Medicine and Health Sciences Commons^™

Development Of A Vascularized, Induced Pluripotent Stem Cell-Derived Liver-Tissue Mimic For Therapeutic Applications., Venkat Madhav Ramakrishnan

Electronic Theses and Dissertations

This dissertation describes the incorporation of several technologies (stem cells, gene therapy, tissue engineering and regenerative medicine) into a single project that aims to produce a liver-tissue mimic for therapeutic applications. The liver is arguably one of the most complex organs in the body. In addition to its remarkable capacity to regenerate, it performs a host of vital functions. As a result, its impairment has widespread systemic consequences. The work described herein focused on the liver in the context of cardiovascular disease and used the heritable disorder Familial Hypercholesterolemia (FH) as a clinical disease model. As (a) the only definitive …

The Relevance Of Client-Healthcare Provider Communication To The Appraisal Of Illness Uncertainty In Women With Fibromyalgia Syndrome., Melody Dawn Reibel

Electronic Theses and Dissertations

Illness uncertainty and impaired client-healthcare provider (HCP) communication are critical healthcare problems for women with fibromyalgia syndrome (FMS). However, the relationship between illness uncertainty and client-HCP communication has not been previously examined. The purposes of this dissertation were to (a) gain a deeper understanding of the lived experiences of women with FMS, (b) to examine the relationships among client-HCP communication, illness uncertainty, helplessness, and subjective well-being (SWB) in women with FMS, and (c) evaluate the psychometric properties of the patient-HCP communication scale (PHCPCS) in women with FMS. A mixed-methods design enhanced validity of the findings. The qualitative pilot study showed …

Circulating Angiogenic Stem Cells In Diabetes., Nagma Zafar

Electronic Theses and Dissertations

Circulating angiogenic stem cells (CACs) are rare cells found in peripheral blood that have been shown to contribute to endothelial repair and new blood vessel formation. These cells could be biomarkers and/or therapeutic targets for the assessment and prevention of cardiovascular disease (CVD), which is the leading cause of mortality globally and in the United States. Diabetes is an independent risk factor for CVD, and there are inconsistent reports on the role of CACs in diabetic vasculopathy. To study this further we tested the hypothesis that diabetes depletes circulating levels of CACs, due to hyperglycemia or insulin resistance and that …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Immunomodulation Of Myeloid-Derived Suppressor Cells By Particulate B-Glucan In Cancer., Sabrin Husein Albeituni

Electronic Theses and Dissertations

Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of immature myeloid cells that promote tumor progression. In this study, we investigated the effect of dectin-1 stimulation by yeast-derived particulate β-glucan in MDSC function and differentiation in cancer. In vivo treatment of mice bearing lewis lung carcinoma and mammary cell carcinoma with particulate β-glucan decreased tumor weight and splenomegaly, and reduced the accumulation of polymorphonuclear-MDSC (PMN-MDSC) but not monocytic-MDSC (M-MDSC) in the spleen and tumor. In addition, particulate β-glucan differentially modulated the function of different MDSC subsets; it enhanced PMN-MDSC respiratory burst and apoptosis, and induced the differentiation of M-MDSC into …

Evaluation Of Liver Transplant Prioritization Methods For Hepatocellular Carcinoma Patients Using Multistate Models., Sarah Katharine Alver

Electronic Theses and Dissertations

The Model for End Stage Liver Disease (MELD), used for prioritizing liver transplantation, predicts mortality from liver disease. Patients with hepatocellular carcinoma (HCC) risk disease progression not reflected in their MELD score. Exception scores prioritize HCC patients higher than their MELD scores, but advantage them over non-HCC patients. To address this, a delay of six months for using exception scores has been implemented, and alternative HCC-specific scores have been developed. Using multistate models, this study projects waitlist dropout and transplant probabilities under the delay and under two alternative scores. The delay improves equity between HCC and non-HCC patients for the …

The Pedagogy Of Medical Humanities : Using Literature And The Visual Arts To Help Future Caregivers Maintain Their Compassion And Resilience., Lisa Higgins Shugoll

Electronic Theses and Dissertations

This dissertation argues that medical humanities education for students considering careers in healthcare should begin at the general undergraduate level and should have two primary objectives, (1) providing tools that will help students foster therapeutic, compassionate relationships with their patients, and (2) providing strategies that will help students maintain healthy habits of mind that afford resilience against compassion fatigue. I assert that in order for students to practice compassion for themselves and others three core objectives must be met. (1) Students must be exposed to the fundamentals of bioethics in order to understand the virtue of compassion itself, (2) they …

