Medicine and Health Sciences Commons^™

Is Trauma Informed Care Practiced In Public Std Clinics In New York State, Antonia Brewer

Electronic Theses and Dissertations

Introduction: Sexually transmitted diseases (STDs) are increasing in the United States and often result in long-term adverse health outcomes. New York State (NYS) local health departments (LHDs) provide public STD clinics for high risk populations also found to have high rates of violence. This study examined if/how trauma informed care (TIC) is implemented in these settings. The study sample were LHD STD Program Directors in NYS.

Method: A convergent parallel mixed methods study design was used which included an online survey and follow up interviews. Survey data were analyzed using univariate statistics and conventional content analysis was used to analyze …

Determinants Of Reproductive Freedom Among Israeli Women Ages 18-50: A Mixed Methods Study, Abby Kra-Friedman

Electronic Theses and Dissertations

Introduction: Reproductive freedom is a social determinant of health (SDOH) that reduces health disparities and increases health equity. Through the National Health Insurance Plan, Israeli women can access a range of contraceptive methods. Scant data on Israeli women limits development of policies and interventions to meet international benchmarks for reproductive freedom. The purpose of this dissertation study is to synthesize current international multidisciplinary literature using the capability approach for reproductive freedom, explore determinants of reproductive freedom among Israeli women ages 18-50 using Nussbaum's capability approach, and make recommendations for nursing research, practice, and theory.

Methodology: Using Whittemore and …

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Social Entrepreneurial Skills And Practices Of Occupational Therapists Engaging In Emerging Community Practice Roles: A Working Theory Of Practice Improvement, Retta M. Martin

Electronic Theses and Dissertations

The purpose of this mixed-methods study was to explore the relationship between emerging practice in occupational therapy and social entrepreneurship by examining the behaviors and skills used by occupational therapists who are engaged in emerging practice. Five occupational therapists who engage in emerging practice were recruited to participate. The occupational therapists completed two surveys related to behaviors and competencies of social entrepreneurs. The participants also completed a semi-structured interview regarding behaviors, competencies and the occupational perspective of their practice.

Quantitative data was analyzed through descriptive statistics. The quantitative data determined a relationship between the skills used by social entrepreneurs as …

Exploring Cultural Values, Beliefs, And Perceptions Of Human Papillomavirus Vaccine Acceptance In African American Men, Rashida Henderson

Electronic Theses and Dissertations

Introduction: African American (AA) /Black men have a higher rate of anal and rectal HPV-associated cancer, which the HPV vaccine can prevent. Purpose: This study aimed to understand the cultural values, perceptions, and beliefs of the HPV vaccine in African American/Black Men. Method: Through a focused ethnography, a semi-structured guide was utilized to interview 24 AA men. Inclusion criteria included identifying as AA/Black, aged 18-30 years, born and living in the United States, identify and born as male, and able to understand, read, and write English. Results: Through Leininger’s Four Phases of Analysis, three themes emerged: 1) lack of knowledge …

Cultural Care Needs Of Spanish Speaking Parents With Limited English Proficiency Whose Children Are Hospitalized: An Ethnonursing Study, Jennifer Stephen

Electronic Theses and Dissertations

Purpose: Parents’ inability to speak English proficiently is associated with communication barriers in the care process of their children, social determinants of health, and poor child health outcomes. Research exploring perspectives of Spanish speaking parents with limited English proficiency (SSP-LEP) whose children are hospitalized in the context of culture is lacking in the literature. The purpose of this study was to explore the cultural experiences, values, and beliefs of SSP-LEP, of Mexican origin, whose children were hospitalized and understand nurses’ role in providing culturally congruent care.

