Medicine and Health Sciences Commons^™

Exploration Of Linguistic And Extra-Linguistic Factors In Stroke Knowledge And Emergency Response: Studies Of Input, Output, And Outcome, Laura L. O. Froeschke

Dissertations

This dissertation is comprised of three studies centered on addressing factors that influence stroke knowledge and decision-making during the acute stroke emergency in both general and Hispanic populations. The first study provided data on patterns of explicit stroke knowledge in a sample of 94 Hispanic subjects. This study assessed relationships between stroke knowledge (Stroke Action Test; STAT; Billings-Gagliardi & Mazor, 2005) and subjects’ typical language use (Short Acculturation Scale for Hispanics; Marín, Sabogal, VanOss Marín, Otero-Sabogal, Pérez-Stable, 1987). No relationship was found between language use (Spanish/English) and stroke symptom knowledge. Contrastingly, STAT scores were found to …

Increasing Physical Activity In Young Adults With Autism Spectrum Disorder, Katherine B. Lalonde

Dissertations

Experts recommend that individuals walk 10,000 steps or more per day and doing so has been shown to have several health benefits. Unfortunately, many people fall short of 10,000 steps per day. Exercise levels are characteristically lower in people with Autism Spectrum Disorders (ASD) than in people without ASD. The present study comprised two experiments that used goal setting and reinforcement to increase physical activity in young adults with ASD. The first study employed a multiple-baseline-across-participants design in combination with a reversal design to determine the effects of a treatment package on the number of daily steps taken by young …

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …

Qualitative Study Of The United States Marine Corps Wounded Warrior Regiment, Webster F. Nicholson Jr.

Dissertations

Serious health care issues were discovered first at Walter Reed Army Medical Center in 2007 and later at U.S. Department of Veteran Affairs health care organizations in 2014 (Brady, 2012; Cohen, Griffin, & Bronstein, 2014; Wright, 2013). The continued success of the Wounded Warrior Program requires a system that will constantly assess and analyze health care quality from the patient’s experience. From a systems perspective, health care quality encompasses six dimensions, and the study involved examining the dimension and four core concepts of patient-centered care (Institute of Medicine, 2001; Lees, 2011; Wexler, 2002; World Health Organization, 2006). A qualitative, phenomenological …

Transient Cardiovascular Hemodynamics In A Patient-Specific Arterial System, Jr Rodward Hewlin

Dissertations

The ultimate goal of the present study is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present study a full cardiovascular experimental phantom and digital phantom (CFD model) was fabricated to study: (1) the effects of local hemodynamics on global hemodynamics, (2) the effects of transition from bed-rest to upright position, and (3) transport of dye (drug delivery) in the arterial system. Computational three dimensional (3-D) models (designs A, B, and C) …

Knowledge Of Stroke Symptom And Risk Factors And Acculturation Among Cambodian Immigrants Living In Southern California, Samantha N. Sangsanoi-Terkchareon

Dissertations

The purpose of this quantitative study was to describe and examine the relationships between age, gender, educational level, health insurance status, and income to level of acculturation and knowledge of stroke symptom and risk factors recognition among Cambodian immigrants (n=200) living in Southern California. The data were analyzed using Pearson correlation, Kendal Tau, Chi-Square, and multiple regression to the determine relationship between depend and independent variables. The results of this study were that Cambodian participants’ mean age was 46.07 (SD= 17.51), average years of education were 8.95 (SD=5.26) and the mean number of people in each household was …

Experimental Investigation On The Relationship Between Lead Exposure And Thyroids In Diabetes, Salah Sumar Ali Al-Zadjali

Dissertations

Lead exposure can cause multiple systemic toxicities, particularly affecting the hematopoietic, nervous and renal systems. However, its effects on the thyroid functions are not well elucidated and the published studies are controversial. In addition, although there are several experimental thyroid models, each one of them has its own limitations. Accordingly, in this dissertation, we investigated the possible relationship between lead exposure, thyroid functions and short-term systemic toxicity in two animal models, namely normal (non-diabetic) and diabetic animals. We also investigated the possibility of developing a hormonal thyroid model. In the non-diabetic model, Wistar rats were divided into five groups and …

