Medicine and Health Sciences Commons^™

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

Enriching The Pcos Lifestyle, Callie Coleman

Electronic Theses and Dissertations

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting approximately 4 – 20% of women worldwide. It is associated with insulin resistance, fertility problems, and an increased susceptibility to chronic conditions through multiple inflammatory pathways. Women with PCOS are also at increased risk for disordered eating. The Mediterranean diet is associated with decreased inflammation and risk of chronic conditions, and intuitive eating principles are associated with decreased disordered eating patterns. The purpose of this study was to determine if a six-week nutrition education workshop incorporating information and skills related to both the Mediterranean lifestyle and intuitive eating principles can improve …

Moral Disengagement And The Tendency To Engage In Academic Dishonesty In Prelicensure Nursing Students, Sarah Guimaraes

Electronic Theses and Dissertations

Despite decades of research, academic dishonesty remains a significant concern in nursing education. The connection of academic dishonesty to dishonest clinical practice presents a moral imperative for nurse researchers to find new facets of understanding these phenomena. Literature regarding moral disengagement in health care is minimal and is even less prevalent in the context of nursing education. The purpose of this study was to determine the effects of moral disengagement on prelicensure nursing students’ tendencies to engage in academic dishonesty in their last or next to last semester of a nursing program. A correlational design via survey method was used. …

Soreness And Perceptual Responses From The Combined Use Of Accentuated Eccentric Loading And Cluster Sets During A Strength-Endurance Training Block, Ryan Lis

Electronic Theses and Dissertations

The first purpose of the current study was to analyze palpation and movement soreness via the visual analog scale (PVAS and MVAS, respectively) between accentuated eccentric loading (AEL) and traditional resistance training (TRAD) during a month of strength-endurance training. This was measured at the lower body (LB: gluteus maximus and vastus lateralis) and the upper body (UB: pectoralis major, anterior deltoid, and triceps brachii) every day of training (1-20 days) immediately before warming up and after finishing the training session. The MVAS was conducted at a self-selected fast speed. The second purpose was to measure perceptual responses between AEL and …

Stigma Reduction And Resiliency Training For First Responders (Srrt-Fr): A Feasibility And Initial Efficacy Evaluation, Thalia P. Nicholson

Electronic Theses and Dissertations

First responders, especially law enforcement, frequently encounter individuals experiencing substance use concerns. Previous research has documented that a greater understanding of substance use disorders promotes a decrease in stigmatizing perspectives. We present a novel approach to training law enforcement officers to improve their interactions with community members exhibiting substance use disorders, while also promoting their professional well-being. The present study sought to evaluate the feasibility and acceptability of the Stigma Reduction and Resiliency Training for First Responders (SRRT-FR) in a sample of law enforcement officers, as well as its efficacy in decreasing stigmatizing perspectives towards substance use disorders and increasing …

A Comparison Of Maxent Models For Aedes Aegypti Species Distribution In South America Utilizing Different Bioclimatic And Environmental Variables, Matthew Beer

Electronic Theses and Dissertations

Aedes aegypti is the principal vector for dengue transmission across large areas of the world. Understanding where this critically important vector lives is paramount to preventing the continued expansion of dengue globally. Using 1981-2010 bioclimatic (bioclim) variables, as well as additional environmental variables and elevation data, multiple MaxEnt models were constructed for Ae. aegypti within the South American continent to identify ecologically important variables and areas of persistent high suitability. All models had acceptable AUC scores (> 0.70), indicating accurate model fitting. Annual mean precipitation and temperature were found to be important model variables; however, when added, humidity became the …

Food Insecurity And Self-Rated Health Of Older Adults In Appalachia, Sarah Kelley

Electronic Theses and Dissertations

Food insecurity is prevalent in the United States. Although older adults experience food insecurity at lower-than-average rates, this population is vulnerable to the nutrition and health related implications. Food insecurity is tied to both a diminishment of diet quantity and quality, and is associated with incidence of chronic disease, loss of functional status, and quality of life. This survey seeks to fill a gap in research by looking into the prevalence of food insecurity among older adults in Northeast Tennessee, associations between food insecurity and self-rated health, and associations between food insecurity and geographical limitations.

