Medicine and Health Sciences Commons^™

Orchestrated Architecture Dismantling: Borrelia Burgdorferi’S Coordinated Destruction Of Adaptive Immune Responses, Craig A. Land

Electronic Theses and Dissertations

Borrelia burgdorferi represents the most prevalent vector-borne bacteria in North America, affecting ~476,000 Americans annually yet persisting despite robust immune responses. This project reveals spirochetes target adaptive immunity through coordinated lymphatic colonization and precision immune dysregulation.

Using comparative host models (C57BL/6 vs. reservoir Peromyscus leucopus), we demonstrate lymph node colonization within 48-hours, with spirochetes exploiting LYVE-1-positive lymphatic structures as dissemination highways while avoiding the interior of follicular regions. Critically, we identify targeted CD4+ T-cell elimination in germinal center border zones at 21-DPI, precisely when these cells should be coordinating protective immunity. Concurrent upregulation of inhibitory receptor CD32b creates molecular …

Resistance Training Load-Volume Effects On Maximal Strength, Isometric Force-Time Characteristics, And Force-Velocity Relationships, Chieh-Hsin Yu

Electronic Theses and Dissertations

The investigations concerned the effects of resistance training programs with different load–volume configurations on multiple strength characteristics, including maximal strength, isometric force–time properties, and force–velocity (F–v) relationships. Following a review of training interventions across these variables, two ecologically valid resistance training prescriptions were compared: high-load, low-volume (HLLV) and moderate-load, moderate-volume (MLMV). Fourteen recreationally trained participants were grouped into either HLLV (three sets of two repetitions at ≥ 80% 1RM) or MLMV (three sets of ten repetitions at 60–80% 1RM), incorporated into the main lifts of a 4-week program. Strength was assessed using back squat one-repetition maximum …

The Impact Of Estrogen Loss On Caveolin Expression And Cardiac Myocyte Remodeling In Ovariectomized Mice Following Chronic Sympathetic Stimulation, Juliana Barnie

Electronic Theses and Dissertations

Cardiovascular disease (CVDs) remains the top cause of death globally, with postmenopausal women at higher risk due to estrogen decline. Beta-Adrenergic (β-AR) signaling is a major regulator of heart function. Caveolins, structural proteins of caveolae, coordinate cell signaling activities in the heart by co-localizing with estrogen receptors and β-AR and contribute to maintaining healthy cardiac function. The caveolin scaffolding domain (CSD), a binding component of caveolin, has shown therapeutic potential in animal models of heart disease. However, most studies on CSD have been completed in male mice. This thesis evaluates the therapeutic potential of CSD in female mouse models and …

The Lived Experiences Of Navajo Nurses During The Covid-19 Pandemic, Stephnie Ann Leeson

Electronic Theses and Dissertations

When COVID-19 was diagnosed on the Navajo Nation, the impact on the people and the healthcare system was not understood. For almost three years, Navajo healthcare workers battled what was known to the Navajo as Dikos Nitsaaígíí Náhást’éíts’áadah, translated as The Big Cough. The Navajo Nation President, Jonathan Nez, referred to it as a Monster, as did many people in the Navajo Nation. Navajo nurses on the frontlines battled the monster daily as they saw friends and relatives succumb to the insidious disease. Much has been written about nurses off the reservations working on the frontline during the pandemic. However, …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

The Role Of Adolescent Depression Heterogeneity And Resilience Resources In Adulthood Cardiometabolic Health And Depressive Symptoms, Samantha R. Scott

Electronic Theses and Dissertations

Depression in adolescence is a major public health problem and is a risk factor for early-onset cardiometabolic disease. Although adolescent depression is a risk factor for poor cardiometabolic health, depression is heterogeneous and associations may differ by sex. Additionally, if risk factors such as depression can predict adulthood cardiometabolic health, resilience factors (e.g., social, school, neighborhood) that are protective for depression may also be protective for physical health, but this is an ongoing area of research. The goals of the current dissertation were to gain a better understanding of what depressive symptom presentations in adolescents are most concerning for adulthood …

Representation Of Diseases And Health Care In Selected African Gyno-Texts, Rachael K. Aderoju

