Medicine and Health Sciences Commons^™

An Investigation Into Formulation And Therapeutic Effectiveness Of Nanoparticle Drug Delivery For Select Pharmaceutical Agents, Dustin Cooper

Electronic Theses and Dissertations

Drug based nanoparticle (NP) formulations have gained considerable attention over the past decade for their use in various drug delivery systems. NPs have been shown to increase bioavailability, decrease side effects of highly toxic drugs, and prolong drug release. Furthermore, polymer based, biodegradable nanodelivery has become increasing popular in the field of NP formulation because of their high degree of compatibility and low rate of toxicity. Due to their popularity, commercially available polymers such as poly lactic acid (PLA), poly glycolic acid (PGA) and polylactic-co-glycolic acid (PLGA) are commonly used in the development and design of new nano based delivery …

Investigation Of Novel Functions For Dna Damage Response And Repair Proteins In Escherichia Coli And Humans, Benjamin A. Hilton

Electronic Theses and Dissertations

Endogenous and exogenous agents that can damage DNA are a constant threat to genome stability in all living cells. In response, cells have evolved an array of mechanisms to repair DNA damage or to eliminate the cells damaged beyond repair. One of these mechanisms is nucleotide excision repair (NER) which is the major repair pathway responsible for removing a wide variety of bulky DNA lesions. Deficiency, or mutation, in one or several of the NER repair proteins is responsible for many diseases, including cancer. Prokaryotic NER involves only three proteins to recognize and incise a damaged site, while eukaryotic NER …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

Spirituality And Psychological Well-Being Among Als Caregivers: Hope And Perceived Stress As Mediators, Bridget R. Jeter

Electronic Theses and Dissertations

The empirical study of the salutary relationship between spirituality/religiousness and psychological well-being is burgeoning. However, mechanisms of this association have received less empirical attention. Theory suggests that spirituality/religiousness may lead to positive psychological characteristics such as hope, which may function as a means of coping in the context of a significant stressor or stressful situation. The perceived burden and stress associated with caring for individuals with chronic illnesses such as ALS is significant, and caregivers may be at risk for increased symptoms of depression, symptoms of anxiety, somatic symptoms, and other deleterious psychological well-being related outcomes. Within the context of …

Assessing Cultural Competence In A Mental Health Outpatient Facility., Alexis N. Keen Crook

Electronic Theses and Dissertations

Cultural competence is a concept that has been thoroughly investigated in healthcare, but there is a dearth of literature and research on this topic as it pertains to mental health services. In healthcare, research has shown that a lack of cultural competence is directly linked to high levels of misdiagnoses, mistrust of healthcare and professionals, and overall poor health in minority populations. Using the Campinha-Bacote model for cultural competence in health care, I explore how cultural competence is defined and operationalized in an outpatient mental health facility. I hypothesize that, similar to research addressing cultural competency in healthcare systems, cultural …

Impact Of Epigallocatechin-3-Gallate (Egcg), A Broad-Spectrum Anti-Inflammatory, In Controlling Intestinal Factors Contributing To Inflammatory Bowel Disease., Gerald Wayne Dryden, Jr.

Electronic Theses and Dissertations

This dissertation explores the role of epigallocatechin-3-gallate (EGCG), as a potential treatment for patients with inflammatory bowel disease (IBD). IBD is a common disorder that causes a great deal of suffering. Our understanding of the etiologies, pathogenic mechanisms, and treatment targets continues to evolve. Many new therapeutic targets are making their way through the pharmaceutical pipelines. However, not all patients benefit from these therapies. EGCG has long been studied as an anti-cancer agent. Most of our understanding of this compound comes from the oncologic literature. As the pathways of oncology and inflammation converge, new lessons can be taken from the …

Objective Evaluation Of Clinical Shade-Matching Outcomes., Erin Ballard

Electronic Theses and Dissertations

The purpose of this study was to objectively evaluate shade-matching outcomes within an academic institution. Using the Spectrophotometer, E was calculated between the reference shade: restoration shade () and restoration shade: prescription shade (). The t-test was used to determine if E maintained clinical acceptance at E: 3.7. Satisfaction with shade-match and need for objective measurement were surveyed using a Five Point Likert Scale. Correlational relationships were assessed via Pearson Correlation. Mean E values were above the acceptance value (pppp

Leveling The Playing Field Through Partnerships And Collaboration : Neighborhood Revitalizations And The Influence Of Social Determinants Of Health And Institutional Logics., J. M. Bohn

