Medicine and Health Sciences Commons^™

The Impact Of Sitting And Crawling On The Acquisition Of Object Permanence In Infants With Motor Delays And Infants With Typical Development, Karl Jancart

Electronic Theses and Dissertations

Object permanence (OP) is the ability to understand that objects continue to exist even when they cannot be perceived. During play, infants with an understanding of OP will continue searching for toys when the toys have been obscured by other items. Searching requires movement. The theory of embodied cognition maintains that the form and function of an organism’s body influence how the organism learns; Therefore, if a child has difficulties with movement, as demonstrated by children with motor delays, they will likely have difficulty engaging in play, the modality by which children learn about their world. The current research is …

Numerical Investigation Of Subglottal Stenosis Effects On Human Voice Production, Dariush Bodaghi

Electronic Theses and Dissertations

This dissertation aimed to advance knowledge of how subglottal stenosis impacts voice production physiology. An in-house fluid-structure-acoustic interaction approach based on the hydrodynamic/acoustic splitting technique was employed. This technique was rigorously verified for simulating phonation by matching the acoustic behavior to a compressible flow solver for phonation-relevant geometries. Simulations of an idealized 2D vocal tract model demonstrated the effects of supraglottal acoustic resonance on vocal fold kinematics and glottal flow waveform. Results showed that the acoustic coupling between higher harmonics and formats generated pressure oscillations, modifying vocal fold dynamics and glottal flow rate.

A major novelty was the incorporation and …

On The Anti-Adipogenic Function Of Collagen Triple Helix Repeat-Containing Protein 1, Matthew E. Siviski

Electronic Theses and Dissertations

Adipogenesis is regulated by the coordinated activity of adipogenic transcription factors, including PPAR-gamma (PPARG) and C/EBP alpha (CEBPA). Thus, dysregulated adipogenesis predisposes adipose tissues to adipocyte hypertrophy and hyperplasia. We have previously reported that mice possessing a homozygous null gene mutation in collagen triple helix repeat-containing protein 1 (CTHRC1) have increased adiposity compared to wildtype mice, supporting the concept that CTHRC1 regulates body composition. Herein, we investigated the anti-adipogenic activity of CTHRC1. Using 3T3-L1 preadipocytes, we showed significantly reduced adipogenic differentiation in the presence of CTHRC1 commensurate to marked suppression of Cebpa and Pparg gene expression. In addition, CTHRC1 increased …

Minoritized Medical Students' Integration Of Professional Identities: A Phenomenological Study, Travis Erickson

Electronic Theses and Dissertations

This qualitative study fills a gap in the extant literature by exploring how medical students with minoritized identities make meaning about sense of self-definition and emerging professional identities while enrolled in medical school. More specifically, the focus of this study explored how minoritized medical students perceived their sense of self and dimensions of identity were shaped during their medical education, and what perceptions these medical students had about how they manage their professional identity development. Emergent themes included: (a) making connections between self-definition and professional identities, (b) past experience of difference shaping identities, (c) self-definition with complexity, (d) fluidity as …

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …

E-Cigarettes: What Is The Relationship Between E-Cigarette Usage And Periodontal Disease?, Deborah Rose

Electronic Theses and Dissertations

The dental community has a broad understanding of how traditional combustible cigarettes affect the oral cavity of the dental patient but there is little research available on the effects that e-cigarettes have on the patient’s dental health. Vaping products have been marketed as a healthier option over traditional combustible cigarettes. Since they were first introduced in 2003, very little research has been performed to understand their dental implications. This project was executed to investigate the chemicals associated with these vaping products and how they possibly contribute to the progression of periodontal disease. This research project was conducted with the contribution …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Investigating The Effects Of Subchronic Dietary Zinc Supplementation On Diet-Induced Metabolic Dysfunction-Associated Steatotic Liver Disease., Oluwanifemi Esther Bolatimi

Electronic Theses and Dissertations

Zinc deficiency is associated with metabolic dysfunction-associated steatotic liver disease (MASLD). Previous studies show zinc supplementation improves steatosis, but its therapeutic effects in established MASLD remain unclear. We developed a model to characterize the effects of zinc supplementation on high-fat diet (HFD) induced MASLD and hypothesized established MASLD would be attenuated. Mice were fed control diet or HFD for 12 weeks and then grouped into normal or zinc-supplemented diets for 8 additional weeks. At euthanasia, plasma and liver tissues were collected for phenotypic analysis. Twelve weeks of HFD altered glucose clearance and body composition. Eight weeks of subsequent zinc supplementation …

Genetic Risk Scores For Hypertension And Chronic Kidney Disease In African Americans., Aastha Kakar