A Comparative Analysis Of Data Collection Systems Used In Radiography Educational Programs And The Role Mobile Electronic Devices Play, Robin S. Garner

Electronic Theses and Dissertations

Each radiography program has a system to collect important data from didactic and clinical settings in order to accurately assess the progress and success of students, provide the needed student intervention, and provide accreditation agencies with appropriate documentation that demonstrates student success in reaching program learning outcomes. The purpose of this research study was to determine the method of data collection and documentation used by radiography programs to evaluate student progress and to examine if MEDs play a role in evaluating and documenting student skills at the point of care.

The majority of radiography programs in this study were using …

Nurse Educators' Transition To Flipped Classroom: An Interpretive Description Study, Jean S. Bernard

Electronic Theses and Dissertations

To meet learning needs of current undergraduate nursing students, and respond to mandates for bettered prepared graduates, nurse educators must restructure curricula and teaching strategies. One strategy garnering increased attention is the flipped classroom model (FCM). This form of instruction requires students to have access to and be accountable for lecture material on their own time, and then use face-to-face classroom time for interactive learning that can include discussion, case study analysis, or application of pre-class lecture content. Although the FCM has gained popularity, few researchers have fully studied this strategy or considered experiences of faculty who implement the model. …

Nurses’ Perceptions Of Self As Role Models Of Health, Shelia Hurley

Electronic Theses and Dissertations

Given the sad state of obesity and lifestyle-related illnesses in the US, nurses, as the largest and most trusted health profession, must take the cause of health promotion seriously and personally. This study seeks to close the gap in knowledge of nurses’ perception of self as a role model of health and personal healthy lifestyle behaviors. This study focuses on four specific behaviors that lead to a healthy lifestyle: limit alcohol, avoid tobacco, improve nutrition, and engage in physical activity. The purpose of this study is to determine the relationship between nurses’ health practices and their perceptions of self as …

Medical Assisting Credentialing, Karmon L. Kingsley

Electronic Theses and Dissertations

The purpose of this study was to investigate the hiring practices of physicians’ offices as they relate to medical assistants and to gain insight into their hiring preferences. Knowing how physicians and medical office managers view the profession of medical assisting may help medical assisting professionals improve the standing of the profession and provide a consistent foundation for education programs.

I surveyed 15 physicians’ practices in eight states across the country to obtain a cross-country perspective and found that many practices hire credentialed or non-credentialed individuals for clinical positions for various reasons. The reasons were minimally due to the lack …

Patients' Perception Of The Use Of Motivational Interviewing For Childhood Obesity Treatment: A Qualitative Study, Penelope L. Neal Dr.

Electronic Theses and Dissertations

The purpose of this qualitative interpretive descriptive study was to better understand children’s perceptions of the use of motivational interviewing (MI) as a communication style for childhood obesity treatment. Childhood obesity in the United States has reached epidemic proportions and much research effort has been dedicated to reversing this trend. One approach that has demonstrated positive outcomes in the clinical setting is MI. Leading organizations in pediatric healthcare now recommend MI as a communication style to be used for childhood obesity-related behavior change. Although empiric studies have demonstrated improvement in outcomes when this communication style is used with patients and …

Teaching The Spiritual Dimension Of Nursing Care: A Survey Of Associate Degree Nursing Programs In The Southeast United States, Nancy L. Labine

Electronic Theses and Dissertations

Spirituality is a subject which is often neglected in nursing education. The purpose of this study was to determine associate degree nursing faculty’s perception of their ability to teach the spiritual dimension in the delivery of nursing care. The study explored whether faculty have received training related to spiritual care, how and where nursing programs integrate spirituality education into the curriculum, nursing faculty’s understanding of the terms spirituality and spiritual care, and faculty members perception of whether they receive sufficient support and guidance in teaching related to spirituality and spiritual care.

