Medicine and Health Sciences Commons^™

Design And Synthesis Of Salvinorin-Based Compounds For The Opioid Receptors., Nicholas S. Akins

Electronic Theses and Dissertations

Opioid receptors (OR) are expressed throughout both the peripheral and central nervous system and play crucial roles in the modulation of antinociception, addiction, anxiety, and depression. Salvinorin A, the main isolate of the hallucinogenic plant Salvia divinorum, is one of the most potent naturally occurring kappa opioid receptor agonists. Salvinorin A possesses beneficial effects as a therapeutic in a variety of CNS disorders, but due to its strong hallucinating, anxiogenic effects, and short half-life(t1/2), it has never advanced to clinical trials. Instead, salvinorin A has been used as an important prototype for the development of related drug candidates. Our initial …

Abuse Deterrent Formulation Using Hot Melt Extrusion Technology, Vishvesh Raje

Electronic Theses and Dissertations

The purpose of the current study was to formulate hot melt extruded (HME) abuse deterrent pellets of acetaminophen(APAP), a model drug with the aid of high molecular weight hydroxypropyl methylcellulose (HPMC 4M ) and gelling agents (starch, pectin and carbopol). The formulated HME pellets were assessed for their abuse-deterrence (AD) potential using Category- 1 laboratory in-vitro evaluation standards. The pellets were examined for the particle size reduction (PSR), extraction in small volume, syringeability, thermal manipulation and dissolution for evaluating the resilience of the AD properties. Though, most of the formulation showed complete particle size reduction after grinding, grounded pellets were …

Applications Of Hot-Melt Extrusion (Hme) Technology And Investigation Of A Screening Tool For Hme, Gauri Deepak Shadambikar

Electronic Theses and Dissertations

Hot-melt extrusion (HME), an adaptable technology, has established its position in manufacturing operations like amorphous solid dispersions, immediate and controlled oral formulations, implants and taste masked products. In recent years the industrial focus has shifted towards continuous manufacturing, thus HME is being explored for new applications. The aim of this research was to investigate the novel applications of HME by carrying out an in-depth study to understand the interaction between the process and product and to investigate a screening tool for its small-scale formulation and development.As HME consumes large amount of samples during the developmental phase, we investigated a screening …

An In-Depth Approach For Functional Oligosaccharide Analysis, Hao Liu

Electronic Theses and Dissertations

Heparin and heparan sulfate (Hp/HS) are linear complex glycosaminoglycans (GAGs), which are involved in diverse biological processes. Although Hp/HS GAGs influence numerous physiological and pathophysiological processes, their high degree of size polydispersity and sequence microheterogeneity make structure-function characterization challenging. In addition, it is hard to understand the structures that underlie any of the various functions with MS, because of the lability of the sulfate group during tandem mass spectrometry (MS/MS) analysis. The work presented here describes an in-depth approach for functional oligosaccharide characterization including chemical derivatization of Hp to inhibit COVID-19 infection, multi-dimensional liquid chromatography (LC) fractionation method, chemical derivatization …

Qualitative Study Of Collaboration Between Independent Reading Specialists And Elementary Classroom Teachers, Lindsay Lee Hawbaker

Electronic Theses and Dissertations

Abstract

The failure of educators to meet the needs of elementary students who require separated, differentiated, and intensive reading interventions (Tier 3) has been attributed to the scarcity of administrative resources and a lack of effective collaboration between reading specialists and classroom teachers. Experts opine that common barriers to effective collegial collaboration between institutional reading specialists, who are employed by the school, and classroom teachers include: an unsupportive school culture, the classroom teachers’ fear of losing pedagogical autonomy, the absence of mutual trust and interdependence between the reading specialists and their students’ classroom teachers, and the inability of reading specialists …

Design And Synthesis Of Pyrimidine Based Fused Heterocyclics In The Potential Treatment Of Cancer And Opportunistic Infection, Farhana Islam