The Effects Of A Period Of Match Congestion On Countermovement Jump Height And Match Performance Variables In Ncaa Division I Female Soccer Players, Fiona Dodge

Electronic Theses and Dissertations

Effects of a congested match period on countermovement jump height (CMJ) and match performance variables were examined over the course of a D-I female soccer season. Twenty-one female collegiate soccer players (20.3 ± 1.8 yrs, body mass (kg): 62.3 ± 7.3, height (cm): 168.9 ± 6.1, body fat (%): 23.0 ± 3.7. performed CMJ testing prior to regular season matches. Global Positioning System (GPS) was used to assess physical match performance, while pre- and post-season lab and field-based testing was also performed. Analysis of variance trend analyses (ANOVA) were conducted using a linear mixed-effects model (LMM) to examine trends in …

Pilz Domain-Containing Proteins Regulate Motility In Acinetobacter Baumannii, Gabriel Smith

Electronic Theses and Dissertations

Acinetobacter baumannii is an increasingly multidrug-resistant pathogen contributing to hospital-acquired infections, necessitating a greater understanding of how it interacts with its surroundings. Many bacteria utilize different methods of bacterial motility to move about and interact with these surroundings. A bacterial second messenger, cyclic diguanosine monophosphate (c-di-GMP), can regulate various motility factors that are potentially advantageous for survival in and adaptation to their environment. Concentrations of c-di-GMP are regulated by specific synthesizing and degrading enzymes. Controlled levels of c-di-GMP allow interaction between the c-di-GMP and its binding effectors that induce changes in bacterial phenotypes such as biofilm formation and motility. A …

Interpretation Models For Prostate Lesion: Detecting, Explaining, And Understanding., Mehmet Akif Gulum

Electronic Theses and Dissertations

Prostate cancer is a major public health concern, affecting millions of men worldwide. While early detection and treatment of prostate cancer is critical for improving patient outcomes, the detection of prostate lesions is even more important for timely intervention and management of the disease. Prostate lesions are abnormal growths or lumps within the prostate gland, which may or may not be cancerous. The timely detection and accurate diagnosis of prostate lesions is crucial for effective treatment and management of the disease. In recent years, deep learning models have shown promise in accurately detecting and characterizing prostate lesions using advanced imaging …

Unraveling The Complex Dynamics Of Cardiac Fibrosis: Ccn1 As A Novel Regulator Of Scar Collagen Architecture And Structural Integrity In Myocardial Infarction., Annalara Garland Fischer

Electronic Theses and Dissertations

Expansion of the extracellular matrix (ECM), known as fibrosis, accompanies nearly all forms of cardiac disease; however, its most significant and complex manifestations arise following a myocardial infarction (MI). This process, principally led by fibroblasts, constitutes a necessary and adaptive response acutely to fill the void from cardiomyocyte necrosis following ischemic injury due to the heart’s lack of regenerative capacity. This acute response never fully resolves and contributes to ongoing collagen accumulation in non-infarcted regions, leading to diminished ventricular compliance, ongoing myocyte loss, and attrition in function—culminating in heart failure. Further, recent research demonstrates that concomitant with progressive increases in …

Exosomal Cannabidiol: A Promising Candidate For Targeted Oral Delivery Against Breast Cancer., Disha Nagesh Moholkar

Electronic Theses and Dissertations

Cancer therapies are limited by lack of specificity, selectivity and numerous adverse effects. Repurposing potential anticancer compounds with appropriate drug carriers can help overcome these drawbacks. In our present study, we address the major obstacle for cannabidiol (CBD): its low oral bioavailability, using exosomes. Exosomes (Exo) are promising non-toxic and biocompatible drug delivery vehicles Our project aims are to address the research gap by formulating exosomal cannabidiol (ExoCBD): a tumor-targeted oral delivery system for the treatment of breast cancer. The targeting approach relies on the overexpression of folate receptors at the tumor site by using folic acid functionalized exosomes (FA-Exo). …

Regulation And Mechanisms Of Ocular Dominance Plasticity At Cellular Resolution., Thomas Christopher Brown

Electronic Theses and Dissertations

Sensory systems throughout the brain require experience to aid in proper wiring during development. While forming, many sensory systems have periods of heightened sensitivity where alterations in the quality of experience can have a profound impact on cortical responses throughout life. These periods of heightened sensitivity have been coined critical periods. In the visual system of mice a critical period for ocular dominance has been well studied and defined between postnatal days nineteen and thirty-six. During this critical period, altering visual experience by suturing one eye closed called monocular deprivation (MD) shifts responses in cortex towards the non-deprived eye. Similar …

