Medicine and Health Sciences Commons^™

“You Came To Not Normal Land”: Nurses' Experience Of The Environment Of Disaster: A Phenomenological Investigation, Stasia Elizabeth Ruskie

Doctoral Dissertations

Previous research suggests US nurses are unprepared for disaster, and suffer from adverse psychosocial outcomes following their disaster response. Current disaster preparedness focuses on providing hospital-centric trauma and acute care in fully resourced Western conditions, and does not include the environmental realities of the disaster setting. This study utilized an existential phenomenological approach to explore the meaning of the nurse’s experience of the disaster environment. Eleven nurses with broad disaster expertise and training levels participated in this research. The essence of their disaster experiences can be summed up by the central theme of “You came to not normal land.” Four …

Health Assessment Of Two Reintroduced Populations Of American Martens (Martes Americana) In Michigan, Maria Catherine Spriggs

Doctoral Dissertations

The American marten (Martes americana) was extirpated from Michigan during the early-20th century due to loss of vast areas of mature conifer forest and unregulated trapping. The species was reintroduced into the Upper Peninsula (UP) and Northern Lower Peninsula (NLP) during the mid-20th century. While the American marten population in the UP has grown and is doing well, the population in the NLP has been less successful. The reasons for the limited success of the NLP population are unknown, but may include lack of suitable habitat, limited reproductive success, poor genetic diversity, disease, or negative environmental impacts. American …

Characterization Of Hypothalamic Neuropeptides In Mammalian Reproduction, Valeria Tanco

Doctoral Dissertations

Understanding of regulation of reproduction at the level of the brain changed dramatically with the discovery of reproductive neuropeptides. To date there have been no studies to characterize the distribution of reproductive neuropeptides in the bovine hypothalamus at different stages of the estrus cycle or to determine the physiological effects of peripheral administration of Gonadotropin inhibiting hormone (GnIH) in intact female cattle and ovariohysterectomized bitches.

The goal of the first study was to determine distribution and connectivity of kisspeptin, dynorphin, and GnIH in the hypothalami of sexually mature female cattle during the estrous cycle. To this end, hypothalami of female …

Targeting Early Events In Herpetic Stromal Keratitis, Fernanda Giménez

Doctoral Dissertations

Herpetic stromal keratitis [HSK] is an immunoinflammatory corneal lesion caused by Herpes simplex virus type 1 [HSV] infection. SK is usually the consequence of virus reactivation from latency in the trigeminal ganglion. Studies in animal models have revealed that SK lesions are orchestrated mainly by CD4+T cells that infiltrate the corneal stroma. However, prior to this immunoinflammatory phase, multiple events occur that set the stage for subsequent pathology. These include production of cytokines and chemokines, infiltration of innate immune cells and neovascularization of the avascular cornea.

The first part of this dissertation reviews literature regarding the current understanding of human …

Examining The Relationships Between Gratitude And Readiness For Self-Directed Learning In Undergraduate Nursing Students, Kellee Renee Vess

Doctoral Dissertations

The purpose of this study was to explore the relationships between gratitude and readiness for self-directed learning among nursing students enrolled in a four-year baccalaureate nursing program. For this study a sample of 59 nursing students were selected from a four-year baccalaureate nursing program, situated in a private, faith-based college in the Southeast United States. During data collection, participants were asked to complete the Gratitude 6-item questionnaire [GQ-], the 40-item Self-Directed Learning Readiness Scale for Nursing Education [SDLRS-NE], and two demographic questions (i.e., age and class rank). Using both parametric and nonparametric statistics, this study examined eight research questions, and …

The Metastatic Receptor Status Impact On First-Line Treatment Plans And Outcomes For Recurrent Metastatic Breast Cancer, T. Allen Pannell

Doctoral Dissertations

Background: For more than two decades, breast cancer researchers have studied the benefits, risks and clinical importance of testing the receptor status of metastatic tumors. While there is a growing consensus that the status should be re-tested and under what circumstances that re-testing should occur, there is little to no evidence that utilizing test results for metastatic tumor receptor status improves the clinical outcomes of patients. In fact, there is evidence that changes to treatment plans based on this re-testing can be harmful to patient outcomes.

