higher rate of anal and rectal HPV-associated cancer, which the HPV vaccine can prevent. Purpose: This study aimed to understand the cultural values, perceptions, and beliefs of the HPV vaccine in African American/Black Men. Method: Through a focused ethnography, a semi-structured guide was utilized to interview 24 AA men. Inclusion criteria included identifying as AA/Black, aged 18-30 years, born and living in the United States, identify and born as male, and able to understand, read, and write English. Results: Through Leininger’s Four Phases of Analysis, three themes emerged: 1) lack of knowledge …

Respecting The Ethical Tension Between Surveillance And Privacy In Promoting Public Health And Disease Management, Kamal Althobaiti

Electronic Theses and Dissertations

The recognition of the need to undertake surveillance and to protect privacy is well established. However, the continually changing circumstances and fast-paced development of healthcare today requires a continuing need to respect this ethical tension between surveillance and privacy. Hence, this dissertation is to respect the ethical tension between surveillance and privacy in promoting public health and disease management. This dissertation investigates the ethics of conducting public health surveillance, including the challenges associated with obtaining consent and protecting data from unauthorized access. The dissertation will focus on the ethical consequences of big data, including issues associated with obtaining informed consent, …

Novel Signal Sequences And Fusion Partners For Paratransgenesis In Asaia, Christina Grogan

Electronic Theses and Dissertations

Mosquitoes transmit many pathogens that cause human disease. One such disease, malaria, is caused by parasites in the genus Plasmodium, infecting over 200 million people and killing over 600,000 per year. Current strategies to control vector-transmitted diseases are increasingly undermined by mosquito and pathogen resistance. Research has turned to additional and novel methods of control, such as altering the microbiota of the vectors. In this method, called paratransgenesis, symbiotic bacteria are genetically modified to affect the mosquito’s phenotype by engineering them to deliver antiplasmodial molecules into the midgut to kill parasites. These molecules must be released by the …

Neural Stem Cells: Age-Dependent Outcomes During Viral Infections In The Central Nervous System, Manisha N. Chandwani

Electronic Theses and Dissertations

Viral infections in the central nervous system (CNS) are associated with neurodevelopmental and neurobehavioral deficits. The outcomes of viral infections can be driven by damage and death of neurons. Neural stem cells (NSCs) play key roles in neurodevelopment, repair, and physiological brain function. During a viral infection, NSC activity can disturbed by direct infection of NSCs by the virus or by anti-viral immune response. Here, we aimed to assess whether the anti-viral immune response can impact NSC activity during an immunocompetent response in the adult brain. We utilized a transgenic mouse model of Measles virus infection where only the CNS …

Induction Of Trained Immunity By Particulate Β-Glucan Controls Cancer Metastasis Through The Sphingolipids-Mediated Mitochondrial Fission Pathway., Rejeena Shrestha

Electronic Theses and Dissertations

Metastasis is the leading cause of cancer-related deaths and innate immune cells are critical players in the metastatic microenvironment. Here, we explore the implications of harnessing the pre-metastatic niche myeloid cells through induction of trained immunity using a natural compound yeast-derived whole β-glucan particle (WGP). WGP training in macrophages results in an increased responsiveness to not only the conventional secondary stimulus LPS but also specifically to tumor cells and tumor-derived factors. WGP in vivo treatment leads to a trained immunity phenotype in lung interstitial macrophages (IMs). Induction of trained immunity by WGP inhibits tumor metastasis and enhances tumor-free survival in …

A New Sir Model With Mobility., Ciana Applegate

Electronic Theses and Dissertations

In this paper, a mobility-based SIR model is built to understand the spread of the pandemic. A traditional SIR model used in epidemiology describes the transition of particles among states, such as susceptible, infected, and recovered states. However, the traditional model has no movement of particles. There are many variations of SIR models when it comes to the factor of mobility, the majority of studies use mobility intensity or population density as a measure of mobility. In this paper, a new dynamical SIR model, including the spatial motion of three-type particles, is constructed and the long-time behavior of the first …

Optimizing Exposure For Contamination Ocd: What Happens When Digust Is Specifically Targeted?, Molly E. Wickenhauser

