Digital Commons Network^™

Surgeon Ergonomics While Performing Total Knee Arthroplasty, Cameron Dahman

Electronic Theses and Dissertations

One of the most prevalent hazards to orthopedic surgeons are musculoskeletal disorders with 97% of arthroplasty surgeons reporting procedural-related musculoskeletal pain and 66% of orthopedic surgeons reporting procedural-related musculoskeletal injury [1], [2], [3]. With the annual number of total knee arthroplasties (TKA) on the rise, orthopedic surgeons are taking on larger annual caseloads and retiring later in life [4], [5]. The goal of this study was to quantify postural demand for 11 discrete surgical steps of TKA to identify ergonomically unfavorable positions surgeons experience while operating. Four orthopedic surgeons performed TKA while their motions were recorded using marker-based motion capture. …

Examining Whiteness: A Narrative Inquiry Into Racial Identity Among White Women In Study Abroad Programs, Audrey Moreno Townsend

Electronic Theses and Dissertations

The purpose of this narrative inquiry study was to better understand race in contexts both domestically and abroad through the perspectives and experiences of white women who studied abroad outside of Europe and the Anglosphere. The investigation explored on how these experiences shaped white women’s understanding of racial identity upon returning to their home institutions. The research question which was addressed was: How do white women experience study abroad programming? Research highlights a critical gap in existing literature on this topic. While white women are centered in the study, it is contextualized considering how People of Color experience the world. …

“My Body Was Never Mine”: An Arts-Based Phenomenological Analysis Of Queer And Trans Adolescent Involuntary Psychiatric Hospitalization Experiences, Megan Doyle

Electronic Theses and Dissertations

Involuntary psychiatric hospitalization has life-saving and crisis-stabilizing intentions for queer and trans adolescents experiencing mental health crises; however, there are significant concerns about the adverse effects of this practice. This study employed two interwoven qualitative methods, interpretative phenomenological analysis and arts-based research, to gain a deeper understanding of queer and trans individuals’ adolescent experiences of involuntary psychiatric hospitalization. The theory of abolition was applied to examine the carcerality and identity-based oppression embedded within this procedure. Participant narratives and artwork revealed how involuntary psychiatric hospitalization is non-affirming for queer and trans young people in crisis, and the impacts of experiencing coercion, …

Influence Of Obesity On Knee Joint Mechanics: A Subject-Specific Musculoskeletal Modeling Approach, Ryan C. Knowles

Electronic Theses and Dissertations

Obesity has been consistently linked to knee osteoarthritis (KOA), a debilitating joint disease. While prior work has shown that obese individuals often walk with altered biomechanics compared to normal-weight (NW) individuals, which may accelerate KOA progression, less is known about how these mechanics affect load distribution between the medial and lateral tibiofemoral (TF) compartments, particularly during higher-demand activities. This study developed subject-specific musculoskeletal models of five obese and five NW individuals, incorporating CT-based bone measurements and individualized joint contact points. Simulations were driven by six degree-of-freedom (6DOF) kinematics obtained from high-speed stereo radiography (HSSR) to predict TF loading and associated …

Chew On It: A Pilot Study Of A Multimodal Assessment Of Mastication Protocol, Michelle Catão

Electronic Theses and Dissertations

Despite its subconscious nature, deglutition is an elaborate and multifaceted process, contingent on the activation of specific neural pathways and muscles. The inherent complexity gives rise to a wide array of potential complications and difficulties, known as dysphagia. Screening and assessment for dysphagia aid in determining the presence and etiology of swallowing difficulties, providing information that is critical for maintaining and improving the health status of vulnerable populations from the standpoint of nutrition, hydration, and socialization (Dziewas et al., 2017). Previous studies surrounding dysphagia assessment have prioritized formulating clinical protocols to evaluate the nonvolitional stage, often failing to address the …

Illness Terminable And Interminable: A Lacanian Exploration Of Medical Assistance In Dying, Matthew Devine

