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Articles 1 - 30 of 44
Full-Text Articles in Medicine and Health Sciences
Intra-Skeletal Variation In Stable Isotopes Through Non-Destructive Approaches: Applications Of The Patterns Of Skeletal Remodeling To Biological Anthropology, Armando Anzellini
Intra-Skeletal Variation In Stable Isotopes Through Non-Destructive Approaches: Applications Of The Patterns Of Skeletal Remodeling To Biological Anthropology, Armando Anzellini
Doctoral Dissertations
Stable isotope analysis is a well-established method in biological anthropology used to deliver data on residence, diet, and life history. Samples for these analyses are often collected from the diaphyses of long bones with an assumption of an expected rate of turnover between five and ten years, depending on the skeletal element. However, the biological foundations of this assumption are still uncertain, especially concerning the intra-skeletal and intra-element variation of isotopic signatures that may relate to patterns of remodeling. Exploring these gaps in intra-element isotopic variation requires fine-grained work using multiple bones from multiple individuals, but such work is limited …
Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell
Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell
Doctoral Dissertations
South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall …
Perinatal Health In North Dakota: Emerging Issues, Grace N. Njau
Perinatal Health In North Dakota: Emerging Issues, Grace N. Njau
Doctoral Dissertations
Preterm birth, newborn screening refusal, and postpartum depression represent three emerging areas of concern that have not been previously investigated in North Dakota. Their potential impact creates significant social, behavioral, and economic burdens. Although various studies have investigated preterm birth and postpartum depression, to the best of my knowledge, newborn screening refusal in the United States has not been previously investigated. In alignment with the role of Title V of the Social Security Act (Maternal and Child Health) Programs to conduct ongoing statewide needs assessments, the objectives of this study was to investigate and identify predictors of preterm birth, newborn …
Sphenoidal Sinuses And Spherical Harmonics: Variation And Covariation Of The Most Morphologically Diverse And Least Understood Paranasal Sinus, Katharine Grace Josephine Ryan
Sphenoidal Sinuses And Spherical Harmonics: Variation And Covariation Of The Most Morphologically Diverse And Least Understood Paranasal Sinus, Katharine Grace Josephine Ryan
Doctoral Dissertations
Understanding the shape variation of the human sphenoidal sinus is important to several areas of research. This includes clinical investigation (sinus pathology and safe endoscopic endonasal surgical practice) and paranasal sinus evolution (for which there is still no consensus). Yet, the sphenoidal sinus has high morphological variation, prohibiting its quantification through traditional geometric morphometric landmarking methods. The sphenoid body, and thus also the sinus contained within, is located directly at the developmental center of the basicranium in humans, where the three cranial fossae meet at the midline, and adjacent to the three synchondroses which are the sites of cranial base …
The Lived Experience Of Losing Employment After Diagnosis With Dementia: A Phenomenological Analysis, Susan K. Blaine
The Lived Experience Of Losing Employment After Diagnosis With Dementia: A Phenomenological Analysis, Susan K. Blaine
Doctoral Dissertations
The purpose of this study was describing the experiences of people with dementia (PWD) who lose their employment after diagnosis with dementia, but sooner than originally planned. A phenomenological approach based on tenets of Maurice Merleau-Ponty was used. Six telephone interviews were conducted, with participants sharing their experiences. Transcripts were transcribed verbatim, and subsequently analyzed via a hermeneutical analysis approach. Themes were identified within and between transcripts, considering the contextual grounds of Merleau-Ponty’s phenomenology: body, others, time, and world, and the contextual ground of participants’ experience: the stigma of dementia. An overarching, central theme of “still working” was identified across …
Identification Of The Type Eleven Secretion System (T11ss) And Characterization Of T11ss-Dependent Effector Proteins, Alex S. Grossman
Identification Of The Type Eleven Secretion System (T11ss) And Characterization Of T11ss-Dependent Effector Proteins, Alex S. Grossman
Doctoral Dissertations
Host-associated microbes live in dangerous environments as a result of host immune killing, nutrient provisioning, and physiological conditions. Bacteria have evolved a host of surface and secreted proteins to help interact with this host environment and overcome nutrient limitation. The studies included within this dissertation describe the identification of a novel bacterial secretion system which has evolved to transport these symbiosis mediating proteins. This system, termed the type eleven secretion system (T11SS), is present throughout the Gram negative phylum Proteobacteria, including many human pathogens such as Neisseria meningitidis, Acinetobacter baumanii, Haemophilus haemolyticus, and Proteus vulgaris. Furthermore, …