Electronic Theses and Dissertations

A qualitative study guided by grounded theory was on a Midwest US city (population > 50,000 people), three of its inner city neighborhoods, and community coalition and partnership efforts in neighborhood revitalizations. A two-phase semi-structured interview methodology assessed interviewees’ experiences in initiatives focused on improving social determinants of health in the neighborhoods. Phase I interviews (n= 11) identified the spectrum of partnerships and initiatives while Phase II interviews (n=28) captured detailed experiences of interviewees. Inter-institutional systems and institutional logics theory were applied in the post-data collection analysis. Interviewees were from public and private sectors including: built environment, economic development, residential/commercial property …

Cell-Based Therapies For Ischemic Cardiomyopathy : Investigations Of Intramyocardial Retention And Safety Of High Dose Intracoronary Delivery Of C-Kit Positive Cardiac Progenitor Cells, And Therapeutic Utility Of A Novel Population Of Cardiac Mesenchymal Stem Cells Expressing Stage-Specific Embryonic Antigen-3 (Ssea-3)., Matthew C. L. Keith

Electronic Theses and Dissertations

Over the last decade attempts at reducing morbidity and mortality of patients with chronic heart failure have been made via the development and implementation of novel cell based therapies. Substantial advances in cell based therapies with indications of efficacy have been shown along with a robust safety profile. Despite these advances, there is a substantial unmet need for novel therapies, specifically addressing repair and regeneration of the damaged or lost myocardium and its vasculature. Accordingly, cardiac cell-based therapies have gained attention. Various cell-types have been utilized, including bone marrow-derived mononuclear cells, bone marrow-derived mesenchymal stem cells, mobilized CD34⁺ cells, …

Positive Deviance, Contraceptive Self-Efficacy And Social Desirability In Sexually Active Adolescent Females : A Mixed Methods Approach., Ashley D. Miller

Electronic Theses and Dissertations

Unintended pregnancy is an issue that impacts women of all ages, ethnicities, and socioeconomic statuses. It also impacts the child that results and the society in which they live. In the United States, adolescents experience unintended pregnancy more than adolescents in other countries. The purpose of this dissertation was to explore the factors that contribute to successful contraceptive use among adolescent females (ages 13-18) seeking reproductive health services at a local family planning clinic. The theoretical framework of contraceptive self-efficacy (CSE) was used to frame this understanding. The exploration was conducted in three ways: a critical review of the literature …

Role Of Phosphodiesterase-4 In Alcohol-Induced Organ Injury., Diana Veronica Avila

Electronic Theses and Dissertations

Alcoholic liver disease (ALD) remains a leading cause of death from liver disease in the U.S., and there is still no FDA-approved therapy. Alcohol metabolism leads to generation of free radicals and oxidative stress with a resultant formation of lipid peroxidation products, which, in turn, contribute to the development of ALD. Alcohol induced hepatic steatosis is the earliest and most frequent manifestation of ALD and a significant risk factor for progressive liver disease. Cyclic adenosine monophosphate (cAMP) signaling has been shown to significantly regulate lipid metabolism. Moreover, agents that increase cAMP have been shown to effectively mitigate oxidative stress both …

The Influence Of Mir-99a On Mtor Signaling Regulation In Colorectal Cancer Cell Lines., Jonathan Rice

Electronic Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of death. These are staggering statistics for a disease that can essentially be cured if caught early and the pathology is favorable to therapeutic intervention. There is currently a drastic decrease in five year survival as the cancer stage increases from locally confined disease to metastatic disease. These statistics suggest that although some strides have been made with colon cancer screening and early intervention, there is still much room for improvement in both screening and treatment of CRC. One of the pathways that have …

Environmental Vegetation : A Possible Association With Cardiovascular Disease Risk., Ray Anthony Yeager Ii

Electronic Theses and Dissertations

The built environment affects numerous aspects of human health and wellbeing, including risk of cardiovascular disease (CVD), the leading cause of morbidity and mortality in both the U.S. and worldwide. The amount and quality of environmental vegetation, is an important aspect of the built environment that affects known CVD risk factors, including psychosocial stress, health behaviors, and exposure to air pollutants. Nevertheless, little evidence on the role of potential mechanisms and geographic scale in these relationships exists. Of previous studies that describe associations between vegetation and CVD outcomes, limited investigation has been performed to assess these observed relationships in differing …

