Medicine and Health Sciences Commons^™

Investigating The Regulation Of Indole-3-Acetic Acid Production By The Plant Associated Microbe Pantoea Sp. Yr343, Kasey Noel Estenson

Doctoral Dissertations

The auxin indole-3-acetic acid (IAA) plays a central role in plant growth and development and many plant-associated microbes produce IAA. Several IAA biosynthetic pathways have been identified in microbes which use the precursor tryptophan. Pantoea sp. YR343, which was isolated from the Populus deltoides rhizosphere, is a robust plant root colonizer that produces IAA. Using genomic and metabolomics analyses, we predicted that the indole-3-pyruvate (IPA) pathway is the major pathway in Pantoea sp. YR343 for IAA production. To better understand IAA biosynthesis and the effects of IAA exposure on cell physiology, we performed proteomics on Pantoea sp. YR343 grown in …

Description And Practical Application Of The Physiologic Distribution Of 3’-Deoxy-3’-[18f]Fluorothymidine In Companion Animals, Joshua Alan Rowe

Doctoral Dissertations

Access to positron emission tomography (PET), and more recently PET combined with computed tomography (PET/CT), is increasing in veterinary medicine. This molecular imaging technology allows clinicians to map biological functions within patients based on the distribution and selective uptake of specialized positron-emitting radiopharmaceuticals. Although most clinical studies utilize 2-deoxy-2-[¹⁸F]fluoro-Dglucose (¹⁸FDG), a versatile but relatively nonspecific tracer that interrogates the energy metabolism of tissues, there is a growing need to establish reference values for alternative or adjunct tracers in veterinary species. Among these is 3’-deoxy-3’- [¹⁸F]fluorothymidine (¹⁸FLT), a thymidine analog that selectively accumulates …

Do Personal Factors And Interpersonal Influences Affect Commitment To A Plan Of Action For Physical Activity Among African-American Women?, Bobbie W. Brown

Doctoral Dissertations

The lack of physical activity (PA) among African American (AA) women is a predisposition to chronic diseases associated with obesity. Women, particularly AA women, who are between 35 and 60 years of age, are particularly noted to be at highest risk for developing obesity-related chronic diseases. Few PA studies have included AA women older than 25 years of age and younger than 65 years of age (Carter-Parker, Edwards, & McCleary-Jones, 2012).

All analyses were conducted using SPSS Version 21 (Armonk, NY: IBM Corporation) and statistical significance was assumed at an alpha value of .05. The assumption of normality for continuous …

Influence Of Work Environment Conditions On The Ability Of Critical Care Nurses To Provide Efficacious Nursing Care In Puerto Rico, Yolanda M. Torres

Doctoral Dissertations

The purpose of this study was to explore the conditions in the work environment that may contribute to caring efficacy of critical care nurses in Puerto Rico. The study measured nurses’ perceptions of the empowering structures in the work environment, and the relationship to their perceived caring efficacy and explored the correlation between sociodemographic factors of age, education, and experience of work empowerment and/or caring efficacy. The Conditions for Work Effectiveness Questionnaire and Caring Efficacy Scale were used to assess the association between the nurses’ work environment conditions and caring efficacy. The instruments were translated to Spanish and adapted to …

Relational Coordination: A Predictor Of Nurse Job Satisfaction, Organizational Commitment, And Turnover Intention, Rawaih Falatah

Doctoral Dissertations

The purpose of this cross-sectional correlational study was to examine the psychometric properties of the relational coordination scale among nurses in the Kingdom of Saudi Arabia (KSA). In addition, it examined the relationship between relational coordination (RC), job satisfaction, affective organizational commitment (AOC), and turnover intention. Finally, it identified potential moderators and mediators between these four concepts. The study population included staff nurses 22 years or older, who have worked in a healthcare setting for at least six months in the Kingdom of Saudi Arabia. Participants completed an online survey via Survey Monkey “Survey Monkey (www.surveymonkey.com).” A link to the …

Robust Biosensors For Healthcare Applications: From High-Content Screening To Point-Of-Care Testing, Ngoc D. B. Le

