Digital Commons Network^™

What Does A Successful, Sustainable Telemedicine Program Look Like? An Inside View Of Six Telemedicine Programs In Maine, Edwina Ducker

Muskie School Capstones and Dissertations

The purpose of this capstone is to better understand the successes and lessons learned in the development and implementation of successful programs to help guide future decision making when planning a new program. The study relies on semi-structured interviews with Telehealth forum members and staff from a select number of telemedicine programs for its primary data source. Initially, secondary data sources and members from the Maine Telehealth Forum were used to inform the development of the list of programs to be interviewed. The programs interviewed include; a behavioral health, two specialties, a home health, a primary care, and a hospital …

Aberrant Neurogenic And Epigenetic Processes Are Associated With Depression Induced By Developmental Arsenic Exposure, Christina René Tyler

Biomedical Sciences ETDs

Arsenic is a pervasive environmental contaminant derived from both natural and anthropogenic sources. Epidemiological evidence supports a correlation between arsenic exposure in drinking water and increased rates of psychiatric disorders, including depression, in exposed populations. Previous studies have established that perinatal exposure to arsenic (through all three trimesters of fetal/neonatal development, DAE) has long-lasting consequences into adulthood including deficits in learning and memory, molecular aberrations in the hypothalamic-adrenal-pituitary (HPA) axis, and depressive-like symptoms in mice. The studies described in this dissertation were designed to assess the impact of DAE on adult hippocampal neurogenesis (AHN) as a possible mechanism of action …

The Role Of Mir-137 In Schizophrenia, Carrie Leigh Wright

Biomedical Sciences ETDs

The genetic basis of schizophrenia is still largely unknown. Recent evidence suggests that a microRNA (miRNA), miR-137 may be involved. The first large schizophrenia genome wide association (GWAS) study, published in 2011, identified a variant within the host gene of this miRNA (MIR-137) as the top association. Since then, further evidence for the potential influence of this miRNA within the disorder has accumulated. These studies used a variety of methods from GWAS to neuroimaging. However, few studies have evaluated the mechanism for the association of the MIR-137 variant, nor how alterations in the miRNA may have downstream effects on its …

Investigation Into The Early Events Of Epithelial Wound Healing And Hpv16 Infection, Michael P. Kivitz

Biomedical Sciences ETDs

HPV16 infection evidently occurs within wounded epithelial tissue, but the cellular and molecular events that culminate in infection establishment remain poorly understood. While HPV is exposed to a multitude of cells in the wound environment, only hyperproliferative keratinocytes are believed to support productive infection. Keratinocytes acquire mobility during wound repair by undergoing prominent phenotypic alterations through an epithelial-to-mesenchymal transition (EMT). In this study, cell- and tissue-based models were employed to characterize HPV infection during epithelial wound healing, using both physical injury and growth factor treatment to induce keratinocyte migration. In a tissue-based model of wounding and infection using NIKS-derived organotypic …

District 1 Climate Change Vulnerability Assessment And Pilot Studies Fhwa Climate Resilience Pilot Final Reports, Ghd, Trinity Associates, Esa Pwa

State & Federal Reports and Publications

No abstract provided.

District 1 Climate Change Vulnerability Assessment And Pilot Studies, Appendices, Ghd, Esa Pwa, Trinity Associates

State & Federal Reports and Publications

No abstract provided.

In Vivo Dosimetry Using Plastic Scintillation Detectors For External Beam Radiation Therapy, Landon S. Wootton

Dissertations and Theses (Open Access)

In vivo dosimetry, the direct measurement of dose delivered to patients during radiation therapy, has significant potential in ensuring safe and effective treatment in radiation therapy. It can serve as point-of-delivery, patient specific quality assurance and direct verification of treatment. Despite evidence that in vivo dosimetry can detect errors in patient treatment that would otherwise go undetected, it is not commonly practiced. This is due in part to a lack of available detectors ideally suited to perform in vivo dosimetry. Plastic scintillation detectors (PSDs) possess a number of dosimetric characteristics advantageous for in vivo dosimetry including water equivalence, real-time capability, …

