Medicine and Health Sciences Commons^™

Synthesis Of 2,4,6-Substituted Pyrrolo[2,3-D]Pyrimidines As Potential Anticancer Agents, Si Yang

Electronic Theses and Dissertations

This thesis mainly focuses on the introduction of the background and work have been done in the areas of antifolates development, such as folate function, its three uptake mechanisms inside human cells, antifolates’ role in chemotherapy, et. al. In addition, the Structure-Activity-Relationship design rationale for the series of antifolates will also be discussed. Nevertheless, the details of synthesizing these pyrrolo[2,3-d]pyrimidines as potential antifolates have been described, including chemistry reviews on the pyrrolo[2,3-d]pyrimidine scaffold, and the challenges encountered and the solutions how to solve or improve in order to achieve better yield.

Design And Validation Of A Scale For Preschoolers: Measuring Nutrition Knowledge, Beliefs, And Behaviors, Michelle E. Johnson

Electronic Theses and Dissertations

The literature indicates a lack of validated scales to measure nutrition knowledge, attitudes and behaviors in preschool-aged children. Reliable and valid assessment tools are critical in the development of nutritional interventions for young children; careful design, including psychometric evaluation of reliability and validity, is the best approach to scale development. Best practice points to an efficient, yet comprehensive look at the constructs of knowledge, attitudes, and behaviors. This multi-phase study included 298 preschool children ages 2-6 years (151 girls, 147 boys; mean age 3.936). A 45-item scale was created, with 4 subscales to measure the nutrition knowledge, attitudes, and behaviors …

The Bobsled Push Start: Influence On Race Outcome And Push Athlete Talent Identification And Monitoring, Alex Harrison

Electronic Theses and Dissertations

Bobsled is an Olympic sport that has progressed from rudimentary in the 1800’s to highly technological replete with biomechanical analyses and investment in engineering from the world’s top engineers. Little to no investigation has been carried out on all the tracks and the interrelationship between various measures of starts and sled-travel down-track. Further, little quality research has been produced in the athletic characteristics required for high-level competition in bobsled.

The present manuscript investigates the reliability of, and interrelationship between, start time, start velocity, split times, and finish times in World Cup 2- and 4-man bobsled competition. A strong relationship between …

Job Embeddedess Of Nurses Working In South Central Appalachia’S North Carolina Counties, Susan L. Adams Mrs.

Electronic Theses and Dissertations

Nurses working in the North Carolina counties of South Central Appalachia (NC-SCA) are a unique subset of nursing professionals. A continued nursing shortage is projected in this area while staffing has improved in other areas of SCA. The purpose of this research was to ascertain the level of job embeddedness of nurses working in NC-SCA in order to offer guidance regarding retention of nurses working in this area. Actively working licensed practical nurses, registered nurses, and advanced practice nurses (nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists) from 29 North Carolina counties included in South …

Pre-Licensure Nursing Students’ Perceptions Of Safety Culture In Schools Of Nursing, Kristen Hershey

Electronic Theses and Dissertations

Safety culture has been demonstrated to be a key factor in high-reliability organizations (HROs), yet healthcare has not achieved a safety culture as seen in HROs despite decades of effort. Student nurses are enculturated into their profession during their pre-licensure education. This period offers an excellent opportunity to teach students the values, norms, and practices of safety culture. However, little is known about the state of safety culture in schools of nursing.

The purpose of this study was to examine the state of patient safety culture as perceived by students in pre-licensure nursing programs in the US using a modified …

Prescription Drug Abuse And Provider-Patient Communication: A Qualitative Analysis Of The Perspectives Of Prescribers And Patients, Stephanie M. Mathis

Electronic Theses and Dissertations

Prescription drug abuse is a public health problem of epidemic proportions in the United States. Provider-patient communication underpins many initiatives aimed at preventing and reducing the public health burden of prescription drug abuse. The characteristics of and factors contributing to this interpersonal process, however, have not been fully explored.

The purpose of this research was to examine: 1) the overall problem of prescription drug abuse and provider-patient communication about prescription drug abuse from the patient perspective; and 2) provider-patient communication about prescription drug abuse from the prescriber perspective. In 2014-2015, semi-structured interviews were conducted with 20 patients from primary care …

The Effects Of A Supermarket Tour On Improvement Of Nutrition Knowledge And Eating Behavior, Elizabeth Hall

Electronic Theses and Dissertations

The purpose of this study was to determine if participation in a supermarket tour improves nutrition knowledge and eating behavior in adult participants. Participants were recruited in communities surrounding Food City stores, a local supermarket. Prior to completing a standardized tour, participants completed a survey to assess nutrition knowledge and eating behavior. This survey was given to participants again three months later. A program evaluation was given one time at the end of the tour. Data analysis revealed no significant findings, other than the behavior-based question: “How many meals or snacks on most days included vegetables”. Vegetable consumption appeared to …