The Influence Of Nutrition Education And Self-Efficacy On Fruit And Vegetable Consumption For Low-Income Women In Rural West Kentucky., Lewatis Darnell Mcneal

Electronic Theses and Dissertations

Objective: To examine how participation in nutrition education programs, self-efficacy to consume fruit and vegetables and predictor of behavior to eat health foods (POB) influences the consumption of fruit and vegetables for low-income women in west Kentucky eligible or participating in federal supplemental nutrition assistance programs. Methods: A comparative study was conducted between low-income women participating in Special Supplemental Nutrition Assistant Program for Women and Children (WIC) and those eligible for SNAP but were not participating. The study examined consumption in six categories of fruit and vegetables, self-efficacy to consume fruit and vegetables, predictor of behavior to eat healthy foods …

Modification Of T9ss Cargo Proteins Of Porphyromonas Gingivalis For Their Secretion In Soluble Form And Purification By Affinity Chromatography., Apoorv Goel

Electronic Theses and Dissertations

Background: Porphyromonas gingivalis, a keystone-pathogen associated with periodontitis, utilizes the Type IX Secretion System (T9SS) to secrete proteins bearing the conserved C-terminal domain (CTD), many of which are essential virulence factors. These include, besides gingipains and PPAD, 29 other proteins. During or after the outer membrane translocation the CTD is cleaved off and a glycan moiety is covalently attached anchoring the secreted proteins at the bacterial cell surface. Objective: Most of the CTD bearing proteins have only hypothetical functions assigned. It is plausible that these CTD bearing proteins may also play a crucial role in P. gingivalis pathogenesis. Therefore, …

Tobacco-Gene Activity Profile In Porphyromonas Gingivalis, Filifactor Alocis And Treponema Denticola., Neelima Chowdary Cherukumalli

Electronic Theses and Dissertations

Smoking is an established risk factor for periodontitis. Prior studies have shown that cigarette smoke extract (CSE) can induce profound phenotypic changes in Porphyromonas gingivalis and alters the virulence of this important periodontal pathogen. We hypothesized that CSE might also alter gene expression in established periodontal pathogens, Porphyromonas gingivalis and Treponema denticola, as well as in the emerging pathogen, Filifactor alocis. Oral bacteria were grown in CSE-conditioned medium (1000 ng/ml nicotine equivalents) or in unconditioned control medium. Total RNA was extracted and CSE-regulated genes were identified by comparison of the mRNA profiles of CSE with control cultures using RNA-Seq …

The Impact Of Medicaid Expansion On Utilization Of Mental Health Services In West Louisville, Kentucky., Susan Theresa Buchino

Electronic Theses and Dissertations

Mental health is an essential component of overall health status, and mental illnesses are a leading cause of disability. In addition to expanding insurance coverage, the Affordable Care Act (ACA) reinforced parity for mental health services in insurance plans. This mixed-methods study assessed mental health service utilization by an urban and predominately African-American population following the successful implementation of the ACA and Medicaid expansion in Louisville, KY. Claims data from one Medicaid Managed Care Organization were analyzed to assess mental health care utilization patterns pre- and post- Medicaid expansion and determine differences in utilization rates between the Medicaid expansion population …

Identification Of Predictors And Moderators Of Weight-Related Behaviors In College Students., Heather Owens

Electronic Theses and Dissertations

College students are at increased risk for weight-gain and obesity compared to their non-student peers. Although many studies have confirmed these findings, few address the underlying causes of weight-related behaviors in college students. Associations between sleep behaviors (sleep duration and sleep quality), stress and weight-related behaviors (physical activity and food choices) have been identified, but studies have not adequately explored these associations among college students. Further, the influence of bioecological determinants of health cannot be overlooked when addressing health-related behaviors in diverse populations. The purpose of this dissertation was to explore factors impacting sleep behaviors and weight-related behaviors in college …

Examining The Motivations And Benefits Of Student-Athletes Performing Community Service., Matthew Ryan Huml

Electronic Theses and Dissertations

With over 460,000 active student-athletes (NCAA, n.d.), the student sub-population is large enough to investigate potential options for institutions to increase their academic achievement. Additionally, participating in academic-related activities is especially important because of concerns about student-athletes spending more than the 20 hours per week the NCAA allows for working on their sport (Wolverton, 2008). Studies frequently highlight a lack of effort by student-athletes to adjust to academic opportunities and expectations within higher education (Adler & Adler, 1991; Lally & Kerr, 2005; Levine, Etchison, & Oppenheimer, 2014; Miller & Kerr, 2003). To combat this adjustment to higher education, community service …

