Digital Commons Network^™

An Assessment Of The Readiness Of King Fahad Medical City, Saudi Arabia, In Adopting Effective Online Staff Development Programs, Adnan Dhafer Alwadie

Wayne State University Dissertations

Internet access has grown in Saudi Arabia between 2000 and 2005 by more than 1000% and many governmental organizations are starting to provide part of their services using the internet. In addition, the Ministry of Higher Education has provided funding to all governmental universities to start developing strategies and guidelines for online education. Healthcare services in Saudi Arabia are funded by the government and are provided to all citizens free of charge. In addition, the majority of healthcare workers are expatriates. King Fahad Medical City (KFMC) is a tertiary healthcare organization that provides specialized medical care. To assure quality of …

Optimal Port Placement And Automated Robotic Positioning For Instrumented Laparoscopic Biosensors, Brady King

Wayne State University Dissertations

OPTIMAL SURGICAL PORT PLACEMENT AND AUTOMATED ROBOTIC POSITIONING FOR RAMAN AND OTHER BIOSENSORS

by

BRADY KING

January 2011

Advisors: Dr. Abhilash Pandya, Dr. Darin Ellis, Dr. Le Yi Wang, and Dr. Greg Auner

Major: Computer Engineering

Degree: Doctor of Philosophy

Medical biosensors can provide new information during minimally invasive and robotic surgical procedures. However, these biosensors have significant physical limitations that make it difficult to find optimal port locations and place them in vivo. This dissertation explores the application of robotics and virtual/augmented reality to biosensors to enable their optimal use in vivo.

In the first study, human …

Effects Of Managed Care On The Health And Health-Care Of The Non-Elderly With Diabetes, Meihua Lu

Wayne State University Dissertations

This dissertation attempts to examine the quality effect of managed care plans (as compared with traditional fee-for-service plans, or FFS) on the health outcome and health care use of patients with diabetes. As the number of diabetics is growing rapidly with many of them are relying on managed care plans, knowing better the effects of different plans on health status and health care utilization is of great interest and significance to consumers, employers, and policymakers, especially at a time that universal health care is under being implemented.

Using up-to-date data from MEPS, a nationally representative survey, I compared 484 HMO …

Frazzled And Abelson Interact To Regulate The Actin Cytoskeleton In Drosophila, Bridget Elsa Varughese

Wayne State University Dissertations

Guidance receptors such as Frazzled affect cell shape and motility by directly or indirectly modulating the cytoskeleton. Fra is particularly needed for the formation of the posterior commissures in a developing Drosophila embryo. The cytoplasmic tyrosine kinase, Abelson Kinase (Abl) enhances the loss of commissures observed in fra mutant. Abl physically interacts with Frazzled to help guide commissural axons across the midline. Furthermore, the loss of commissural axons is only seen when the actin dynamics are perturbed. Abl is also known to regulate actin-dependent processes underlying formation of filopodia, microspikes and membrane ruffles. So, we established a Drosophila S2 cell …

The Role Of Organizational Climate And Culture In Service Encounters, Beth Ann Heyart

Wayne State University Dissertations

This study explored the link between culture and climate with respect to customer service ratings. Two hospital units, one with high customer service ratings and one with low customer service ratings, were identified for analysis. A mixed-method design was implemented to assess climate and culture on each unit. Climate was assessed with a survey that combined elements of Schneider, White, and Paul's (1998) Assessment of Service Climate Instrument and Litwin and Stringer's (1968) Organizational Climate Questionnaire. An ethnographic approach using observation, interviews and archival data analysis was completed to understand each unit's culture. Findings indicate high customer service environments rated …

An Examination Of The Primary And Secondary Effects Of Cyber-Bullying: Development And Testing Of A Cyber-Bullying Moderator/Mediator Model, Crystal Lin Johnson

Wayne State University Dissertations

This study examined cyber-bullying as a social transgression and the potentially negative effects it has on individuals, specifically adolescents and young adults from experiences recalled by college students. Findings established support for a moderator/mediator model, designed and tested for this study, that describes the psychological process prompted by a cyber-bullying message, which is moderated as well as mediated by several factors. This study examined the theoretical and practical value of the model in terms of being able to reflect the psychological process that individuals move through when exposed to a cyber-bullying message, and its ability to account for both primary …

Effects Of Two Group Approaches On Life Satisfaction And Mood Of Older Females In Nursing Homes, Bede Redpath Ryan

