Digital Commons Network^™

Integrated Behavioral Health And Primary Care: Refining A Determinant Framework, Ariel Michelle Domlyn

Theses and Dissertations

The integration of behavioral health and primary care is a best practice to improve patient outcomes and achieve health equity. However, the process of integrating is opaque, requiring organizational change and sometimes a complete system overhaul. Implementation science offers useful ideas for helping healthcare organizations to implement care. This field has identified potential environmental conditions and determinants of successful implementation; however, much is still unknown about how these factors may be relevant for organizations seeking to integrate care. To address the limited existing knowledge in this area, this dissertation gathers practice-based evidence using exploratory methods. Results are translated into an …

A Hawaiian Heroine’S Journey: The Early Life And Career Of Dancer Jean Erdman Campbell, Diane B. Mcghee

Theses and Dissertations

This biographical study covers the early life and career of dancer, choreographer, and avant-garde theatre artist, Jean Erdman Campbell (1916-2020). Based on extensive research of historical literature and archival materials, the manuscript traces Erdman’s ancestry and follows the subject through age 32, when she became established as a star of modern dance and prepared for a world tour. The guiding question for this study was what influences shaped the life course, identity and artistry of Erdman, and how might the subject be presented as biography? The researcher examined the influences on Erdman as related to various dance traditions, especially Hawaiian …

Meaningful And Interactive Learning Experiences Provided Through A Learning Management System: An Action Research Study In Ninth Grade Advanced Placement Human Geography, Daniel Robert Plonski

Theses and Dissertations

The purpose of this mixed methods action research was to determine if increased interactive Schoology-based modules could alter learner perceptions concerning the lack of meaningful learning (learner-instructor, learner-learner, learner-content) in the culture unit of instruction in an Advanced Placement Human Geography (APHG) classroom. A series of instructional modules were facilitated through the learning management system (LMS) Schoology to students (n = 16) in APHG at a southeastern U.S. high school. The interactions were designed to enhance interaction based upon the criteria provided by Piaget’s (1981) social constructivist theory, specifically Moore and Kearsley’s (2011) systems approach and Miyazoe and Anderson’s (2010) …

Methodological Mutability: Shifting Research In The Rhetoric Of Health And Medicine, John Schuler Benson Iii

Theses and Dissertations

The Rhetoric of Health and Medicine (RHM) is a growing body of scholarship that pulls from technical communication, rhetorical theory, and a number of other disciplines to inquire about the capacities of rhetoric at the intersection of medical practitioners and scholars, the medical humanities, and the publics they inform and treat. Among RHM scholars there is a consensus that the field’s methodological diversity is one of its greatest strengths; indeed, field leaders articulate one of RHM’s exigencies as “encouraging methodological collaboration and experimentation” (Melonçon and Scott, Methodologies 4). This dissertation takes up these calls with the introduction of shifting, a …

Unearthing An Emerging Neglected Bacterial Disease: Evidence Of Spotted Fever Group Rickettsioses In El Salvador, Kyndall Christian Braumuller

Theses and Dissertations

The main objectives of this dissertation were to investigate the seroprevalence of Spotted Fever Group Rickettsioses (SFGR) antibodies in a specific vulnerable population at high risk for vector-borne disease in El Salvador, understand the relevant risk factors for SFGR past and acute infection in this same population through logistic regression modeling, and clarify the presence of SFGR bacteria in locally collected ticks.

SFGR are a group of bacterial diseases caused by species in the Rickettsia genus of the phylogenetic spotted fever group. These are tick-borne diseases (TBD) that have been described in almost every region of the world. SFGR are …

Role Of Epigenome In Regulation Of Inflammation By Ahr Ligands 2,3,7,8-Tetrachlorodibenzo-P-Dioxin And 6-Formylindolo[3,2-B] Carbazole, Alkeiver Cannon

Theses and Dissertations

Autoimmune Hepatitis (AIH) is a chronic inflammatory disease of the liver mediated by immune cells and characterized by a variety of parameters including circulating autoantigens, elevated immunoglobulin G (IgG) and aminotransferases, and interface hepatitis. Unfortunately, despite treatment with broadly immunosuppressive drugs, the disease progresses to cirrhosis and end-stage liver disease in several cases. In order to develop a more specific treatment, the mechanisms governing the liver injury resulting from inflammation and autoimmunity need to be elucidated.