Mechanisms Underlying Control Of Anti-Microbial Immunity By Acetylcholinesterase Inhibition, Ray M. Esam Al-Barazie

Dissertations

Inflammation is a crucial defense mechanism that protects the body from the devastating effects of invading pathogens. However, an unrestrained inflammatory reaction may result in systemic manifestations with dire consequences to the host. The extent of activation of the inflammatory response is tightly regulated through immunological and neural pathways. Previously, we demonstrated that cholinergic stimulation confers enhanced protection in experimental animals orally infected with a lethal dose of Salmonella typhymurium. In this study, we investigated the mechanism by which this enhanced protection takes place. We showed that cholinergic stimulation enhanced host survival following oral-route infection, which correlated with significantly reduced …

Experimental Investigation On The Relationship Between Lead Exposure And Thyroids In Diabetes., Salah Sumar Ali Al-Zadjali

Dissertations

Lead exposure can cause multiple systemic toxicities, particularly affecting the hematopoietic, nervous and renal systems. However, its effects on the thyroid functions are not well elucidated and the published studies are controversial. In addition, although there are several experimental thyroid models, each one of them has its own limitations. According, in this dissertation, we investigated the possible relationship between lead exposure, thyroid functions and short-term systemic toxicity in two animal models, namely normal (non-diabetic) and diabetic animals. We also investigated the possibility of developing a hormonal thyroid model.

In the non-diabetic model, Wistar rats were divided into five groups and …

Elucidation Of The Cellular And Molecular Mechanisms Of Missense Mutations Associated With Familial Exudative Vitreoretinopathy And Congenital Myasthenic Syndrome, Reham Mahmoud Mohammed Milhem

Dissertations

The endoplasmic reticulum (ER), within eukaryotic cells, is a hub for protein folding and assembly. Misfolded proteins and unassembled subunits of protein complexes are retained in the ER and degraded by a process termed endoplasmic reticulum associated degradation (ERAD). Frizzled class receptor 4 (FZD4) and muscle, skeletal, receptor tyrosine kinase (MuSK) are Wnt receptors. These proteins contain the frizzled cysteine-rich domain (Fz-CRD) required for dimerization in the ER. Mutations in FZD4 and MuSK genes are known to cause familial exudative vitreoretinopathy (FEVR, an autosomal dominant disease) and congenital myasthenic syndrome (CMS, an autosomal recessive disease), respectively. It was hypothesized that …

Retrospective Electronic Health Record Review Of Preoperative Screening Of Candidates For Total Joint Replacement, Jill Ann Rude

Dissertations

Advanced practice nurses (APNs) play an important role in preoperative screening. The purpose of this project was to determine the effectiveness of pre-operative screening criterion established February 2012 for patients greater than 40 years old who underwent total knee or hip replacement surgery. Of the 1850 electronic health records reviewed, 1065 (57.6%) total knee and total hip replacement surgeries took place before and 785 (42.4%) took place after screening criteria were implemented. Before implementation of screening criteria 53 (4.98%) patients experienced critical changes (code blue or critical assessment team call); after the implementation of screening 30 (3.82%) patients experienced critical …

Academic And Non-Academic Variables As Predictors Of Nclex-Rn Success Among Traditional Associate Degree Students At Southern Adventist University, Christine Moniyung

Dissertations

Problem

The School of Nursing at Southern Adventist University offers both Associate of Science and Bachelor of Science in nursing degrees. A majority of the students who sit for the NCLEX-RN are associate of science in nursing graduates. The pass rate dropped from 94.9% in 2010 to 88.8% in 2011. The pass rate went up to 93.3% in 2012, but dropped again by almost 5% in the following year, and to an all-time low of 76.5% in 2014.