Electronic Theses and Dissertations

Hypertension (HT) and chronic kidney diseases (CKD) are complex conditions, disproportionally prevalent among African Americans (AA) and are influenced by multiple genetic as well as environmental factors. Genetic risk scores (GRS) enable the analysis of the combined effects of multiple single nucleotide polymorphisms (SNPs). This study investigates the association of blood pressure (BP) and CKD GRS with BP, hypertension (HT) and CKD; early-onset HT and CKD; and investigates interactions of the GRSs with environmental measures in AA. We observed a significant association between the BP-GRS with HT, SBP and DBP. The odds of HT for one standard deviation (s.d.) increase …

Monitoring External Workloads And Countermovement Jump Performance Throughout A Preseason In Division 1 Collegiate Women’S Basketball Players, Michelle Van Dyke

Electronic Theses and Dissertations

Monitoring external workloads and countermovement jump performance may be useful for coaches. PURPOSE: The purpose of this study was to determine the effects of external load on player performance as measured by a CMJ and specific blood biomarkers throughout the preseason. METHODS:10 female division 1 basketball athletes had PlayerLoad^TM (PL) monitored for all mandatory basketball training during six weeks of the preseason and CMJs were performed weekly. Blood biomarkers were collected before preseason and at the end of preseason. Data were analyzed via the Catapult Sport software (Openfield, Catapult, Innovations, Melbourne, VIC, Australia) to quantify all participant …

Transformational Leadership Training For Leaders, Kristie Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …

Project: Mhealth Applications For Educating Community Nurses, Nkemdilim Stacy Egbo

Electronic Theses and Dissertations

Hypertension is a chronic health condition linked to high morbidity and mortality rates in America and around the world. Hypertension care in developing and underdeveloped countries requires quick intervention. The proliferation of smart technologies and mobile health applications offer some leverage for the alternative management of hypertension, but evidence related to effectiveness in Nigeria are limited. The purpose of the study was to assess the impact of m-Health apps on hypertension self-management through nurses’ education in Southern region of Nigeria, as well as their self-confidence or efficacy using the Hypertension Evaluation of Lifestyle Management assessment. A quasi-experimental pretest-posttest design was …

The Relationship Between Job Challenge And Leadership Aspiration From The Perspective Of The Entry Level Nurse Leader, Rose M. Johnson

Electronic Theses and Dissertations

While the nurse leader plays an important and integral role in the success of healthcare organizations, the nurse leader pipeline has experienced a troubling and downward trajectory for several years. The lack of leadership aspiration among direct care nurses has been noted as one of several reasons for the downward trajectory. In addition, researchers identified the lack of understanding of perspectives of the various nurse leader roles and the lack of understanding of the effectiveness of experiential learning in the nurse leader role as potential contributions to the problem. The purpose of this quantitative, correlational research was to examine the …

Ethanol Dysregulates Sirt1-Mediated Lipogenic Signaling Pathways Through Α4*-Nicotinic Acetylcholine Receptors In Hepatocytes., Caitlin Christina Wilkerson

Electronic Theses and Dissertations

Alcohol-associated liver disease (ALD) is a broad spectrum of diseases ranging from steatosis to severe hepatic cirrhosis, none of which have any FDA approved therapies. Downregulation of hepatic Sirtuin 1 (Sirt1) activity by ethanol has been shown to lead to an upregulation of the pro-lipogenic gene targets under its jurisdiction, resulting in increased lipogenesis and triglyceride accumulation. It was hypothesized that ethanol acts on α4*-nicotinic acetylcholine receptors (α4*-nAChRs) in hepatocytes to decrease Sirt1 expression, which ultimately dysregulates lipid metabolic homeostasis. Ethanol’s effects were investigated in cultured AML12 hepatocytes and in WT primary mouse hepatocytes acutely exposed to ethanol. Consistent with …

Environmental Exposures And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

In recent years, research into air pollution has shown that exposure to certain components in air pollution, primarily PM2.5 can accelerate biological aging and thereby lead to increased susceptibility to multiple diseases. We hypothesize that prolonged exposure to air pollutants can result in premature aging leading to extensive tissue dysfunction and susceptibility to diseases. To examine this, we exposed mice to PM2.5 for 9, 15, and 21 days, then measured the telomere lengths, cellular senescence, and histone methylation patterns of multiple cell types. We found consistently increased telomere attrition, cellular senescence and advanced age-consistent histone methylation patterns in groups exposed …

Genetically Engineering Gingipains For High Yield Large Scale Purification., Andrew E. Fuchs