Survey research was used in this study. The participants …

Radiography Clinical Instructors' Perceptions Of The Transition From Technologist To Educator, Christina G. Lee

Electronic Theses and Dissertations

Radiologic technologists who transition into the role of clinical instructor are usually expert practitioners but may lack knowledge of best practices regarding student instruction and evaluation. The purpose of this phenomenological qualitative study was to investigate how CIs experience the transition from practitioner to educator and what knowledge or education of best practices of instruction and evaluation they bring to the position. This study consisted of interviews with radiography CIs from one associate degree radiography program in the southeastern part of the United States. While some CIs felt prepared to transition into the CI role, none of them had previously …

Synthesis And Functional Evaluation Of Peptide Modified Poly (Lactic-Co-Glycolic Acid) Nanoparticles To Inhibit Porphyromonas Gingivalis Biofilm Formation., Paridhi Kalia

Electronic Theses and Dissertations

Periodontal disease is an oral inflammatory disorder that afflicts roughly 46% of the adults in the U.S. Currently, treatment of periodontal disease involves the removal of plaque from the gingival pocket (with possible antibiotic treatment) and if necessary, gingival surgery. To our knowledge, no therapeutic approach exists that promotes host-biofilm homeostasis by limiting pathogen recolonization of the oral cavity after prophylaxis or treatment. The interaction of the pathogen Porphyromonas gingivalis with commensal streptococci is critical for initiation of periodontitis and represents a target for limiting P. gingivalis colonization of the oral cavity. Previous studies showed that a synthetic peptide …

Cardiovascular Regulation And Effects Of Respiratory Motor Training In Patients With Chronic Spinal Cord Injury., Bonnie Legg Ditterline

Electronic Theses and Dissertations

This dissertation attempts to discover the mechanisms between cardiovascular and respiratory motor control post spinal cord injury (SCI): in normal, non-injured (NI) persons, cardiovascular regulation is dependent upon respiration, but there is nothing that suggests the mechanism for this relationship post-SCI. Thus we hoped to evaluate various aspects of cardiovascular regulation to further illustrate how this relationship is changed or unchanged by SCI. Chapter I describes the anatomy and physiology of the spine, respiratory system, and cardiovascular system in a NI person, and then describes how the function of these systems is changed by SCI. In addition, we describe therapies …

Predicting Desired Outcomes From Applicants’ Medical School Admission Data, Mark D. Linville Jr.

Electronic Theses and Dissertations

Medical schools in the United States serve to train the next generation of physicians, admitting students who will continue to advance each school’s mission. Admission committees are tasked with identifying those candidates who will be successful academically and who promote the objectives of the school with respect to mission. The Quillen College of Medicine at East Tennessee State University in northeast Tennessee seeks to attract and retain physicians with an interest in rural and primary care medicine. A total of 630 students were included in this study representing classes from 2001 to 2011. This study examined admissions data including MCAT …

The Effects Of Alpha Stimulation On Induced Anxiety, Nolan Thomas Hill

Electronic Theses and Dissertations

Anxiety is defined as an emotional and physical reaction that prepares us to confront a feared stimulus. Among the many measureable changes induced by anxiety are changes in facial electromyography (EMG), heart rate (HR), and sweat gland activity (EDG). At a pathological level anxiety interferes with cognitive processes. Currently, when anxiety crosses into the pathological level, it is treated with a variety of therapies that share in their use of periods of exposure to anxiety-inducing stimuli. Several devices have been developed to alter brain activity by transcranial electrical stimulation (TCES). One such device, Alpha-Stim^®, has been shown to …

Stability Of Isometric Strength Asymmetry And Its Relationship To Sprint And Change-Of-Direction Performance Asymmetry In Division-I Collegiate Athletes, Benjamin H. Gleason

Electronic Theses and Dissertations

The purpose of this dissertation was to evaluate the stability of strength asymmetry over a long-term period (1 year) and investigate the relationship of strength asymmetry to field test performance asymmetry in NCAA division-1 athletes. Isometric mid-thigh pull (IMTP) peak force asymmetry, ground contact time and finish time asymmetries on 10m sprint and 505 agility test performances were also observed. The impact of strength was also investigated in these studies to determine its effect on the magnitude of asymmetry.