Wayne State University Dissertations

The purpose of this study was to examine the effects of two group counseling therapy interventions on levels of life satisfaction and mood disturbance of older women, age 65+, living in two Detroit-based skilled nursing home facilities. This quasi-experimental, two-treatment group design examined the pretest-posttest data of two group counseling therapy interventions, Group Art Therapy (GAT) and Group Life Stories Narrative Therapy (GLSNT). Seventeen participants completed the bi-weekly, 90-minute sessions, over a four-week period. A univariate ANCOVA with group membership as fixed independent variable was used to compare life satisfaction post scores with pre scores as covariates. Mean scores were …

The Impact Of Regulatory Changes On The Providers Of Treatment For Opioid Dependence, Paul Aaron Fisher

Wayne State University Dissertations

In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse ("withdrawal"), or physicians can keep patients on buprenorphine indefinitely ("maintenance"). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the …

The Creative Content Programme And Audiovisual E-Platform: An Institutional Analysis Of Unesco's Influence On The Development Of Independent Documentary Content And Production Practice, Deborah Joanne James

Wayne State University Dissertations

This dissertation is an institutional analysis of two interrelated UNESCO (United Nations Education Science and Cultural Organization) activities. These include the Creative Content Programme, and the Audiovisual E-Platform, an online catalogue and social networking hub for independent filmmakers/media producers from the global South. Contained by these activities, the author focuses the multi-method approach on gender and access by (A) conducting an analysis of the composition of programs and practices of the Creative Content Programme and the E-Platform; (B) conducting textual analysis of documentary media and interviews with Diaspora women producers; and (C) participating in and observing community-based multimedia production …

Effects Of A Group Counseling Career Intervention On The Hopefulness And Future Orientation Of At-Risk Middle School Students, Amy Kathryn Macey

Wayne State University Dissertations

The purpose of this study was to examine the effects of a small group counseling career intervention on levels of total hope, willpower (agency), waypower (pathways), and future orientation of at-risk middle school students attending an urban middle school in Southeast Michigan. This true experimental, randomized, pretest-posttest control group design compared the statistical outcomes of a small group counseling career intervention with a control group. Forty-four middle school students in the eighth grade (18 males and 26 females) were randomly selected and participated in the research study. Twenty-two students were randomly assigned to an experimental group and twenty-two students were …

Computer Simulation In Mass Emergency And Disaster Response: An Evaluation Of Its Effectiveness As A Tool For Demonstrating Strategic Competency In Emergency Department Medical Responders, Daniel Joseph O'Reilly

Wayne State University Dissertations

This study examined the capability of computer simulation as a tool for assessing the strategic competency of emergency department nurses as they responded to authentically computer simulated biohazard-exposed patient case studies. Thirty registered nurses from a large, urban hospital completed a series of computer-simulated case studies of virtual biohazard-exposed patients. The completed case studies were assessed by the host computer according to computer-programmed criteria. The same case studies were also assessed by a trio of emergency medicine physicians acting as subject matter experts according to their own criteria. The results of this study demonstrated a significant correlation between computer-assessed and …

Chemotherapy For Lung Cancer: Determinants Of Guideline Adherence And Associated Patient Outcomes, Ramzi George Salloum

Wayne State University Dissertations

Evidence-based guidelines recommend chemotherapy for medically fit patients with stage II-IV non-small cell lung cancer (NSCLC). Adherence to chemotherapy guidelines has rarely been studied among large populations, mainly because performance status (PS), a key component in assessing chemotherapy appropriateness, is missing from claims-based datasets. Among a large cohort of patients with known PS, this dissertation describes chemotherapy use relative to guideline recommendations and identifies patient factors and outcomes associated with guideline concordant use. Among these patients 29% do not receive guideline recommended chemotherapy treatment, missing opportunities for cure or receiving chemotherapy with more risk of harm than benefit, thereby likely …

Monitoring, Diagnosis, And Control For Advanced Anesthesia Management, Zhibin Tan

Wayne State University Dissertations

Modern anesthesia management is a comprehensive and the most critical issue in medical care. During the past dacades, a large amount of research works have been focused on the problems of monitoring anesthesia depth, modeling the dynamics of anesthesia patient for the purpose of control, prediction, and diagnosis.