Objective: This dissertation evaluates the current state of evidence related to altering patient treatment …

Experiences Of Newly Licensed Registered Nurses Who Stay In Their First Jobs, Lisa D. Kirkland

Doctoral Dissertations

Most newly licensed registered nurses go to work in acute care hospitals, which means they enter an increasingly complex healthcare environment where they experience staffing shortages, high nurse-patient ratios, and workplace violence. The purpose of this study is to attempt to understand the experiences of newly licensed registered nurses who have endured the early years of bedside hospital nursing and continue to work in their first nursing job. The existential phenomenological philosophy of Merleau-Ponty serves as the guiding framework for this qualitative research study. Following IRB approval, criterion and snowball sampling were used to recruit newly licensed registered nurses who …

Brown And Beige Adipocytes: Effects Of Inflammation And Nutritional Intervention, Jiyoung Bae

Doctoral Dissertations

Recent findings of brown adipocytes and brown-like or beige adipocytes, capable of dissipating energy as heat, in adult humans have promised new hope for obesity treatment and prevention. Understanding of the regulation of brown and beige adipocytes will provide novel strategies to reach the goal. Pattern recognition receptors (PRR) are responsible for inflammation in adipose tissue, which leads to adipose dysfunction and obesity associated chronic diseases. It has been shown that PRR activation induces inflammation, leading to insulin resistance in white adipocytes and white adipose tissue (WAT). However, the roles of PRR activation in brown adipocytes and brown adipose tissue …

Epidemiology Of Select Species Of Filarial Nematodes In Free-Ranging Moose (Alces Alces) Of North America, Caroline Mae Grunenwald

Doctoral Dissertations

North American moose (Alces alces) are a culturally and economically valued species. Recent population declines raise concern for the survivability of this natural resource. The Minnesota population has experienced the most dramatic decline, with a 60% loss in total numbers since 2006. Nematode parasites, particularly some species of filarids, are important pathogens of moose and could be contributing to morbidity and mortality. This study investigates the eco-epidemiology of two filarial parasites of moose: Rumenfilaria andersoni and Elaeophora schneideri. By surveying cervid species from six U.S. states, we discovered R. andersoni was present in moose from all sample locations …

Effects Of Varus Knee Alignment And Using Toe-Cages On Frontal Plane Knee Biomechanics In Stationary Cycling, Guangping Shen

Masters Theses

Effects of varus knee alignment on the internal knee abduction moment (KAM) in walking has been widely studied. KAM has been shown to be closely associated with the development of medial knee osteoarthritis (OA). Despite the importance of the knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of varus knee alignment and using a toe-cage on the knee frontal plane biomechanics during stationary cycling. Eleven participants in each of the varus and neutral groups participated in the study. The participants performed in …

Associations Of Cooking Self-Efficacy And Frequency Of Icook-4h Youth Participants With Dietary Quality And Bmi At Baseline, Amber Donaldson Ford

Masters Theses

Background: With increased obesity has come increased ready-made and fast food consumption and decreased homemade food consumption. Previous studies have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth.

Objective: The objective of this project was to determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4-H.

Methods: …

Icloudecg: A Mobile Cardiac Telemedicine System, David S. Clifford

Masters Theses

With rising healthcare costs and a substantially growing number of patients 65 or over, the benefits of telemedicine and patient self-monitoring systems are becoming increasingly evident. Patients, physicians, hospitals, and even insurance providers benefit from vigilant, cost-effective patient monitoring systems. This thesis describes the development of a portable, smart-phone connected system for continuous cardiac monitoring. The system is capable of continuously monitoring the conditions of the heart, automated detection of cardiac arrhythmias, and real-time notifying patients and physicians of the detected abnormalities. The system consists of four main subsystems: 1) a Bluetooth capable chest-strap ECG, 2) an Android-enabled mobile device, …

Cirugía Cosmética: Un Análisis De Su Historia Y Prevalencia En Latinoamérica, Elena R. Hamilton

Chancellor’s Honors Program Projects

No abstract provided.