Evaluation Of Ocelot And Bobcat General And Reproductive Health In South Texas And Assessment Of Assisted Reproductive Techniques For Wild Felid Conservation, Ashley Reeves
Doctoral Dissertations
Recent studies of wild felid populations in southern Texas have shown loss of genetic variability and inbreeding depression over time, increasing the risk of reduced reproductive and immune fitness leading to an overall decrease in reproductive success, increase in disease susceptibility, and further population demise. Assessment of general health, pathogen exposure, and reproductive health can provide documentation of the possible effects of inbreeding and inform the development of conservation strategies. Assisted reproductive technologies have been used in many other species and can address behavioral or physical incompatibilities among breeding pairs, connect distant populations by transporting frozen gametes, preserve genetic diversity …
Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis
Doctoral Dissertations
Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …
Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert
Addressing Interprofessional Competence In Interpretation Of Electronic Fetal Monitor Tracings, Susan H. Hébert
Doctoral Dissertations
Interpretation of electronic fetal monitor (EFM) tracings is a critical clinical practice skill nurses and physicians perform during the intrapartum stage of pregnancy. However, if performed inaccurately can potentially jeopardize the well-being of the neonate. This risk is present because if concerning EFM tracings are not interpreted accurately, preventative care interventions to promote the well-being of the unborn child do not occur. The project was initiated by completing a scoping literature review on the methods for training and evaluating EFM interpretation competence, which revealed current EFM interpretation training and evaluation methods are lacking. A concept analysis defined nurse competence in …
Unobtrusive Assessment Of Upper-Limb Motor Impairment Using Wearable Inertial Sensors, Brandon R. Oubre
Unobtrusive Assessment Of Upper-Limb Motor Impairment Using Wearable Inertial Sensors, Brandon R. Oubre
Doctoral Dissertations
Many neurological diseases cause motor impairments that limit autonomy and reduce health-related quality of life. Upper-limb motor impairments, in particular, significantly hamper the performance of essential activities of daily living, such as eating, bathing, and changing clothing. Assessment of impairment is necessary for tracking disease progression, measuring the efficacy of interventions, and informing clinical decision making. Impairment is currently assessed by trained clinicians using semi-quantitative rating scales that are limited by their reliance on subjective, visual assessments. Furthermore, existing scales are often burdensome to administer and do not capture patients' motor performance in home and community settings, resulting in a …
The Political Economy Of Intimate Partner Violence And Crisis Management: An Institutional Ethnography In Rural Vermont, Anna L. Mullany
The Political Economy Of Intimate Partner Violence And Crisis Management: An Institutional Ethnography In Rural Vermont, Anna L. Mullany
Doctoral Dissertations
Intimate partner violence (IPV) is a significant public health issue affecting one in four women in the United States. Tasked with addressing IPV, crisis centers can significantly impact women’s health outcomes and approaches to perpetrator accountability and community education. Informed by eight months of field work at a rural crisis center and 40 in-depth interviews, this dissertation investigated how the lives of Vermont women experiencing violence and crisis center work are both shaped by larger social, political, and economic relations within capitalism. Dorothy Smith’s method of institutional ethnography provides an investigative pathway for centering survivor experiences and examining crisis center …
Mixture Models For Interval Censored Outcomes, Yibai Zhao
Mixture Models For Interval Censored Outcomes, Yibai Zhao
Doctoral Dissertations
Silent events such as the first detectable HIV infection, the onset of Type 2 diabetes and prostate cancer progression are often ascertained by diagnostic tests and/or self-reports that are scheduled periodically. In such applications, we only observe the time to the event of interest to lie between the times of last negative and the first positive tests, resulting in interval-censored observations. In addition, in some medical studies, a substantial proportion of participants may experience the events before the study, so-called prevalent cases, or participants may never experience the event, that is regarded as non-susceptible cases (or indolent cancer or long-term …
Frontiers In The Self-Assembly Of Charged Macromolecules, Khatcher O. Margossian
Frontiers In The Self-Assembly Of Charged Macromolecules, Khatcher O. Margossian
Doctoral Dissertations
