Medicine and Health Sciences Commons^™

Theta Burst Brain Stimulation In Painful Diabetic Neuropathy Patients: Investigating Neural Mechanisms, Bhushan Thakkar

Theses and Dissertations

Chronic pain (CP) is a significant contributor to disability and disease burden globally. In 2019, approximately 50.2 million adults (20.4% of the US population) experienced chronic pain, contributing to $560-635 billion in direct medical costs. In addition, the worldwide prevalence of diabetes mellitus has reached epidemic proportions and is set to increase to 629 million by 2045. Almost 50% of patients with diabetes present with diabetic neuropathy (DN), and one in five patients with diabetes presents with painful DN (pDN) which is the most common cause of neuropathic pain (NP) in the US. Symptomatic treatment is the mainstay of management …

Protein Structure And Interaction: The Role Of Aromatic Residues In Protein Structure And Interactions Between Pyridoxine 5'-Phosphate Oxidase/Dopa Decarboxylase, Mohammed H. Al Mughram

Theses and Dissertations

Naturally developed proteins are capable of carrying out a wide variety of molecular functions due to their highly precise three-dimensional structures, which are determined by their genetically encoded sequences of amino acids. A thorough knowledge of protein structures and interactions at the atomic level will enable researchers to get a deep foundational understanding of the molecular interactions and enzymatic processes required for cells, resulting in more effective therapeutic interventions. This dissertation intends to use structural knowledge from solved protein structures for two distinct objectives.

In the first project, we conducted a bioinformatics structural analysis of experimental protein structures using our …

Development And Optimization Of A Low Volume Air-Jet Dry Powder Inhaler (Dpi) Platform For The Delivery Of High Dose Aerosolized Powder To Infants, Connor Howe

Theses and Dissertations

The goal of this research project was to develop an infant air-jet dry powder inhaler (DPI) platform for high-efficiency nose-to-lung (N2L) aerosol administration to infants through optimization of individual system components followed by expansion of the system to higher doses and different formulations using a new approach. Primary challenges associated with aerosol delivery to infants using the N2L route include the extremely narrow extrathoracic airways, short inspiratory times (~0.2 sec), low safe airway pressure (H₂O), and very low volumes of air (~10 mL) available to form the aerosol. The infant air-jet DPI system was comprised of three main …

Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar

Theses and Dissertations

Tummy time or awake, supervised, prone play is an important developmental play position in infancy. Engaging in more than 15 minutes of tummy time per day is associated with a lower risk of plagiocephaly, lower body mass index, and achievement of higher motor scores in full-term and at-risk preterm infants. However, there are significant gaps in the measurement of tummy time in current literature. Conventionally used subjective parent reports have not been validated against gold standard direct observation, and the feasibility and real-world validity of objective solutions such as wearable sensors has not been examined in full-term and at-risk preterm …

An Analysis Of The Special Focus Facility Program And Nursing Home Quality, Annie S. Rhodes

Theses and Dissertations

The Special Focus Facility Program is an intensive program meant to rapidly support 88 of the lowest quality nursing homes in the United States, as determined by the Five-Star Quality Ranking system. There are also 435 facility candidates which are similarly low performing but not enrolled in the program. Academic literature has largely ignored this program, and the existing grey literature is more than a decade old and does not include COVID-19 data. Applying a political economy of aging framework and using a case matching methodology, Special Focus Facilities (SFF), Special Focus Facility Candidate (SFFc) nursing homes, and 5-star nursing …

Behavioral Screening And Chiral Bioanalysis Of Emerging Stimulant-Type Drugs In Rats, Tyson R. Baird

Theses and Dissertations

The epidemic of drug use in the United States and elsewhere in the world has resulted in tragic loss of life and substantial economic costs. Novel psychoactive substances (NPS) are one of the contributors to this problem, and the lack of information about many of these drugs compounds their risk. This dissertation proposes a strategy to use intracranial self-stimulation (ICSS) as a behavioral screening tool to assess emerging drugs of abuse for their abuse potential in order to generate a proactive threat assessment. A series of stimulant-type drugs including methcathinone, α-pyrrolidinohexanophenone (α-PHP), cocaine, and the phenyltropane analogs of cocaine WIN35428 …