How Microbiomes Can Feed The World: A Look Into Bovine Reproduction, Hannah Noel Mcdonald

Chancellor’s Honors Program Projects

No abstract provided.

The Effects Of Electronic Treatment Reminder Cues On Relapse Prevention, Kathrin Ritter

Doctoral Dissertations

Substance use is highly prevalent in the United States, and although treatments designed to reduce substance use have shown promise, relapse rates between 40% and 70% following treatment have been reported in recent studies. Given the high rate and chronicity of relapse following substance abuse treatment, conducting research aimed to develop techniques to lower the risk of relapse following treatment is imperative. A promising option to reduce relapse is to use treatment reminder cues, or cues that are salient features of the treatment environment that can be used to extend the effects of treatment into non-treatment settings. This study investigated …

Developing An Optimal Model For Infant Home Visitation, Isaac Atuahene

Doctoral Dissertations

The United States, Great Britain, Denmark, Canada and many other countries have accepted home visitation (HV) as a promising strategy for interventions for infants after births and for their mothers. Prior HV studies have focused on theoretical foundations, evaluations of programs, cost/benefit analysis and cost estimation by using hospital/payer/insurance data to prove its effectiveness and high cost. As governments and private organizations continue to fund HVs, it is an opportune time to develop and formulate operations research (OR) models of HV coverage, quality and cost so they might be used in program implementation as done for adult home healthcare (HHC) …

Evaluating The Effects Of Standardized Patient Care Pathways On Clinical Outcomes, Anna V. Romanova

Doctoral Dissertations

The main focus of this study is to create a standardized approach to evaluating the impact of the patient care pathways across all major disease categories and key outcome measures in a hospital setting when randomized clinical trials are not feasible. Toward this goal I identify statistical methods, control factors, and adjustments that can correct for potential confounding in observational studies. I investigate the efficiency of existing bias correction methods under varying conditions of imbalanced samples through a Monte Carlo simulation. The simulation results are then utilized in a case study for one of the largest primary diagnosis areas, chronic …

Newly Licensed Registered Nurses' Experiences With Clinical Simulation, Carrie Ann Bailey

Doctoral Dissertations

The purpose of this study was to understand how new graduate nurses perceive the value of simulation in making the transition into professional practice. This study will use a descriptive qualitative approach with a sample of first year nurses. Kolb’s Experiential Learning Model serves as this study’s conceptual framework. For the current study, the sample consisted of 10 newly graduated, female nurses with less than one year of experience working in the hospital setting were interviewed. Data analysis included interviews and transcription by the researcher. Finally, participants were asked about themes to increase rigor. Four themes emerged from this research: …

Enzyme Catalyzed Alginate Nanogels For Drug Delivery, Danna Nichole Sharp

Masters Theses

Developing nanoscale carriers for the delivery of therapeutics is an important topic of investigation in current biomedical research. As opposed to traditional drug delivery systems, nanoscale systems offer enhanced tissue and cell permeation in addition to reducing drug elimination from the body. Biological based therapeutics such as DNA and proteins are now widely employed in medical applications and research has focused on using nanoscale drug delivery systems to administer these more effectively. Current synthesis methods of nanoscale biotherapeutic carriers face significant challenges. Among these are creating carriers with: sizes between 10-200 nm, low polydispersity, and non-cytotoxic materials. In this thesis, …

Nutrition Marketing On The Front-Of-Package: 2007-2014, Ana Elizabeth Hoffmann

Masters Theses

Objective: The objectives of this research were to describe the proportion of packaged foods with front-­‐of package nutrition marketing or marketing to children that were high in saturated fat, sodium, and/or sugar content, and to delineate changes in the proportions of these foods from 2007 to 2014.