Electronic Theses and Dissertations

More and more people worldwide are requesting euthanasia, physician-assisted suicide (PAS), or medical assistance in dying (MAiD). Arguments in favor of expanding access to MAiD tend to prioritize the rational, competent, autonomous subject who has the right to make decisions about their body, including their death. Some have argued that this perspective – common in biomedical and bioethical literature – tends to neglect the fact that requests for assisted dying involve a relational structure: a relationship between the subject who requests an assisted death and the Other to whom this request is addressed. After reviewing relevant psychoanalytic approaches to suicide …

Collecting The Strands: A Psychoanalytic Study Of Hair-Pulling In Women, Jacklyn Corsitto

Electronic Theses and Dissertations

This dissertation investigated compulsive hair-pulling (i.e., trichotillomania) in women from a psychoanalytic perspective. The assumption, from a psychoanalytic viewpoint, is that the symptom of hair-pulling serves meaningful, and multiple, psychical purposes that should be analyzed rather than immediately removed, as would be the case in the current gold standard of treatment—behavioral therapy with habit reversal training. This behavioral modality leaves little to no room for exploring the historical, relational, symbolic, and emotional dimensions of hair-pulling. This dissertation fleshed out these dimensions and investigated what hair-pulling was doing for the individual, what its function or purpose was, and, indeed, what ideational …

Healthy And Successful Aging Outside The Closet: How Outness And Social Support Relate To Health And Aging Concerns, Jessica Segal

Electronic Theses and Dissertations

The ability to disclose an LGBTQ+ identity is a significant part of many queer lives. A person’s outness can often be tied into their social support whether through their network or available resources. This study investigated how outness, social network, and access to resources relate to older LGBTQ+ individuals’ concerns regarding their care and their aging. A secondary data analysis was conducted using survey data from the American Association of Retired Persons (AARP). The results showed that an increase in one’s social network indicated a decrease in aging-related care concerns; an increase in access to resources indicated a decrease in …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

The Application Of Macrophage-Targeted, Anti-Inflammatory Celecoxib Nanoemulgel For Nerve Regeneration In Peripheral Nerve Injury, Lu Liu

Electronic Theses and Dissertations

Peripheral nerve injury (PNI) refers to damage to the nerve located outside the brain and spinal cord. PNI is commonly caused by a physical accident (trauma) or medical operation^{1, 2}. The impact on the quality of life of PNI patients is directly correlated to neuropathic pain, resultant depression, and increased stress². Even after recovering from the PNI, patients still experience phantom pain and lose the ability to work due to the loss of tactile sensory or motor function^2-4. However, unlike damage to the central nervous system (CNS), peripheral nerves can regenerate because macrophages clean …

Exploring The Self-Efficacy And Experiences Of Caregivers Using Thickened Liquids To Manage Pediatric Dysphagia, Jaimee E. Conmy

Electronic Theses and Dissertations

Pediatric dysphagia affects 1 in 37 typically developing children under five, with increased prevalence in at-risk populations. Thickened liquids are often used as an intervention despite limited evidence supporting their effectiveness in the pediatric population. Caregivers play a critical role in managing their child’s dysphagia, yet their experiences, self-efficacy, and challenges with thickened liquids remain underexplored. This mixed-methods study surveyed 57 caregivers of children on thickened liquid diets, to assess their self-efficacy, education, perceptions of effectiveness, and overall impact on their quality of life. Findings highlight gaps in caregiver training, concerns about preparation, and benefits and/or challenges experienced by caregivers. …

The Protective Role Of Resilience In Indirect Aggression Perpetration And Victimization, Amelia Klass

Electronic Theses and Dissertations

This study examines the relationship between resilience and indirect aggression, specifically relational and social aggression, utilizing a sample of 104 females aged 18–22. Indirect aggression, characterized by behaviors such as social exclusion, gossip, and manipulation, is associated with significant emotional and interpersonal difficulties. Using a theoretical basis that includes gender schema theory, social learning theory, and social information processing theory, this study investigates whether resilience has a significant relationship in both the perpetration of and victimization through the use of indirect aggression. Participants completed self-report measures, including the Adult Resilience Measure – Revised and the Young Adult Social Behavior Scales …

The Influence Of Visualization Type And Gender On Multimedia Learning Performance: An Experimental Study, Ziji Wang

Electronic Theses and Dissertations

The widespread availability of multimedia learning resources, driven by technological progress, presents both opportunities and challenges in education. While these resources, often designed with animations to aid learning, their effectiveness in learning across STEM and non-STEM fields remains controversial. Besides, researchers have increasingly turned their attention to understanding how individual learner characteristics such as gender and spatial ability influence effectiveness of multimedia learning.