Electronic Theses and Dissertations

Dose-limiting toxicities of clinically used agents and development of resistance are two significant limitations in cancer chemotherapy. Microtubule targeting agents (MTAs) are a structurally diverse set of compounds that disrupt microtubule dynamics and exert their anticancer effect. Combination chemotherapy with antiangiogenic agents and microtubule targeting agents has shown an advantage against both these drawbacks. Single agents with dual antiangiogenic activity and cytotoxicity would afford a therapy that circumvents pharmacokinetic problems of multiple agents, avoid drug-drug interactions, lower the drug dose, decrease overlapping toxicities, and delay or prevent tumor cell resistance. The work in this dissertation reflects the progress of fused …

Pharmacological Characterization Of Novel Serotonin Transporter Inhibitors Identified Through Computational Structure-Based Virtual Screening, Michael Wasko

Electronic Theses and Dissertations

Depression is a mental health disorder affecting greater than 350 million people worldwide with roughly 7% of the United States population diagnosed as of 2017. The selective serotonin reuptake inhibitors (SSRIs) have been the mainstay of pharmacotherapies for depression for the last 40 years. The SSRIs target the serotonin transporter (SERT), a monoamine transporter (MAT) responsible for terminating serotonergic neurotransmission. The SSRIs are not perfect therapeutics and suffer from delayed response times, inconsistent efficacy among patients, and often produce intolerable side effects. Therefore, a strong need exists to develop new antidepressants that are more efficacious and have fewer adverse effects. …

Retrospective Cohort Study Of Patients With Chronic Low Back Pain In An Outpatient Pain Specialist Clinic, Gauri Desai

Electronic Theses and Dissertations

Background: Chronic low back pain (LBP) is a back pain that lasts for three or more than three months in the lumbar region of the spinal cord. A nerve injury or damage in the spinal cord region (neuropathic pain) requires multimodal treatment approach for pain reduction. With various treatment options utilized in the pain management of these patients, identifying demographical and clinical characteristics of patients with chronic LBP utilizing interventional procedures and pharmacologic treatments is imperative.

Objective: (i) To describe the demographics (age, gender, race, ethnicity, smoking status, alcohol consumption status, drug use status) and clinical characteristics (procedures, medications) …

Examining The Intersectionality Of Religious Faith, Spirituality, And Healthcare Communication, Felix Okeke

Electronic Theses and Dissertations

This dissertation is my own contribution in responding to the concern raised by certain communication scholars. Their concern was that little research and few publications have been done in the communication field by communication scholars that trace the relationship among religious faith, spirituality, and healthcare communication. While Parrott (2004) describes this apparent neglect as “collective amnesia,” others label it “religion blindness.” Thus, in trying to trace this relationship, this project uses Christian, biblical, and bioethics backgrounds to establish the value, sacredness, and dignity of human life, since these concepts make healthcare and healthcare communication necessary in the first place. These …

Trust In The Nurse And Perceived Quality Nursing Care By Adult Oncology Patients With Implantable Vascular Access Port Devices: A Mixed Methods Study, Lois Rajcan

Electronic Theses and Dissertations

Objective: The purpose of this study was to obtain an understanding of nurse behaviors that promote trust and quality nursing care as perceived by oncology patients with totally implantable vascular access devices (TIVAD).

Methods: An explanatory sequential mixed-method design was used to answer the study questions. This design was comprised of two phases: 1) a quantitative online survey of oncology patients with TIVADs followed by; 2) qualitative interviews using purposively selected patients from the survey sample.

Results: Trust in the nurse and perceived quality of nursing care by patients with TIVADs were determined to be of average levels. Two qualitative …

The Contribution Of A Global Ethics Approach To Health And The Environment In The Niger Delta Region, Augustine Wayii

Electronic Theses and Dissertations

ABSTRACT

THE CONTRIBUTION OF A GLOBAL ETHICS APPROACH TO HEALTH AND THE

ENVIRONMENT IN THE NIGER DELTA REGION

By

Augustine Lezorgia Wayii, M. ED, M.A.