For decades, activation of Aryl Hydrocarbon Receptor (AhR) was excluded from consideration as a therapeutic approach due to the potential toxic effects of AhR …

Sports Nutrition- And Strength And Conditioning-Based Interventions To Bolster Health And Human Performance In Male And Female Tactical Personnel, Harry Paul Cintineo

Theses and Dissertations

Military and law enforcement personnel are required to possess sufficient physical and cognitive fitness to perform their official duties. Tactical athletes must have fast reaction times (RT), high levels of various aspects of muscular performance, including power, strength, and endurance, as well as high anaerobic and aerobic capacities. The purpose of this dissertation was to investigate acute sports nutrition and chronic strength and conditioning strategies to improve health and human performance in tactical athletes, including law enforcement officers, active-duty military service members, and Reserve Officers’ Training Corps (ROTC) cadets and midshipmen.

The first study tested the effects of a combination …

Mass Spectrometric Investigation Of Removal/Transformation Of Emerging Contaminants For Safer Potable Wastewater Reuse, Kristin Cochran

Theses and Dissertations

Water scarcity is of increasing global concern as rising demand depletes current sources, so other sources such as potable wastewater reuse are being utilized. Advanced wastewater reuse removes pathogens and many contaminants, but there are concerns about resistant contaminants and the transformation products that are generated during the treatment process. This research focuses on several different contaminant classes, how well they are removed via advanced treatment processes, what transformation products arise from both advanced treatment and chlorination disinfection, and how those treated waters may impact health via toxicity and estrogen activity.

Contaminant classes considered are illicit drugs, pharmaceuticals such as …

Measuring Orthographic Influences On Phonological Processing In Beginning Readers: An Eyetracking Study, Emily Grace Fisher

Theses and Dissertations

Purpose – Both orthographic and phonemic awareness are essential to reading. However, the role of orthographic knowledge in phonemic awareness has not been thoroughly investigated in beginning readers until recently. The purpose of this study was to examine if orthographic knowledge influenced phonological processing in beginning readers and to establish a proof of concept for the use of eyetracking measures to examine these skills in young children.

Method – 22 participants, aged 6-7 years, completed norm-referenced assessments of language and reading ability as well as experimental measures of orthographic and phonological awareness while their eye movements were monitored.

Results – …

Neurochemical, Molecular, And Behavioral Effects Of Intranasal Insulin, Jennifer Marie Erichsen

Theses and Dissertations

Age-related cognitive decline (ARCD) is one of the most dreaded aspects of growing old and a public health concern. Unfortunately, there is currently no treatment that effectively ameliorates ARCD. In recent decades, intranasal insulin (INI) has demonstrated promising memory enhancements for rodents and individuals with Alzheimer’s disease, both in basic science research laboratories and multi-center clinical trials. Other studies have shown INI improves memory and cognition in healthy rodents and humans, indicating that INI may hold promise as a successful ARCD therapeutic. However, there is a glaring lack of evidence regarding how INI produces these effects. The goal of these …

A Novel Cognitive Stress Paradigm To Assess Subtle Cognitive Differences In Women With The Fmr1 Premutation, Jillian Margaret Gierman

Theses and Dissertations

Fragile X premutation (FXPM) is a genetic mutation of the FMR1 gene characterized by having between 55-200 CGG repetitions. FXPM women are at risk for a variety of reproductive, cognitive, and neuropsychiatric deficits, including fragile X-associated primary ovarian insufficiency (FXPOI) and fragile X-associated tremor/ataxia syndrome (FXTAS). FXTAS is a late-onset neurodegenerative disorder characterized by tremor, gait ataxia, cognitive decline, brain atrophy, and deficits in executive functions. With the evidence supporting premature aging, prevalence of cognitive deficits, and risk of developing FXTAS and dementia, it is imperative to find a reliable measure that identifies at-risk FXPM women and their subtle cognitive …

Complex Functional Joint Models For Longitudinal Electronic Health Record, Siyuan Guo