Targeting Bcl-2 Family Proteins In Therapy Induced Senescent Cancer Cell Models, Wade Cook

Theses and Dissertations

Non-small Cell Lung Cancer (NSCLC) originates from numerous different cell types in the lungs and is among the deadliest of cancers. Head and Neck Squamous Cell Carcinomas (HNSCC) are derived from the mucosal membranes of the oral cavity, pharynx, and larynx. Both NSCLC and HNSCC are predominately caused by tobacco smoke inhalation and as such mutations in the tumor suppressor gene TP53 are common. Since similarities exist in the root cause of NSCLC and HNSCC, they may also share similarities in treatment methods. Cisplatin is a platinum-based DNA damaging agent that has been used as a cancer chemotherapy for decades. …

Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox

Theses and Dissertations

Although there is robust empirical support that poor sleep contributes to declines in mental health, explanations of this relationship remain unclear. The purpose of the present study was to examine the pattern of associations between sleep quality, sleep self-efficacy, loneliness, physical activity, and mental health among U.S. adults across the lifespan, and whether they differed by gender or age group. A structural equation model with invariance analysis was developed and examined data from 2,300 adults (M_age = 44.1, SD = 16.78) participating in the online study Investigating Sleep Longitudinally Across Normal Development (ISLAND). Sleep quality was measured by …

Examination Of Common And Rare Variant Genetic Architecture Of Psychiatric Disorders, Mohammad Ahangari

Theses and Dissertations

Psychiatric disorders are often heterogenous in their manifestation and genome-wide association studies have identified many common risk variants involved in their polygenic architectures with varying degrees of pleiotropy. In recent years, large-scale biobanks have also begun sequencing the genome of their participants to elucidate the role of rare risk variation in the genetic architecture of complex phenotypes, including psychiatric traits. This dissertation sought to better understand the role of both common and rare risk variation in the genetic architecture of psychiatric disorders with a particular focus on schizophrenia and alcohol problems. In the first three analyses, we focused on characterizing …

Disparities Between Native Americans And Whites In Trajectories Of Functional Independence And Life Satisfaction Over The 5 Years After Traumatic Brain Injury, Jack Watson

Theses and Dissertations

A traumatic brain injury (TBI) can have a host of negative consequences including impairments to motor and cognitive function and can result in a decrease in quality of life (i.e., life satisfaction). TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the U.S. and elevated likelihood for fatality and severe complications. The current study used a subsample of the national TBI Model Systems Database of 80 demographically and injury severity matched Native American and White individuals (total n = 160) to …

A Method For Predicting Dose Changes For Hn Treatment Using Surface Imaging, Sarah E. Holler

Theses and Dissertations

Head and neck cancer is commonly treated with a six- to seven-week course of radiotherapy, during which a patient’s anatomy may change substantially, due to target reduction or weight loss. Anatomical changes lead to reduction in treatment quality due to decreased setup reproducibility and altered dose deposition compared to the original plan. Few clinics have developed a standard method for triggering resimulation and replan due to anatomic changes. This work investigates a new method for determining when to resimulate and replan HNC patients by utilizing their topographic anatomical changes to predict differences in planned versus delivered dose distributions. The first …

Family History Of Substance Problems Among African Americans: Associations With Drug Use, Drug Use Disorder, And Prescription Drug Misuse, Rebecca Mahrs-Gould

Theses and Dissertations

Background: Understanding individual risk for substance use and substance use disorders is important in the efforts of reducing risk and prevention of these problems. A family history of alcohol and/or drug problems often increases the risk for these problems, however the majority of research in this area is conducted in samples that are predominantly White. African Americans face disparate outcomes from substance use and substance use disorders, and the risks for substance problems may not be the same as for Whites. A systematic review of the literature identified nine studies that examined a family history of either substance problems or …

Black Hearts Matter: A Comparative Study Of Sociodemographic, Clinical, And Psychosocial Characteristics In Black And White Persons With Heart Failure, Hannah M Anderson Hughes