Novel Posttranslational Modification In Lkb1 Activation And Function, Szu-Wei Lee

Dissertations and Theses (Open Access)

Cancer cells display dramatic alterations in cellular metabolism to meet their needs of increased growth and proliferation. In the last decade, cancer research has brought these pathways into focus, and one emerging issue that has come to attention is that many oncogenes and tumor-suppressors are intimately linked to metabolic regulation (Jones and Thompson, 2009). One of the key tumor-suppressors involved in metabolism is Liver Kinase B1 (LKB1). LKB1 is the major upstream kinase of the evolutionarily conserved metabolic sensor—AMP-activated protein kinase (AMPK). Activation of the LKB1/AMPK pathway provides a survival advantage for cells under energy stress. LKB1 forms a heterotrimeric …

Insulin Resistance And Muscle Insulin Receptor Substrate-1 Serine Hyperphosphorylation, Charles A. Stuart, Mary E. A. Howell, Brian M. Cartwright, Melanie P. Mccurry, Michelle L. Lee, Michael W. Ramsey, Michael H. Stone

ETSU Faculty Works

Insulin resistance in metabolic syndrome subjects is profound in spite of muscle insulin receptor and insulin-responsive glucose transporter (GLUT4) expression being nearly normal. Insulin receptor tyrosine kinase phosphorylation of insulin receptor substrate-1 (IRS-1) at Tyr896 is a necessary step in insulin stimulation of translocation of GLUT4 to the cell surface. Serine phosphorylation of IRS-1 by some kinases diminishes insulin action in mice. We evaluated the phosphorylation status of muscle IRS-1 in 33 subjects with the metabolic syndrome and seventeen lean controls. Each underwent euglycemic insulin clamps and a thigh muscle biopsy before and after 8 weeks of either strength or …

An Exploratory Study On The Use Of Concentric Velocities In The Back Squat As A Monitoring Tool, Kevin M. Carroll, Josh D. Christovich, Caleb D. Bazyler, Nicholas J. Fiolo, George K. Beckham, Kimitake Sato

ETSU Faculty Works

Abstract available in the 9th Annual Coaches and Sport Science College .

Perceived Mother And Father Acceptance-Rejection Predict Four Unique Aspects Of Child Adjustment Across Nine Countries, Diane L. Putnick, Marc H. Bornstein, Jennifer E. Lansford, Patrick S. Malone, Concetta Pastorelli, Ann T. Skinner, Emma Sorbring, Sombat Tapanya, Liliana Maria Uribe Tirado, Arnaldo Zelli, Liane Peña Alampay, Suha M. Al-Hassan, Dario Bacchini, Anna Silvia Bombi, Lei Chang, Kirby Deater-Deckard, Laura Di Giunta, Kenneth A. Dodge, Paul Oburu

Psychology Department Faculty Publications

Background

It is generally believed that parental rejection of children leads to child maladaptation. However, the specific effects of perceived parental acceptance-rejection on diverse domains of child adjustment and development have been incompletely documented, and whether these effects hold across diverse populations and for mothers and fathers are still open questions.

Methods

This study assessed children's perceptions of mother and father acceptance-rejection in 1247 families from China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States as antecedent predictors of later internalizing and externalizing behavior problems, school performance, prosocial behavior, and social competence.

Results

Higher perceived parental …

Teacher Internship Report- Ceres High School, Michael L. Patterson

Agricultural Education: Graduate Internship Reports

This internship/project report includes validation documents required in meeting the quality criteria for secondary-level programs of instruction in agriculture. The documents are concurrently used for the Agriculture Incentive Grant review process at Ceres High School conducted by representatives of the California Department of Education. The internship included the development of a comprehensive program plan for Ceres High School. The plan includes information to receive state/local funding, outline the goals and objectives of the program, along with an overview of Ceres High School, the agriculture program and community.

