Medicine and Health Sciences Commons^™

Age-Dependent Increase In Tyrosine Level Depletes Tyrosyl-Trna Synthetase And Causes Neuronal Oxidative Dna Damage In Alzheimer’S Disease, Megha Jhanji

Theses and Dissertations

Alzheimer’s disease (AD) is the most common form of dementia, and it currently affects more than 50 million people worldwide. Much of the population develop late-onset AD after 65 and constitute more than 95% of the cases. Currently, there is no definitive cure or way to slow down the progression of this disease that addresses the neurodegeneration and loss of cognitive functions. Although the underlying cause of AD is still unknown, the “amyloid cascade hypothesis” attributed it to the aggregation of amyloid beta (AU+03B2) peptides and has been the focus for targeting most disease-modifying drugs in clinical trials. However, emerging …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Impact Of Acetylcholine On Amygdala Network Oscillations, Joshua Xavier Bratsch-Prince

Theses and Dissertations

The ability to appropriately respond to and store memories of emotionally salient events is a critical feature of survival. The basolateral amygdala (BLA) is a temporal lobe structure that is essential in mediating emotional behaviors, learning, and memory. Important to circuit function are synchronized neuronal oscillations. Different oscillatory signatures are implicated in mediating different aspects of behavior and learning and memory processes: theta frequency (3-12 Hz) oscillations represent “online” states and are important for information encoding and learning, and sharp wave ripples (SWRs) represent more “offline” states that are important for the consolidation of memory. In the BLA, both of …

Modern Representations Of Childbirth In American Comedy Television Shows, Emily Smith

Senior Theses

This is a concurrent, mixed methods pilot study that combines quantitative analysis and qualitative observations with the aim of examining the portrayal of childbirth in modern American comedy shows. 38 episodes airing from 2010 to 2020 (n=38) were analyzed according to objective elements of representation (e.g., location of birth, interventions employed, etc.), as well as coded for common themes. Quantitative data revealed that the most represented births in comedy shows on American television from the 2010s were vaginal (82.1%), in the hospital (69.2%), uncomplicated (66%), and represented technological interventions (66%). Qualitative analysis found six main themes: chaos surrounding childbirth; disgust …

Spiritual Care: The Overlooked Need In End-Of-Life Care, Michael Howard Vrmeer

Doctor of Nursing Practice Scholarly Projects

Background: A number of studies have validated the use of the FICA tool to evaluate a patient’s spirituality. FICA has been helpful in many palliative care settings to screen for spiritual problems that influence the patient's overall health. Aim: The project was a quality improvement initiative with the purpose of implementing the FICA tool as part of the admission assessment to increase chaplain referrals for inpatient palliative care services. Methods: The staff received an in-service on using the FICA questions on admission, and a prompt to complete the screen was placed at each work station in the project setting. Results: …

The Impact Of Nurse Leader Learning Labs On Nurse Managers' Perception Of Leadership Competency In The Acute Care Setting, Carolyn Rivers Swinton

Doctor of Nursing Practice Scholarly Projects

Problem Statement: It is critically important that our nurse managers (NMs) have the leadership skills to support the care team in providing safe care to patients. Historically, nurse managers have received minimal training in the leadership role. Failure to address NMs’ coaching needs can compromise the organization's ability to achieve operational goals. Purpose: The project's primary aim was to improve NMs’ perceptions of leadership competency in the acute care setting through experiential nurse leader learning labs. The secondary aim was to demonstrate that the confident and prepared nurse manager can achieve organizational goals in the acute care setting. Method: There …

The Effects Of Debriefing On Nurse Distress After Perinatal Loss, Russin Marie Kelly