Electronic Theses and Dissertations

This study explores the interdisciplinary field of literature and medicine through a feminist psychoanalytic lens, focusing on how Nigerian female writers represent illness, healthcare, and medical ethics in post-independence gyno-texts. Traditionally, scholarship in this field has centered on andro-texts (literary works authored by men), leaving a critical gap in the exploration of women’s perspectives. This research addresses that gap by analyzing nine prose works authored by Nigerian women, including texts by Chimamanda Ngozi Adichie, Ayobami Adebayo, Lola Shoneyin, and Samira Haruna Sanusi. These texts are examined for their portrayal of diseases such as infertility, cancer, bipolar disorder, and renal failure, …

Carbon Monoxide Releasing Polymeric Micelles, Riya Joshi

Electronic Theses and Dissertations

Carbon monoxide (CO), traditionally known as a toxic gas, has emerged as a potential therapeutic agent due to its cytoprotective, anti-inflammatory, and vasodilatory properties. This study explores the development of CO-releasing polymeric micelles as a controlled delivery system for biomedical applications. Using ring-opening metathesis polymerization (ROMP), we synthesized diblock copolymers incorporating CO-releasing moiety diphenylcyclopropenone (DPCP) with hydrophilic polyethylene glycol (PEG) to enhance solubility and stability of the overall CO releasing system. Dynamic light scattering (DLS) and electron microscopy (EM) confirmed the formation of well-defined micelles, while fluorescence assays demonstrated efficient CO release with the use of Iridium photocatalyst under 470 …

Survival Guide For Queer Families In Heteronormative Healthcare: Liberatory Consciousness And The Paradox Of Dependent Healthcare, A Critical Policy Discourse Analysis, Dwenna A. Holden

Electronic Theses and Dissertations

In this study I explored and analyzed how the queer experiences of an anonymous higher education institution in the western United States’ self-identified queer faculty and staff intersected with the discursive framing of the college’s dependent healthcare structure and documents. Within a critical paradigm I designed research around a high-density theoretical approach to weaving various branches of queer theory together with critical theory around policy and law in relation to queer bodies and hostile heteronormative policy environments. I arrived at solutions based in complaint, survival, and transformation. I used critical policy discourse analyses to interrogate the college’s dependent healthcare documents …

Weight Recidivism Post-Bariatric Surgery: A Lifestyle Modifications Educational Intervention, Kimeshia Johnson

Electronic Theses and Dissertations

Weight recidivism after bariatric surgery is a frustrating phenomenon for bariatric surgery patients and healthcare professionals. A 90-day lifestyle modification intervention for patients at least 18 months postsurgery was performed in the primary care setting to determine if a structured program could promote or maintain weight loss. The intervention aimed to investigate if participation in a structured lifestyle modification program would impact the body mass index of bariatric patients at least 18 months postsurgical intervention. In coordination with a nutritionist specializing in addiction and obesity education, a booklet detailing the guidelines for a 12-week program was provided to 41 bariatric …

Leadership And Peer Support Of Surgeons Post-Adverse Event: A Phenomenological Study, Maxine E. Trent

Electronic Theses and Dissertations

Abstract Surgeons are leaving the active practice of surgery and fewer physicians are pursuing surgical training, as a result the United States is predicted to have a shortage of surgeons until 2050. Surgery hosts a multitude of occupational stressors, one of which is interoperative adverse events and the subsequent experience of second victims. The literature indicates surgeons prefer psychological/emotional support from peers after interoperative adverse events. However, best practices for how to deliver peer and leadership support responses when surgeons experience second victims have not been established. This was a phenomenological qualitative study targeting practicing surgeons across the United States. …

The Contribution Of Catholic Compromise Principles In Global Health, Scott N. Helstad

Electronic Theses and Dissertations

The Roman Catholic tradition has developed comprehensive ethical principles to address complex practical scenarios that encounter foundational value compromises. These are referred to as compromise principles and they have both a narrow and a broad focus. Narrowly, these compromise principles are critical for Catholic healthcare organizations in the United States with regard to the guidelines of the US Bishops in their Ethical and Religious Directives for Catholic Health Care Services. More broadly, these compromise principles are relevant in the secular realm regarding global health. This dissertation examines these varying perspectives, hence its title, “The Contribution of Catholic Compromise Principles …