This dissertation examined the impact of visualization type and gender on learning algorithms (STEM) and Chinese characters (non-STEM) after accounting for the effect of spatial ability, focusing on learning outcomes and cognitive load. The fact that males …

Sociodemographic, Neighborhood-Level, And Health-Related Factors Associated With Progression To Bariatric Surgery: A Retrospective Chart Review., Angela Godwin

Electronic Theses and Dissertations

Background: Bariatric surgery is the most effective treatment for patients with Class 3 obesity. However, of individuals who start the bariatric surgical process, only about half undergo surgery. Factors associated with completion, including race, have been described; however, consistent evidence on obstacles remains to be identified.

Objectives: To explore variables based on the Social Ecological Model (SEM) that may be related to bariatric surgery completion.

Setting: A large, private hospital with a Bariatric Center of Excellence in New York City

Methods: This retrospective chart review utilized data from adults who established an initial bariatric surgery visit from April 1, 2012, …

Adding Varying Degrees Of Performance Feedback Components To The Taped Problems Intervention, Alyson C. Honaker

Electronic Theses and Dissertations

Math fact fluency, the ability to quickly and accurately solve one-digit by one-digit math problems, is a common challenge for many school-aged children. Difficulties with fluency often lead to reliance on inefficient strategies, hindering progress in more advanced math skills. Evidence-based interventions like Taped Problems Intervention (TPI) have demonstrated effectiveness in improving math fluency. However, research suggests incorporating behavioral components such as Performance feedback (PF) and goal setting/reinforcement (GS/R) may enhance its effectiveness. The present study used a multiple-probe across-task design to evaluate the effects of three variations of TPI on the subtraction fluency of five elementary students in a …

Identifying The Experiences And Perceptions Of School Psychologists On Racial Disparities In Autism Spectrum Disorderidentifying The Experiences And Perceptions Of School Psychologists On Racial Disparities In Autism Spectrum Disorder, Anna Marie Paolicelli

Electronic Theses and Dissertations

This paper investigates the experiences and perceptions of school psychologists who identify as experts in autism spectrum disorder (ASD) regarding racial and ethnic disparities in ASD identification. Utilizing a convergent embedded mixed-methods design grounded in Consensual Qualitative Research (CQR), the study explores how school psychology practices may have contributed to recent changes in ASD outreach and assessment, as well as persistent disparities, particularly for Black children with co-occurring intellectual disability (ID). Thirteen credentialed school psychologists with extensive experience in diverse educational and clinical settings participated in semi-structured interviews and binary survey items. Findings reveal perceived progress in ASD awareness and …

"Driving Circles Around The Holler:" Liminality And The Grotesque In Donald Ray Pollock's Knockemstiff, Celia A. Ranniger

Electronic Theses and Dissertations

Donald Ray Pollock’s 2008 short story cycle, Knockemstiff, is a regionalist work of grotesque Grit Lit featuring characters from a small, rural holler community in southern Ohio. This work examines the form, narratives, and characters through close reading, illuminating the layers of different liminalities present in the cycle. These liminalities include narrative liminality of the form of the short story cycle, the social and economic liminal spaces inhabited by the characters, and the ways that the text comments on the liminal nature of storytelling itself. This thesis will argue that the geography of the cycle’s setting coupled with the subject …

Rural Roots, Academic Roads: Exploring College Persistence Among Rural Students, Misty Wilburn

Electronic Theses and Dissertations

This study examines the financial and social challenges faced by first-generation college students from rural backgrounds as they transition from K-12 to four-year regional institutions. Using quantitative analysis of secondary data from the class of 2024 at a selected institution, this study examines factors influencing graduation rates and financial aid needs. Key metrics include geographic origins, high school backgrounds, academic assistance, and financial support. By highlighting these challenges, this study contributes to a deeper understanding of the structural and social barriers that first-generation rural students encounter.