Theses and Dissertations

Heart failure (HF) is a chronic, progressive, debilitating illness that disproportionately affects Black individuals, often leading to poor quality of life (QOL). Various sociodemographic, clinical, and psychological characteristics are related to QOL in patients with HF. Because most studies do not include representative Black samples or report findings from racial subgroup analyses, these relationships and any existing racial differences are not well understood. The purpose of this descriptive, comparative study was to explore the relationships among sociodemographic, clinical, and psychological characteristics and QOL in patients with HF and to determine if there were racial differences between Black and White individuals. …

Modelling Muscle Activation Using Emg Signal, Mercy U. Okonna

Electronic Theses and Dissertations

(EMG) is a method for measuring muscle activity by an electrical signal, and is useful in studying motor control, postural control, and in physical therapy. A current research topic is creating an algorithm that can use the EMG signal to reliably classify a muscle as active or inactive. This thesis presents a classification algorithm for leg muscles with a single activation spike while walking. Time is rescaled into steps, which are identified using data from cameras measuring joint angles while walking. The algorithm is based on moving averages and a convex combination of mean signal strength in active and inactive …

Evaluating The Role Of Mmp9 In Hyperhomocysteinemia Induced Cerebrovascular Pathology, Alexandria Linton

Theses and Dissertations--Neuroscience

Vascular contributions to cognitive impairment and dementia (VCID) is one of the leading causes of dementia, along with Alzheimer’s disease (AD), and often manifests as a comorbidity of AD. Elevated plasma homocysteine, known as hyperhomocysteinemia (HHcy), is a risk factor for VCID; however, the mechanism underlying the connection between HHcy and development of VCID pathology remains elusive. Understanding this mechanism would reveal novel therapeutic targets with the potential to be disease modifying, which are a critical need for a disease that lacks any approved treatment. Previous studies from our lab have strongly associated neuroinflammation and blood brain barrier (BBB) dysregulation …

A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl

Theses and Dissertations--Communication

Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …

Learner Outcomes From An Echo In Augmentative And Alternative Communication, Lillie Reinhart

Theses and Dissertations--Communication Sciences and Disorders

Background: Students with complex communication needs (CCN) rely on the use of augmentative and alternative communication (AAC) to support their communication; however, many students are leaving high school without an effective form of communication. To build capacity and increase school professionals’ knowledge and self-efficacy in AAC, this thesis used an adaptation of Project ECHO (Extension for Community Healthcare Outcomes) for use with AAC.

Methods: Using a post then pre-retrospective survey, participants self-reported changes in knowledge, confidence, and overall satisfaction with ECHO sessions. Paired sample t-tests assessed participant-reported change in knowledge. Frequency counts were used to analyze responses about confidence and …

Succinylated Polyethylenimine Gene Delivery Agents For Enhanced Transfection Efficacy, Md. Nasir Uddin

Theses and Dissertations--Chemistry

Gene therapy aims to treat patients by altering or controlling gene expression. Today, most clinical approaches are viral-based due to their inherent gene delivery activity. However, there is still a significant interest in nonviral alternatives for gene delivery, particularly synthetic lipids and polymers, that do not suffer the immunogenicity, high cost, or mutagenesis concerns of viral vectors. Polymeric vectors are of particular interest due to the ability to further tune the polymer properties through the incorporation of additional functional units such as targeting ligands or shielding domains. Polyethylenimine (PEI), a highly cationic polymer, is often considered a benchmark for polymer-based …

Antibiotic Permeation In Gram-Negative Bacteria And Contribution Of Inflammasome Activation And Pyroptosis In Pathogenesis Of Salmonella Systemic Infection, Ankit Pandeya

Theses and Dissertations--Chemistry

Antibiotic resistance is one of the major global issues in the field of public health and medicine. Good antibiotic candidates need to be selectively toxic, inhibit cellular target, and effectively penetrate and accumulate in bacterial cells. The last factor is a formidable barrier in the development of antimicrobials effective in Gram-negative bacteria, due to the presence of two layers of cell envelope. The first half of my thesis focuses on understanding the permeation of small molecules through this formidable cell envelope, distribution inside the cell of Gram-negative bacteria, and design of novel methods to make small molecules effectively cross the …

Nicotine And Cotinine: Microbial Modulators Of The Immune Response, Jourdan Lakes