Access To Healthy Foods: A Descriptive Analysis Of Farmers’ Markets, Food Deserts & Usda Food Assistance Programs In Tennessee Census Tracts, Twanda D. Wadlington

Electronic Theses and Dissertations

Food deserts are a growing problem in the United States, and occur in areas of low-income where people have limited access to healthy foods. In response, the presence of farmers’ markets has grown exponentially, and improved healthy food access. Additionally, the USDA has strived to connect families to healthy foods through food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Senior Farmers’ Market Nutrition Program (SFMNP). This study investigated the relationship between farmers’ markets, their acceptance of food assistance benefits, and their locations within Tennessee …

Effect Of Total Body Iron On Metabolic Dysfunction Among U.S. Females In The Nhanes 2003-2010, Aged 12-49., Joseph Michael Carhart

Electronic Theses and Dissertations

Experimental and epidemiological studies have reported positive associations between iron parameters and metabolic dysfunction including: Type 2 diabetes mellitus (T2DM) (1-6), metabolic syndrome (7-15), non-alcoholic fatty liver disease (NAFLD) (16-22) and insulin resistance (23,24) with a number of studies showing that reductions in total body iron via dietary modification (e.g., reducing red meat intake) or phlebotomy lead to increases in insulin sensitivity (25), decreases in insulin resistance (26), and reductions in the prevalence of complications associated with T2DM (5, 27), metabolic syndrome (28) and NAFLD (22, 29). Moreover, the risk associated with these outcomes and total body iron differ between …

Deficiency Of Rdh10 Causes Cleft Secondary Palate In Mouse., Swetha Raja

Electronic Theses and Dissertations

The focus of this project is to understand the role of Retinoic Acid (RA) produced by RDH10-mediated metabolism of Vitamin A in palate development. For 80 years now, we have known that dietary restriction of RA/Vitamin A can cause cleft palate but we have failed to understand how RA deficiency causes cleft palate. Our gap in knowledge about how RA deficiency causes cleft palate is mainly owing to the fact that we lack a model system to study such defects. The aim of this thesis research project was to determine if conditional inactivation of the Vitamin A metabolic gene Rdh10 …

Metabolic Regulation Of Myocardial Adaptation To Exercise., Andrew Alan Gibb

Electronic Theses and Dissertations

While the benefits of exercise affect several organs, a significant adaptive response occurs within the heart. Exercise promotes cardiac growth, increases angiogenesis, and enhances cardiac function and these adaptations are associated with a cardioprotective phenotype. Additionally, extensive evidence shows that exercise dynamically regulates myocardial metabolism. This can be attributed to both changes in hormonal stimulation, increases in bioenergetic demand, and the bioavailability of circulating substrates. However, it is unclear whether these changes in metabolism contribute to physiologic cardiac growth. We reason that exercise-induced changes in metabolism are required to balance the catabolic and anabolic reactions needed for growth. Specifically, we …

Nurse Perspectives On The Work Impacts Of Decentralized Nursing Unit Design, Susan Mcdevitt

Electronic Theses and Dissertations

This study investigated nurse perspectives on the work impacts of a decentralized inpatient unit model. The study involved two rural acute-care hospitals in rural Nebraska that moved from a centralized to a decentralized inpatient unit design. The researcher conducted focus group discussions with staff and nursing management at both facilities with a total of 28 participants. In addition, the participants completed a 12-item questionnaire using a five-point Likert scale for responding. Focus group discussion and questionnaire were designed to investigate the areas of quality of care, communication, documentation, stress and wellbeing, and transition. Data gathered revealed that on all survey …

Approachability Of Nursing Clinical Instructors: Psychometric Assessment Of A Scale Development, Angela Collier

Electronic Theses and Dissertations

Approachability of nursing clinical instructors is largely unknown and misunderstood, yet critical for millennial students which currently comprise 82% of nursing students (National League for Nursing, 2014). Nursing education consists of both a didactic and a clinical component. Clinical education is dynamic and allows the student an experiential learning opportunity. Therefore, clinical nursing educators are vitally important. Approachability has been identified in many studies as a leading characteristic of an effective instructor. Although the importance of approachability of the instructor is established, currently no scale exists to measure this concept. The purpose of this study was to examine the validity …

The Effect Of Periodized Strength Training And Periodized Concurrent Training On Running Performance, Nicholas Fiolo

Electronic Theses and Dissertations

The objective of this dissertation was to evaluate the changes in preparedness over the course of training for a marathon in two well-trained runners. The athletes completed periodized strength training or a periodized concurrent training. This dissertation consisted of two separate investigations:

Study 1 – The purpose of this study was to monitor changes in force production ability and running performance in one sub-elite marathon runner before, during, and after undertaking a short-term block periodized strength training program. The athlete ceased strength training during the off-seasons and resumed testing after 10. The athlete experienced likely true, meaningful changes in force …