Doctoral Dissertations

Efficient detection of proteins, mammalian cells, microorganisms and other biological systems in complex mixture is essential in disease diagnosis and environmental health. Therefore, technological platforms that provide sensors of high sensitivity, selectivity and stability are greatly desired. Recently, the ‘chemical-nose’ sensing approach has proved to be an effective strategy for profiling bio-relevant targets in complex mixtures. Detecting analytes in complex mixture is a challenge that conventional specificity-based sensors are still trying to solve due to the requirement of prior knowledge of the analyte, which is unknown in many cases. This thesis focuses on how to develop simple and robust …

Relational-Cultural Perspectives Of African American Women With Diabetes And Maintaining Multiple Roles, Ayesha Ali

Doctoral Dissertations

The growth of diabetes in the United States is viewed by some as epidemic with a particular concern as related to African American women. African American women experience diabetes disproportionately to other groups with higher risks of complications and premature death. Historically, they have led all women in labor force participation and maintained roles within and outside the home. The purpose of this study was to gain understanding and meaning of the lived experience of African American women with diabetes and maintaining multiple roles using sensitizing concepts of Relational-Cultural theory. Relational-Cultural theory was described as related to use with women …

Testing A Skills Training Course For Use In A Peer-Delivered Mental Health Intervention, Samantha L. Bernecker

Doctoral Dissertations

Millions of people who could benefit from mental health services do not receive treatment. If non-professional peers could learn to administer basic psychotherapeutic interventions to each other, taking turns as care provider and care recipient, this unmet need for mental health care could be partially filled. This study sought to test whether non-professionals could learn supportive psychotherapy skills from a massively scalable, free online course. Thirty pairs of individuals who were experiencing psychological distress or who wished to increase their mental well-being were enrolled in the study, and 19 pairs completed the prototype online course. Objective raters assessed participants’ skills …

Perceived Barriers To The Pre-Transplant Evaluation: A Patient Perspective, Linda K. Buck

Doctoral Dissertations

Patients who are afforded the opportunity for a kidney transplant tend to have better short and long-term outcomes, including improved physical health, quality of life, and long-term survival over those who are treated with prolonged dialysis (Landreneau, Lee, & Landreneau, 2010; Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients (OPTN/SRTR), 2014; Wolfe et al., 1999). At the end of 2012, 402,514 people were being treated with hemodialysis while 40,605 were receiving peritoneal dialysis (USRDS, 2014). At this same time, only 92,885 people were listed on the OPTN national waitlist for kidney transplantation. The aim of this project …

Rural Appalachian Person And Family Decision Making At End Of Life, Mary Lou Clark Fornehed

Doctoral Dissertations

The dynamics of delivering care to persons at end of life (EOL) have dramatically changed in the last twenty years. Improved management of chronic illness and provision of aggressive life sustaining measures for an illness once deemed fatal are more common, significantly increasing longevity. While it is estimated that more than 40 million persons with life-limiting illness worldwide are candidates for some form of palliative or end-of-life care (EOLC), less than 14% of them will receive it.

When coping with life-limiting illness, people and their families are asked to make many complex and difficult decisions about EOL, palliative, or hospice …

Evaluation Of Increased Targeted Enforcement And Community-Based Outreach And Education Programs To Increase Nighttime Seatbelt Use In East Tennessee, Kwaku Frimpong Boakye

Doctoral Dissertations

According to the National Highway Traffic Safety Administration (NHTSA), motor vehicle crashes are the leading cause of death among people aged 1-54 in the United Sates. In 2015, the number of motor-vehicle deaths on U.S. roadways totaled 35,092, a 7% increase from 2014 (32,744). Though lower gas prices and increased vehicle mileage combined with risky driving behaviors (e.g. speeding, driving while texting) account for the increased fatality rate, seatbelt non-use has been a significant contributory factor. It is estimated that nearly half (48%) of passenger vehicle occupants involved in fatal crashes each year are unrestrained.

In a recent 2014 report …

Using The Suprachiasmatic Nucleus As A Model System To Assess Tolerance And Withdrawal To Alcohol, Jonathan Houghton Lindsay

Doctoral Dissertations

Alcohol abuse induces many disorders including depression, metabolic syndrome, and sleep disturbances. The strong link between alcohol abuse and sleep problems, along with the close connection between sleep and circadian rhythms, led us to investigate ethanol’s effects on the circadian clock. Previous work has shown that acute ethanol blocks photic phase shifts in vivo and glutamatergic phase shifts in vitro. However, neural systems become tolerant to ethanol across different timeframes. Despite both ethanol tolerance and ethanol withdrawal syndrome being listed as criteria for developing alcohol use disorders, little is known about how ethanol tolerance and withdrawal induced hyperexcitability develop and …