The self-assembly of charged macromolecules forms the basis of all life on earth. From the synthesis and replication of nucleic acids, to the association of DNA to chromatin, to the targeting of RNA to various cellular compartments, to the astonishingly consistent folding of proteins, all life depends on the physics of the organization and dynamics of charged polymers. In this dissertation, I address several of the newest challenges in the assembly of these types of materials. First, I describe the exciting new physics of the complexation between polyzwitterions and polyelectrolytes. These materials open new questions and possibilities within the context …
The Effect Of Linguistic Context And Explicit Contrast On The Fast Mapping Of Verbs, Samantha L. Scripture
The Effect Of Linguistic Context And Explicit Contrast On The Fast Mapping Of Verbs, Samantha L. Scripture
Doctoral Dissertations
In typical language acquisition, word learning is an induction problem. When word learners hear an unfamiliar word, they make assumptions about the possible referent and its meaning. For nouns, this is relatively easy as word learners can rely on perceptual and pragmatic cues. For verbs, these two cues are fleeting, and word learners require additional kinds of cues for their meaning to be acquired. Two cues that affect verb learning include linguistic context and contrastive information. The current study used a within group comparison to examine the effect of linguistic context (i.e., rich vs. sparse) and contrastive information (i.e., implicit …
Use Of A Checklist As A Decision Support Aid For Heart Failure Assessment And Management, Maryann Hogan
Use Of A Checklist As A Decision Support Aid For Heart Failure Assessment And Management, Maryann Hogan
Doctoral Dissertations
Heart failure is a serious chronic health problem requiring ongoing management to control disease progression. Consequences of inadequate heart failure management include acute exacerbation, worsening baseline status, and possibly death. Nurses play a key role in surveillance of patients with heart failure and in management of their condition as part of the interprofessional health care team. During episodes of acute decompensation of heart failure, nurses must be able to detect onset of signs and symptoms, initiate appropriate nursing interventions promptly, and communicate with the provider and other team members as needed. Although heart failure is a common health problem in …
Contributions Of Asymmetry And Instability To Transfer And Retention Following Locomotor Adaptation, Daniel L. Gregory
Contributions Of Asymmetry And Instability To Transfer And Retention Following Locomotor Adaptation, Daniel L. Gregory
Doctoral Dissertations
Gait asymmetry resulting from neurological injury is more costly and less stable than healthy gait. Split-belt treadmills, which drive limbs at different speeds, lead to spatial and temporal gait asymmetries, and perturb walking balance, have been used to study locomotor adaptability and learning related to asymmetry and stability. This knowledge may be leveraged to design more effective rehabilitation protocols. In experiment 1, we asked how constraining stride-rates away from preferred during split-belt walking influences learning revealed in a retention test. We found that constraints to stride rate during asymmetric walking uncovered the capacity to leverage redundant degrees-of-freedom for walking control, …
Biomedical Applications Of Protein Films And Polymeric Nanomaterials, Sanjana Gopalakrishnan
Biomedical Applications Of Protein Films And Polymeric Nanomaterials, Sanjana Gopalakrishnan
Doctoral Dissertations
Biomaterials are widely applied for the diagnosis and treatment of numerous diseases. In addition to fulfilling specific biological functions, biomaterials must also be non-toxic, biocompatible, and sterilizable to be regarded as safe-for-use. Polymers are excellent candidates for fabricating functional biomaterials due to their wide availability and varied properties and may be natural or synthetic. Polymer precursors are fabricated into coatings, foams, scaffolds, gels, composites, and nanomaterials for several biomedical applications. This dissertation focuses on two types of polymeric biomaterials – protein-based materials and synthetic polymeric nanoparticles. Proteins are biopolymers that naturally occur with a variety of structural and functional properties. …
Physical Activity, Daily Step Counts And Functional Ability In Older Adults: Using Nhanes Database, Chunfang(Maggie) Chen
Physical Activity, Daily Step Counts And Functional Ability In Older Adults: Using Nhanes Database, Chunfang(Maggie) Chen
Doctoral Dissertations
Maintaining functional ability and independence are essential in the healthcare of older adults. Physical activity(PA) has been acknowledged as effective and economical health promotion strategies in older population. However, the amount of PA needed to maintain functional ability in older adults remains unclear. This investigation used PRISM Dose-response Curves Stimulation Variable slope model to explore the relationships between the amount of PA and functional ability in community-dwelling young-old, middle-old and old-old age group adults. ANOVA analysis was used to examine the relationship between functional ability and self-perceived active level changes compared to 10 years ago. NHANES 2005-2006 older participants datasets …
Interplay Of Environmental Pollutants And Folate In The Etiology Of Autistic Traits Analysis Using Multipollutant Approaches, Michael T. Mascari
Interplay Of Environmental Pollutants And Folate In The Etiology Of Autistic Traits Analysis Using Multipollutant Approaches, Michael T. Mascari