Theses and Dissertations

Longitudinal measurements are important components in electronic health record (EHR) data. In practice, using longitudinal EHR history is expected to improve the estimation or prediction performance when studying some outcomes of interest, such as binary outcome or time to event outcome. However, the longitudinal observations in EHR data is complex due to irregular and sparse EHR visits. Therefore, modelling longitudinal data and further incorporating them with different types of outcomes is challenge. In this dissertation, we aim to develop methodology to first, describe the pattern of the longitudinal predictors with continuous or binary observations, and second, model the longitudinal predictors …

Unintended Consequences Of The Electronic Health Record And Cognitive Load In Emergency Department Nurses, Carolyn S. Harmon

Theses and Dissertations

Background: The electronic health record (EHR) was rapidly implemented to improve patient safety. However, this rapid and widespread EHR implementation negatively connects to patient safety. Clinician cognitive overload is also thought to be negatively connected to patient safety, especially in the chaotic emergency department (ED) setting. Limited research has been conducted on unintended consequences of the EHR (UC-EHR) and cognitive load (CL) in ED nurses. Understanding the UC-EHR and CL in ED nurses facilitate informed interventions to improve nursing practice and patient safety.

Aims: Guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 framework, the aims of this …

Sex Differences And Potential Non-Invasive Treatments For Calcific Aortic Valve Disease, Henry Pascal Helms

Theses and Dissertations

Calcific Aortic Valve Disease (CAVD) is a progressive heart disease that ranges from aortic valve sclerosis to aortic valve stenosis. It is characterized by intense calcification and compromised valve function. CAVD affects 25% of people older than 65 and 50% of people older than 85. These rates are expected to increase in the United States due to higher levels of obesity and diabetes, as well as an aging population. CAVD is the leading cause of valve replacement surgery. Annual healthcare costs for these valve replacements are currently estimated to be approximately 2 billion dollars. There are currently no medications approved …

Sensory Processing In Male Children With Fragile X Syndrome And Idiopathic Autism: Implications For Maladaptive Behavior And Within-Syndrome Heterogeneity, Chandler Knott

Theses and Dissertations

Proficient sensory processing affords adaptive responses that are necessary for daily functioning. Atypical sensory processing patterns are common across neurodevelopmental disorders, including autism spectrum disorder (ASD) and fragile X syndrome (FXS), two disorders with a high degree of phenotypic overlap. However, little is known about whether types of atypical sensory processing in FXS vary as a function of genetic etiology or the presence of ASD. Atypical sensory processing has been also associated with maladaptive outcomes in certain clinical populations; however, the impact of these impairments on internalizing and externalizing behavior remains unknown in FXS. Study participants included 37 male children …

Trajectories, Prevention Strategies, And Health Impacts Of Perinatal Depression, Sabrina Karim

Theses and Dissertations

Background

Perinatal depression is one of the most common and underdiagnosed obstetric complications. Extant research on perinatal depression is mostly focused on white women and women who are not at risk for depression. Little is known about the trajectories, prevention strategies and adverse outcomes of perinatal depression among high-risk populations, for example, women with overweight and obesity or women of color or low socioeconomic status.

Purpose

Our study examined the longitudinal trajectories of perinatal depression, effect of a behavioral lifestyle intervention on perinatal depression and association between prenatal physical activity and perinatal depression among women with overweight and obesity. We …

Healthy Aging Beyond Sex And Gender Binaries, Nicole M. Lampe

Theses and Dissertations

An estimated 2.7 million sexual and gender minority (SGM) adults 50+ reside in the United States (US) with this number projected to increase to more than 5 million by 2060 (Flatt et al. 2022; Fredriksen-Goldsen and Kim 2017). Medical research, education, and practice in the United States (US) often erase sex and gender variation, thus ignoring the experiences of older adults living beyond Western sex and gender binary systems (e.g., female/male and women/men), particularly transgender, non-binary, and/or intersex (TNBI) populations. Such erasure stems from TNBI older adult structural incompetency or the failure to understand how macro-level systems, institutions, and structures …

Identifying Novel Pharmacogenetic Markers For Cancer Treatments: Exploiting Cancers Deficient In The Nucleotide Pool Sanitizing Hydrolases Nudt15 And Nudt18, Jacob Chandler Massey