A Grounded Theory Inquiry Into Crying In Women Dealing With The Emotional Stress Of Personal Crisis, Mary Bess Griffith

Doctoral Dissertations

The belief that crying leads to healing is so widely held and of such longstanding that many healthcare professionals—including nurses, physicians, psychiatrists, and psychologists—accept it as fact even though there is little substantiating scientific evidence. Crying is commonly believed to be an essential factor in restoring mind-body equilibrium after physical and/or emotional trauma has been experienced. If, as has been hypothesized by many scientists and healthcare practitioners, emotional crying is a biopsychosocial healing modality, then specifics of its therapeutic praxis, including limitations and ambiguities, should be incorporated into nursing education and practice. In this grounded theory study, the meaning and …

Assessment Of Physical Activity And Sedentary Behavior Using Wearable Sensors: Measurement Considerations And Clinical Applications, Amanda Hickey

Doctoral Dissertations

The aims of study one of this dissertation were two-fold: 1) To understand the variability of sedentary behavior (SB) throughout a seven-day measurement period and 2) To determine the number of days of SB measurement required to reliably estimate seven-days of measurement. To address these aims, we utilized activPAL (AP) data from two existing data sets from the Physical Activity (PA) and Health Laboratory. Data were from 62 adults and 34 adolescents who had seven consecutive days of valid monitor wear. We found that adults were more sedentary on weekdays compared to weekend days, but there were no differences by …

Lesbian Veterans Experiences In The Military: A Case Study, Carolyn Gustason

Doctoral Dissertations

Extant research suggests that lesbians, as a group, are a vulnerable population who engage in risky health behaviors and often do not receive regular care from healthcare providers, due to fears of discrimination and mistreatment. Recent research conducted with military Veterans suggests that some lesbian Veterans may engage in similar health behaviors, but may not choose to receive care from the VA. It is not well understood why lesbian Veterans choose to receive care elsewhere, but extant research suggests a trusting relationship between a lesbian and a healthcare provider may increase healthcare utilization. A person’s sense of self, their identity, …

Verbal -S Productions In The Structured Writing Samples Of Variable Aae-Speaking Fourth-Grade Students With And Without Language Impairment, Jacklyn High Felton

Doctoral Dissertations

Researchers in speech-language pathology and ethnolinguistics have worked to gain knowledge about typical and atypical language patterns of African American children who are identified as African American English (AAE) dialect speakers. Much progress had been made, but limitations in this field of knowledge have persisted, especially for AA children who demonstrate variable use of AAE, presumably through the process of assimilation in the school setting. Therefore, more information is needed to provide diagnostic markers for deviations in typical language development for variable AAE-MAE speakers. Prior empirical research has found that third- and fourth-grade AAE-speaking children with typical language development overtly …

Micronutrients, Inflammation And Depression Among Women Of Reproductive Age From The National Health And Nutrition Examination Survey 2005-2008, Joycelyn M. Faraj

Doctoral Dissertations

Depression is the leading cause of disease burden among women. Recent evidence indicates that inflammation is associated with depression, and factors that contribute to inflammation can be addressed through nutritional and lifestyle interventions. Vitamins B₆ and D have been linked with depression and have established roles in inflammation, yet their associations with depression in the presence of low-grade inflammation remain unknown. The purpose of this research was to investigate how high sensitivity C-reactive protein (hs-CRP), a biomarker of inflammation, contributes to different dimensions of depression and to determine to what degree inflammation affects the association between vitamins B_{6 …}

Cancer Pain Processes In The Hospice Caring Triad: A Grounded Theory Study, Olga Ehrlich

Doctoral Dissertations

The author conducted this constructivist grounded theory study to describe perceptions, behaviors, and communication that hospice caring triads engage in while managing cancer pain, specifically how these social processes can be assessed and used to improve poorly-controlled pain. Three hospice caring triads comprised of patients, family caregivers, and nurses along with one nurse-patient dyad, were recruited into this longitudinal qualitative study. Each group was observed during nursing visits. Triad and dyad members were individually interviewed. Nurses participated in a focus group and survey. The author used constant comparative methods of data analysis, including line-by-line gerund coding, theoretical codes from cancer …

The Effects Of Exercise Training On Insulin Supply And Demand In Breast Cancer Survivors, Richard Viskochil