Improving Community Case Management Of Diarrhoea And Pneumonia In District Badin, Pakistan Through A Cluster Randomised Study--The Nigraan Trial Protocol, Fauziah Rabbani, Aftab A. Ali Mukhi, Shagufta Perveen, Xaher Gul, Saleem Iqbal Perwaiz, Shamim Ahmed Qazi, Iqbal Azam Syed, Khalid Hussain Shaikh, Wafa Aftab

Community Health Sciences

BACKGROUND:

Diarrhoea and pneumonia contribute 30% of deaths in children under 5 in Pakistan. Pakistan's Lady Health Workers Programme (LHW-P) covers about 60% of the population but has had little impact in reducing morbidity and mortality related to these major childhood killers. An external evaluation of the LHW-P suggests that lack of supportive supervision of LHWs by lady health supervisors (LHSs) is a key determinant of this problem. Project NIGRAAN aims to improve knowledge and skills of LHWs and community caregivers through supervisory strategies employed by LHSs. Ultimately, community casemanagement (CCM) of childhood pneumonia and diarrhoea will improve.

METHODS/DESIGN:

NIGRAAN …

Plumbing And Wiring: Atherosclerosis In Epilepsy., Scott Mintzer, Md

Department of Neurology Faculty Papers

Over the long term, epilepsy is clearly associated with cognitive impairment. This has been demonstrated functionally, using neuropsychological testing, and reinforced by structural studies showing progressive atrophy in patients with chronic epilepsy ^1-3. The prevailing explanation for this, of course, has been the direct and cumulative effects of seizures on the brain. The basic science literature is chock full of studies showing impairment of neuronal function after seizures, both acutely and chronically. And for those of us who see patients, the progressive memory complaints and clear-cut decline in function seen in those with drug-resistant epilepsy — particularly temporal lobe …

Increasing Student Achievement In English Language Learners Through Dual Language: A Policy Advocacy Document, Melissa Durrance

Dissertations

English language learners (ELL) represent the fastest growing population of learners in our schools. A substantial and continuing education achievement gap exists between ELLs and English speaking students and an alarmingly disproportionate number of ELL students contribute to the dropout rate. As educators, it is imperative that we provide educational programs to help reduce the achievement gap. All students deserve an education that will enable them to be productive citizens and that will provide them with the skills needed to enter either a career or an institution of continuing education upon graduation. As a solution to the increasing dropout rate …

Teacher And Evaluator Perspectives On The Teacher Evaluation Process For Teachers Of English Language Learners: A Change Leadership Plan, Nancy Martinez

Dissertations

This paper examines the need to add indicators to the current teacher evaluation system that are specific to English Language Learners (ELLs). Florida teacher evaluation protocols do not specify ELL-specific instructional strategies. This study explores perceptions of ELL teachers and school administrators on the fairness of current evaluative practices for ELL teachers. I considered research that supported the need for differentiated instruction for ELLs. I used the diagnostic framework by Wagner et al. (2006) to identify “arenas” of change: culture, context, conditions, and competencies. I used these arenas to present the existing situation in a school district. I then presented …

Recruiting Minority Faculty: The Effects Of The Bradley Memo Of Understanding On An Urban School District - A Program Evaluation Dissertation, Lois Mckee

Dissertations

This Program Evaluation Plan (PEP) explores aspects of the Bradley Memorandum of Understanding (MOU) with respect to its implementation in Pinellas County Schools (PCS). Although the Bradley MOU has many facets, this dissertation examines the minority faculty initiative portion of the agreement. There are many obstacles to overcome regarding attracting African American teachers to the PCS district, and they seem to be similar to struggles found in other districts across the state of Florida. By implementing a pre and post survey and conducting interviews with teachers and district employees, I was able to discover that Pinellas County Schools is showing …

Applying Social Return On Investment Analysis To A Large Central Florida County Public School District, David F. Lewis

Dissertations

All social organizations are faced with basic questions pertaining to the value they add to their community and how effectively and efficiently they do so. These questions are increasingly being directed to public schools and school districts as well relative to the various programming they offer and the results they achieve. By completing all aspects of a Social Return on Investment (SROI) analysis with fidelity, I have established a statistically reliable baseline SROI ratio based on a comparison of inputs (revenues) to outputs (outcomes). This baseline ratio serves as the foundation for subsequent change initiatives that will lead to district-wide …

A Policy Advocacy Dissertation To Increase Transparency And Accountability Through Social Return On Investment Analysis, David F. Lewis