May 2020

Dissertation supervised by Gerard Magill, PhD

The dissertation presents a global ethics approach that connects health and the environment in the context of the Niger Delta Region. The people of the Niger Delta region in Nigeria are experiencing major catastrophes that connect health and the environment. In the bid to ameliorate these pivotal problems, this dissertation undertakes an ethical analysis that connects health and the environment. Insofar as these problems can be characteristic …

The Ethical Challenge For Hipaa’S Privacy Rule In The Genomics Era Of Data Analytics., Reem Shinawi

Electronic Theses and Dissertations

The thesis of this dissertation focuses on the Ethical Challenge for HIPAA’s Privacy Rule in the Genomics Era of Data Analytics. Data Analytics in Genomic Medicine challenges the individuals’ right to privacy. Hence, a balance is needed between the previous centrality of individual privacy and the need for population information to make breakthroughs in Genomic Medicine using Data Analytics. Such a problem demands regulatory solutions. And such solutions require the collaboration of professionals. Genomic Medicine is a field that deals with sensitive genetic information in both medicine, and research, it is essential to view it through HIPAA as it is …

The Ethical Accountability Of Organizational Leadership To Communities Of Stakeholders In Healthcare, Lisa Martinelli

Electronic Theses and Dissertations

ABSTRACT

THE ETHICAL ACCOUNTABILITY OF ORGANIZATIONAL LEADERSHIP TO COMMUNITIES OF STAKEHOLDERS IN HEALTHCARE

By

Lisa A. Martinelli, JD, MA

October 2020

Dissertation supervised by Professor Gerard Magill

While much is written on organizational ethics in healthcare, this dissertation uniquely links organizational ethics and stakeholder theory to the ethical accountability of leadership to their distinct, vulnerable stakeholder communities. It does so by examining the healthcare organization’s moral agency in relation to stakeholder theory and applies those considerations to three major stakeholder categories: confidentiality and privacy of healthcare information, research and attention to specific pediatric populations, and ethics of care concerning the …

Epidemics, Politics And Public Health: Ludwig Rajchman, Md, The League Of Nations Health Organization And The Creation Of A Transnational Health Institution, Paul J. Weinbaum

Electronic Theses and Dissertations

Traditional scholarship on the League of Nations labels the organization as a failure because it did not prevent the outbreak of the World War II. Recent research examines League activities in a more comprehensive manner and concludes that the organization should be credited with important and enduring achievements. Perhaps the most successful work was carried out by the Health Section led by Dr. Ludwick Rajchman. Using primary sources from the League archives in Geneva, documents from organizations such as the Rockefeller Foundation, articles from medical journals and other relevant secondary sources, I argue that the Health Section, became the world’s …

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

Plasma Resuscitation Attenuates Intestinal Barrier Disturbance Following Hemorrhagic Shock., Jessica E. Schucht

Electronic Theses and Dissertations

Background: Intestinal ischemia-reperfusion injury (IIRI) following resuscitated hemorrhagic shock (HS/RES) leads to endothelial damage, microcirculatory dysfunction and intestinal barrier breakdown, increasing intestinal permeability. This pathologic process contributes pathophysiology of multiple organ dysfunction syndrome (MODS) in some trauma patients. Although vascular smooth muscle machinery remains intact, microvascular vasoconstriction occurs secondary to endothelial cell damage, resulting in further ischemia and organ injury. Used separately, resuscitation with Fresh Frozen Plasma (FFP) or Direct Peritoneal Resuscitation (DPR) improves the intestinal microcirculation and alleviates organ injury. Further examination of these effects individually or combined could aid in the resuscitation of hemorrhagic shock. Methods: Sprague Dawley …

Characterization Of Adiposity And Inflammation Genetic Pleiotropy Underlying Cardiovascular Risk Factors In Hispanics., Mohammad Yaser (Anwar)