Doctoral Dissertations

Elevated insulin concentrations may influence cancer and cardiometabolic disease onset and prognosis, and lower insulin levels after exercise may contribute to disease prevention and overall health. The effect of exercise training on systemic and tissue-specific insulin supply and demand in breast cancer survivors and adults at risk for cardiometabolic disease is unclear. The objective of this dissertation was to evaluate the effects of exercise training on postmeal insulin concentrations in breast cancer survivors, and identify mechanisms responsible for changes to insulin supply and demand following exercise training in breast cancer survivors and adults at risk for cardiometabolic disease. Study 1 …

Comparison Of The Efficacy Of Arv Medications Alone And In Combination With Herbal Medications In The Treatment Of Hiv Among Nigerian Hiv+ Patients, Abdulfattah Durojaiye

Doctoral Dissertations

ABSTRACT COMPARISON OF THE EFFICACY OF ARV MEDICATIONS ALONE AND IN COMBINATION WITH HERBAL MEDICATIONS IN THE TREATMENT OF HIV AMONG NIGERIAN HIV+ PATIENTS MAY 2017 ABDULFATTAH B. DUROJAIYE, BSN, UNIVERSITY OF MEDICINE & DENTISTRY OF NJ (NOW RUTGERS UNIVERSITY) BSc, UNIVESITY OF AGRICULTURE, ABEOKUTA, NIGERIA MSc, UNIVERSITY OF IBADAN, NIGERIA PhD, UNIVERSITY OF MASSACHUSETTS, AMHERST Directed by Prof. Donna Zucker Background/Purpose: There is disproportionate incidence of HIV in Sub-Saharan Africa in comparison to the rest of the world. Of the estimated 35.3 million people living with HIV, Sub-Saharan Africa has the highest level of HIV infections, accounting for 69% …

Exploring The Balance: A Path Analysis Examination Of The Maintaining The Balance Model, Sheila Pennell

Doctoral Dissertations

Home is the desired site of care for most adults in the US (Eckert, Morgan & Swamy, 2004). The number of older adults who potentially require supportive care at home is rapidly growing. Our current healthcare infrastructure must evolve to accommodate the preference for homecare. This investigation will provide quantitative testing of a qualitatively-derived model called Maintaining the Balance (MTB) developed by Jacelon (2010). MTB describes the factors that drive a community-dwelling older adult’s ability to achieve OW in the home environment. Secondary analysis of data collected for the National Social Life, Health, and Aging Project (NSHAP) was utilized. Path …

Using The Electronic Patient Portal To Engage Patients With Multiple Chronic Conditions, Kimberly Ryan Powell

Doctoral Dissertations

Three in four Americans aged 65 and older is living with multiple chronic conditions. These patients have complex care needs and stand to benefit from tools facilitating engagement in their healthcare. Little is known regarding use of the electronic patient portal as a tool to support self-care in patients with multiple chronic conditions. The purpose of this multiple-methods study was to (1) explore characteristics and patterns of portal use by patients with multiple chronic conditions and (2) to understand the perceived usefulness of this tool to improve self-care. In phase 1, the quantitative phase, data from electronic health records and …

Influence Of Patient Satisfaction Of Total Knee Replacement Patients On Stair Negotiation And Walking Biomechanics, Strength, And Balance, Kevin Alan Valenzuela

Doctoral Dissertations

Total knee replacement (TKR) patients have shown alterations in lower extremity biomechanics during level ground walking and stair negotiation, strength levels, and balance abilities, however, it is unknown how dissatisfied TKR patients compare to satisfied TKR patients in these activities. Study One examined the lower extremity biomechanics of dissatisfied and satisfied TKR patients during level ground walking. Study Two investigated knee biomechanics during stair ascent and descent activities. Study Three compared isokinetic strength, balance abilities, deep knee flexion abilities, and functional abilities of the dissatisfied patients to the satisfied patients. Study Four performed a logistic regression as a means of …

The Effects Of Motivational Interviewing On Heart Failure Self-Care During Transitional Care In An Appalachian Population, Jennifer Lynn Mabry

Doctoral Dissertations

Research has shown that patients who are successfully engaged in self-care for a chronic illness have a higher quality of life and reduced hospitalizations than those who are not. According to the National Center for Health Statistics, transitional care in the home setting has seen a 51% increase in mortality over the last 15 years (Reeder et al., 2015). This finding contrasts with the reported decline in hospital readmissions for chronic illnesses. With the lack of agreement on best practices for patient discharge education, transitional care has proven to be a weakness in chronic illness care that requires further research. …