Theses and Dissertations--Chemistry

The consumption of tobacco products is a known contributor to a variety of health conditions and disease pathologies including cardiovascular and lung diseases. In addition to these well-known pathological effects of tobacco use, it has been established recently that tobacco consumption as well as nicotine consumption alone results in distinct, dysbiotic perturbations to the enteric microflora of the gastrointestinal tract. Previous research into the intestinal microbiome has demonstrated that these microbes are active contributors to the maintenance of a homeostatic and tolerogenic environment within the host. In fact, the presence of our enteric microflora is necessary for the proper development …

Speech-Language Pathologists On The Autism Spectrum, Rebecca Freeman Barnett

Master's Theses and Doctoral Dissertations

This thesis consists of three journal articles for publication that addresses three different aspects of the research that examines the state of diversity in the field of speech-language pathology (SLP) as it pertains to autistic representation and possible implications. In the first article, Demographic Analysis of Autistic Speech-Language Pathologists, the purpose was to determine the demographic differences between SLPs that identified on the autism spectrum and those that did not. A mass survey was conducted of SLPs in the states of Wisconsin, Michigan, and Ohio. It was concluded that 2.98% of SLPs self-identified on the autism spectrum. Chi-square analyses found …

Demographic Profiles Of Clinical Research Participants In Fda-Approved Nmes, Abayomi Oladoye Ojetayo

Master's Theses and Doctoral Dissertations

Drug development is a rigorous and expensive process that takes between 10 and15 years. Recruitment and retention of human subjects in clinical trials is challenging. This study collected the demographics of trial participant in trials for New Molecular Entities (NMEs) approved by the U.S. Food Drug Administration (FDA) for 2010 and 2020 to compare demographic representation. Demographic representation of trial participants for 61 FDA-approved NMEs for 2010 and 2020 were gathered; 21 NMEs were excluded from analysis. The trends in demographic representation in trials for the 40 FDA-approved NMEs in 2010 and 2020 were similar, and White participant representation was …

The Prevalence Of Substance Abuse Within The Nursing Profession, Kaylie Paige Cox

Senior Honors Theses and Projects

No abstract provided.

Covid Fears And Social Anxiety In College Students, Clayton Crozier

Masters Theses

The COVID-19 pandemic has been associated with numerous negative mental health outcomes such as social anxiety, and lead to a great deal of uncertainty. Intolerance of Uncertainty is a relatively new concept in the psychology literature and has begun to be studied in the context of anxiety. Literature has found a positive correlation between Intolerance of Uncertainty and several types of social anxiety. With these findings, researchers have begun to examine the COVID-19 pandemic to see how Intolerance of Uncertainty affects people’s mental health during the pandemic. Intolerance of Uncertainty may be a mediator between social anxiety and the fears …

Analysis Of Pelvic Alignment Patterns Utilizing The Postural Restoration Institution Approach, Marisa Mills

West Chester University Master’s Theses

Background: Low back pain is a common problem that can include injury to the sacroiliac joint (SIJ) with 15-30% of cases arising from LBP. Treatment for SIJ includes muscle energy. A newer approach from Postural Restoration Institution (PRI) centered around pelvic patterns alignment has also been used. There’s limited research found describing the prevalence of pelvic patterns within populations with PRI method.

Purpose: To examine prevalence of pelvic patterns and investigate a relationship of low back pain. Furthermore, to explore the specific patterns closely and the ability to re-align pelvic patterns by utilizing PRI repositioning exercises.

Study Design: Cross …

Comparison Of Landing Biomechanics Between Different Competitive Levels Of Irish Dance, Jade Shields

West Chester University Master’s Theses

Abstract

Objectives: To determine differences in lower limb landing biomechanics and lower extremity function scale scores between champion levels, in young female Irish dancers.

Design: Cross-sectional.