Doctoral Dissertations
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a spectrum of communication deficits and repetitive behaviors. The challenges in learning, thinking, and problem-solving abilities of people with ASD can be debilitating. There is currently no cure for ASD. Many environmental pollutants are suspected to contribute to the etiology of ASD and its associated traits, whereas folate and folate supplements have been shown to exhibit both protective and adjuvant roles. Little is known about the interplay of multiple environmental pollutants and folate in the etiology of ASD. Additionally, statistical approaches that consider the effects of pollutant mixtures instead …
Controlling Myosin’S Function Via Interactions Between The Substrate And The Active Site, Mike K. Woodward
Controlling Myosin’S Function Via Interactions Between The Substrate And The Active Site, Mike K. Woodward
Doctoral Dissertations
Molecular motors, such as myosin, have evolved to transduce chemical energy from ATP into mechanical work to drive essential cellular processes, from muscle contraction to vesicular transport. Dysfunction in these motors is a root cause of many pathologies necessitating the application of intrinsic control over molecular motor function. We hypothesized that altering the myosin’s energy substrate via minor positional changes to the triphosphate portion of the molecule will allow us to control the protein and affect its in vitro function. We utilized positional isomers of a synthetic non-nucleoside triphosphate, azobenzene triphosphate, and assessed whether myosin’s force- and motion-generating capacity could …
Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter
Doctoral Dissertations
Literature exploring clinicians' perspectives on the effectiveness of trauma-focused cognitive behavioral therapy with African American children who suffer from trauma-related disorders is very limited. The current study examined clinicians' perspectives on the TF-CBT model when utilized with this population, including their experiences working with African American children and families with observable types of trauma-related disorders. This research study also explored the various facets of trauma that African Americans encounter in childhood and the barriers that prevent them from receiving adequate mental health care. Thematic analysis was utilized to explore themes that emerged when treating African American children with TF-CBT. Five …
An Evaluation Of Methods To Reduce Inframammary Surface Dose In Prone Breast Irradiation, Seth Alvarado
An Evaluation Of Methods To Reduce Inframammary Surface Dose In Prone Breast Irradiation, Seth Alvarado
Doctoral Dissertations
In cases of breast radiation treatments via external beam radiation therapy, the incidence of radiation dermatitis has been reported. In prior studies, this acute radiation side-effect has been correlated with the immobilization devices in cases of prone breast irradiation. They attribute this to the bolus effect that occurs with the interaction of the incident photon beam at different projections causing an increase in measured surface dose. The type of radiation planning technique, and patient positioning during the undertaking of these techniques, have also shown to influence this bolus effect. This study focuses on these factors in treatment planning in order …
Implantable Medical Devices For Local Drug Delivery And Tissue Regeneration To Combat Chronic Bacterial Infection, Caroline J. Billings
Implantable Medical Devices For Local Drug Delivery And Tissue Regeneration To Combat Chronic Bacterial Infection, Caroline J. Billings
Doctoral Dissertations
Local drug delivery has been an area of exceptional interest in the treatment of chronic bacterial infections, particularly in areas where there are medical implants placed. Medical implants are widely utilized and are becoming increasingly popular with time. With the increasing use of medical implants, concomitant bacterial infection is also increasing, and this type of bacterial infection can be exceedingly difficult to clear. The following body of work focuses on implant-associated bacterial infection, with an emphasis on chronic Staphylococcus aureus (S. aureus) infection, particularly osteomyelitis. Specifically, this work is focused within the scope of utilizing locally implantable medical …
Investigating Person-Specific Profiles Of Readiness-To-Exercise: Exploring Associations With Hypothetical Experiential Outcomes And Perceived Relevance, Cory Beaumont
Doctoral Dissertations
Autoregulation is a person-adaptive strategy wherein exercise workloads are adjusted to match one’s readiness (e.g., acute mental, physical, perceptual state). Prior work demonstrated that structural features of readiness profiles (i.e., which factor(s) are most important) differ across individuals. As this work relied on mathematical modeling, research is needed to understand the informational utility of person-specific profiles (PSPs) of readiness. Purpose: Model heterogeneity in PSPs of readiness (Aim 1), explore associations between PSP factor scores and forecasted experiences to hypothetical muscle-strengthening exercise (Aim 2), and explore participants’ perceptions of relevance and utility regarding their PSP (Aim 3). Methods: For …