Hospital Organizations’ Obligation To Promote Spiritual Well-Being Among Nurses: Development Of A Normative Ethical Argument, Michael Jordan

Electronic Theses and Dissertations

This dissertation presents an innovative strategy to promote the support of nurses' spirituality within hospital organizations. By focusing on the spiritual well-being of nurses by hospital organizations, with a natural extension into nursing schools, the approach aims to enhance nurse’s ability to protect their own spirituality, provide comprehensive spiritual care to patients, and increase nurse moral resilience. By investing in nurses' spirituality and spiritual growth, hospitals can potentially increase job satisfaction among nursing staff, improve patient care outcomes, and create a more holistic healing environment for both nurses and patients. As the nursing shortage continues and the number of nurses …

The Ethical Imperative Of The Renewal Of Virtue Within The Moral Community Of Catholic Healthcare, Amanda Altobell

Electronic Theses and Dissertations

Catholic healthcare is one of the largest nonprofit organizations and providers in the United States, offering medical care to many diverse communities. The fundamental mission of Catholic healthcare is to bring about Christ’s healing ministry and live out the fundamental principle of caring for the vulnerable in pursuit of the common good. However, there have been many missteps, not only due to a more polarized and secular community but also to scandals and conflict due to previous hierarchical and rules-based anthropology that often misses the person's lived experience. Therefore, this dissertation will argue that for Catholic healthcare to survive the …

The Effects Of Loving-Kindness Meditation (Lkm) On Relationship Satisfaction In Couple Therapy, Ruimeng Gao

Electronic Theses and Dissertations

This thesis explores the integration of loving-kindness meditation (LKM) into couple therapy sessions and its impact on relationship satisfaction. Meditation, historically rooted in religious practices, has increasingly been adopted in Western therapeutic contexts due to its demonstrated benefits for mental health and interpersonal well-being. Although mindfulness-based interventions have gained popularity in psychotherapy, research specifically examining the use of LKM in couple therapy remains limited. This study investigates whether incorporating LKM into therapy sessions enhances relationship satisfaction compared to standard therapy alone. Couples were randomly assigned to either a control group, which received standard therapy, or an experimental group, which practiced …

Investigating The Effect Of Fasting On Senescent Cells In Nothobranchius Furzeri Fish, Israel A. Akinola

Electronic Theses and Dissertations

Senescent cells (SCs) have been documented to accumulate with age in the organism. Recent studies have shown that reducing the number of SCs in an organism result in tissue rejuvenation and extension of life expectancy. Intermittent fasting is reported to have multiple health benefits and is speculated to reduce the burden of SCs. Nothobranchius furzeri are a new model organism for studying aging and for which there are short- and long-lived strains available. We hypothesize that long- and short-lived strains of N. furzeri will accumulate SCs at different rates; and that fasting will reduce the burden of SCs.

The results …

Heterotopias Of Confinement: Zoo Architecture And The Loss Of Elephant Agency, Clayton Gill Beasley

Electronic Theses and Dissertations

Zoos functions as a site where human-animal relationships are structured through built environments that mediate control and representation. This study examines zoos as heterotopias—spaces where power and surveillance are negotiated between human observers and captive nonhuman animals. While zoos are often framed as spaces of conservation and education, their architectural design reinforces hierarchies of observation and confinement, shaping both human perceptions of nature and the lived experiences of nonhuman animals. This research focuses on Asian elephants as a critical species within this framework, exploring how their captivity illuminates tensions between human-imposed structures and nonhuman autonomy. Drawing from theories of heterotopia, …

Acute Metabolic, Physiological, And Perceptual Responses To Different Set And Rep Schemes In The Back Squat, Shawn Wayland

Electronic Theses and Dissertations

The purpose of this study was to examine the acute effects of ecologically valid schemes of sets and repetitions in the back squat during the bout and into recovery. Such understanding is expected to contribute to knowledge of the strength-endurance continuum and differential responses to various training emphases in practical settings. Eleven participants completed back squat protocols consisting of a warm-up followed by either 3 x 2 at 90% of 1RM, 3 x 5 at 82.5% of 1RM, and 3 x 10 at 62.5% of 1RM in a randomized and counterbalanced design. VO2, heart rate (HR), lactate, and RPE were …