Electronic Theses and Dissertations

Disgust is a basic emotion with distinct subjective, physiological, cognitive, and behavioral processes that include revulsion, parasympathetic nervous system activity, contamination-specific appraisals, and disease-avoidance behaviors. Pathological disgust responses may contribute to the development and maintenance of anxiety-related psychopathology, particularly spider and blood-injection-injury phobias, health anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder (OCD). Evidence-based treatments for these disorders were developed based on theories of fear and anxiety and involve exposure-based cognitive-behavior therapy. However, traditional exposure methods appear to be less effective at achieving habituation to disgust compared to fear and anxiety. Additionally, individuals with elevated disgust and primary contagion concerns seem …

The Role Of Middle And High School Principals During The Covid-19 Pandemic: A Phenomenological Study, Dustin Ford

Electronic Theses and Dissertations

The purpose of this qualitative study was to examine middle and high school principal roles prior to and during the COVID-19 pandemic to gain a better understanding about how leadership responsibilities adapted or changed. Data collection strategies included one-on-one interviews with nine middle and high school principals in East Tennessee. To qualify for the study participants had to have experience in the principalship prior to the pandemic. The analysis of data was based on the theoretical frameworks of adaptive leadership (Heifetz et al., 2009) and change theory (Fullan, 2020). The results revealed five key themes that were consistent during the …

Cyberchondria And Covid-19 Health Threats Related To Attentional Bias And Safety Behaviors, Jacqueline J. Charles

Electronic Theses and Dissertations

Cyberchondria is described as excessively searching online for health information that ultimately increases worry and anxiety about one’s health (Starcevic et al., 2019). Research has demonstrated an increased attentional bias in anxious individuals for threat-related stimuli. Attentional bias for health information exacerbated by the frequent exposure to health threats during the COVID-19 pandemic may contribute to additional health-seeking behavior. The current study aimed to explore the potential relationship between COVID-19 health threats and cyberchondria level on attentional bias toward illness-related stimuli (symptom words) and the intent to perform safety behaviors while controlling for Trait Anxiety and Health Anxiety. Participants ( …

Reducing Inpatient Falls And Falls With Injury, Constance Leigh Cannon

Electronic Theses and Dissertations

Patient falls are a costly problem for many inpatient hospitals and are exacerbated by poor training of nursing and ancillary staff. The researcher sought to determine if there was a difference in inpatient falls and falls with injury after a hospital facility in the Southwestern United States revised its fall prevention policy, reorganized its fall prevention committee, and provided new interventions for nurses assessing patients for fall risk. In this quantitative, retrospective, comparative project, the researcher reviewed data from 2017–2020 related to the facility’s fall prevention program, including its new interventions and efforts to involve patients in their safety and …

Design And Synthesis Of Fused Pyrimidines As Multi-Targeted Potential Anticancer Agents, Nian Tong

Electronic Theses and Dissertations

Dissertation supervised by Dr. Aleem Gangjee

Targeted cancer chemotherapy represents agents that inhibit cancer cell growth by interfering with specific processes that are required for tumor growth. The crucial aim of the treatment administered to cancer patients should be to improve the quality of life and inhibit the progression of the disease. The current failure of conventional cancer chemotherapy is attributed to both toxicities and the development of resistance. There is an unmet need for new cancer therapies of tumor-targeted agents (that work without harming normal cells or tissues) with a low propensity to develop resistance. Multi-targeted single agents with …

Evaluation And Application Of Crispr-Cas12a-Based Systems For Amphibian Detection From Dietary And Environmental Dna, Macie Chess

Electronic Theses and Dissertations

Current methods for monitoring biodiversity are hindered by detection efficiencies or rely on expensive laboratory equipment. The goal of this study was to evaluate the application of a CRISPR-Cas12a-based system for the species-specific detection of amphibians from dietary and environmental DNA samples. A Cas-12a-based platform was designed and analyzed for the fluorescent detection of three salamander species; Desmognathus fuscus, D. ochropheaus, and Erycia bislineata. This system was applied to the identification of salamander DNA extracted from the fecal sacs of nestling Louisiana Waterthrush (Parkesia monticola), amplified with PCR primers targeting the CYT B mtDNA gene, and compared to DNA metabarcoding. …