Porphyromonas Gingivalis Gingipains Induce A Pro-Inflammatory Extracellular Microenvironment : The Role Of Par-2 And Fibronectin., Jeffrey S. Marschall

Electronic Theses and Dissertations

Periodontitis is a chronic inflammatory disease that is characterized by severe tissue destruction of the gingiva and other tooth supporting structures; if left untreated, tooth loss and disintegration of the alveolar bone occurs. This chronic inflammatory state has been linked to other systemic diseases such as cardiovascular disease, diabetes, rheumatoid arthritis, and Alzheimer’s disease. Porphyromonas gingivalis is the major pathogenic microbe in periodontitis. The main virulence factors of P. gingivalis are the Arg-aa and Lys-aa gingipains, which are proteolytic enzymes implicated in a plethora of activities that allow P. gingivalis to subvert the human immune system in the oral cavity …

Abin1 In The Pathogenesis Of Glomerulonephritis And The Novel Polocyte-Neutrophil Proinflammatory Axis., Erik Anderson Korte

Electronic Theses and Dissertations

Glomerulonephritis (GN) is the most common cause of end-stage renal disease worldwide and is characterized by deposition of immune complex, inflammation, proteinuria and podocyte damage. Immunosuppressive therapy is effective in less than 50% of patients, indicating that immunological activity is not the only relevant cause of kidney injury. While methods have been described for neutrophil-mediated immune activation, specific glomerular mechanisms for recruitment of neutrophils and development of GN have not been determined. Here I present a pathogenic mechanism for the development of GN involving a novel podocyte-neutrophil axis and reveal the importance of glomerular NF-κB inhibition by the ubiquitin binding …

Acrolein Is A Critical Mediator Of Alcohol-Induced Liver And Intestinal Injury In Alcoholic Liver Disease., Wei-Yang (Jeremy) Chen

Electronic Theses and Dissertations

Alcohol consumption can cause alcoholic liver disease (ALD), which remains a major cause of morbidity and mortality in the United States. Chronic alcohol consumption causes a pro-oxidant environment in the liver and increases hepatic lipid peroxidation. Acrolein is the most reactive and toxic aldehyde generated through lipid peroxidation. Acrolein forms protein adducts and triggers endoplasmic reticulum (ER) stress and hepatocyte apoptosis, which are recognized etiologic factors in ALD. Several studies have established the critical role of the gut-liver axis in ALD pathogenesis, wherein alcohol-induced gut barrier dysfunction contributes to liver injury. This study investigates, in vitro and in vivo, the …

A Hermeneutic Phenomenological Study Of The Lived Experience Of Adult Female Sexual Assault Survivors, Ann N. Hellman

Electronic Theses and Dissertations

Sexual assault is an international problem affecting hundreds of thousands of women each year. Significant psychological, physical, and financial consequences result from sexual assault. The prevalence of sexual assault suggests that nurses frequently encounter survivors yet minimal literature exists focusing on how nurses should adjust their care to meet the needs of this population.

The phenomenon of sexual assault has been widely studied from multiple perspectives and across disciplines. Likewise, studies of spiritual and religious beliefs and practices and their impact at the end-of-life and in disease, grief, and loss are extensive in nursing literature. However, a nominal number of …

Interprofessional Patient Simulation Training Compared To Online Training For Learning To Use In-Line Speaking Valves, Kristi A. Moore

Electronic Theses and Dissertations

Restoring speech in persons who are tracheostomy and ventilator dependent, through the use of a Passy-Muir Speaking Valve (PMSV), requires specific training. Methods of training interprofessional team members to assess in-line PMSVs are unclear. This study used a pretest/ post-test design to compare effects of online training and online training plus simulation training on knowledge acquisition, skills performance, and comfort levels when working with persons who are tracheostomy and ventilator dependent. Twenty-six students studying either respiratory therapy (N=13) or speech-language pathology (N=13) were assigned to the control group or experimental group. Results revealed that online training proved beneficial for increasing …

Comparison Of In Vivo Simulation Training Compared To Video Simulation Training For Identifying Clinical Markers Of Distress When Feeding Preterm Infants, Emily M. Wagner