The Effect Of Gamification On Audiology Awareness Among Young Adults, Shenque Lester

Doctoral Dissertations

The profession of audiology is projecting a critical shortage of practicing professionals in the near future. Although there are many potential factors that are contributing to this problem, it is generally agreed that audiology as a profession is not readily identified as a career choice by undergraduate students, nor a recognizable healthcare field/service among the general public. Due to the increased instances of hearing loss in the general population as well as the aging of the population and need for audiological services, it is imperative to find an efficient means to improve the awareness of audiology as a potential career …

Acoustical Properties Of Amplified And Unamplified Stethoscopes When Examining Typical Body Sounds, Jeni Abrams Dunnington

Doctoral Dissertations

A stethoscope is intended for three main diagnostic purposes: listening to heart sounds, listening to lung sounds, and determining the presence or absence of bowel sounds (Callahan, Waugh, Matthew, & Granger, 2007). Currently, on the market there are two types of stethoscopes for practitioners to choose: unamplified and amplified stethoscopes. Furthermore, there is little research on the sound pressure levels (SPLs) produced by stethoscopes on the market. Therefore, the current study seeks to measure the SPL produced by various popular unamplified stethoscopes and compare those findings to the SPLs produced by amplified stethoscopes. Secondly, the SPL of selected amplified stethoscopes …

Colicins - A Sound Antimicrobial Approach For The Prevention Of Catheter-Associated Urinary Tract Infections, Sandra M. Roy

Doctoral Dissertations

The emergence and spread of antibiotic resistance has created one of the greatest challenges in fighting infectious disease. We address the rise of antibiotic-resistant pathogens by examining the evolutionary history of a class of resistance determinants, the SHV b-lactamases. We isolated the genes that encode the SHV beta-lactamases (bla_SHV genes) from clinical settings and from an environment essentially devoid of antibiotic use. Our data suggests that, counter to current dogma, the use of antibiotics in the clinic is not creating these resistance genes; genes for antibiotic resistance already exist in nature and our use of antibiotics in clinical …

Labor Force Participation, Disability, And Implications For Healthcare Utilization And Employment, Lawrence C. Pellegrini

Doctoral Dissertations

The study period (i.e., 1999-2014) is characterized by declining labor force participation rates, rising disability enrollment, varying healthcare utilization, and increasing and changing composition of healthcare provider employment. However, little is known about the effect labor force participation and disability enrollment both have on the US healthcare system (i.e., healthcare utilization and employment). This dissertation is comprised of three manuscripts answering questions related to these relationships. Results show that labor force participation is a more robust indicator than the unemployment rate for exploring the effect of the labor market on healthcare spending and health outcomes, with healthcare spending itself exhibiting …

Total Organic Iodine Quantification And Occurrence In Drinking Water, And Toxicity Assessment Of Iodinated Disinfection By-Products, Rassil El Sayess

Doctoral Dissertations

The focus of this work has been placed is on iodinated DBPs (I-DBPs), measured using total organic iodine (TOI), a surrogate measure of iodinated organics. This is due to the growing toxicity literature that places I-DBPs among the most toxic of all DBPs. To measure TOI in water, a new method was developed. This method combines adsorption, combustion, and trapping of combustion products, with an offline inductively coupled plasma/mass spectrometer (ICP-MS) for iodide detection. Three factors were varied across two levels each in order to optimize the method. The chosen method used a sample pH of less than 1 prior …

Patient-Centered Medical Home Model Of Care For Non-Elderly Adults With Mental Illness: Preventive Care, Healthcare Quality, Services Utilization, And Cost Analyses, Jennifer Bowdoin

Doctoral Dissertations

Background. Patient-centered medical homes (PCMHs) may improve outcomes for non-elderly adults with mental illness while containing the cost of care. However, additional research is needed to assess the association between receipt of care consistent with the PCMH and preventive care, healthcare quality, healthcare services utilization, and healthcare services cost for a nationally representative sample of non-elderly adults with mental illness in the United States. Research is also needed to examine whether non-elderly adults with mental illness receive care consistent with the PCMH. Methods. A surveillance study was conducted using self-reported data for a nationally representative sample of non-elderly adults …