Design and Methods: Leininger’s qualitative, ethnonursing method was used for this study. The Theory …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Quality By Design Based Optimization Of Anti-Inflammatory Nanoemulgels For Local Treatment Of Burn Wounds, Leah Dickey

Electronic Theses and Dissertations

Burns are some of the most traumatizing and damaging skin injuries, with the potential of causing extensive internal damage that increases the risk of chronic wound development. Oral and topical analgesics in combination with antibiotics can provide temporary relief and improve wound healing progress for both mild and severe burns. However, recurrent systemic exposure to pain relievers and antibiotics has been associated with adverse side effects including nausea, drowsiness, abdominal pain, etc., and increased risk of new infections or even ulcers. Local and targeted drug delivery systems, such as nanomedicine, have gained attention as potentially more effective alternatives to improve …

Ethical Oversight Of Roles & Relationships In Treatment & Research In Advanced Disease States, Alexa Vercelli

Electronic Theses and Dissertations

There is often ethical analysis focusing solely on the care of the patient by the physician or on the protection of the research participant by the clinical investigator, but those two are often overlapping. By paralleling the analysis of treatment and research, it emphasizes the specific ethical approaches necessary for individuals facing advanced diseases states in the separate roles of being a patient or participant. It also gives guidance to the complexity of the ethics surrounding medical professionals who float between the roles of treating physicians and clinical investigators. As individuals with advanced disease states are considered a vulnerable population …

Respecting The Ethical Tension Between Surveillance And Privacy In Promoting Public Health And Disease Management, Kamal Althobaiti

Electronic Theses and Dissertations

The recognition of the need to undertake surveillance and to protect privacy is well established. However, the continually changing circumstances and fast-paced development of healthcare today requires a continuing need to respect this ethical tension between surveillance and privacy. Hence, this dissertation is to respect the ethical tension between surveillance and privacy in promoting public health and disease management. This dissertation investigates the ethics of conducting public health surveillance, including the challenges associated with obtaining consent and protecting data from unauthorized access. The dissertation will focus on the ethical consequences of big data, including issues associated with obtaining informed consent, …

Labeling Melanoma Cells With Black Microspheres For Improved Sensitivity In Detection Via Photoacoustic Flow Cytometry, Tori Kocsis

Electronic Theses and Dissertations

Melanoma is an aggressive form of skin cancer known for developing into metastatic disease. Current clinical diagnostics, including medical imaging and tissue biopsy, provide a poor prognosis since the cancer is in the late stages of disease progression. In recent years, photoacoustic flow cytometry has allowed for the detection of circulating melanoma cells within patient blood samples in vitro. Although this method exploits the naturally-produced melanin within the cells, it has only successfully detected highly-pigmented melanoma cell lines. Since various forms of melanoma exist, each with varying melanin concentrations, this research aims to provide a novel method for detecting lightly-pigmented …

Prevalence And Predictors Of Polypharmacy In Adolescents Who Have Engaged In Sexually Abusive Behaviors, Rebecca Gilley

Electronic Theses and Dissertations

Polypharmacy, or the concurrent use of multiple medications, is associated with detrimental outcomes for patients and has gathered increasing attention within the scientific clinical literature. Pediatric populations warrant special consideration for the practice of polypharmacy, as medication effects are more pronounced in youth and adverse effects may have a lasting impact on development. This dissertation study examined psychotropic prescribing practices in a sample of adolescents who have engaged in sexually abusive behaviors, a subset of justice-involved youth who are at risk for polypharmacy. General prescribing trends were examined, and a principle components analysis involving variables associated with risk of polypharmacy …

When The Costs Outweigh The Benefits: Examining Variations In Nulliparous, Term, Singleton, Vertex And Elective Cesarean Delivery Rates Across The United States, 2016-2020, Kathleen Tatro

Electronic Theses and Dissertations

The overutilization of cesarean deliveries is a major public health issue in the United States (U.S.). The rates of cesarean deliveries have increased substantially from the mid 1990s. Low-risk, defined as nulliparous, term, singleton, vertex (NTSV) pregnancies with no medical indication of need, and elective cesarean deliveries have been implicated as drivers of these increases. Elective cesarean deliveries are NTSV cesarean deliveries in which no trial of labor was attempted. There is a lack of clear rationale as to the noted increases in cesarean delivery rates as the evidence shows that these procedures provide no additional health benefits to mothers …