Dissertations

The connection between the funding of public schools and student achievement is complex. Facing dwindling revenue streams, schools and the communities they serve must begin to assess how effectively and efficiently school systems are utilizing federal, state, and local taxpayer resources. As seen in the previous program evaluation and change leadership projects, the Social Return On Investment (SROI) methodology provides a framework that yields a statistically reliable vehicle for doing so that garners trust through transparency. Toward this end, this document advocates for school districts and their boards of education to incorporate the SROI analysis as an essential element of …

Passive Takings: The State's Affirmative Duty To Protect Property, Christopher Serkin

Michigan Law Review

The purpose of the Fifth Amendment’s Takings Clause is to protect property owners from the most significant costs of legal transitions. Paradigmatically, a regulatory taking involves a government action that interferes with expectations about the content of property rights. Legal change has therefore always been central to regulatory takings claims. This Article argues that it does not need to be and that governments can violate the Takings Clause by failing to act in the face of a changing world. This argument represents much more than a minor refinement of takings law because recognizing governmental liability for failing to act means …

Reconciliation Ecology: A New Paradigm For Advancing Creation Care, Dave P. Warners, Michael Ryskamp, Randall Van Dragt

University Faculty Publications and Creative Works

Current global environmental challenges—species loss, overconsumption, climate change, and others—have not been countered in the faith community with a response worthy of their signifi cance. While the prevailing faith-based creation-care paradigm, environmental stewardship, has been invaluable in moving us beyond the utilitarian notion of “dominion,” the stewardship concept does not suffi ciently emphasize our embedded, dependent relationship with the creation. To better represent our creationcare responsibilities, we propose a new paradigm based on a model of servanthood and informed by the concept of reconciliation ecology, which focuses on mending broken relationships between human beings and nonhuman creation. Drawing from the …

Strategic Planning Tool Development Using Portfolio Decision Analysis, Luis B. Vargas Rojas

Graduate Theses and Dissertations

A portfolio decision analysis strategic planning tool was developed for the Facilities Management Office at the University of Arkansas. The tool provides information to support budget allocation decisions based on their Strategic Planning Project List, project attributes (e.g, seat utilization, scheduling preferences, and sustainability rank), and budget constraints. The projects are evaluated using multiobjective decision analysis. We introduce dynamic value functions, which vary the range of the value measures based on the planning horizon, to evaluate the projects). We determine facilities portfolios based on the project values and constraints using Linear Programming. In addition, insightful reports are generated, which provide …

To Prison Or The Brig: Slamming The Door Shut On Military Mental Competency Defenses In United States V. Fry, 70 M.J. 468 (C.A.A.F. 2012), Eric P. Wilber

Southern Illinois University Law Journal

With the prevalence of autism and developmental disabilities in today’s society, the military courts have been asked to wrestle with the implications of enlisted soldiers who have these disabilities.  This issue is especially important because the Uniform Code of Military Justice (UCMJ) requires that soldiers have the mental capacity to contract for the enlistment to be valid, and therefore for the military courts to have jurisdiction of the case at all.  The nation’s highest military court, the Court of Appeals for the Armed Forces, recently addressed this issue in United States v. Fry by ruling that a developmental disability does …

Emerging Adults' Friends With Benefits Relationships, Emily Child Aguilar, Taelor Trimble

Psychology and Child Development

Friends with benefits is a relationship where friends are sexually, but not romantically, involved (Lehmiller, VanderDrtift, & Kelly, 2011). It is a type of relationship that is growing in popularity for young adults, frequently replacing traditional dating (Bradshaw, Kahn, & Salville, 2010). The goal of friends with benefits relationships is to maintain a friendship while engaging in physical intimacy without romantic emotional attachment (Gusarova, Fraser & Alderson, 2012). Although this type of relationship aims for equality, friends with benefits relationships are controversial due to the presence of a sexual double standard in which men are permitted to have more sexual …

Social Media Marketing For The Medical Industry: Best Practices To Avoid Legal And Ethical Issues, Jessica Padilla