In the second study, peak force asymmetry over a one-year period was observed to be a rather volatile quality, with ranges …

An Investigation Of The Relationship Between A Static Jump Protocol And Squat Strength: A Potential Protocol For Collegiate Strength And Explosive Athlete Monitoring, Cody Haun

Electronic Theses and Dissertations

The purpose of this study was to examine the relationship between estimated absolute and relative squat strength and a static jump protocol with potential to provide desirable training adaptation data to practitioners in the field of collegiate strength and conditioning. Forty-one young (20.80 ± 2.44 years), healthy volunteers reported estimated back squat 1RM’s based on the most recent training block and completed a static jump protocol. Males (n=19, est. 1RM 141.29 ± 32.02kg) and female (n=22, est. 1RM 71.56 ± 19.64kg) jump data revealed large to very large correlations between squat strength, mean jump heights of jumps and other calculated …

Comparison Of External Kinetic And Kinematic Variables Between High Barbell Back Squats And Low Barbell Back Squats Across A Range Of Loads, Jacob Goodin

Electronic Theses and Dissertations

This study compared peak force, peak power, peak velocity, impulse, work, and vertical displacement between the high bar back squat (HBBS) and low bar back squat (LBBS). Six trained males performed each using 20, 30, 40, 50, 60, 70, 80, and 90% of their recent training 1 repetition maximum. Dual force plates recorded force-time curve characteristics of ground reaction forces and four potentiometers tracked vertical and horizontal barbell displacement. Repeated–measures analysis of variance revealed a significant main effect for load (p<0.01) across all variables, but no significant effects for condition or interaction. The HBBS generated higher peak force in loads 20%–80%, higher peak power in loads 20%–60% and 80%–90%, higher peak velocity at every load, and greater vertical displacement at every load. The LBBS generated a larger impulse at loads 30%-90% and the HBBS generated more work at loads 20%, 40%, and 60%–90%.

The Impact Of Training Loads On In-Match Soccer Performance Variables: A Position-Based Case Report, Garett Bingham

Electronic Theses and Dissertations

It is critical to maintain multiple fitness characteristics during the soccer season through the use of training, but also to ensure that the training loads do not hinder subsequent match performance. The purpose of this thesis is to investigate the impact of the training load on key physical performance variables in the subsequent match. Five Division I female soccer players were analyzed across six weeks of training and matches. Training loads in the forms of odometer, high intensity odometer, estimated odometer and sRPE were accumulated at time points from one to five days prior to a match. The accumulated training …

The Relationships Of Physiological And Strength Variables To Run Performances, Jana Hollins

Electronic Theses and Dissertations

Monitoring progress of athletes is an essential component of the training process. Collegiate distance running coaches often use field tests to assess progress because of a lack of time and resources to do laboratory testing. The purpose of this dissertation was to examine the relationships between physiological and strength variables measured in a laboratory and field testing measures in collegiate distance runners. Collegiate distance runners completed a series of tests in the Sport Science laboratory at East Tennessee State University to obtain physiological and strength parameters, such as V̇ O2max and vertical jump height. The athletes then completed one of …

Minority College Students’ Attitudes And Beliefs Regarding The Profession Of Dental Hygiene In Comparison To Their Oral Health And Dental Knowledge, Trina J. Morgan

Electronic Theses and Dissertations

The purpose of this study was to find out the attitudes and beliefs of minority college students enrolled at Missouri College in Brentwood, Missouri in reference to the dental hygiene profession. In particular, does their oral health and dental knowledge relate to their knowledge of profession of dental hygiene? One hundred and six students gave their consent to participate in the study via Survey Monkey. The study was conducted in May 2015 for a period of four weeks. Four statements were designed to gauge minority students’ knowledge of dental hygiene as a career. No differences were found based on gender, …

Rural Opioid And Other Drug Use Disorder Diagnosis: Assessing Measurement Invariance And Latent Classification Of Dsm-Iv Abuse And Dependence Criteria, Billy Brooks

Electronic Theses and Dissertations

The rates of non-medical prescription drug use in the United States (U.S.) have increased dramatically in the last two decades, leading to a more than 300% increase in deaths from overdose, surpassing motor vehicle accidents as the leading cause of injury deaths. In rural areas, deaths from unintentional overdose have increased by more than 250% since 1999 while urban deaths have increased at a fraction of this rate. The objective of this research was to test the hypothesis that cultural, economic, and environmental factors prevalent in rural America affect the rate of substance use disorder (SUD) in that population, and …

Improved Oncolytic Virotherapy By Increasing Virus Spread Within Tumors., Stephen Wechman