Peer-Led Support Groups For People With Early Onset Parkinson's Disease, Linnea Tabaka

Electronic Theses and Dissertations

Introduction: Early onset Parkinson’s Disease (EOPD) is a diagnosis of Parkinson’s Disease when diagnosed between the ages of 21 and 50. This population faces unique challenges due to family, social, and career demands that correlate with the age of diagnosis. Support groups have been utilized frequently for people with traditional PD and their caregivers but may not meet the unique needs people with EOPD face. This study explores the existing benefits of a peer-led support group (group led by members of the group) for persons with EOPD. Methodology: This is a qualitative case study of an established support …

Disability Inclusion In Local Public Health Community Health Assessments And Community Health Improvement Plans, Haleigh Leslie

Electronic Theses and Dissertations

Introduction: Local health departments (LHDs) use community health assessments (CHAs) and community health improvement plans (CHIPs) to identify and address health needs of the populations they serve. People with disabilities experience health disparities, and there is limited information about how the health needs of people with disabilities are included in CHAs and CHIPs. The purpose of this study was to describe and quantify disability inclusion in LHD CHAs and CHIPs.

Methods: This cross-sectional, mixed methods study used the CHAs and CHIPs of accredited local health departments, data about LHDs and populations served, and interviews with LHD staff and community partners …

The Reliability And Validity Of Accelerometry And Gnss, Christine Coniglio

Electronic Theses and Dissertations

This dissertation seeks to evaluate the reliability, validity, and utility of accelerometers and GNSS in sport-like scenarios, assess accelerometry-derived metrics and GNSS for distance prediction, and explore how accelerometer placement, specifically chest and back, affect the detection of various locomotor events. In Study I, the purpose was to investigate the accelerometer reliability and predictive capabilities of accelerometers and GNSS to predict a known distance. Thirty physically active female participants (mean height = 163.6 ± 6.8 cm, mean weight = 57.8 ± 8.7 kg) completed jogging trials over two courses (5m and 20m). Each participant wore two tri-axial accelerometers (100Hz) and …

Assessing The Relationship Between The Incidence Of Campylobacteriosis And Ecological Risk Factors In Tennessee, Emmanuel Angmorteh Mensah

Electronic Theses and Dissertations

Background: Campylobacteriosis although is the leading causes of bacterial diarrheal illnesses, have not gained prominent awareness and there are gaps in the understanding of transmission routes for sporadic, non-outbreak cases and their risk factors at the communal level to humans. This study, therefore, aimed to identify the campylobacteriosis risk factors and risk perception from the existing literature in the United States, determine the incidence and ecological risk factors for campylobacteriosis zip code level in Tennessee, and to perform spatiotemporal analysis of campylobacteriosis incidence cases in Tennessee.

Method: To achieve the first aim, a scoping review was conducted to synthesize …

Racial And Geographic Disparities In Primary Care Transitions For Postpartum Women With Gestational Diabetes And Hypertension In South Carolina, Kajol Dahal

Electronic Theses and Dissertations

Introduction Gestational diabetes (GDM) and gestational hypertension (GH) are significant public health issues with lasting implications for maternal and child health (MCH). Despite clinical guidelines recommending postpartum care for all women, especially those with chronic conditions, less than 50% receive a visit within 12 months of childbirth. Recent policy changes extend postpartum Medicaid coverage from 60 days to 12 months. This study assessed differences in postpartum care visits by race/ethnicity and geography after the extension of postpartum coverage in South Carolina. Methods A retrospective cohort of 27,056 women (aged 20-44) who gave birth in 2021 were analyzed using Medicaid claims …

Advancing Research On Retinitis Pigmentosa: An Investigation Of Natural History, Visual System Plasticity, And Mutation-Independent Treatment., Cecilia A. Attaway