Computer Aided Diagnosis System For Breast Cancer Using Deep Learning., Asma Baccouche

Electronic Theses and Dissertations

The recent rise of big data technology surrounding the electronic systems and developed toolkits gave birth to new promises for Artificial Intelligence (AI). With the continuous use of data-centric systems and machines in our lives, such as social media, surveys, emails, reports, etc., there is no doubt that data has gained the center of attention by scientists and motivated them to provide more decision-making and operational support systems across multiple domains. With the recent breakthroughs in artificial intelligence, the use of machine learning and deep learning models have achieved remarkable advances in computer vision, ecommerce, cybersecurity, and healthcare. Particularly, numerous …

Meeting The Mental Health Needs Of College-Aged Young Adults: Evaluating The Value And Impact Of Digital Mental Health Interventions., Sara Atherton Choate

Electronic Theses and Dissertations

BACKGROUND: The growing prevalence of common mental health problems poses a serious hindrance to young adults, and the majority of those in need of mental health support do not seek professional psychological services. Digital mental health interventions (DMHIs) that allow for self-management of mental health symptoms could provide a useful adjunctiveto traditional one-on-one counseling or therapy and offer a useful prevention tool for students at risk for experiencing mental health crises. This dissertation explored the efficacy of self-guided DMHIs targeting college students, the factors associated with help-seeking in young adults, and the impact of implementing an evidence-based DMHI at a …

Acute Effects Of Match Play Induced Fatigue On Jump Performance In Collegiate Women's Volleyball, Grayson Flora

Electronic Theses and Dissertations

This study investigated changes in maximal jump performance in response to match play induced fatigue. During six sets of tournament match play, seven National Association of Intercollegiate Athletics women’s volleyball athletes accumulated a mean Player Load of 758.6±216.89 au (measured via microsensor accelerometry), and mean session rate of perceived exertion of 1184.1±363.2. Repeated measures ANOVAs were used to identify change with Hedge’s g effect sizes used to assess magnitude of change. Short recovery stress scale results indicated elevated stress (ES=1.401 to 1.588) and decreased recovery (ES = -1.358 to -1.848) 24 hours post-match, trending towards baseline 48 hours post-match. Countermovement …

Cyclic Di-Gmp Regulates Motility, Biofilm Formation, And Desiccation Tolerance In Acinetobacter Baumannii, Garrett Reynolds

Electronic Theses and Dissertations

Acinetobacter baumannii is an increasingly multidrug-resistant pathogen contributing to hospital-acquired infections necessitating the discovery of novel treatments. A bacterial second messenger, cyclic diguanosine monophosphate (cyclic di-GMP), can regulate various persistence factors that are potentially advantageous for survival in hospital environments. Cyclic di-GMP–modulating enzymes and cyclic di-GMP–binding effectors predictively are encoded in the Acinetobacter baumannii genome. I hypothesized that cyclic di-GMP controls motility, biofilm formation, and desiccation tolerance in Acinetobacter baumannii. Disrupting cyclic di-GMP–modulating enzymes or cyclic di-GMP–binding effectors should alter the regulatory effectiveness of these phenotypes. I tested the multidrug-resistant isolate Acinetobacter baumannii strain AB5075 and identified several transposon …

Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller

Electronic Theses and Dissertations

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making.