Journalism

This study analyzes the best social media practices for medical industry professionals and the proper and ideal uses for social media. It analyzes the public relations functions of social media—relationship building, reputation management, and crisis communication. With the constant rise of social media as a widely-used medium for marketing comes increased potential for damage to a medical business’ reputation, loss of medical licensing, or lawsuits if practitioners do not act within the lines of legal and ethical standards. Medical offices must have an online presence to remain relevant and build and keep relationships with new and current patients. This study …

Stroke Rehabilitation In Pakistan: What We Know And What We Need To Do?, Farooq Azam Rathore, Akhtar Waheed

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is one of the leading causes of adult neurological disability all around the globe. There have been some remarkable improvements in the acute management of stroke. These include the use of thrombolysis, development of radiological investigations including computerized tomographic scan and magnetic resonance imaging and establishment of acute stroke units. There have been some promising advances the field of stroke rehabilitation as well in the last three decades.

Prof. Akhtar Ahmed – A Memoir Of Love, Respect, Admiration, And..., Ismail A. Khatri

Pakistan Journal of Neurological Sciences (PJNS)

Prof. Akhtar Ahmed – a majzoob, how can it be. What an unusual analogy! I was kind of surprised when I heard this from one of my revered teachers Prof. Iftekhar Ahmed who happen to be one of the students of Prof. Akhtar Ahmed like me. However, when he explained this analogy it made complete sense. He explained that a majzoob throws stones on the salik and treats the salik harshly until he is confident that the salik can go through and endure the hardships on the path. Once satisfied, the majzoob opens up for the salik and the knowledge …

Pattern And Outcome Of Epilepsy At Department Of Neurology At Cmc Teaching Hospital Larkana, Alam Ibrahim Siddiqui, Badaruddin Junejo, Lal Chander Dhingra, Anila Mumtaz

Pakistan Journal of Neurological Sciences (PJNS)

Epilepsy is third most common chronic neurological disease. Mortality is 2-3% more common in epilepsy patients than in general population. World wide survey have shown that epilepsy responds to treatment in about 70 % of epileptic patients and three fourth of the affected people do not get the treatment they need. So objective of our study was to know the outcome and pattern of epilepsy at Department of Neurology CMC teaching hospital Larkana ,so that in next step we could know which factors could reduce the morbitity and mortality due to epilepsy hence could prevent complications due to epilepsy. Total …

Radiological Findings In Peri-Partum Neurological Emergencies: Experience From A Tertiary Care Hospital, Pari Gul, Bushra Rehan, Saleha Anwar, Muhammad Usman Aziz

Pakistan Journal of Neurological Sciences (PJNS)

Acute neurological diseases requiring hospitalization are unusual in young women. Some of these diseases are unique to pregnancy and the post-partum period including pre-ecclampsia. Others such as cerebral venous thrombosis, ischemic stroke, intracranial hemorrhage, etc. are indirectly related to pregnancy and seen less frequently. To explore the causes of neurological emergencies in this specific patient population, we performed a radiological audit of young women in pregnancy and postpartum period presenting with neurological emergencies. Material and methods: This was a retrospective study carried in the Department of Radiology, Liaquat National Hospital over one year from January 2013 till January 2014, after …

Frequency Of Peripheral Neuropathy In Newly Diagnosed Patients Of Diabetes Mellitus Iion Clinical And Electrophysiological Basis, Muslim Ali Lakhiar, Naila Naeem Shahbaz, Abdul Hafeez Bughio, Jai Prakash

Pakistan Journal of Neurological Sciences (PJNS)

To determine the frequency of peripheral neuropathy in newly diagnosed patients of Diabetes Mellitus type II on clinical and electrophysiological basis. Methods: This is Hospital based descriptive cross sectional study conducted at department of Neurology Civil Hospital Karachi/ Dow University of Health Sciences from 20th December 2011 to 20th June 2012. Data was collected from Neurology OPD, Medicine OPD and Diabetic Clinic Civil Hospital Karachi. Results: Total no of patients were 107 who were already diagnosed as type 2 Diabetes Mellitus. Out of these, there were 57 (53.3%) male patients and 50 (46.7%) female patients, with ratio of males to …