Enumerating Escherichia Coli (E. Coli) Concentrations And Evaluating Optical Brighteners As A Potential Indicator Of Human Wastewater Contamination In La Nana Bayou, Banita Creek, And Their Tributaries, Nacogdoches, Texas, Swastika Acharya, Matthew Mcbroom, Yuhui Weng, Yanli Zhang

Electronic Theses and Dissertations

La Nana Bayou was added to the Texas 303(d) list in 2000 after it failed to meet water quality standards set by the Texas Commission on Environmental Quality (TCEQ) for primary contact recreation due to elevated Escherichia coli (E. coli) levels. E. coli is a bacterial species commonly found in the intestines of humans and warm-blooded animals. It serves as an indicator of fecal contamination in freshwater, though its presence alone cannot identify the contamination source. Optical brighteners (OBs), chemicals found in laundry detergents, cleaning agents, toilet papers, and clothing, are unique to human wastewater. This study aimed …

From Afghanistan To Louisville: Changing Face Of Family And Gender Roles In Afghan Immigrants In Louisville, Kentucky., Zohal Ghoura

Electronic Theses and Dissertations

This study explores how Afghan immigrant families navigate gender roles and domestic responsibilities following their migration to the United States. Although current research recognizes the impact of migration on gender norms and labor division in immigrant families, the lived experiences of Afghan families in the United States remain largely unexplored. Based on 12 in-depth semi-structured interviews with Afghan women, this study explores how cultural expectations, economic constraints, and social context shape the division of domestic responsibilities. Findings reveal that migration opened new opportunities for Afghan women, including sense of freedom, access to education and employment opportunities. Exposure to egalitarian values …

Hybrid Geographies And Nature In The City: A Tale Of Two Greenspaces In Louisville, Ky., Rebecca Dixon

Electronic Theses and Dissertations

Many conservation initiatives position nature and the urban as opposing constructions, which means the possibilities where cities can work with nature are often overlooked. This study uses the lens of relational geographies to examine nature in the city by comparing two greenspaces in the Beargrass Creek watershed in Louisville, Kentucky: Waterfront Botanical Gardens and the Louisville Nature Center. The two organizations are compared by using a combination of content analysis, discourse analysis, and GIS flood analysis methods to determine how their geographical location and history affect the ways in which the dynamic between nature and culture is reproduced. Results show …

Crossed Stitches: Tension And Transformation In Nineteenth-Century Embroidery Samplers., Hayley Salo

Electronic Theses and Dissertations

Originally designed as practice pieces, embroidery samplers have long been studied as domestic objects and part of sewing history. Interpretations of the material and textual significance of individual samplers is less common. However, recent scholarly attention has turned to using sewing practices and objects as a means for understanding individual stitchers and their contributions to public discourse. As such, a focused study of the material and textual content of embroidery samplers furthers our understanding of the genre on its own and as a wider textile practices. Crossed Stitches is interested in the production, portability, circulation, and reception of embroidery samplers …

Rhetorical Analysis Of Kristen Bell's Articulation Of Imperfect Motherhood On Armchair Expert., Sarah J. Neff

Electronic Theses and Dissertations

This thesis explores how Kristen Bell’s articulation of imperfect motherhood, as heard on the popular podcast Armchair Expert, contributes to broader social discourses surrounding motherhood, empowering some mothers while inadvertently constraining others. Using rhetorical analysis grounded in Goffman’s dramaturgical approach, facework theory, and McGee’s theory of fragments, this study explores Bell’s discourse and performance of motherhood within the podcast medium. The podcasting medium provides a rich source for rhetorical analysis due to the long form interview content, and emotionally nuanced content, leading to a stronger connection with the audience. This is evident with the new headlines that follow Bell’s appearance …

Role Of Cardiac Ketone Body Metabolism In Myocardial Perfusion And Exercise Performance., Kara R. Gouwens

Electronic Theses and Dissertations

Cardiorespiratory fitness, a crucial determinant of overall health and a strong predictor of all-cause mortality, is largely dependent on the capacity of the cardiovascular system to deliver oxygen and nutrients. The heart, as the central pump, requires a continuous and adaptable oxygen supply, particularly during increased workload such as occurs with exercise. Impaired myocardial blood flow (MBF) in response to increased demand can lead to ischemia, limiting exercise capacity and potentially causing severe cardiac events. Interestingly, changes in myocardial metabolism and cardiac work correlate with changes in MBF. Therefore, understanding the regulation of MBF, especially the link between local cardiac …