Electronic Theses and Dissertations

Retinitis Pigmentosa (RP) is an inherited retinal disease characterized by rod and then cone photoreceptor degeneration. ~25% of cases are caused by a genetic mutation that results in autosomal dominant RP (adRP). There has been a lack of exploration of the progression of degeneration in adRP models. In Chapter Two, I examined visual acuity (VA) changes, retinal structure, and function from early to late-stage disease in a murine P23H Rho ‘knock-in’ mouse model (Rho^P23H/+), the most common form of adRP in North America. To establish a natural history, I evaluated behavioral VA, using the visual water task, …

The Dynamic Role Of Hyaluronan In Acute Cardiac Wound Healing., Danielle T. Little

Electronic Theses and Dissertations

During acute myocardial infarction (MI), the composition of the extracellular matrix (ECM) undergoes significant changes. While collagen accumulation is one of the most well-documented ECM alterations, hyaluronan (HA) is equally abundant. However, the cellular sources, enzymatic regulation, and functional significance of HA accumulation remain largely unexplored. Here, we hypothesized that activated cardiac fibroblasts produce HA via hyaluronan synthase 2 (HAS2), facilitating scar formation and stability. Our findings demonstrate that HA accumulates post-MI and persists for at least four weeks. Through HA sizing techniques, we determined the molecular weight of this persistent HA. Additionally, RNA sequencing analysis of failing human hearts …

New Bayesian Methods For Longitudinal Data Analysis With Complex Dependence Structures., Anish Mukherjee

Electronic Theses and Dissertations

Longitudinal data in real-world settings are frequently found to be heterogeneous and exhibit intricate spatio-temporal dependence structures. Analyzing such complex data to obtain reliable estimation while quantifying uncertainty necessitates using sophisticated Bayesian methodology. In this work, we present novel Bayesian methods developed to address these challenges. We often observe heterogeneity in longitudinal data, where the mean and variance for certain profiles meaningfully differs from the rest. Some profiles may also exhibit outliers at a limited number of measurements. Using a standard mixed effects model, which assumes homogeneity, can lead to overestimating the residual variance and inefficient estimation. In this work, …

The Role Of Tgfβ-Activated Kinase 1 In Fibroblast Differentiation And Cardiac Remodeling After Injury., Daniel Chien Nguyen

Electronic Theses and Dissertations

Immediately following myocardial injury, a robust reparative response is orchestrated through intercellular communication. While various cell populations play critical roles in this process, cardiac fibroblasts have long been recognized as essential mediators of collagen synthesis and scar maturation; however, recent investigations have uncovered significant heterogeneity within the cardiac fibroblast population, revealing distinct subpopulations with roles that extend beyond their traditional functions. Notably, after tissue injury, fibroblasts exposed to damage signals can transition to an inflammatory phenotype, utilizing paracrine and autocrine signaling to coordinate immune cell recruitment and activation. Yet, the mechanisms underlying inflammatory cardiac fibroblast differentiation and their influence on …

Racial Disparity And Environmental Influences On Perinatal Health In Jefferson County, Kentucky., Felicia A Pugh

Electronic Theses and Dissertations

Background: Severe maternal morbidity (SMM) risk has tripled over the past 30 years. Adverse infant birth outcomes in the U.S. have also increased with substantial Black-White disparities. Objectives: This work compares the frequency of adverse maternal and infant birth outcomes by maternal race (Black vs White) and examines associations between maternal ambient heavy metal exposures and birth outcomes in Jefferson County, Kentucky, 2017-2022. Methods: Jefferson County inpatient hospital delivery and birth certificate records of self-identified Black or White birthing parents were used. Incidence of SMM, stillbirth, preterm birth (PTB), and small for gestational age (SGA) with 95% confidence intervals (CI) …

Advancing Speech Intelligibility Assessment: Comparing School-Based Speech-Language Pathologists, Laypersons, And Speech Recognition Software., Hannah Stewart

Electronic Theses and Dissertations

This non-experimental study utilized a convenience sample (N = 86) to investigate the comparability of school-based speech-language pathologists (SLPs), laypersons, and speech recognition software in the assessment of speech intelligibility for children with phonological disorders. Eighty-nine percent of participants were female, and 92% were white. All participants completed a survey comprised of 25 audio recordings of single-word utterances from an AI-generated voice of a four-year-old male with a phonological disorder and were asked to select what word they believed was heard from a pool of 12 options. The survey also included a passage read by the same AI-generated voice, and …