Methods: Front-­‐of-­‐pack nutrition marketing, child marketing, and nutrient criteria from the Nutrition Facts Label on all packaged food items in a large Midwestern supermarket were recorded in 2007 (n = 5,500) and again in 2014 (n = 6,324). Products were coded as high/not high in saturated fat, sodium, and/or sugar according to agreed …

Population Modeling For Resource Allocation And Antimicrobial Stewardship, Jason Bintz

Doctoral Dissertations

This dissertation contains two types of population models with applications in conservation biology and epidemiology. In particular, it considers models for resource allocation and antimicrobial stewardship.

In a population model with a parabolic differential equation and density dependent growth, we study the problem of allocating resources to maximize the net benefit in the conservation of a single species while the cost of the resource allocation is minimized. The net benefit is measured in terms of maximizing population abundance and the goal of maximizing abundance is divided between the goal of maximizing the overall abundance across space and time and the …

Do Increases In Fruit Intake Lead To Substitutive Eating Patterns And Decreases In Overall Energy Intake In Normal Weight Adults?, Shireen Amanda Sobhani

Masters Theses

Background: It is suggested that increasing intake of fruits and vegetables may lead to decreased energy intake via substitution of higher energy-dense foods, such as snack foods (SF; i.e. candy, chips, cookies). This study investigated the impact of increasing fruit (F; grapes) intake, via increased portion size, on SF (potato chips) intake during a meal and whether increases in F intake affected total meal energy intake, via reducing SF intake (substitutive eating), in normal-weight adults. A secondary objective investigated whether the relative reinforcing value (RRV) of SF was a moderator of the substitutive relationship between F and SF.

Methods: Using …

Biodegradable Nano-Hybrid Polymer Composite Networks For Regulating Cellular Behavior, Charles Henley Sprague

Masters Theses

Photo-crosslinkable polymeric biomaterials have emerged in the field of biomedical research to promote tissue regeneration. For example, scaffolds that can be crosslinked and hardened in situ have been known to make suitable implant alternatives. Since injectable and photo-crosslinkable biomaterials offer the advantage of being minimally invasive, they have emerged to compete with autografts, a current highly invasive method to repair diseased tissue. A series of novel photo-crosslinkable, injectable, and biodegradable nano-hybrid polymers consisting of poly(ε-caprolactone fumarate) (PCLF) and polyhedral oligomeric silsesquioxane (POSS) has been synthesized in our laboratory via polycondensation. To engineer the material properties of the nano-hybrid networks, varied …

Characterization And Development Of Amyloid-Reactive Peptides As Tracers For Quantitative Molecular Imaging, Emily Brooke Martin

Doctoral Dissertations

Amyloidosis is a degenerative protein misfolding disorder that leads to the extracellular accumulation of amyloid deposits containing protein fibrils, heparan sulfate proteoglycans, glycoproteins and apolipoproteins. To date, at least 27 proteins have been identified as components of pathologic amyloid fibrils. In systemic forms of the disease, amyloid deposits can evade the immune system and expand throughout various tissues. As the deposits grow, tissue architecture is disrupted, leading to organ dysfunction and death.