Unlike most AS nursing program student populations in the nation, the majority of SAU students are young and considered traditional-age college students. …

Influence Of Maternal Prior Life Adversity On The Psycho-Neuroendocrine-Immune Profile During Pregnancy, Karen J. Kotz

Dissertations

Pregnancy is accompanied by a multitude of physical and psychological changes. Adaptation to these changes through reduced anxiety and attenuated stress responsiveness is necessary across gestation and into the postpartum period for optimal maternal-infant health. In contrast, exposure to higher amounts of stressors during pregnancy can disrupt neuroendocrine-immune processes required for successful pregnancy outcomes. Evolving evidence demonstrates that exposure to adversity early in life has long-lasting effects on stress response systems that alter stress reactivity during adulthood. Given this evidence, it is posited that women who experience greater pre-pregnancy adversity during their childhood are at greater risk for negative maternal-infant …

Effects Of Aggregated Alpha-Synuclein On Cultured Neuronal Cells, David Freeman

Dissertations

α-synuclein dysregulation is a critical aspect of Parkinson's disease pathology. Recent studies have observed that α-synuclein aggregates are cytotoxic to cells in culture and that this toxicity can be spread between cells. However, the molecular mechanisms governing this cytotoxicity and spread are poorly characterized. Recent studies of viruses and bacteria, which achieve their cytoplasmic entry by rupturing intracellular vesicles, have utilized the redistribution of galectin proteins as a tool to measure vesicle rupture by these organisms. Using this approach, we demonstrate that α-synuclein aggregates can induce the rupture of lysosomes following their endocytosis in neuronal cell lines. This rupture can …

Extended Treatment Window Exists For Improving Sensorimotor Recovery Using Anti-Nogo A Immunotherapy In Adult Rats With Chronic Stroke Deficits, Katherine Marie Podraza

Dissertations

Stroke related death ranks as the fourth most common cause of mortality in the United States. Current therapeutic options following stroke are limited. One potential therapy involves the use of anti-Nogo-A immunotherapy post-stroke. Our laboratory has shown that the administration of this novel treatment results in sensorimotor recovery in adult and aged rats. This therapy has been shown to be efficacious when applied immediately, 24 hours, and 1 week post-stroke in rats with mild to moderate sensorimotor deficits. In addition, recent results suggest that administration of anti-Nogo-A immunotherapy up to 9 weeks after stroke still induces functional recovery and neuroanatomical …

Characterization Of The Effect Of Anti-Nogo-A Antibody Treatment On Sensorimotor Recovery After Traumatic Brain Injury, Stephen Nawara

Dissertations

Estimates indicate that over 5 million Americans are currently living with Traumatic Brain Injury (TBI) related disability. Much effort has been put into enhancing functional recovery with physical therapy and other rehabilitative approaches. These strategies are thought to function by facilitating the brain’s innate capacity for neuroregeneration and neuroplasticity. However, the success of these strategies may be limited due the presence of growth- and plasticity- inhibiting factors expressed in the adult brain.

The presence of the membrane protein Nogo-A has been associated with reduced neurite outgrowth in vitro, identifying it as one such molecule. In addition, rodents treated with antibodies …

Attitude, Subjective Norm, And Perceived Behavioral Control As Indicators For Nurse Educators’ Intention To Use Critical Thinking Teaching Strategies: A Structural Equation Model Analysis, Angerlita Yolanda Smith

Dissertations

Problem

Deficiencies in new nursing graduates’ ability to use critical thinking skills have been documented. Researchers have found that the continued use of traditional teaching methods and less student-centered approaches for critical thinking development has contributed to this problem. This particular issue has evoked much concern for institutions and organizations involved with the safe delivery of patient care. The purpose of this study was to examine (a) the relationship between the factors educator characteristics, attitude, subjective norm and perceived behavioral control in a hypothesized model that may influence nurse educators’ intention to use instructional methods that promote critical thinking in …

Educator's Implementation Of The Connecticut Guidelines For The Identification And Education Of Children And Youth With Autism, Linda K. Grimm

Dissertations

The Problem

As the number of children with autism needing educational support continues to increase, combined with the limited availability of resources, this study aims to examine how educators responsible for teaching children with autism have experienced implementation of the Connecticut Guidelines for the Identification and Education of Children and Youth with Autism (2005), (Guidelines). At this time there have been no studies done in the State of Connecticut to assess the implementation of the components for effective education of children with autism, as set forth in the Connecticut Guidelines.