The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher …

An Investigation Into The Use Of Biomechanical And Performance Data From Vertical Jump Testing To Monitor Competitive Weightlifters, Dylan Suarez

Electronic Theses and Dissertations

This investigation aimed to employ novel analyses to longitudinal jump testing data gathered from competitive weightlifters to identify how certain biomechanical and performance characteristics obtained from the countermovement jump (CMJ) relate to changes in weightlifting performance over time and if they can differentiate higher and lower performers. A linear mixed-effect model was used to assess and compare the ability of countermovement jump height and net-impulse to predict Sinclair weightlifting total. CMJ force-time waveforms were compared in cross-sectional and repeated measures analyses to distinguish the force application patterns of higher-performing weightlifters and if they change over extended periods of training. It …

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC …

Investigating Force-Velocity Profile Alterations And Methodology After Traditional Resistance Training, Joseph D'Amato

Electronic Theses and Dissertations

The purposes of this dissertation were to examine the agreement the agreement between double integration using the trapezoidal method and measurements for push-off distance to create force-velocity profiles, examine the change in push-off distance between loading conditions when force-velocity profiling, and to observe the alterations in mechanical outputs of force-velocity profiles after 15-weeks of off-season training. The major findings are as followed. Using double integration with the trapezoidal method may be a reliable way to estimate push-off distance, despite a small systematic bias. This bias should have negligible effects on push-off distance and therefore not alter or effect calculations in …

Ecological Differences In The Associations Between Air Pollution, Greenness, And Risk Of Stroke: The Regards Study., Daniel W. Riggs

Electronic Theses and Dissertations

The adverse health effects of air pollution have long been recognized, with the majority of morbidity and mortality due to its effects on the cardiovascular system. Alternatively, living in areas with higher greenness has been found to be beneficial to a wide range of health outcomes. However, few studies have considered that these relationships may vary depending on the surrounding ecosystem. The purpose of this dissertation was to examine the effects of long-term exposure to air pollution and greenness on incidence of stroke, and how these relationships vary with the major ecological regions of the United States. We utilized the …

Role Of Deep Learning Techniques In Non-Invasive Diagnosis Of Human Diseases., Hisham Abouelseoud Elsayem Abdeltawab

Electronic Theses and Dissertations

Machine learning, a sub-discipline in the domain of artificial intelligence, concentrates on algorithms able to learn and/or adapt their structure (e.g., parameters) based on a set of observed data. The adaptation is performed by optimizing over a cost function. Machine learning obtained a great attention in the biomedical community because it offers a promise for improving sensitivity and/or specificity of detection and diagnosis of diseases. It also can increase objectivity of the decision making, decrease the time and effort on health care professionals during the process of disease detection and diagnosis. The potential impact of machine learning is greater than …

Molecular Mechanisms Of Hexavalent Chromium-Induced Centrosome Amplification., Jennifer Haruka Toyoda

Electronic Theses and Dissertations

Lung cancer is the deadliest form of cancer and resulted in 1.8 million deaths worldwide in 2020. While cigarette smoking is the most familiar cause of lung cancer, up to 25% of cases occur in non-smokers, thus other environmental agents are also causative. Hexavalent chromium [Cr(VI)] is a known lung carcinogen and poses occupational and environmental exposure risks relevant to humans, wildlife, and ecosystems. This dissertation considers the carcinogenic mechanisms of a highly potent, particulate, hexavalent chromium compound, zinc chromate. The molecular mechanism of carcinogenesis induced by Cr(VI) is not fully understood, but it is known that chromosome instability is …

Environmental Noise Exposure And Its Association With Elementary Standardized Testing Scores And Adult Mental Ill-Health In Louisville, Kentucky., Lindsey Adelle Wood

Electronic Theses and Dissertations

Background and Aim: The current body of literature on the associations of environmental noise exposure with varying psychological outcomes is inconclusive, with many conflicting findings. Limitations include exposure measurement error and lack of investigation of effect modification by important factors. This dissertation aims to expand on the current understanding of these relationships by limiting exposure measurement error and by assessing effect modification. Methods: We estimated the distribution of total environmental noise in Louisville, Kentucky for several time-periods using land use regression (LUR) methodologies. Additionally, through multiple regression models, we estimated the association of environmental noise during relevant time-periods with childhood …