Electronic Theses and Dissertations

Preterm infants have multiple health complications due to their underdeveloped neurological systems. Bottle-feeding difficulties are one complication that leads to pulmonary illness secondary to aspiration. Preterm infants exhibit clinical markers when experiencing distress during bottle-feeding. Training caregivers to identify clinical markers reduces the risk for aspiration. Simulation training provides a safe learning environment without harming patients. Twenty-two speech-language pathology and pre-requisite students divided into two simulation groups, video-simulation (N=12) and in-vivo simulation (N=10), were trained to document clinical markers of distress exhibited by preterm infants and make clinical judgments about bottle-feeding. Students rated their levels of anxiety during simulation training. …

Oregon's Death With Dignity Act: Socially Constructing A Good Death, Erin E. Mauck

Electronic Theses and Dissertations

As aid-in-dying legislation expands across the United States, this study examines the dynamics influencing participation in Oregon’s Death with Dignity Act. In addition to data from secondary sources, this thesis analyzes field research data collected in Oregon, including 14 in-depth interviews with volunteers and employees of two advocacy organizations at the center of legalized physician-assisted death. Themes emerged including the conditions that motivate participation, the importance of both personal and professional autonomy, the significance of a good death, and the growth of open dialogues about end of life choices. This thesis concludes with a discussion of the impact Death with …

Assessing Adult Tobacco Smoking Cessation In Low-And-Middle Income Countries: Analysis Of The Global Adult Tobacco Survey Data, 2009 – 2012, Daniel Owusu

Electronic Theses and Dissertations

Smoking cessation can reduce health risk and prevent millions of tobacco-related deaths. However, cessation rates are low in low-and-middle income countries (LMICs), with only a small proportion of smokers intending to quit. Given the paucity of literature to support tobacco cessation programs in LMICs, this study aimed to: 1) identify factors associated with intention to quit smoking, 2) assess the relationship between health care provider quit advice/tobacco screening and utilization of cessation assistance, and 3) examine the relationship between home smoking rule and smoking intensity across three stages of smoking cessation (precontemplation, contemplation and preparation) in LMICs. Data were obtained …

A Descriptive Study Of The Effect Of Payer Source On Multiple Longitudinal Outcome Measures Within The Tbi Model Systems National Database Using Longitudinal Hlm Analyses, Melissa Carole Hofmann

Electronic Theses and Dissertations

Using longitudinal data from the TBIMS ND, this study utilized a longitudinal hierarchical linear modeling approach to describe the effect of primary payer source on individual level change in outcomes including the FIM and DRS. To facilitate the use of parametric statistics, Rasch-transformed FIM and DRS scores were utilized; thus approaching an interval level of measurement. The FIM was separated into 3 separate cognitive, mobility, and self-care subscales. In this way, rehabilitation professionals including speech, physical, and occupational therapists for this TBI sample could reference results to inform current clinical practice.

Results indicated that FIM and DRS trajectories were best …

The Stigma Effect: The Role Of Internalized Racism And Internalized Homophobia In Risky Sexual Behavior Among Black Gay Men, Darren Lovell Whitfield

Electronic Theses and Dissertations

Black gay, bisexual, queer, and same-gender-loving (GBQSGL) men account for less than 1% of US population, yet account for 36% of all new HIV infections. While, Black GBQSGL men experience higher rates of HIV infection compared to other gay, bisexual, and men who have sex with men (MSM) from other racial groups, they are no more likely to report engaging in condomless anal sex (CAS). These findings suggest that one possible explanation is that the context of sexual behavior for Black GBQSGL men may be riskier because of the prevalence of HIV in the community. Furthermore, research suggests that racism …

Effects Of A 10-Week Introductory Judo Course On Postural Control During Reactionary Bilateral Gripping Task With Varied Stances And Lower Body Power Performance, Tyler Muddle

Electronic Theses and Dissertations

PURPOSE: The purpose of the present study is twofold: 1.) Examine the effects of 10-weeks of an introductory judo course on postural control during maximal bilateral isometric handgrip testing using different stance conditions and lower body power performance, and 2.) To analyze the relationship between maximal bilateral handgrip exertions on postural control during varied stance conditions. METHODS: Twenty recreationally active men and women divided into two an experimental group, (JDO) (n = 10; 21.70 ± 3.83 y; 169.91 ± 6.01 cm; 73.89 ± 12.10 kg; 19.01 ± 8.06% BF), and a control group, (CON) (n = 10; 21.50 ± 2.84 …