Setting: McDade-Cara School of Irish Dance

Participants: 12 Open Champion (OC) level female Irish dancers (11.9 ± 3.37 years) and 9 Preliminary Champion (PC) Irish dancers (13.5 ± 3.37 years) performed the landing error scoring system test (LESS), and completed the lower extremity functional scale (LEFS) and a descriptive data questionnaire

Main outcome measures: LESS scoring sheet and LEFS PRO

Results: No significant differences found between OC and PC levels on …

Etiology Of Firefighter Injuries: A Health Care Practitioner Perspective, Alyssa Quinn Eastman

Theses and Dissertations--Kinesiology and Health Promotion

BACKGROUND: Structural firefighting involves the performance of rigorous occupational tasks in unpredictable, dynamic, and hot environments which increases firefighters’ risk of injury. Specifically, the National Fire Protection Association reported that musculoskeletal injuries account for 56% of non-fireground and 41% of fireground injuries. Furthermore, physical training is the most common cause of injury, accounting for one-third of all injuries and resulting in 41% of post-injury absences from work. There is limited research identifying occupational and exercise injury risk factors among firefighters. However, experienced health care practitioners working with fire departments may provide critical insight into potential mechanisms of these common injuries. …

The Effectiveness Of An Aprn-Led Pain Service On Patient Satisfaction Scores: A Retrospective Analysis, Maripatricia Welz-Bosna

West Chester University Doctoral Projects

Abstract

This quality improvement (QI) project examined if the implementation of an Advanced Practice Registered Nurse (APRN) led consult pain service, was able to improve patient satisfaction measured on the HCAHPS and Press Ganey pain satisfaction scores. A one-way ANOVA analysis was used to examine if mean outcome scores varied at a statistically significant level (p<.05) by year (2018, 2019, 2020). Bonferroni Post Hoc tests reflecting How Often Staff Talk About Pain by year using the dependent variable Top Box Score, indicated that the mean score for year 2020 (M=74.10, SD=17.45) was significantly higher than year 2018 (M=63.22). The mean score for year 2019 (M=64.62, SD=22.80) did not differ significantly from the other two years. Bivariate analysis indicated that Press Ganey Scores reflecting Staff Talk About Pain Treatment did not vary significantly by year, F(2, 445) = .41, p=.66. Results from this QI project and the effectiveness of an APRN-led pain service on patient satisfaction scores are inconclusive, and further research is needed. Pain is complex, and a patient's satisfaction with pain is never straightforward. The effectiveness of an APRN-led pain service on patient satisfaction remains under-researched and in need of more methodological evaluation. APRNs need to focus on multidimensional validated outcome measures, which can measure our effectiveness in the management of patients with pain.

Keywords: Patient Satisfaction, Pain, HCAHPS, Advanced Practice Registered Nurse (APRN), Effectiveness

A Pilot Randomized Controlled Trial Of Smoking Cessation Induction Treatment For Rural, Underserved Cancer Survivors Across The Continuum Of Motivation To Quit, William Bowling

Theses and Dissertations--Psychology

The United States’ smoking prevalence has decreased substantially, but this public health improvement is unevenly distributed across the population. A promising individual-level approach to cancer control equity is to develop more acceptable and efficacious interventions that are widely disseminated to rural and other disadvantaged cancer survivors. Smoking cessation induction focuses not on long-term abstinence, but on engaging people in the process of making quit attempts and may be ideal for hard-to-reach populations. The aim of this pilot randomized controlled trial was to evaluate the feasibility and acceptability of a smoking cessation induction intervention designed for rural cancer survivors. The treatment …

Exploring Climate, Wellbeing, Resilience, And Resistance In 2slgbtq+ Leisure Spaces: A Mixed Methods Study To Advance Inclusion, Tin Vo

Theses and Dissertations (Comprehensive)

Participating in queer sports groups, rainbow choirs, trans virtual discussion groups and other Two-Spirit, lesbian, gay, bisexual, transgender, queer, and other sexually and gender diverse (2SLGBTQ+) leisure activities can offer participants safety from societal heterosexism and cisgenderism and opportunities for community connection and peer support, as well as foster their overall wellbeing. Yet, transgender/gender nonconforming (TGNC), racialized, and/or disabled individuals, and those with other diverse identities are often marginalized in these spaces. Though researchers have studied exclusion within 2SLGBTQ+ leisure spaces, relatively little is known about how the climate of these spaces shapes social and mental health outcomes. Connected to …