Health Professions Education And Critical Action Engagement: A Mixed Method Analysis., Leonda Richardson

Electronic Theses and Dissertations

Poorer health outcomes disproportionately impact racial/ethnically minoritized (e.g., Black Indigenous People of Color, or BIPOC) populations in the U.S. One plausible reason for the persistence of poorer health outcomes among this population is the teaching of racialized curricular content within academic health professions programs. This includes the absence of appropriate context through explicit socio-political curricular content (SPC) and critical pedagogy (i.e., social and structural determinants of health, history of racism in health care, social justice concepts; dialogue and reflective writing). Racialized curriculum is thought to initiate and/or exacerbate existing racial biases, cultural incompetence, and perpetuate dominant medical ideologies and myths …

Molecular Mechanisms Of Exercise-Stimulated Resolution Of Inflammation And Its Dietary Dependence., Ernesto H. Pena Calderin

Electronic Theses and Dissertations

Diet-induced obesity and adipose tissue (AT) inflammation that ensues sets the stage for systemic metabolic inflammation, disrupted insulin signaling, and eventual type 2 diabetes (T2D) development. At the center of this pathology lies a disruption in endogenous inflammation resolution pathways characterized by an imbalance in lipid mediator production (greater abundance of pro-inflammatory to pro-resolving lipids). Additionally, obese states are characterized by adrenergic deficiency, especially in response to physical activity. Inflammatory processes have been experimentally mitigated by either the pharmacological inhibition of pro-inflammatory signals (i.e., Leukotriene B₄ (LTB₄) and its receptor BLT1, which establishes a potent chemotactic stimulus …

Epidural Stimulation For Urogenital Dysfunction In The Spinal Cord Injured Rat., Natasha Lorraine Wilkins

Electronic Theses and Dissertations

Spinal cord injury (SCI) is a devastating, life changing event that greatly impacts quality of life. SCI can have body-wide, multi-system consequences including dysfunction within the urogenital system. Challenges with the urinary system include urinary incontinence, urine retention, and detrusor-sphincter dyssynergia all of which require maintenance through the regular use of catheters. Sexual dysfunction in men, who comprise nearly 80% of the SCI population, includes erectile dysfunction, anejaculation, retrograde ejaculation, poor expulsive force during ejaculation, and poor sperm quality. The treatment for sexual function in SCI men is focused more on fertility through the collection of sperm for insemination procedures …

Associations Of Natural Vegetation In Relation To Colorectal Cancer Hotspots And Colorectal Cancer Survival., Johnnie Newton

Electronic Theses and Dissertations

Background: Across Kentucky, county-level geographic disparities in colorectal cancer (CRC) incidence and outcomes exist. Given the heterogeneity of lifestyle, socioeconomic (SES), and environmental factors within a county, more granular approaches should be used to identify local areas with a high CRC burden and identify the area-level factors that may contribute to geographic disparities. Studies reported that living in greener areas is associated with beneficial health outcomes, including lower mortality. Despite growing evidence that natural vegetation (greenness) exposure is associated with increased physical activity and obesity, two well-known CRC risk factors, epidemiological studies investigating the association of residential greenness exposure with …

Covid-19 Infection And Mortality, Patient Comorbidities, Social Determinants Of Health, And Environmental Influences In Kentucky., Shaminul Hoque Shakib

Electronic Theses and Dissertations

OBJECTIVES: To investigate patient- and county-level disparities in COVID-19-related mechanical ventilation use and mortality by SDOH factors and comorbidities among Medicaid non-pregnant adult beneficiaries in Kentucky. Additionally, to compare the association of COVID-19-related infections and mortality with social mobility and weather between Indiana and Kentucky during the stay-at-home period (March 1 to May 15, 2020). METHODS: In chapter 2, an administrative claims-based retrospective cohort study was conducted using the Kentucky Health Facility and Services database. Medicaid beneficiaries who were hospitalized during 2020–2021 in Kentucky were considered in the logistic regression and the Cox regression model to estimate the risk of …

Understanding Barriers To Effective And Equitable Covid-19 Response Through The Evaluation Of Essential Needs Program In Jefferson County, Ky., Haritha Pallam