Theses and Dissertations

The NUDIX hydrolases are a super family of enzymes with purported enzymatic activities of nucleotide hydrolases. The activity of the founding member, NUDT1 (also known as MTH1) is established to be a nucleotide hydrolase for d-8-oxoGTP, which is a mutagenic precursor if incorporated into DNA. Therefore, its activity serves to sanitize the nucleotide pool of mutagenic precursors. While known to be highly conserved among all organisms, the enzymatic and biological functions for nearly all the family members remain largely unexplored and unknown. Substrates of family members have been found to include canonical (deoxy)nucleotide triphosphates, oxidized (deoxy)nucleotide triphosphates, and non-nucleoside polyphosphates. …

Where The Home Fires Burn: The Heart Of Geographic Mobility In Rural Southern America, Mariah Moran

Theses and Dissertations

In the context of the recent surge of interest in domestic U.S. geographic mobility, this study presents findings on the reasons people choose to move or not move that challenge the predominant explanations of geographic mobility and responds to the need for theoretical expansion. This qualitative study is set in a rural county of Georgia, further situating the findings alongside the rural-urban continuum literature. In-depth interviews were conducted with thirty participants from the rural county that represent three different mobility decisions: people who stayed, left, and returned. The findings suggest that there are multiple connected reasons for mobility including three …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

Subject Cognitive Decline In Informal Caregivers, Eunika Simons

Theses and Dissertations

Purpose. The United States is experiencing unprecedented demographic shifts as the population continues to age. More than 53 million Americans are caregivers and that number is continuing to grow. Caregiving has become a significant societal and public health issue to be addressed. This study provided a population-based national perspective regarding informal caregivers to identify differences between caregivers reporting cognitive decline and those caregivers reporting no cognitive decline. The analysis explored the relationships between the type and characteristics of informal caregivers, the nature of the caregiving relationship, caregiver unmet needs, and the general, physical, and mental health-related outcomes of the caregivers. …

Association Between Postpartum Weight Retention And The Dietary Inflammatory Index, Nyrobi Tyson

Theses and Dissertations

Objective: The objective of this thesis is to examine the relationship between the Dietary Inflammatory Index (DII), measured during the postpartum period, and postpartum weight retention.

Setting and Participants: We used the Infant Feeding Practices Study (IFPS) II (n=5000), a longitudinal study of women from late pregnancy through their infant’s first year of life conducted between 2005 and 2007. Survey topics included feeding practices, infant health, food allergies, sleeping arrangements, mother’s employment, childcare, and mother’s dietary intake.

Main Outcomes: Postpartum weight retention (PPWR) was calculated in kilograms by subtracting self-reported body weight at 3, 6, 9, and 12 months postpartum …

Impact Of A Novel Marine Algae Supplement On Inflammatory And Immune Response After High-Intensity Exercise, Caroline Sara Vincenty

Theses and Dissertations

INTRODUCTION: High-intensity exercise (HIE) can damage the musculotendon complex and impact the immune response, which may result in post-exercise inflammation and reductions in strength and performance. Sufficient rest and recovery will improve muscular resilience against future damaging bouts, however HIE with minimal durations of rest are common in athletic competitions that facilitate persistent inflammation and immune dysregulation. Marine algae-derived fucoidans (MA) have previously shown promise to mitigate pro-inflammatory and immune dysregulation responses, however it has not been investigated in the context of HIE. The purpose of this research is to investigate the safety and efficacy of MA on markers of …

Mechanisms Of Connectivity In Neuronal Development, Janay Vacharasin

Theses and Dissertations

The development of neuronal connectivity requires the careful orchestration of multiple cellular processes including the control of neuronal arborization and synapse formation or function. Defects in these processes during neuronal development will give rise to disorders of neuronal connectivity like autism. In the present work, we examine the genetic and epigenetic mechanisms that build the neuronal wiring of the developing brain. We use human stem cell-derived neurons to study neuronal arborization and function focusing on genetic and environmental risk factors of neurodevelopmental disorders that include autism and intellectual disability. Specifically, we focused on the contribution of the endomembrane, chromatin, and …