Doctor of Nursing Practice Scholarly Projects

Labor and delivery nurses are the first-line caregivers for women suffering a perinatal loss which involves miscarriage, stillbirth, and infant death. This loss of life can cause nurses’ distress. This project proposes using the PEARLS healthcare debriefing tool as an intervention to decrease distress and improve nurse satisfaction. Before and after the debriefing intervention, a survey allowed the nurse to rate their distress from zero to ten using the distress thermometer and answer questions about job satisfaction. The data analyzed shows that the debriefing intervention decreased nurse distress after perinatal loss compared to the prior practice of no debriefing after …

Expanding The Discharge Bundle To Reduce Preventable Readmission Among Adult Patients With Heart Failure, Leah Caccam Ramos

Doctor of Nursing Practice Scholarly Projects

Individuals with a heart failure (HF) diagnosis have a high risk of readmission following hospital discharge, increasing care costs. In an academic medical center (AMC) in Charleston, SC, the all-patient-related DRG of HF had 576 30-day readmissions for FY 2020, equivalent to a 26.3% readmission rate. This project aimed to decrease the readmission rate of adult patients diagnosed with HF admitted to cardiac units in the AMC by expanding the discharge bundle. The current discharge process is not bundled. The discharge bundle elements include HF education, pharmacy medication reconciliation, medication counseling, and appointment to the HF clinic prior to discharge. …

Improving Hand Hygiene In A Rural Critical Access Hospital, Katherine H. Miller

Doctor of Nursing Practice Scholarly Projects

Hand hygiene adherence is the single most important infection control practice among healthcare workers in United States hospitals. Hand hygiene is cost effective and adherence to protocols can reduce hospital acquired infections and employee illness. While hand hygiene adherence has been shown through research to improve patient safety and reduce hospital acquired infections, adherence to hand hygiene protocols among healthcare workers is poor and improvement efforts lack sustainability. A potential barrier to performing hand hygiene includes failure of healthcare workers to realize they are carrying microbes on their hands and what proper hand hygiene is, whether using soap and water …

The Development Of Novel Cdk8 And Cdk19 Inhibitors And Degraders As Potential Anti-Cancer Agents, Li Zhang

Theses and Dissertations

CDK8 and its homolog CDK19 are essential for transcription regulation and their dysregulation has been identified in numerous diseases, especially in cancers. CDK8 and CDK19 have been implicated in cancer development through their kinase activity and kinase independent functions. Despite the existing CDK8/19 inhibitors, there is still a need to develop novel CDK8/19 inhibitors with improved potency and PK profile. It is also necessary to develop CDK8/19 degraders that are able to eliminate the kinase-independent functions. Although two CDK8-degrading PROteolysis Activating Chimeras (PROTACs) have been reported, they have limited CDK8 degradation efficacy and no effect on CDK19. PROTACs with improved …

The Association Of Antidepressants Use With Healthcare Utilization, Patient-Reported Outcomes, And Alzheimer's Disease And Related Dementias (Adrd) Among Medicare Beneficiaries With Depression, Abdulrahman Abdullah A Alnijadi

Theses and Dissertations

Background: Depression and Alzheimer's Disease and Related Dementias (ADRD) are common among older adults. Currently, depression is recognized as one of the risk factors for ADRD. There is conflicting evidence on the association between depression and ADRD. Inadequate detection, diagnosis, and management of depression appear to pose a significant risk to the quality of life and healthcare utilization among older adults. To date, there are few studies on the impact of depression on self-reported healthcare utilization and self-reported health outcomes among Medicare beneficiaries.

Objectives: The aims of this study were to (1) quantify the association between depression and ADRD, quality …

Sex Differences And Neuroimmune Effects Of Microglial Response In The Mesolimbic Reward Pathway In Nicotine Substance Use Disorder, Erin Leigh Anderson

Theses and Dissertations

Smoking remains the leading cause of morbidity and mortality in the United States, with less than 5% of smokers attempting to quit succeeding. This is due to the unpleasant withdrawal symptomology, which includes affective symptoms, such as irritability, weight gain, anxiety, and severe craving among others, as well as the cognitive effects, such as difficulty concentrating. This low smoking cessation success rate is also thought to be due to the long-lasting sensitization of nicotinic acetylcholine receptors (nAChRs) leading to long-term neuroadaptations in the brain’s reward system and alterations in synaptic plasticity that occur following chronic nicotine exposure and withdrawal. Glial …