Monitoring the anesthesia depth is not only for keeping the patient in adquate anesthesia level but also for preventing the patient from overdosing. Several EEG based indexes have been developed such as the BIS, and Entropy etc. for measuring depth. However, reports mentioned that those indexes in some cases fail in detecting …

Pleiotropic Regulatory Function Of The Lysr Family Transcriptional Regulator Cpsy During Streptococcus Iniae Systemic Infection, Jonathan Paul Allen

Wayne State University Dissertations

The ability of a pathogen to metabolically adapt to the local environment for optimal expression of virulence determinants is a continued area of research. Orthologs of the Streptococcus iniae LysR family regulator CpsY have been shown to regulate methionine biosynthesis and uptake pathways, but appear to influence expression of several virulence genes as well. A S. iniae mutant with an in-frame deletion of cpsY is highly attenuated in a zebrafish infection model. The cpsY deletion mutant displays a methionine-independent growth defect in serum, which differs from the methionine-dependent defect observed for orthologous mutants of S. mutans and S. agalactiae. …

Small Gtp-Binding Proteins In Insulin Secretion, Bhavaani Jayaram

Wayne State University Dissertations

Type 2 diabetes mellitus is marked by a substantial beta-cell failure which is characterized by defective insulin secretion and resistance to insulin. Understanding the molecular events leading to Glucose-stimulated insulin secretion [GSIS] might serve as therapeutic potential towards diabetes. GSIS involves interplay between small G-proteins and their regulatory factors. Herein, I tested the hypothesis that Arf nucleotide binding site opener [ARNO], a guanine nucleotide exchange factor [GEF] for the small G-protein Arf6, mediates the activation of Arf6, and that ARNO/Arf6 signaling axis, in turn, controls the activation of downstream effectors. Salient features of my study are: [i] ARNO/Arf6 is expressed …

Mechanisms Of Translation Arrest Following Focal Brain Ischemia, Monique K. Lewis

Wayne State University Dissertations

MECHANISMS OF TRANSLATION ARREST FOLLOWING FOCAL BRAIN

ISCHEMIA

by

MONIQUE K. LEWIS

August 2011

Advisor: Dr. Donald DeGracia

Major: Physiology

Degree: Doctor of Philosophy

The loss of blood flow to the brain is termed ischemia and the subsequent resumption of blood flow is termed reperfusion. Brain ischemia and reperfusion (I/R) occurs primarily following resuscitation from cardiac arrest and stroke and presents one of the most significant clinical challenges. At present, there are no clinically effective pharmacologic interventions to halt brain damage following I/R. The major Aim of this dissertation will be to investigate possible mechanisms involved in neuron death following …

Axogial Communication Mediated By Soluble Neuregulin-1 And Bdnf, Zhenzhong Ma

Wayne State University Dissertations

During peripheral nervous system development, successful communication between axons and glial cells including Schwann cells in peripheral nervous system and oligodendrocytes in central nervous system, is required for the proper functions of both neurons and glia. Three types of alternatively-spliced proteins belonging to the neuregulin1 (NRG1) gene family of growth and differentiation factors are essential for Schwann cell survival and peripheral nerve development. While membrane-bound NRG1 forms (type III) has been strongly implicated in the regulation of myelination process at late stage of Schwann cell development, little is known about the role of soluble, heparin-binding forms of NRG1 (type I/II) …

Mechanisms Of Regulation Of Islet Function By Nadph Oxidase, Ismail Syed

Wayne State University Dissertations

Glucose stimulated insulin secretion (GSIS) involves a series of metabolic and cationic events, leading to translocation of insulin-laden secretory granules from a distal site toward the plasma membrane for fusion and release of insulin into circulation. Vesicular transport and fusion events are tightly regulated by signals which coordinate between vesicle- and membrane-associated docking proteins. It is now being accepted that reactive oxygen species [ROS] plays a second messenger role in islet â-cell function. Further, evidence from multiple laboratories suggests a tonic increase in ROS generation is necessary for GSIS and fatty acid-induced insulin secretion. On the other hand, excessive ROS …

Recognition Of The Transgender Self: An Examination Of The Apologia Of The 'Pregnant Man', Erika Marie Thomas

Wayne State University Dissertations

In 2008, Thomas Beatie, a legally recognized male, transgender man, became pregnant with his first child and approached the American mass media to tell his story and defend his decisions. Shortly thereafter, the public fought against his image, attempting to normalize his body and gender. Beatie's unique gender blurring, his choice for exposure and social recognition, and the resulting public controversy surrounding the incident makes for an important test case to understand Beatie's discursive and visual strategies directed toward the American public.