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive …

Social-Ecological Factors Affecting Patient Shield Use Among Radiologic And Computed Tomography Technologists, Megan Housenick-Lee

Electronic Theses and Dissertations

Medical radiation is estimated to contribute to over 200,000 deaths annually. Recent increases in the use of radiation-producing medical imaging examinations have led to increasing cumulative radiation dose to the general public. Multiple measures have been taken to address this alarming trend, including physician education, technologist education on dose reduction, and equipment-facilitated dose reduction techniques. Shield use can reduce the primary beam by up to 95%. Medical imaging technologists are the primary individuals responsible for applying shielding during an examination. Currently, literature shows that technologists are not shielding individuals as often as they should.

After pilot testing, medical imaging technologists …

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

1. How are interactions and relationships experienced by persons living with dementia in the community?
2. How is community engagement experienced by PLWD?
3. To what extent and …

Role Of Cannabinoid Receptor Type 2 (Cb2) In Late Stage Atherosclerosis, Makenzie Fulmer

Electronic Theses and Dissertations

Atherosclerosis is a chronic inflammatory disorder of medium and large vessels. Immune signaling and dyslipidemia are two of several processes which influence lesion development in atherosclerosis. Cannabinoids, such as those found in marijuana, exert their effects through two cannabinoid receptors, CB1 and CB2. Recent studies using CB2 knockout mice and CB2-selective ligands have shed light on a protective role of CB2 in early stages of atherosclerosis. However, the role of CB2 in advanced stages of atherosclerosis remains unclear. To determine if CB2 plays a role in advanced atherosclerotic lesion composition and progression, we investigated the effects of systemic CB2 gene …

Pcb-Associated Steatohepatitis And The Role Of Nuclear Receptors., Heather Brooke Clair

Electronic Theses and Dissertations

Metabolic diseases, including fatty liver disease, hyperglycemia, and obesity, result when body systems responsible for managing allostasis (dynamic homeostasis across systems) are pressured beyond their collective compensatory reserve. Nutritional excess contributes to this state, the capacity of which is limited by genetic variation, and failure of one system will gradually lead to pathological overload in the others. Agents which act directly on the communication machinery linking these connected systems can also change the point at which allostatic load becomes allostatic overload. Environmental exposure to polychlorinated biphenyls (PCBs), a class of persistent organic pollutant, is associated with a specific form of …

Evaluating Work Place Wellness In Greater Louisville's Technology Organizations : A Case Study., Andrew L. Mccart

Electronic Theses and Dissertations

Employers in the Southern Indiana and Greater Louisville region are looking for strategies to help them become a healthier workplace. Many employers see the expense of paying for an unhealthy workforce and they are looking to limit these expenses. The purpose of the study is to determine the state of workplace wellness activities in organizations in Southern Indiana and Greater Louisville. Due to the poor health statuses of Indiana and Kentucky, 39th and 45th, respectively, this study is significant for a number of stakeholders in our area. The purpose of this case study was to understand the state of health …

The Role Of Kinases And Phosphatases In The Pathobiology Of Porphyromonas Gingivalis., Sarah Whitmore

Electronic Theses and Dissertations

Periodontal diseases result from the interplay between the dysregulation of the host inflammatory response and the actions of a dysbiotic bacterial community. These chronic inflammatory conditions affect persons on a worldwide scale. P. gingivalis is strongly implicated as a key periodontal pathogen in the more severe manifestations of periodontal diseases such as periodontitis. A core element of P. gingivalis pathogenicity is its dysregulation of innate immunity, including suppression of IL-8 production by gingival epithelial cells. The NF-κB family of related transcription factors plays a central role in regulating many important aspects of innate immune responses. NF-κB RelA/p65 homodimers regulate transcription …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

Type Ix Secretion System : Characterization Of An Effector Protein And An Insight Into The Role Of C-Terminal Domain Dimeration In Outer Membrane Translocation., Lahari Koneru

Electronic Theses and Dissertations

Porphyromonas gingivalis and Tannerella forsythia are two of the primary pathogens that are associated in the etiology and progression of chronic periodontitis. In T. forsythia, KLIKK proteases are the recently identified group of proteolytic enzymes that are secreted through Type IX secretion system (T9SS). Among, these KLIKK proteases a synergistic relationship was observed between karilysin and mirolysin in invading the host complement system for the survival of the bacteria. Since, karilysin has been already characterized, in this study we propose to study about mirolysin through structural, biochemical and biological characterization. The obtained results from the experiments has shown the …

Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat

Electronic Theses and Dissertations

Type 2 diabetes (T2D) is often associated with serious complications. African American adults have higher rates of diabetes-related complications than other ethnicities. Diabetes self-management reduces the risk of developing biological and psychological symptoms. Social support promotes positive behavior change and self-management that leads to improved biobehavioral and psychosocial outcomes. Few studies explored the relationship between social support dimensions and self-management behaviors, diabetes biomarkers, and psychosocial outcomes of African American adults with T2D. The purpose of this dissertation was to examine the relationships of various dimensions of social support with self-management behaviors and diabetes biomarkers and psychosocial outcomes of African American …

Role Of Human Arylamine N-Acetyltransferase 1 In Tumorigenesis And Cancer Biology., Marcus William Stepp

Electronic Theses and Dissertations

Human arylamine N-acetyltransferase 1 (NAT1) is a well-known phase II metabolic enzyme that has been associated with carcinogenesis. Its role in the biotransformation of aromatic and heterocyclic amine carcinogens has been investigated for many years, but more recent investigations focus on a possible endogenous role of human NAT1 in cancer initiation and progression. To further explore and understand possible endogenous roles for NAT1, we conducted in vitro enzymatic reactions, in vivo studies using homozygous high (rapid) or low (slow) NAT2 activity congenic F344.WKY rats, and genetically modified human breast cancer cell lines. Human NAT1 and rodent NAT2 hydrolyzed acetyl-coenzyme …

Targeting The Major Regulator Of Mitosis., J. Mason Hoffman

Electronic Theses and Dissertations

Mitosis-inhibiting chemotherapeutics (e.g. taxanes) are frequently used to treat multiple cancer types. Recently, there has been much concern about the limited success of these drugs due to resistance and a lack of molecular targets. Thus, there is high demand for new drugs with diverse cellular targets. Targeting the regulators of mitosis is a promising approach. The anaphase promoting complex/cyclosome (APC/C) is an E3 ubiquitin ligase that controls cell cycle progression at multiple points. The interaction of ANAPC2 and ANAPC11, catalytic core subunits, is necessary for APC/C function. An in silico approach was used to identify compounds predicted to prevent assembly …

Prospective Studies Of Cardiovascular Risk Factors And Mild Cognitive Impairment, Kevin Sullivan

Electronic Theses and Dissertations

The association of cardiovascular risk factors including hypertension, diabetes, cholesterol, kidney function, and arterial stiffness with cognitive impairment in older adults is a well-studied phenomenon. However, there is considerably less evidence relating cardiovascular health specifically to a diagnosis of Mild Cognitive Impairment (MCI). As a precursor state of dementia, MCI is characterized by a decline in cognitive function from previous level, but not to the degree that activities of daily living are impaired. Not everyone who is diagnosed with MCI will eventually transition to dementia, but the transition rates are much higher compared to the general population (5-15% per year …

Nanocellulose Fibers As A Potential Material For Orthopedic Implantation Application, David Gregg Holomakoff

Electronic Theses and Dissertations

The field of biomaterials is of immense importance and will continue to grow and develop in the coming years. Novel materials, as well as new approaches for use of existing materials, are sought after now more than ever. Current metal orthopedic implants have an over engineered stiffness and Young’s modulus, causing a phenomenon called stress shielding. Metal implants absorb the majority of force typically exerted on bone and the osteocytes within. When osteocytes fail to sense mechanical forces bones become less dense and weaken, causing possible fracture and other complications. A new orthopedic material is needed matching Young’s modulus of …

Role Of Tlrs, Hippo-Yap1 Signaling, And Micrornas In Cardiac Repair And Regeneration Of Damaged Myocardium During Ischemic Injury, Xiaohui Wang

Electronic Theses and Dissertations

Cardiovascular disease is a leading cause of death in the United States. Toll-like receptor (TLR)-mediated pathways have been demonstrated to play a role in myocardial ischemia/reperfusion (I/R) injury. We and others have shown that PI3K/Akt signaling is involved in regulating cellular survival and protecting the myocardium from I/R induced injury. In this dissertation, we provide compelling evidence that miR-125b serves to “fine tune” TLR mediated NF-kB responses by repressing TNF-a and TRAF6 expression. We constructed lentiviral expressing miR-125b, delivered it into the myocardium. The data showed that delivery of lentivirus expressing miR-125b significantly reduces myocardial infarct size and improves cardiac …

Outcomes Of An Integrated Approach To Speed And Strength Training With An Elite-Level Sprinter, Eric D. Magrum

Electronic Theses and Dissertations

The purpose of this study was to observe changes in sprint velocity, ground contact time, and peak force demonstrated by a competitive sprinter following an integrated approach to speed development and strength training. As part of an ongoing monitoring procedure the participant completed 20m sprint testing through an optical measurement system and isometric-strength testing before and after each phase of training. Sprint velocity, ground contact time and peak force were analysed using Tau-U, smallest worthwhile and percent change statistics. Results indicate sprinting velocity statistically improved while changes in peak force were practically significant and ground contact time remained trivial throughout …