Electronic Theses and Dissertations

Oncolytic adenoviruses (Ads) have great therapeutic potential for lung cancer. Cancer selective E1b-deleted Ads are safe, however their efficacy remains limited clinically. To improve E1b-deleted Ads, Adhz60 was selected for greater anti-cancer efficacy by a process called bioselection, producing AdUV. AdUV preferentially lysed A549 and H1299 lung cancer cells more effectively than both the cancer selective Adhz60 and non-selective Ad5. AdUV induced greater LC3-II expression, relative to LC3-I, indicating that AdUV (30.9-fold) induced autophagy more effectively than Ad5 (12.2-fold) and Adhz60 (7.8-fold) in A549 cells. Mice treated with AdUV had significantly smaller tumors (p-value < 0.001) and prolonged survival (p-value = 0.0005) than mice treated with the negative control AdGFP. These results suggest that AdUV efficiently lyses lung cancer cells in vitro and in vivo.

Chronic Ethanol Exposure Sensitizes The Lung In A Mouse Model Of Endotoxemia-Induced Acute Lung Injury : Potential Role Of Plasminogen Activator Inhibitor-1., Lauren G. Poole

Electronic Theses and Dissertations

The goal of this project is to characterize a new mouse model of alcohol-enhanced acute lung injury (ALI) and to determine the role of plasminogen activator inhibitor-1 (PAI-1) in this model. Male mice (WT and PAI-1-/-) were exposed to ethanol-containing Lieber-DeCarli diet or pair-fed control diet for 6 weeks; some animals were administered intraperitoneal lipopolysaccharide (LPS) prior to sacrifice. Chronic alcohol feeding enhanced induction of the chemokines MIP-2 and KC (murine IL-8 homologues) after LPS injection in wild type animals. This enhanced chemokine expression did not correlate with enhanced pulmonary neutrophil infiltration, however animals exposed to chronic ethanol showed sustained …

Regulation Of Receptor Tyrosine Kinases By Ubiquilin1., Zimple Kurlawala

Electronic Theses and Dissertations

Receptor Tyrosine Kinases (RTK’s) like EGFR, Insulin Receptor, IGF1R and others mediate growth, proliferation and balance between apoptosis and survival. Dysregulation of RTK activity has been identified in a wide range of cancers and contributes to initiation, progression and metastasis of tumors. Ubiquilins (UBQLN) are fairly novel proteins and are studied mostly in the field of neurodegenerative disorders. Our laboratory recently discovered a link between UBQLN1 function and tumorigenesis. UBQLN1 is lost in about 50% of non-small cell lung cancer (NSCLC) cases. We have identified an interaction between UBQLN1 and IGF1R. Furthermore, UBQLN1 regulates activity of IGF1R and EGFR. Following …

Identifying Hepatocellular Carcinoma (Hcc) Cells With Cancer Stem Cell-Like Properties., Harshulkumar M. Pandit

Electronic Theses and Dissertations

Hepatocellular Carcinoma (HCC) is a challenging condition to treat in the clinic due to its distinct tumor phenotype, aggressive growth, and chemotherapy resistance. Cancer Stem Cells (CSCs) are a poorly differentiated subpopulation of cells within the tumor microenvironment, and role of CSCs in tumor initiation and chemotherapy resistance is not well understood in HCC. In this study, we have successfully identified HCC cells with CSC-like properties that showed resistance to Doxorubicin. Using the established serum free culture techniques, we have enriched CSC-like cells among hepatocellular cancer cells. These enriched cells exhibit all CSC-like properties i.e. self-renewal capability, anchorage independent growth …

The Effect Of Protandim Supplementation On Oxidative Damage And Athletic Performance., Seteena Leigh Ueberschlag

Electronic Theses and Dissertations

A double-blind placebo-controlled trial determined the long term effects of Protandim® supplementation on 5-km running performance, as well as on acute and long-term oxidative damage assessed by serum lipid peroxides (Thiobarbituric acid-reacting substances: TBARS). Thirty-eight subjects were placed into one of two groups: an experimental (675 mg/day Protandim®) or control group (675 mg/day corn starch). 5-km runs were performed at baseline and 88 (SD 4) days post-supplementation with samples taken immediately pre- and 10-min post 5-km run, as well as at rest ∼30 and ∼60 days during the supplementation period. There was ~25% week-to-week coefficient of variation of TBARS at …