Electronic Theses and Dissertations

Porphyromonas gingivalis is a keystone oral pathogen in the progression of periodontal disease and has been implicated in the etiology of many other systemic human diseases. P. gingivalis produces primary virulence factors termed the gingipains, a group of cysteine proteases. There is a high demand for high purity gingipains for downstream in vitro studies where P.g. is implicated, both oral and systemic. Gingipain production candidate mutant P.g. strains were generated to isolate each gingipain for large scale purification and the purified gingipains characterized. Two mutants were determined not to be viable for large scale purification of gingipains, each for different …

Formalizing The Faustian Bargain Within The Healthcare Domain: An End-Of-Life Approach., Rachel Appel

Electronic Theses and Dissertations

A Faustian Bargain refers to an individual making a “deal with the devil,” exchanging something moral or sacred for an unattainable earthly good. The Faustian Bargain has been used to describe a ubiquitous social dilemma inherent to human civilization: exchanging individual liberty for public goods (e.g., security) provided by societal leaders and governments (Ostrom, 1980). Research on Faustian Bargains often examines tradeoffs between outcome utility (i.e., value derived from the outcomes of a decision) and procedural utility (i.e., value derived from being involved in the decision process (e.g., Frey et al., 2004). Much of the research on Faustian Bargains has …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …

Investigation Of Heterocyclic Amines And N-Acetyltransferase 2 Genetic Polymorphism In The Dysregulation Of Hepatic Energy Homeostasis: A Gene-Environment Approach., Kennedy M Walls

Electronic Theses and Dissertations

Heterocyclic amines (HCAs) are mutagens generated when cooking meat for prolonged periods of time or until well-done. Recent epidemiological studies reported significant associations between dietary HCA exposure and insulin resistance and type II diabetes. However, no previous studies have examined if HCAs, independent of meat consumption, contributes to pathogenesis of insulin resistance or metabolic disease. It is well known that HCAs require hepatic bioactivation by cytochrome P450 1A2 (CYP1A2) and N-acetyltransferase 2 (NAT2). NAT2 expresses a well-defined genetic polymorphism in humans that, depending on the combination of NAT2 alleles, correlate to rapid, intermediate, or slow acetylator phenotypes that exhibit differential …

Evaluation Of Cardiovascular Risk Compliance For Primary Prevention: A Quality Improvement Project, Rachelle S. Campbell

Electronic Theses and Dissertations

The American College of Cardiology and American Heart Association clinical practice guidelines recommend a cardiovascular risk assessment every 4–6 years in ages 40–75 to prevent cardiovascular disease. This DNP project aimed to improve awareness, compliance with cardiac risk assessments, and stratification of high and low-risk patients. This quality improvement project utilized the Johns Hopkins nursing evidence-based model to create the inquiry question and foundational plan for implementing the clinical practice guideline, calculating the cardiac risk score, and creating a clinical workflow process. A retrospective chart audit was guided by the Plan-Do-Study-Act (PDSA) method to collect pre- and postintervention data on …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

Psychological Safety And Conflict Management Among Nurse Practitioners In Interprofessional Teams, Scott Faust

Electronic Theses and Dissertations

This quantitative correlational study explored the relationships between perceived psychological safety, conflict management styles, and perceived conflict management success among nurse practitioners (NPs) operating in interprofessional acute or critical care teams in the United States. Despite existing literature on conflict management and psychological safety, there is a noticeable gap concerning the interplay of these factors, specifically among NPs. A multi-item survey was developed from validated measures to assess psychological safety, conflict management success, and conflict management style. The final sample included 944 NPs. The findings revealed a statistically significant difference in the scores of perceived psychological safety, depending on the …

Assessment Of Self-Efficacy And Practice Change Following Pressure Injury Education In A Long-Term Care Facility, Charity L. Booker

Electronic Theses and Dissertations

The purpose of this scholarly project was to evaluate if pressure injury education improved nursing knowledge and self-efficacy in the prevention and management of pressure injuries with the intent to improve practice. A literature review was conducted to evaluate educational interventions for adult learners and nursing roles in the care process. Existing studies indicated that patient outcomes are improved when nurses have adequate knowledge in pressure injury prevention. This quality improvement project was implemented in a long-term care facility with 28 nursing staff. The Agency for Healthcare Research and Quality pressure injury best practices presentation was the basis for the …

An Educational Program To Improve African American Women’S Knowledge And Self Efficiency In Seeking Treatment For Endometrial Cancer, Lauren Elise Rosenthall

Electronic Theses and Dissertations

In the United States, there is a significant difference in the survival rate for endometrial cancer for African American women when compared to women of other ethnic groups, specifically White women. There is supporting evidence that supports that morbidity and mortality rates for endometrial cancer increase if diagnosed in later stages. There are many contributing factors to a patient receiving an early diagnosis of a disease. One of the key determinants to early diagnosis of endometrial cancer is understanding risk factors, and what symptoms require further evaluation. An educational program was developed to identify knowledge deficits in the African American …