In the US, there are ~3500 newly diagnosed patients with amyloidosis annually. The deposition of light chains as amyloid (AL amyloidosis) is the most common form of visceral …

Investigation Of Zyflamend On Ampk Signaling And Potential Interactions Of Its Components, Yi Zhao

Doctoral Dissertations

The reductionist approach contributes greatly to our understanding of anticancer properties of phytonutrients, but in vitro studies demand concentrations that are 100-1000 times higher than achievable in humans, producing results with little physiologic relevance, resulting in disappointing outcomes in clinical trials. However, maintaining these bioactives in the presence of other compounds originally derived from the food/extract of origin may synergistically lower the bioactive dose so translatability becomes feasible. The first objective of this study was to determine if bioefficacy of phytonutrients can be enhanced when used in combination at doses that are ineffective when used in isolation. In this project, …

Effectiveness Of Proloquo2goTm In Enhancing Communication In Children With Autism During Aba Therapy, Taylor Eastin Krcek

Doctoral Dissertations

Autism is a bio-neurological developmental disorder presenting in early childhood that has a profound effect on an individual's ability to communicate. The iPad® with the Proloquo2Go^TM app is a multilingual Augmentative and Alternative Communication (AAC) solution designed to assist people who have difficulty speaking or cannot speak at all. This study examines the effectiveness of the Proloquo2Go^TM app delivered via iPad® to enhance the tacting, manding, and verbal completion repertoires of children with autism. Participants included five children between the ages of three and four years old diagnosed with an autism spectrum disorder (ASD) and with low to …

Dynamic Simulation And Neuromuscular Control Of Movement: Applications For Predictive Simulations Of Balance Recovery, Misagh Mansouri Boroujeni

Doctoral Dissertations

Balance is among the most challenging tasks for patients with movement disorders. Study and treatment of these disorders could greatly benefit from combined software tools that offer better insights into neuromuscular biomechanics, and predictive capabilities for optimal surgical and rehabilitation treatment planning. A platform was created to combine musculoskeletal modeling, closed-loop forward dynamic simulation, optimization techniques, and neuromuscular control system design. Spinal (stretch-reflex) and supraspinal (operational space task-based) controllers were developed to test simulation-based hypotheses related to balance recovery and movement control. A corrective procedure (rectus femoris transfer surgery) was targeted for children experiencing stiff-knee gait and how this procedure …

Lower Extremity Biomechanics During Stair Ascent In Healthy And Total Knee Replacement Older Adults, Tyler Whitney Standifird

Doctoral Dissertations

Altered gait following total knee replacement (TKR) may increase risks for failure of joint replacements and subsequent joint replacements in both the replaced and non-replaced limb of TKR patients. Stair climbing is an activity of daily living that is more demanding than level walking and may be more robust at detecting altered gait biomechanics. Study One reviewed biomechanics during stair ambulation following TKR. Study Two compared lower extremity biomechanics during the first three steps of ascent and level walking in healthy adults. Study Three compared lower extremity biomechanics of the replaced and non-replaced limbs of TKR patients and a healthy …

Exploring Holistic Comfort In Children Who Experience A Clinical Venipuncture Procedure, April Athena Bice

Doctoral Dissertations

Children often experience the uncomfortable effects of invasive procedures as a part of primary health supervision and during times of illness. Inadequate procedural comfort management can lead to numerous lasting harmful effects including distrust of healthcare providers, future intensified pain responses, negative cognitive and emotional experiences, and psychosocial health problems (Czarnecki et al. 2011). Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child’s perspective. The purpose of this study was to explore perspectives of children age 4 to 7 years and their caregivers regarding procedural holistic …

Role Of Microrna-155 In Herpes Simplex Virus Pathogenesis, Siddheshvar Bhela

Doctoral Dissertations

Ocular infection with herpes simplex virus 1 (HSV-1) can result in a chronic immunoinflammatory stromal keratitis (SK) lesion that is a significant cause of human blindness. These lesions are mainly orchestrated by IFN-gamma producing CD4+ T cells (Th1) and neutrophils. HSV being neurotropic in nature can also disseminate into the brain and lead to herpes simplex encephalitis (HSE). In this study we investigated the role of miR-155 in the pathogenesis of HSK and HSE.

The first part of the dissertation (I) reviews literature regarding the contribution of miRNAs in innate and adaptive immune responses. It also focuses on their involvement …