Hear My Voice: Qualitative Studies To Explore What Empowers Patients To Talk With Their Doctor And Participate In Making Health Care Decisions, Alicia Marie Oostdyk

Theses and Dissertations

Patients with fibromyalgia are faced with many decisions throughout the process of seeking and obtaining health care. For patients to feel empowered to take action, it is essential they feel as if they can play a role in making decisions up to their desired level of participation. However, it is unclear what constitutes empowerment in shared decision making between patients and providers. For patients with fibromyalgia, who deal with complex symptomology and individualized treatment choice, it is important to know what makes them feel empowered to participate in care. The objective of this dissertation is to create a patient-centered definition …

Advancing Knowledge Of Exercise As A Therapeutic Management Strategy For Women With Polycystic Ovary Syndrome, Pamela J. Wright

Theses and Dissertations

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among premenopausal women with a prevalence that ranges 15-21%. The estimated financial burden in the United States for evaluating and treating premenopausal women with PCOS was over $8 billion in 2020. PCOS etiology is complex and poorly understood, as is the optimal treatment and management. Endocrine Society Clinical Practice Guidelines recommend exercise as first-line treatment. Yet, the optimal exercise type and “dosing” are not defined. As last reported for women with PCOS, less than 60% are regularly physically active and more than 25% are sedentary. Additionally, little to no published data …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

Real Time Neurochemical Analysis Of The Brain For Pharmacological Treatments In Mood Disorders And Neurodegeneration, Anna Marie Buchanan

Theses and Dissertations

The monoamine, serotonin, is an important modulator in the central nervous system. It is believed to participate in a variety of functions ranging from moderating stress, promoting brain plasticity, and regulating sleep and appetite. Dysfunction of the serotonergic system has also been implicated in mood disorders and neurodegenerative diseases. While serotonin is of great interest to the research community, real-time in vivo serotonin dynamics remain understudied. This is because direct measurement of fast serotonergic transmission is analytically challenging. In 2009, the Hashemi lab pioneered the direct measurement of endogenously evoked serotonin using a method called fast scan cyclic voltammetry (FSCV). …

Variations In Er Stress And Unfolded Protein Response Predict Disease Susceptibility, Youwen Zhang

Theses and Dissertations

Numerous studies linked endoplasmic reticulum (ER) stress and unfolded protein response (UPR) to physiological responses to stress and various human pathologies, including metabolic disorders. Although variability in stress responses among individuals has been widely recognized, how such variations in the UPR affect susceptibility to diseases remains unknown. Using outbred deer mice as a model, we explored the consequences of the differential propensity to UPR at the transcriptomic, cellular, and organismic level.

Initially, we analyzed the correlation between several UPR-related genes in primary fibroblasts, at the whole transcriptome level, after ER stress induction. The analysis of correlated transcripts revealed that their …

Post-Discharge Phone Calls In The Emergency Department: Do Follow-Up Calls Increase Patient Satisfaction And Reduce Post-Discharge Complications?, Saraann K. Fagan

Doctor of Nursing Practice Scholarly Projects

Improvements in discharge instructions are necessary in emergency departments (EDs) across the United States (US). Multiple factors, such as the fast-paced environment and varying levels of acuity in the ED, contribute to inadequate discharge instructions and change is necessary to further prevent negative outcomes. The purpose of the evidence-based practice project was to implement post-discharge follow-up phone calls to ED patients to improve patient satisfaction scores regarding discharge instructions for at-home care and to reduce post-discharge complications. The project was implemented over a three-month period in early 2021 in the ED of a local hospital in Charleston, South Carolina (SC). …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Verbal Fluency In Women With The Fmr1 Premutation And The Broad Autism Phenotype, Emily Szabo