Stromal Vascular Fraction Restores Vasodilatory Function By Reversing Mitochondrial Dysfunction And Oxidative Stress In Aging-Induced Coronary Microvascular Disease., Evan Paul Tracy

Electronic Theses and Dissertations

Background: Coronary Microvascular Disease (CMD) presents in aging post-menopausal women with chronic angina due to microvascular hyperconstriction. The objective was to identify mechanisms of adipose stromal vascular fraction’s (SVF) restorative effects on vasodilation. We hypothesize aging-induced CMD is caused by a) abrogated flow-mediated dilation (FMD) due to loss of nitric oxide signaling and b) ROS-dependent βADR desensitization & internalization, reversible by ameliorating mitochondrial dysfunction and oxidative stress with SVF. Methods: Coronary microvessels were isolated from female rats either young, old, or old with SVF tail-vein injection (OSVF). Pressure myography, RNA-sequencing, immunofluorescence, Western blotting, and morphological analysis were performed to …

Translating Particulate Hexavalent Chromium-Induced Chromosome Instability From Human Lung Cells To Experimental Animals, Human Lung Tumors And Whale Cells., Haiyan Lu

Electronic Theses and Dissertations

Lung cancer is a major human health problem. While smoking is the most well-known cause of lung cancer, people who never smoked develop the disease. Understanding how non-tobacco environmental carcinogens cause lung cancer is key to combating this disease. Hexavalent chromium [Cr(VI)] is a well-established human lung carcinogen, but its carcinogenic mechanism is uncertain. Chromosome instability (CIN) is a hallmark of lung cancer and a major factor in Cr(VI)-induced lung cancer. Studies in human lung cells show Cr(VI) induces DNA double strand breaks and suppresses homologous recombination (HR) repair by targeting RAD51, resulting in CIN. We translated these outcomes to …

Tobacco-Derived Aldehydes, Platelets, And Thrombogenicity: Role Of Transient Receptor Potential Ankyrin-1., Andre D. Richardson

Electronic Theses and Dissertations

Cardiovascular disease (CVD) remains the world’s leading cause of morbidity and mortality. Conventional smoking of tobacco cigarettes is the number one risk factor for onset of CVD. Active cigarette users as well as those individuals who are exposed to second-hand cigarette smoke are at increased risk of CVD. Studies have shown that conventional smoking significantly increases a user’s risk of thrombosis, atherosclerosis, peripheral arterial disease, and coronary artery disease. Any of these diseases may trigger myocardial infarctions, stroke, or hypertension that may lead to cardiovascular morbidity and mortality. New and emerging electronic nicotine delivery systems (ENDS), such as electronic cigarettes …

“…You Can't Unknow It, It's A New Reality": A Case Study Exploring A Social Justice Public Health Intervention's Impact On Critical Consciousness Development In Youth., Monique Williams

Electronic Theses and Dissertations

Even though public health purports to be rooted in social justice, it is not clear how social justice frameworks are integrated in public health research and intervention. The discipline focuses on groups/populations on the margins, without integrating the social and political factors that cause marginalization into the intervention. Seeing communities, and individuals, as assets and experts in their own experiences is key to population-level health improvement. Particularly for public health youth intervention, how youth are labeled and engaged in social change is critical to their healthy development. While public health lags in practically applying asset-based approaches to youth intervention, research …

Addressing Stress In Graduate Nurse Practitioner Nursing Students, Shandria K. Sawyer

Electronic Theses and Dissertations

This project was developed to address the issue of high stress levels among graduate nursing students, which is a common phenomenon that increases the risks of mental health disorders, professional burnout, and poor-quality patient care among students and professional nurses after earning their degrees. This project sought to utilize a simple educational intervention delivered online to impart coping skills to graduate nursing students to assist them in reducing their stress levels. The intervention was a brief, single-session, self-guided educational module featuring informational and participative elements related to stress causes, the impacts of stress, and stress reduction techniques. In total, 11 …