Electronic Theses and Dissertations

The observed overlap between genetic variants associated with both adiposity and inflammatory markers suggests that changes in both adiposity and inflammation could be partially mediated by common pathways. The pervasive but sparsely characterized “pleiotropic” genetic variants associated with both adiposity and inflammation have been hypothesized to provide insight into the shared biology. This study explored and characterized the genetic pleiotropy underpinning adiposity and inflammation using genetic and phenotypic observations from the Cameron County Hispanic Cohort (CCHC). A total of 3,313 samples and >9 million single nucleotide polymorphisms (SNPs) were examined in this study. Mixed model genome-wide association studies (GWAS) were …

Supporting Postnatal Women With Opioid Use Disorder Treated With Medication Avoidance Therapy, Lea Ann Quave

Electronic Theses and Dissertations

Recent data in 28 U.S. states revealed that opioid use during pregnancy had increased by four times since 2014, going from 1.5 to 6.5 per 1,000 admissions. The use of opioids during pregnancy is dangerous to the mother and developing fetus, greatly increasing the risk for maternal death, miscarriage, and premature birth. The increase in the number of women with opioid abuse disorder (OUD) is reflected by a fivefold increase of infants born with neonatal abstinence syndrome (NAS), a withdrawal syndrome from opioids. Corresponding with U.S. trends, a community hospital in the Texas Gulf Coast region has seen an increase …

The Sick Ones., Christian Loriel Lucas

Electronic Theses and Dissertations

This thesis consists of a collection of linked short stories, connected at the intersections of medicine, public health, race, gender, and socioeconomics. The Sick Ones was completed during a time of social unrest and the emergence of the Covid-19 virus. Inspired by medicine’s history of exploiting sick, poor, and racialized bodies, The Sick Ones explores the treatment of illness and societal woes in a near-speculative future. Each story is plot-driven, but complimented by a protagonist who keeps the narrative grounded, as they attempt to survive unprecedented circumstances. Some of the protagonists are complicit in their own medical exploitations, while others …

The Green House Nursing Home Model: The Gh Elements And Their Impact On Quality Of Care In Nursing Homes., Deborah Kaminka Niyongabo

Electronic Theses and Dissertations

Nursing homes (NHs) have been described as hospital-like facilities where residents are more likely to experience isolation or abuse. The Green House (GH) model is a type of culture change which focuses on deinstitutionalizing traditional NHs to provide better quality of care and quality of life to NH residents. The two main objectives of this study are: to describe the GH model and its elements and to identify which GH elements impact the quality of care. This study also seeks to identify organizational theories used in the GH analysis. The next objective is to analyze the impact of the GH …

Evaluating The Effects Of Pcbs In Non-Alcoholic Fatty Liver Disease & Diabetes And The Role Of Ahr In Regulating The Hepatic Proteome And Lipid Metabolism., Jian Jin

Electronic Theses and Dissertations

Polychlorinated biphenyls (PCBs) are persistent organic pollutants associated with non-alcoholic fatty liver disease (NAFLD) and diabetes. Based on their ability to activate the aryl hydrocarbon receptor (AhR), PCBs are subdivided into two classes: dioxin-like (DL) and non- dioxin-like (NDL) PCBs. This study not only evaluated the chronic effect of DL PCBs (PCB126), NDL PCBs (Aroclor1260 mainly contains NDL), and the DL/NDL PCB mixture (PCB126/Aroclor1260 mixture) on liver, but also explored the acute hepatic effects of DL PCB and potential mechanisms in NAFLD and the role of AhR in regulating hepatic proteome and lipid metabolism, and whether the process independent of …

Development Of A Pediatric Cardiac Assist Maglev Pump For Use With A Universal Driver System., Landon Heath Tompkins

Electronic Theses and Dissertations

Heart failure (HF) remains the leading cause of death, affecting 26 million adults worldwide and 6.5 million adults in the United States. Pediatric HF patients have been a historically underserved population with few options for mechanical circulatory support (MCS) therapy, a leading treatment as an alternative to heart transplantation. To address this clinical need, the Inspired Universal MagLev System is being developed; a low cost, universal magnetically levitated extracorporeal MCS system with interchangeable single-use pumps that will ultimately provide adult and pediatric patients ventricular and respiratory assist therapies. The Inspired Pediatric VAD is the first single-use pump application for this …