This study, a rhetorical examination of the discourse and iconic visual image used by Beatie while his pregnant …

The Effect Of Changes In Drug Benefit Design Among Individuals With Diabetes In Large Employer-Sponsored Insurance Plans, Ninee Shoua Yang

Wayne State University Dissertations

THE EFFECT OF CHANGES IN DRUG BENEFIT DESIGN AMONG INDIVIDUALS WITH DIABETES IN LARGE EMPLOYER-SPONSORED INSURANCE PLANS

By

NINEE SHOUA YANG

August 2011

Advisor: Dr. Allen C. Goodman

Major: Economics

Degree: Doctor of Philosophy

With spending for prescription drugs rising so rapidly, employers and insurers are seeking different cost-cutting strategies to stem this tide. Given that prescription drugs have become an indispensable means to treat and manage chronic illnesses, the issues of affordability and trade-offs between medications and other health care services are important for chronically ill patients, particularly for patients with diabetes who typically have more than one comorbidity …

Human Trophoblast Survival And Invasion In The Developing Placenta: Autocrine Regulation By Hbegf, Philip Jessmon

Wayne State University Dissertations

HBEGF is a multifunctional protein in early pregnancy that induces cytotrophoblast (CTB) cell differentiation to an invasive phenotype, protects against apoptosis, and is involved in an autocrine signaling mechanism that leads to its own protein synthesis. CTBs exist in a low O₂ environment during the first 10 weeks of implantation, during which they invade the decidualized uterine stroma. Inhibitors of intracellular signaling pathways demonstrated that at 20% O₂ HBEGF induces an increase in cell migration through the ERK, MAPK14, JNK, or PIK3 pathways downstream of signaling through its ERBB receptors. Also downstream of these four pathways, HBEGF induces …

Deformable Meshes For Shape Recovery: Models And Applications, Chang Liu

Wayne State University Dissertations

With the advance of scanning and imaging technology, more and more 3D objects become available. Among them, deformable objects have gained increasing interests. They include medical instances such as organs, a sequence of objects in motion, and objects of similar shapes where a meaningful correspondence can be established between each other. Thus, it requires tools to store, compare, and retrieve them. Many of these operations depend on successful shape recovery. Shape recovery is the task to retrieve an object from the environment where its geometry is hidden or implicitly known. As a simple and versatile tool, mesh is widely used …

Autonomic Management Of Virtualized Resources In Cloud Computing, Jia Rao

Wayne State University Dissertations

The last five years have witnessed a rapid growth of cloud computing in business, governmental and educational IT deployment. The success of cloud services depends critically on the effective management of virtualized resources. A key requirement of cloud management is the ability to dynamically match resource allocations to actual demands, To this end, we aim to design and implement a cloud resource management mechanism that manages underlying complexity, automates resource provisioning and controls client-perceived quality of service (QoS) while still achieving resource efficiency.

The design of an automatic resource management centers on two questions: when to adjust resource allocations and …

Expression Of Microbial Rhodopsins In Retinal Neurons With Subcellular Targeting Motifs: For The Study Of The Structure/Function Of Aii Amacrine Cells And For Vision Restoration, Chaowen Wu

Wayne State University Dissertations

Protein-targeting motifs serve as addresses for subcellular protein localization. This feature of targeting-motifs was used to study the retina. The first part of the dissertation reports in the axonless spiking AII amacrine cell of the mammalian retina a dendritic process sharing organizational and functional similarities with the axon initial segment, the typical site of action potential initiation. This process was revealed through viral-mediated expression of channelrhodopsin-2-GFP (ChR2-GFP) with the AIS-targeting motif of sodium channels (NavII-III) and was shown to be the site of spike initiation. The second part of the dissertation aimed to improve microbial rhodopsin-mediated gene therapy for vision …

Sons, Daughters, And Arab-American Family Dynamics: Does A Child's Gender Matter?, Sanaa Al Harahsheh

Wayne State University Dissertations

SONS, DAUGHTERS, AND ARAB-AMERICAN FAMILY DYNAMICS: DOES A CHILD'S GENDER MATTER?