Teaching During Covid-19: The Lived Experiences Of Title I Educators Transitioning From Face-To-Face Instruction To Remote Instruction, Nicole Boykins

Electronic Theses and Dissertations

The purpose of this study was to investigate how school closures resulting from the COVID-19 pandemic impacted school educators who teach in Title I schools serving minority students located in a southern region of the United States. Due to the swift nature of the COVID-19 pandemic and the massive impact on many communities’ health and well-being, government officials moved quickly to close schools. Teachers, much like everyone else, had little voice in the launch of remote learning, expectations of remote teaching, or how to best support students and families during a global pandemic. Educators had to rely on their skills …

An Application Of Differential Mathematical Modeling Techniques To Study The Ongoing Rabies Epizootic In China, Christopher Turner

Electronic Theses and Dissertations

Rabies remains a global public health issue with a wide variety of neurological symptoms such as confusion, slight paralysis, hypersalivation, and hydrophobia. Rabies is usually fatal once symptoms appear. Many species are reservoirs for rabies, such as foxes, racoons, and wild dogs, which in turn can transmit the disease to humans, leading to complex transmission chains. There is a long latent period of rabies, between 1 to 3 months after infection, which further complicates control efforts. Mathematical modeling is a valuable tool in the study of infectious disease outbreaks and there have been many models applied to rabies outbreaks. However, …

Aggregatibacter Actinomycetemcomitans Exploits And Modulates The Immune Response By Human Neutrophils For Survival In The Anaerobic Environment., Hazel Ozuna

Electronic Theses and Dissertations

Aggregatibacter actinomycetemcomitans (Aa) is a Gram-negative facultative anaerobe and an opportunistic oral pathogen, strongly associated with localized periodontitis and other inflammatory diseases. Periodontitis is a chronic inflammation of the periodontium resulting from the inflammatory response of the host towards the dysbiotic microbial community present at the gingival crevice. The host immune response creates a hostile environment for microorganisms; therefore, it is important for Aa to be able to regulate the necessary genes to survive and thrive in such an environment. Aaexpresses several virulence factors such as a cytolethal distending toxin (Cdt), lipopolysaccharide (LPS) and leukotoxin A (LtxA), …

Statistical Methods For Assessing Drug Interactions And Identifying Effect Modifiers Using Observational Data., Qian Xu

Electronic Theses and Dissertations

This dissertation consists of three projects related to causal inference based on observational data. In the first project, we propose a double robust to identify the effect modifiers and estimate optimal treatment. Observational studies differ from experimental studies in that assignment of subjects to treatments is not randomized but rather occurs due to natural mechanisms, which are usually hidden from the researchers. Many statistical methods to identify the treatment effect and select the optimal personalized treatment for experimental studies may not be suitable for observational studies any more. In this project, we propose a exible outcome model to select the …

Porphyromonas Gingivalis, Ethanol, And Chronic Diseases., Nicholas Alan Short

Electronic Theses and Dissertations

This dissertation is an investigation into the relationships among Porphyromonas gingivalis, ethanol, and a series of chronic diseases, focusing primarily on atherosclerosis. It uses evolutionary theory to understand clinical parameters related to chronic disease biology. The initial research question was, "If people who drink a glass of wine each day have a lower risk for atherosclerosis, could one explanation involve antibacterial effects on pathogens associated with causing atherosclerosis, namely, Porphyromonas gingivalis?". This dissertation is divided into four chapters. Chapter One provides the foundational information pertinent to the dissertation. Chapter Two describes an in- vitro experiment aimed at understanding …

Understanding Public Emergency Preparedness Before And During The Coronavirus Outbreak: Implications For Effective Public Health And Risk Communication., Raphael Adjetey Fumey

Electronic Theses and Dissertations

The COVID-19 pandemic has resulted in a dramatic loss of human lives globally and presents an unprecedented challenge to public health, the world of work, and our food systems. The social and economic disruption caused by the COVID-19 pandemic is devastating, putting several millions of people at risk of falling into extreme poverty, with over 500 million people being undernourished. It is evident from the data on COVID-19 cases, deaths, and hospitalizations that the United States is the worse hit country, which can be attributed to the lack of preparedness at the individual, environmental, and government levels. This study applied …