Method

The Connecticut Autism Needs Survey, an on-line self-report survey …

Easing My Burden: A Grounded Theory Study Of Kidney Transplant Recipients' Experience With Their Transplant Coordinators, Gwen E. Mcnatt

Dissertations

Organ transplantation holds the promise of new life or better life for thousands of Americans every year. Transplantation involves a process that stretches over time beginning at referral, moving to transplantation and long term care. The transplant coordinator is considered an integral part of this care. Transplant coordinators are considered so important to the care of these patients that transplant centers are required to have at least one transplant coordinator by federal regulations.

The role of the transplant coordinator, however, is not well defined. Although many of the role dimensions attributed to transplant coordinators are consistent with nursing practice, the …

Implementation Of Sleep Problem Screening In A Pediatric Primary Care Office, Jennifer Erin O'Donnell

Dissertations

Sleep problems, a major problem for children and their parents, are the most common complaint brought to pediatric clinicians (advanced practice nurses and other healthcare providers) attention but are often ignored and underdiagnosed in the pediatric population (Faruqui, Khubchandani, Price, Bolyard, & Reddy, 2011). “Sufficient amounts of good quality sleep are necessary for healthy development in childhood” (Bordeleau, Bernier, & Carrier, 2012, p. 254). Inadequate sleep in children has been linked to numerous adverse outcomes psychologically as well as physically (Owens, Jones, & Nash, 2011). The American Academy of Pediatrics (AAP), issued recommendations in 2002 stating screening for snoring, one …

Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd

Dissertations

Purpose and Aims. There is limited information about outcomes of care, resource utilization, and associated costs for patients who receive acupuncture in integrative health settings. The purpose of this study was to address this gap through the following aims: To examine: (1) changes in patient pain levels pre/post acupuncture treatments; (2) relationships between receiving acupuncture treatments (number of treatments, length of time, select demographic factors, (age, gender), pain level pre and post acupuncture treatments; (3) relationships between number of treatments, length of time, age, gender, pain level (pre/post acupuncture treatments) and provider visits (pre/post acupuncture treatments); and (4) relationship between …

Exploring A Diabetic Registry For Cardiovascular Risk Factors, Mary C. Anziano Phd

Dissertations

Background: Cardiovascular disease is the leading cause of death in the United States. There were over 18 million people diagnosed with diabetes in 2002. These disease processes together combine for significant health burden on society (American Diabetes Association, 2008). The purpose of the study was to describe the relationship between select demographics, and clinical characteristics to determine risk factors for cardiovascular disease in a diabetic population. Methods: A retrospective descriptive study was conducted using a diabetic registry database containing patients diagnosed with diabetes from January 1, 2011 to December 31, 2012. Study variables included age, gender, socio-economic status, glycosylated hemoglobin …

The Case Of Reintegration Of Women Post Incarceration, Deana Raley Noble Phd

Dissertations

Women released from prison or jail face particular obstacles and challenges on reentry to the community, many of which are related to their childhood and to gender roles as women and mothers. This study relates the lived experience of one woman's successful transition to economic and mainstream societal reintegration and family reconnection after release from prison and the insights gained by the researcher. Case study methodology congruent with Miller's Relational-Cultural Theory philosophical framework was utilized in this in-depth, single case design and represents a unique case. The overall purpose of this descriptive and explanatory research was to explore precursors to …

Relationship Between Age And Pre-End Stage Renal Disease Care In Elderly Hemodialysis Patients, Rubette Harford Phd, Msn, Rn