Predicting Dental Student's Performance On National Board Dental Examination (Nbde) Part I: Exploring Demographic Factors, Dental Admission Test (Dat) Factors, Pre-Program Academic Factors, And Dental Program Academic Performance., Wei-Shao Lin

Electronic Theses and Dissertations

Dental students need to successfully challenge a national licensure examination to be able to practice dentistry. Dental educators currently have difficulty in identifying candidates who are at risk of failing this examination. This non-experimental quantitative study examined existing dental student data from the 2017, 2018, and 2019 graduating classes, using a retrospective and correlational approach to identify possible markers for at risk students. Demographic factors, dental admission test (DAT) factors, pre-program academic factors, dental program academic performance, and National Board Dental Examination (NBDE) Part I performance. A series of independent t-tests and One-Way analysis of variances (ANOVAs) were used to …

Assessing Nurse Practitioners' Knowledge And Clinical Practice With Regard To The Oral-Systemic Link, Angela Haynes

Electronic Theses and Dissertations

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall …

Chronic Effects Of Methylphenidate On Neuronal Viability And Plasticity, Hannah Oakes

Electronic Theses and Dissertations

Methylphenidate (MPH) is the most commonly prescribed drug to treat Attention Deficit Hyperactivity Disorder (ADHD). ADHD is now considered a life-long disorder; therefore, patients take MPH from adolescence into adulthood, highlighting the need for research studying chronic MPH use. MPH increases dopamine and norepinephrine within the synaptic cleft; therefore, chronic use of MPH may lead to changes within important dopaminergic pathways. One pathway, the mesolimbic pathway, includes the hippocampus, an area where adult neurogenesis occurs. We investigated the effects of chronic low and high doses of MPH on neurogenesis and examined levels of a few key proteins linked to cell …

Collectivism, Individualism, And Interprofessional Education: A Comparison Of Faculty Across Five Academic Health Sciences Colleges, S. Alicia Williams

Electronic Theses and Dissertations

Collaborative practice among interprofessional groups of health care providers is essential to the provision of safe and effective medical care. However, health professions training programs have not traditionally prepared students for interprofessional practice. One challenge in transforming health professions education programs has been a limited number of faculty prepared to teach students in an interprofessional learning environment. Thus, faculty development programs aimed at preparing faculty to provide interprofessional learning experiences across disciplines are increasingly important. Unfortunately, best practice in training faculty for interprofessional education programs is not well-defined.

Interprofessional education faculty development programs should aim to train faculty to model …

Undergraduate Nursing Students’ Learning Style Preferences And Preferred Faculty Teaching Methods Compared To The Actual Methods Used By Faculty, Linda Simpson

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the generational differences of undergraduate nursing students’ learning style preferences and their preferred faculty teaching methods to the teaching methods used most often by nursing faculty in the classroom.

Background. Nursing educators are responsible for creating learning environments that are effective for students that are in different generations and nursing educational pathways. Each generational cohort brings a collective set of characteristics, expectations, and preferences to the classroom, challenging educators to balance the generational learning styles of all students with respectable, evidence-based, pedagogical approaches. This study was one of the …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Perceptions Of Executive Functions And Self-Care Actions In Major Depressive Disorder., Melanie G. Walters

Electronic Theses and Dissertations

This dissertation encompasses a study of the effect of impaired executive functions on decision-making and self-care of depressive illness. The first chapter provides an introduction and summarizes the body of literature on the executive functions and its association with depressive symptoms. The second chapter contains the second of two systematic reviews which examines conceptualizations of executive functions, classical and current measures used to assess the executive functions, and challenges and limitations related to current methods of assessment. The third chapter describes the development of a vignette technique and its use in a study to examine the association of depressive symptoms …

The Lived Experience Of Obesity, Spirituality, And Health Behaviors In African American Women, Andrea S. Poynter

Electronic Theses and Dissertations

Obesity is one of the fastest-growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2014). Novak and Brownell (2012) identified that “obesity rates are consistently rising higher each year than in previous years” (p. 2345). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the …