by

SANAA ALHARAHSHEH

December 2011

Advisor: Dr. Mary Sengstock

Major: Sociology

Degree:Doctor of Philosophy

Gender differences exist in families in all societies and cultures, but expectations are often different from one society/culture to another. Children's gender and its implications for family behavior have recently received a great deal of scholarly attention, especially in western societies; however, the influence of a child's gender on Arab-American family dynamics has not been investigated. Therefore, this study is the first to examine the impact of the gender of the child in selected Arab-American …

La Patria Perdida O Imaginada: Translating Teodoro Torres In "El Mexico De Afuera", Ethriam Cash Brammer

Wayne State University Dissertations

ABSTRACT

LA PATRIA PERDIDA O IMAGINADA: TRANSLATING TEODORO TORRES

IN "EL MÉXICO DE AFUERA"

by

ETHRIAM CASH BRAMMER

December 2011

Advisor: Dr. Renata Wasserman

Major: English

Degree: Doctor of Philosophy

One resent result of the Recovery of the U.S. Hispanic Literary Heritage Project has been the "rediscovery" of the novel La patria perdida (1935), written by acclaimed Mexican journalist Teodoro Torres while in exile in the United States. This novel is a kind of Mexican-American Horacio Algiers tale, detailing the success story of Luis Alfaro, who is eventually able to create a utopian Mexican-American hacienda, called Buenavista, outside of Kansas …

A Comparison Of The Effects Of Non-Normal Distributions On Tests Of Equivalence, Linda Ellington

Wayne State University Dissertations

Statistical theory and its application provide the foundation to modern systematic inquiry in the behavioral, physical and social sciences disciplines (Fisher, 1958; Wilcox, 1996). It provides the tools for scholars and researchers to operationalize constructs, describe populations, and measure and interpret the relations between populations and variables (Weinbach & Grinnell, 1997; Wilcox, 1996). Given that the majority of real data analysis in the behavioral and social sciences is comprised of non-normally distributed data, it is important that researchers be aware of the effects of non-normal distributions on the probability of detecting equivalence between populations.

The present study examined the effects …

Observational Study Of Children With Autism Who Have Participated In Hyperbaric Oxgen Therapy, Tamela Marie Powell

Wayne State University Dissertations

Autism is the fastest growing disability ever. With the growth comes a lot of questions as to the etiologies and treatment of this condition, often putting parents, schools, and traditional medical personnel at odds with what treatments have efficacy. As the popularity of alternative treatments increase, so does the need for research.

Hyperbaric oxygen therapy is one alternative treatment parents are seeking for their child with autism. When one looks at the science behind hyperbaric oxygen therapy and the physical condition of a child with autism the rationale behind the treatment becomes clear. Research has shown that children with autism …

International Student Navigation Through U.S.-American Colleges And Universities: An Autoethnographic Analysis Of Discourse, Nick James Romerhausen

Wayne State University Dissertations

As the population of international students continues to rise at U.S. colleges and universities, the difficulties that international students may face becomes more present and apparent. Intervention strategies used to assist international students in the past have shown remarkable success; however, these strategies have primarily included face-to-face interactions. I explore the role that mediated discourse plays in supporting international students with navigating paths through U.S. colleges and universities by examining ten institutions' assistance handbooks. From inspiration from autoethnography, discourse analysis, and critical education perspectives, I also use an autoethnographic analysis of discourse to understand the types of experiences colleges and …

Functional In Vitro Analyses Of Lipid Raft-Associated Cathepsin B: Implication For The Invasive Phenotype Of Inflammatory Breast Cancer, Bernadette Caroline Victor

Wayne State University Dissertations

FUNCTIONAL IN VITRO ANALYSES OF LIPID RAFT-ASSOCIATED CATHEPSIN B: IMPLICATION FOR THE INVASIVE PHENOTYPE

OF INFLAMMATORY BREAST CANCER

by

BERNADETTE C. VICTOR

December 2011

Advisor: Dr. Bonnie F. Sloane

Major: Cancer Biology

Degree: Doctor of Philosophy

Inflammatory breast cancer (IBC) is an aggressive, metastatic and

highly angiogenic form of locally advanced breast cancer. Breast

cancer invasion has been linked to proteolytic activity at the tumor

cell surface. We observed that uPA, uPAR and enzymatically active

cathepsin B were all present in caveolae fractions isolated from

SUM149 cells. Using a live-cell proteolysis assay, we demonstrated

that both IBC cell lines degrade …