Theses and Dissertations

Women who carry a premutation allele on the FMR1 gene can experience limitations due to their genetic status, including executive function deficits. These subtle deficits are often shared by women who possess the broad autism phenotype (BAP). Poor understanding and limited research on the extent of these executive functioning deficits has led to limited clinical management of these two groups. The current study aimed to clarity whether there is a difference in verbal fluency abilities in mothers that possess the FMR1 premutation, mothers of children with autism who are at risk for the BAP, and mothers of typically developing children, …

An Analysis Of Mental State Verbs In Children With Hearing Loss, Morgan Vachio

Theses and Dissertations

Mental state verbs (MSV) require unique cognitive and linguistic knowledge compared to lower level function words (Shatz et al., 1983). These cognitive and linguistic demands are thought to be difficult for children with hearing loss (CHL) due to deficits in word learning (Werfel, 2017; Lund, 2016), limited depth of vocabulary knowledge (Walker et al., 2018) and deficits in complex syntax (Werfel et al., 2021). The present study recruited 73 preschool children (23 CHLCI, 22 CHL-HA and 28 CNH) to participate. Our analysis examined the frequency, lexical diversity and use of MSV within required complex syntax structures.

Market Segmentation And Targeted Messaging To Improve Hpv Vaccine Intentions In The College Aged Population, Ashley Caitlin Godwin

Theses and Dissertations

Background: Human Papillomavirus (HPV) is a sexually transmitted infection that can lead to 6 different types of cancer, including cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancer. Every year in the United States, nearly 35,000 cancer cases are estimated to be caused by HPV infection. While catch-up HPV vaccination is recommended through age 26 for those not previously vaccinated, only 21.5% of adults age 18-26 have completed the recommended number of HPV vaccine doses as of 2018. Many interventions have been tested to increase vaccination rates, and one such intervention, framed messaging, has shown promise in increasing intention to vaccinate. …

Neural Synchrony During Naturalistic Language Perception In Listeners With Aphasia, Lisa Johnson Norris

Theses and Dissertations

Neural synchrony across listeners during language processing has been found to be associated with successful comprehension in neurotypical adults. At initial presentation of auditory-visual stimuli, neural responses appear to oscillate in different rhythms across brain regions. As the stimulus progresses, the time course of neural activity synchronizes across listeners, particularly in primary auditory and visual processing regions. This phenomenon, which we refer to as ‘neural entrainment,’ has been observed in neurotypical individuals attending to the same stimulus. Neural synchrony occurs due to the inherent neural response elicited by a stimulus and has been shown to be consistent across participants in …

Lexical Properties Of Perceptual Errors Made By Younger And Older Adults Listening To Speech In Multitalker Babble, Hannah Blythe Vickery

Theses and Dissertations

Purpose: The purpose of this error analysis was to analyze the lexical properties of misperceptions made when listening to speech in multitalker babble.

Methods: Twenty young adults with normal hearing (YNH), 20 older adults with normal hearing (ONH), and 22 older adults with hearing impairment (OHI) completed a speech-in-babble task. Participants were asked to repeat the final word in 25 high and 25 low context sentences. On each trial, participants either responded with the correct target word, a misperception error, or skipped the trial response. Misperceptions were compiled and analyzed according to their lexical properties.

Results: Results of this study …

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …

Nurses’ And Patients’ Perceptions Of The Availability Of Post-Hospital Instrumental Support As A Predictor Of 30- And 60-Day Acute Care Utilization, Beth E. Schultz

Theses and Dissertations

Social support is now part of the social determinants of health objective in Healthy People 2030. Positive social support improves health and well-being. Social support is concerned with people having the support they need within the community, including interacting and communicating with others on a regular basis. Instrumental support is a type of social support that is action oriented, involving one person directly assisting another person. A concept analysis of instrumental support was completed and revealed that the concept is well defined, but the terms used to describe it vary. Other terms in the research literature, most commonly “tangible support”, …