Role Of Temperature, Transmission Pathways, And Pathogen Load In Batrachochytrium Salamandrivorans Epidemiology, Edward Davis Carter
Role Of Temperature, Transmission Pathways, And Pathogen Load In Batrachochytrium Salamandrivorans Epidemiology, Edward Davis Carter
Doctoral Dissertations
Amphibian populations are experiencing dramatic population declines. Amphibian diseases are one of the major reasons for these declines. A newly described fungal pathogen, Batrachochytrium salamandrivorans (Bsal), has been recently introduced to Europe and is currently decimating European salamander populations. Sampling efforts have not detected Bsal yet in the United States in captive or wild populations. Disease management hinges on knowing how environmental, host, and pathogen interactions influence disease occurrence and severity. Understanding routes of pathogen transmission is also critical as knowledge of these routes can elucidate management strategies. In Chapter I of my dissertation, I measured how environmental …
The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner
The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner
Doctoral Dissertations
Cardiovascular disease and type 2 diabetes are global epidemics affecting approximately 127 and 21 million people in the U.S., respectively. Women who are overweight, obese or who develop glucose intolerance during pregnancy represent high-risk groups for the development of cardiovascular disease and type 2 diabetes. Hispanic women are both more likely to begin their pregnancies as overweight or obese and have a higher prevalence of type 2 diabetes, compared to non-Hispanic whites. However, prior lifestyle interventions have largely been limited to non-Hispanic whites. Therefore, this research assessed how culturally tailored lifestyle modification may affect cardiovascular disease and type 2 diabetes …
Endocrine Disrupters And Adverse Health Outcomes Among Post-Menopausal Women, Gabriela Vieyra
Endocrine Disrupters And Adverse Health Outcomes Among Post-Menopausal Women, Gabriela Vieyra
Doctoral Dissertations
Globally, chronic diseases that require ongoing medical attention, and limit daily living activities, are the leading cause of disability and mortality. The older population in the U.S. is rapidly growing, and the risk of chronic diseases is higher in this population, specifically older women. In 2018, 51.3% of women compared to 41.8% of men had two or more chronic conditions. Thus, the Women’s Health Initiative (WHI) study, Chapter 1, focused on preventing leading causes of death, disability, and frailty in older women. Phthalates are synthetic industrial compounds, Chapter 2, commonly added to daily used consumer goods, nutritional and dietary supplements, …
Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones
Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones
Doctoral Dissertations
This is a mixed methods investigation of how chronic Lyme disease, including Lyme-like diseases and co-infections, affects the quality of life of women who have chronic Lyme. Both quantitative and qualitative methods were used during three phases of research: a 91-question survey instrument followed by focus group discussions and written narratives. The research considered the socioeconomic impact on quality of life in five areas: obtaining a diagnosis, relationships and personal support systems, struggles with the medical system, the ability to work, and access to treatment. There were 500 responses to the survey, of which 373 were analyzed; 11 participants in …
Elucidating Mechanisms Influencing Maternal Postpartum Health: The Protective Benefits Of Breastfeeding And Associations With Allostatic Load, Experiences Of Stress, And Resiliency, Bi-Sek J. Hsiao
Doctoral Dissertations
Research has established breastfeeding as protective of maternal health, but little is known about the ways breastfeeding interacts with chronic stress pathways and interfaces with stressors such as discrimination and neighborhood deprivation, which are salient in the experiences of many marginalized communities. This research addresses these knowledge gaps through secondary analyses of prospective cohort data generated by the Community Child Health Research Network through Community Based Participatory Research processes. Analytical samples were derived from 2510 postpartum women from five regions in the U.S. who self-identified as Black, Hispanic, or White. Study 1 investigated and found an inverse association between breastfeeding …
Formalized Diabetes Education In A Safety-Net Clinic, Haley N. Wanic
Formalized Diabetes Education In A Safety-Net Clinic, Haley N. Wanic
Doctoral Dissertations
Uncontrolled diabetes mellitus in a Hispanic population can be helped through a quality improvement project focused on progressive verbal and written diabetes self-management education (DSME) Purpose of this article is to review the background, an organizational assessment, a literature review, results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included four patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, minimal workflow adjustments for providers, completed microalbumins, and written education given to patients. In conclusion, the quality improvement project showed positive trends in outcome measures over …