Electronic Theses and Dissertations

This study utilized a multi-method study approach to assess the effectiveness of the Essential Needs Program (ENP), aimed at aiding priority groups in successfully completing isolation or quarantine (I/Q) during the COVID-19 pandemic. It commences with an overview of the COVID-19 pandemic's history and the role of ENP as a local emergency response strategy to mitigate community spread. Chaos and systems theories were employed to comprehensively understand disaster phenomena and factors influencing individual adoption of protective measures during the pandemic. Additionally, institutional decision-making models and implementation science were utilized to elucidate how public health stakeholders coordinated ENP services provision and …

Enhancing The Anticancer Effects Of Apiaceae Spice Phytochemicals., Jared Lee Scott

Electronic Theses and Dissertations

Breast cancer (BC) is a leading contributor to the death of women and is the most common type of cancer. Many chemotherapy drugs are developed from plants, and some plant extracts can exhibit significant anticancer activities while also having less toxic side effects. The Apiaceae plant family consists of several species that are used as culinarily spices which have demonstrated antioxidant, chemopreventive, and anticancer activities. The encapsulation of anticancer phytochemicals into naturally produced membrane-bound nanoparticles known as exosomes could improve their systemic distribution and efficacy. Exosomes are involved in cell-to-cell communication through the delivery of proteins, nucleic acids, and small …

Strength And Endocrine Adaptations From The Combined Use Of Accentuated Eccentric Loading And Cluster Sets During A Strength Endurance Training Block, Kurt Mcdowell

Electronic Theses and Dissertations

The purpose of this study was to investigate the chronic effects of accentuated eccentric loading (AEL) paired with cluster sets (CS) on dynamic and maximal strength, the endocrine system, and body composition. Seventeen recreationally active subjects (male = 11, females = 6, age = 23.05 ± 4.07, height = 172.09 ± 9.98, body mass = 81.29 ± 22.18, back squat to body mass ratio = 1.55 ± 0.33, bench press to body mass ratio = 1.06 ± 0.28) participated in one familiarization week, 2 weeks of testing, and 4 weeks of training. A strength-endurance block (4 wks) was used for …

Poly (Adp-Ribose) Polymerase-1 (Parp1) Expression In The Frontal Cortex And Hippocampus In Major Depressive Disorder (Mdd) And Suicide, Ramona Faith Fulkerson

Electronic Theses and Dissertations

Major Depressive Disorder (MDD) is a prevalent psychiatric disorder that has a complex pathophysiology. In this study we evaluate the expression of PARP1 and the downstream alarmin protein high mobility group box 1 (HMGB1) in two brain areas that have demonstrated pathology in MDD. MDD donors were compared to controls. MDD subgroups that died by suicide were also compared to those that did not die by suicide. Immunoblotting to determine PARP1 and HMGB1 protein expression was performed in white and grey matter from the frontal cortex and the hippocampus. In BA10 white and grey matter, PARP1 protein expression was significantly …

Dengue And Climate Change: Assessing Potential Future Areas Of Concern For Transmission In The United States, Matthew Beer

Electronic Theses and Dissertations

Background: Global climate change severely impacts human life, particularly health, as rising temperatures and extreme weather affect physical and mental well-being. Climate change can also alter the risk factors and epidemiology of infectious diseases, notably vector-borne diseases (VBDs), including those transmitted by mosquitoes. The Aedes mosquito, responsible for dengue, poses a significant threat due to its prevalence vector. Dengue prevention lacks effective methods beyond vector control, and the current vaccine has limitations, emphasizing the need for intensified research and prevention strategies to mitigate the expanding dengue burden worldwide. The goal of these studies was to establish a novel risk index …

Changes In Blood Lactate And High Intensity Exercise Endurance During A Strength - Endurance Accumulation Training Using Accentuated Eccentric Loading, Nicholas Goode

Electronic Theses and Dissertations

The purpose of this study was to investigate the effects of accentuated eccentric load (AEL) resistance training and changes in work capacity, high-intensity exercise endurance (HIEE) and lactate metabolism. Seventeen recreationally trained subjects (11 males and 6 females) (mean ± SD: age = 23.2 ± 4.2 yrs, BM = 81.3 ± 22.2 kg, height = 172.1 ± 10 cm, male relative back squat (BS) [MD1] strength (1RM*BM^-1) = 1.64 ± 0.32 kg*kg^-1, female relative BS strength = 1.39 ± 0.32 kg*kg^-1) participated in the study. Subjects completed a week of familiarization to participate in …