Targeting Ribosome Biogenesis For Pancreatic Cancer Treatment, Carlos Perez Iii

Theses and Dissertations

Pancreatic cancer (PanCa) is one of the leading causes of cancer-related death in the United States. Currently, PanCa is one of the recalcitrant cancers that has very limited therapeutic options available for its treatment. The current standard care of PanCa is gemcitabine (GEM) alone or in combination with FOLFIRINOX, nab-paclitaxel, erlotinib, or 5-FU PanCa, which often show poor response. Therefore, new treatment strategies are required for the prevention and treatment of cancer. Ribosome biogenesis process is dysregulated in most of the cancer types of results in production of more ribosomes and synthesis of oncoproteins which lead to the induction, progression, …

The Impact Of Distance Learning On Nontraditional High School Students' Attendance And Dropout Prevention, Teresita De Saro

Theses and Dissertations

High school dropout rates have long been a problem for school districts, and various contributing factors have excavated the problem. Most of these students have been plagued by the inability to integrate into the mainstream of school life, due to socioeconomic standing, lack of parental support, and many other problems. This qualitative study examined how distance learning courses have the potential to increase high school graduation rates and attendance rates. The research perspective was conducted at an alternative high school where the primary goal is to ensure nontraditional students' academic and personal support needed to graduate from high school …

Predicting The Remaining Service Life Of Railroad Bearings: Leveraging Machine Learning And Onboard Sensor Data, Leonel Villafranca

Theses and Dissertations

By continuously monitoring train bearing health in terms of temperature and vibration levels of bearings tested in a laboratory setting, statistical regression models have been developed to establish relationships between the sensor-acquired bearing health data with several explanatory factors that potentially influence the bearing deterioration. Despite their merits, statistical models fall short of reliable prediction accuracy levels since they entail restrictive assumptions, such as a priori known functional relationship between the response and input variables. A data-driven machine learning algorithm is presented, which can unravel the nonlinear deterioration model purely based on the bearing health data, even when the structure …

Changes In Drought Characteristics Under Future Climate Projections, Diogo Stalin De Alcantara Araujo

Theses and Dissertations

Accumulating evidence on the impact of climate change on droughts, highlight the necessity for developing effective adaptation and mitigation strategies. Global Drought Layers were developed for historic and future runs of nine global climate models (GCM) of the Coupled Model Intercomparison Model 6th phase (CMIP6). Relative changes of drought characteristics were estimated, and hotspots were identified, especially in South America, Africa, Europe, Western USA, and Australia. Further, changes in future drought risk and severity in Australia are quantified. Historic conditions (1981-2014) and projections for mid-century (2015-2050) and end-century (2051-2100) from four shared socioeconomic pathways (SSP1-2.6, SSP2-4.5, SSP3-7.0 and SSP5-8.5) are …

The When, Why, And How: Antecedents Of Illegitimate Task Perceptions, Patricia Jewel Emily Morrison

Theses and Dissertations

Driven, satisfied, and motivated employees are crucial to an organization’s long-term success. The purpose of this research study was to examine factors that may be affecting employee perceptions of tasks as illegitimate. Utilizing a purposive, convenience sampling approach, 14 employees were recruited to participate in this study. Participants completed an interview with the researcher that lasted approximately 30 minutes and was audio recorded and later transcribed. All data was analyzed in NVivo qualitative analysis software utilizing the grounded theory method and thematic analysis approach. The following three themes emerged from the data analysis: (1) Lack of Resources, Lack of Support, …

Electromagnetic Interference Shielding Effectiveness Of A Layered System Consisting Of A Carbon Nano-Reinforced Polymer Composite Coated With Metal Oxide And Graphite, Veronica Montserrat Serrato

Theses and Dissertations

In this study, the electromagnetic interference (EMI) shielding effectiveness (SE) of vapor grown carbon nanofiber (VGCNF) reinforced polyvinylidene difluoride (PVDF) composite and PVDF/VGCNF thermally sprayed with magnetite (Fe3O4) and graphite has been investigated. EMI SE evaluations were performed in the frequency range of 30 kHz-1.5 GHz. The developed nanocomposite (NC) system was fabricated by high shear mixing using a Banbury type mixer. The material was then subjected to compression molding. Subsequently, the films were thermally sprayed using Fe3O4/graphite powder. The NC and coated NC films had average thicknesses of 0.82 mm and 0.93 mm, respectively. The NC films were subjected …