Incarcerated Women: Gendered Rhetoric From The Outside And Reality Inside Prison Walls., Taylor Riley Geiser

Electronic Theses and Dissertations

This dissertation examines how formerly incarcerated women navigate and resist gendered media portrayals through digital platforms, focusing on the “mad” and “bad” woman tropes that shape public perceptions. Drawing on feminist rhetorical theory—particularly Royster and Kirsch’s methodological practices and Ratcliffe’s concept of rhetorical listening—this study combines Critical Discourse Analysis (CDA) of mainstream headlines with Multimodal Discourse Analysis (MDA) of TikTok content. CDA of media coverage surrounding Lori Vallow Daybell, Casey Anthony, and Andrea Yates reveals how language, imagery, and cultural logics sustain harmful binaries that portray women who commit crimes either as depraved or as excused by madness, obscuring the …

Dementia Caregiving Styles: Characterizing Dementia Caregivers Via A Novel Framework., Darby M. Simon

Electronic Theses and Dissertations

As dementia rates increase, effective family caregivers are crucial to meeting the increasing demand for dementia care. However, dementia caregiving is a demanding experience, and caregivers have varying strategies for providing care, leading to positive and negative outcomes and appraisals of their caregiving experience. Limited research explores this relationship, and extant work is qualitative with no clinical measure. This study adapted a pre-existing framework/measure from a different caregiver population (parents) to explore a) if the same framework applied to both caregiving populations and b) the associations between the styles and psychological well-being and other caregiving variables. Exploratory Factor Analysis tested …

Metabolic Regulation Of Cardiac Fibroblast Phenotype And Function., Collin Kleis Wells

Electronic Theses and Dissertations

Cardiac fibroblasts are central effectors of cardiac repair after myocardial infarction (MI). In response to signaling cues, they differentiate to a range of phenotypes with robust capacities to synthesize and secrete extracellular matrix (ECM) and signaling molecules. Although activated fibroblast phenotypes are associated with pronounced changes in metabolism, it remains unclear how the metabolic network upholds the effector functions of fibroblasts in the post-infarcted heart. Here, we identified that critical enzymes in the phosphoenolpyruvate (PEP) cycle, i.e. pyruvate kinase muscle-2 (PKM2) and phosphoenolpyruvate carboxykinase-2 (PCK2), are elevated in the heart after MI and examined their role in regulating post-MI remodeling …

Cbl Regulation Of C-Met Signaling In Corneal Epithelial Cells., Kate Elise Tarvestad Laise

Electronic Theses and Dissertations

The cornea is the most anterior portion of the eye and permits light passage through to retina, allowing formation of a clear image as long as it remains healthy. If the cornea sustains damage, it creates and entrance for foreign body invasion, infection, and ultimately blindness in the immunocompromised eye. Healing the corneal tissue is critical for vision restoration and pain alleviation, as it is the most densely innervated tissue in the body. 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 …

My Achilles Years., Ash William Bittner

Electronic Theses and Dissertations

This dissertation is a historically and rhetorically grounded creative project exploring the traumas of war. This project is divided into three broad chapters, each using a different (and relevant) approach to cover the content contained within that chapter. The first chapter relies on that historical grounding, exploring the history of PTSD as it is currently understood, before exploring ancient Greek poetry and theater and both the historical and military contexts for each, before finally discussing modern warfare and the “Forever War” of the American War on Terror that lasted for nineteen years. With the historical grounding set, it moves into …

Dust Observations Of Occulting Galaxy Pair Vv 191., Clayton Robertson

Electronic Theses and Dissertations

The presence of dust grains as part of the the interstellar medium (ISM) in galaxies is an all-impactful entity in astronomy due its influence on light, and therefore observations. Unlike a true blackbody, dust absorbs, reflects, reddens, and scatters light within a line of sight. We quantify this phenomena with attenuation: the difference between the observed and true magnitudes of an astronomical object due to dust. Therefore, to map dust attenuation, one needs a known background source of light. In the serendipitous case of partially overlapping –occulting– galaxies, the background galaxy serves as the known light source and the transmission …