Dissertations

Purpose: The primary purpose of this dissertation was to examine the relationship between age and receipt of three components of pre-end stage renal disease care prior to first initiation of hemodialysis, and to explore the implications of differences in interpretation of funding policies for dialysis services in Puerto Rico and the U.S. mainland. Background: The growing burden of chronic kidney disease (CKD) is a national public health concern, particularly within the aged population. It is estimated that more than 25 million Americans are living with some level of kidney disease, with an increasing prevalence noted with increasing age (Coresh et …

Tuning Responsiveness Of Polypeptide Based Block Copolymers For Drug Delivery, Ashley J. Johnson

Dissertations

The goal of this dissertation was to tune the pH response and self-assembled morphologies of amphiphilic polypeptide block copolymers for use as drug delivery vehicles. Poly(L-lysine) and poly(L-glutamtic acid) are responsive, ionizable polypeptides that undergo secondary structure transitions, from α-helix to random coil, whereby the change in conformation of the peptide chain results in changes to the global morphology of a self-assembled system. The main focus of this work was to understand how changes in the polymer composition and the local environment can lead to control over the behavior of the overall system. First, the responsive behavior of poly(L-lysine) block …

Meeting The Needs Of Students With Traumatic Brain Lnjury, Heather K. Koole

Dissertations

School reintegration following pediatric traumatic brain injury (TBI) presents a number of challenges. This dissertation comprises three studies exploring common themes of best practice, training, and supporting success for students with TBI in school settings.

Study 1 reports the results of a survey of 70 speech-language pathologists (SLPs) who responded to questions about their use of clinical activities that described more or less contextualized services. Current literature supports contextualized service delivery as best practice. Findings indicated that 98% of participants reported using at least one contextualized practice. Higher use of contextualized practices was associated with working in schools (compared to …

Screening For Novel Inhibitors Of Αlpha-Ynuclein Seeded Nucleation-Dependent Aggregation And Toxicity As A Potential Therapeutic Strategy For Parkinson’S Disease, Mustafa Taleb Ardeh

Dissertations

α-Synuclein aggregation is the key pathogenic event in several important neurological disorders including Parkinson’s Disease, dementia with Lewy bodies and multiple system atrophy, giving rise to a distinct group of neurodegenerative diseases known as synucleinopathies. Although the molecular basis of α-syn toxicity has not been precisely elucidated, recent studies indicate that α-syn toxicity is mediated by a nucleation-dependent aggregation process. To elucidate the structural basis of α-synuclein mediated toxicity, we developed various methods to prepare different α-synuclein species of a defined size and morphology distribution, and we investigated their toxicity in different human dopaminergic cell lines. We observed that crude …

Assessing The Monitoring And Management Of Overweight And Obesity In Children Hospitalized For Asthma, Anne E. Borgmeyer

Dissertations

Asthma and overweight are two of the most common chronic health problems in children. Data support a relationship between the two health issues. Although asthma is one of the top reasons for hospital admission for children, little is known about the prevalence of overweight and obesity or clinical practice related to weight in children hospitalized for asthma. The purpose of this project was to assess weight characteristics of children admitted with asthma, as well as the current practices of monitoring and management of overweight and obesity in children hospitalized with asthma. A retrospective review of medical records was conducted. The …

Depressive Symptomatology And Perceived Social Support In Adolescents With Type 2 Diabetes, Kristiana Gay Huffman Cullum Phd, Cpnp

Dissertations

Type 2 diabetes has increased dramatically in the pediatric population in the last decade. One of the comorbidities of diabetes is depression. In the presence of depression, diabetes may be mismanaged by patients and lead to a decline in health. Diabetes with comorbid depression may have better disease management outcomes in the presence of higher levels of social support. Defining childhood depression, which encompasses adolescence, and the subtleties of this disorder compared to the adult counterpart, was needed to better delineate important variables for this research study. There are several instruments that evaluate adolescents' perceived social support, but a fairly …