The Impact Of Self-Compassion Strategies To Reduce Stress And Support The Transition To Practice For New Graduate Nurses: A Pilot Project, Charity Michelle Ballmann

Electronic Theses and Dissertations

Abstract The purpose of the study was to analyze the impact of self-compassion exercises to reduce stress and support the transition to practice for new graduate nurses. As the years pass, one thing remains a consistent topic in healthcare, and the need for nurses remains constant. The nursing staffing shortage gap seemingly widened further as the COVID-19 pandemic created additional challenges for healthcare systems, patient care, and employees. Retention of the workforce and an intentional focus on new graduate nurses' well-being have become increasingly important. New graduate nurses are a pipeline for the nursing workforce. Supporting the transition to practice …

Emergency Department Registered Nurses’ Perceptions Of Substance Use Disorders And Supervised Consumption Sites, Aleksandra Ilievska

Electronic Theses and Dissertations

Background: Canada is facing increased drug-related harms; thus, a stronger emphasis has been placed on harm reduction strategies such as supervised consumption sites (SCSs). There is a lack of literature on emergency department (ED) registered nurses’ (RNs) perceptions of SCSs and substance use disorders (SUDs), especially in small to mid-sized Canadian cities. Purpose: This study aimed to determine ED RNs’ perceptions of SUDs and SCSs in Southwestern Ontario hospitals. Methods: A 27-question survey was sent to RNs currently working in EDs in Southwestern Ontario using an online Qualtrics® link. The research explored ED RNs’ perception of SCSs and SUDs. Results: …

Emergency Department Registered Nurses’ Perceptions Of Substance Use Disorders And Supervised Consumption Sites, Aleksandra Ilievska

Electronic Theses and Dissertations

Background: Canada is facing increased drug-related harms; thus, a stronger emphasis has been placed on harm reduction strategies such as supervised consumption sites (SCSs). There is a lack of literature on emergency department (ED) registered nurses’ (RNs) perceptions of SCSs and substance use disorders (SUDs), especially in small to mid-sized Canadian cities.

Purpose: This study aimed to determine ED RNs’ perceptions of SUDs and SCSs in Southwestern Ontario hospitals.

Methods: A 27-question survey was sent to RNs currently working in EDs in Southwestern Ontario using an online Qualtrics® link. The research explored ED RNs’ perception of SCSs and SUDs.

Results: …

The Use Of The Agency Healthcare Research And Quality Patient Safety Indicator 11 Toolkit To Decrease Postoperative Respiratory Failure, Nancy Garcia

Electronic Theses and Dissertations

Postoperative respiratory failure incidents can lead to adverse outcomes, including prolonged hospitalizations, increased admissions to intensive care units, and the risk of complications such as ventilator-associated pneumonia, sepsis, and mortality. This project aimed to assess the effectiveness of implementing the Agency for Healthcare Research and Quality Patient Safety Indicator 11 toolkit intervention for noninvasive positive-pressure ventilation in reducing postoperative respiratory failure rates compared to traditional practices. Adopting evidence- based toolkits, such as those provided by the Agency for Healthcare Research and Quality, aids healthcare organizations in enhancing the quality of patient care. The quality improvement project employed a quasi-experimental design, …

Examining The Relationship Of Transformational Leadership And New Graduate Nurse Turnover Intention During The Covid-19 Pandemic, Becky Louise Goens

Electronic Theses and Dissertations

Introduction: The nursing shortage in the Canadian healthcare system presents challenges in meeting the healthcare needs of the population and addressing the growing demand for health services. There is strong evidence emphasizing the pivotal role leaders play in fostering retention through positive practices. As new graduate nurses are crucial to the healthcare team, targeted strategies by nursing leaders and managers are needed to enhance nurse retention. Purpose: The purpose of this study was to examine the relationship between transformational leadership and new graduate nurses’ turnover intention, and organizational commitment. Methods: The study included 106 registered nurses who passed the NCLEX-RN …

Loneliness, Risk-Taking, And Attention Deficit Hyperactivity Disorder During The Covid-19 Pandemic, Rebecca Nurgitz

Electronic Theses and Dissertations

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder, commonly associated with impulsivity, risk-taking, and greater reported loneliness. Risk-taking can manifest in various ways, including reduced regard for health-conscious practices. Recent research indicates that individuals with ADHD may be less likely to follow pandemic safety instruction. (e.g., not following social distancing recommendations). Given that individuals with ADHD tend to discount the value of delayed reward in favour of immediate gratification, it can be presumed that individuals with greater ADHD symptomology may be more likely to not follow social distancing guidelines in an attempt to relieve acute feelings of loneliness. The …