Examining Enrollment & Engagement In A Hospital-Based Violence Prevention Intervention Study At A Level 1 Trauma Center, Leigh Frederick

Electronic Theses and Dissertations

BACKGROUND: Violence is a significant healthcare issue that affects the health and well-being of individuals, families, and communities. Violence prevention and intervention programs are a powerful way to stop the revolving door of violent injury in our hospitals and communities. The Health Alliance for Violence Intervention (HAVI), develops and connects violence intervention programs, promotes equity for victims of violence globally, and is dedicated to engaging patients during the window of opportunity when they are recovering in the hospital after a violent injury to reduce the chance of retaliation (related to the injury) and recurrence. A small body of research shows …

Parental View On Hpv Vaccination, Rebecca Elaine Rhodes

Electronic Theses and Dissertations

The human papillomavirus (HPV) is a sexually transmitted infection widely seen in the United States. Millions of Americans are affected by it each year, especially those in their late teens and early 20s. Although most infections will resolve on their own, 1 in 10 will lead to health problems such as cancer. The HPV vaccine can prevent over 90% of associated precancers and cancers. However, uptake of the HPV vaccine and its completion among adolescents are significantly lower than other recommended adolescent immunizations, falling short of the Healthy People 2030 goal of 80% coverage. Understanding parental attitudes, beliefs, and perceptions …

Implementation Of A Mobile-Based Mindfulness Intervention To Lower Perceived Stress Levels In Undergraduate Nursing Students, Wendy S. Carley

Electronic Theses and Dissertations

This project analyzed the effect of the daily use of a mindfulness-based mobile application on associate degree nursing undergraduate prelicensure students’ perceived stress levels. Nursing students experience elevated stress levels that may be reduced through mindfulness behaviors. Undergraduate, prelicensure nursing students participated in establishing the impact of mindfulness on perceived stress levels in a quantitative pre/postintervention study. The evidenced-based studies chosen for this review consisted of randomized controlled trials, pilot studies, pre/posttest designs, systematic reviews, and quantitative and qualitative studies. The investigator collected presearch data using a pre/posttest design to evaluate the effectiveness of a stress management program in reducing …

Cannabis Exposure During Pregnancy And Neural Mechanisms Of Parenting: Assessing Neural Responses To Infant Cues And Parenting Outcomes, Shannon Powers

Electronic Theses and Dissertations

As legalization of cannabis and cannabinoids spreads in the United States, access and use of cannabis during the prenatal period has increased. There is limited knowledge on the effects of prenatal cannabis use on the parental brain. One way to identify potential effects of cannabis on parenting is through studying parenting brain functions and behavior. Cannabis use disorder (CUD) has been shown to be associated with lower positive parenting and lower sensitivity to infants, but it is unclear by what mechanisms. The following two studies address this gap in knowledge by examining the association between cannabis use during the prenatal …

Neuroinflammation In Alzheimer’S Disease Mouse Brain Following Repetitive Mild Traumatic Brain Injury, Lujain Almuhanna

Electronic Theses and Dissertations

Traumatic brain injuries (TBIs) are a common form of head injury, with mild TBIs (mTBIs) making up 75-90% of the TBI severity scale. It’s been suggested that repetitive mild TBIs (rmTBIs) may enhance effects of Alzheimer’s Disease (AD). With dementia linking TBI and AD together, we investigated the memory hub of the brain - the hippocampus. Astrocytes and microglia are two glial cells that respond to neuroinflammation and therefore imaged in hippocampal regions of the 3xTg-AD mouse brain. We hypothesized that AD brain pathology (i.e., neuroinflammation) would be accelerated in 3xTg-AD mice following rmTBIs early in life. Analyses revealed that …

Exploring The Experiences Of Hiv Positive Pregnant Women On Prevention Of Vertical Transmission Of Hiv/Aids In Rural Malawi, Gertrude Finyiza

Electronic Theses and Dissertations

Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) continues to be the primary conduct that HIV is transmitted to children worldwide. The problem of HIV/acquired immunodeficiency syndrome (AIDS) is having a great impact on the world's children. The prevalence of HIV/AIDS in Malawi continues to be a serious public health issue, especially for expectant mothers. The health outcomes of mothers and children remain significantly threatened by vertical HIV transmission, even with improvements in preventive and treatment efforts. The purpose of this thesis was to explore the experiences of HIV-positive pregnant women in Malawi. I conducted semi structured interviews with thirteen …