Medicine and Health Sciences Commons^™

The Efficacy Of An Educational Intervention To Improve Low Influenza Vaccination Rates Among Federal Health Care Workers, Cynthia Berfect-Shelby

Electronic Theses and Dissertations

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018 it was estimated that 80,000 people died of influenza-related illnesses. Infants and elderly people are among the most vulnerable populations. The Centers for Disease Control and Prevention and Healthy People 2020 recommend that health care facilities have a 90% vaccination rate. Despite the recommendations and a mandatory directive, many facilities within the Veterans Health Administration struggle to reach influenza vaccination rates above 60%. Pender’s health promotion model was used as the theoretical framework to explore the reasons why health care workers refuse …

A Meta-Analytic Review Of Cognitive Functioning In Negative And Positive Symptoms Of Schizophrenia, Tiffany Forsythe

Electronic Theses and Dissertations

The purpose of the study was to conduct two meta-analytic reviews examining cognitive functioning and schizophrenia. The first review examined the literature comparing the cognitive functioning of schizophrenic patients to healthy controls. A second review examined the cognitive functioning within schizophrenic patients, examining the differences between individuals with primarily positive symptomatology and those with primarily negative symptomatology. The first meta-analysis included 19 studies which assessed 861 schizophrenic patients and 858 healthy volunteers overall. The second meta-analysis included 10 studies comparing the cognitive functioning of 1,263 schizophrenics across positive and negative symptoms. Results of the first review indicated that healthy controls …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

The Lived Experience Of Recovery Following Transoral Robotic Surgery (Tors) For Head And Neck Cancer, Katharine Mahalik

Electronic Theses and Dissertations

Abstract

Ongoing advances in minimally invasive surgical techniques, such as transoral robotic surgery (TORS), has enabled select patients with head and neck cancer to receive treatment that results in less disfigurement and dysfunction compared with traditional approaches. While TORS research has focused mainly on functional surgical outcomes, a need exists to understand recovery following TORS from the patient perspective. A hermeneutic phenomenological approach was used to recruit patients who had recently undergone TORS at a major academic health system in northeastern US. Data were collected using audio-recorded telephone interviews and field notes and analyzed concurrently. Participants included 17 HNCS (12 …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

The Development Of Hybrid Process Control Systems For Fluidized Bed Pellet Coating Processes, Hanzhou Feng

Electronic Theses and Dissertations

The conventional basic control for pharmaceutical batch processes has several drawbacks. The basic control often uses constant process settings discovered by trial and error. The rigid process operation provides limited process understanding and forgoes the opportunities of process optimization. Product quality attributes are measured by the low efficient off-line tests, therefore these cannot be used to monitor and inform the process to make appropriate adjustments. Frequent reprocessing and batch failures are possible consequences if the process is not under effective control. These issues raise serious concerns of the process capability of a pharmaceutical manufacturing process.

An alternative process control strategy …

“I Do Have A Softer Side”: A Phenomenological Investigation Of The Prisoner-Dog Relationship In The Canine Partners For Life Training Program, Kathleen Kocherzat

Electronic Theses and Dissertations

This qualitative study investigated the relationship between incarcerated dog handlers and the service dogs they trained. Six men at a large northeastern prison were interviewed during the summer of 2017; all were current or former dog trainers in the Canine Partners for Life (CPL) training program. The men were serving prison sentences ranging anywhere from several years to life without parole. The interviews focused on their lived experience, rasing and training puppies for a period up to eighteen months. The qualitative data consisted of approximately thirteen hours of transcribed interviews, which were then interpreted using the phenomenological psychological method developed …

The Ethical Challenge Of Conflicts Of Interest In Healthcare, Fahad Alhazmi

Electronic Theses and Dissertations

Conflicts of interest are prevalent across all walks of society, and unfortunately, the healthcare industry is not immune to these impediments. Conflicts of interest arise when the objective of upholding a patients’ interest collide with the physicians’ secondary goals and is mostly but not always related to monetary gain.

To avoid conflict of interest, it is advisable for medical practitioners to weigh the pros and cons that their actions would inflict. Medical practices whose benefits outweigh the associated risks are ethically upright hence avoid conflict of interest.

Each section proposes solutions for the conflicts of interest encountered at the disparate …

Modeling And Prediction Of Amorphous Solid Dispersion Formation Using A Molecular Descriptor, Kevin Deboyace

Electronic Theses and Dissertations

Poor aqueous solubility of an active pharmaceutical ingredient (API) is a significant hurdle during drug development. Delivering a drug in its amorphous solid-state is a potential method to overcome this issue, since the amorphous form has increased apparent aqueous solubility. However, the amorphous state is only metastable, and is thermodynamically driven to recrystallize. As a result, pure amorphous drugs are seldom used in marketed products. Intimately mixing a drug in its amorphous form with a polymer, known as an amorphous solid dispersion (ASD), has the potential to significantly extend the physical stability of the amorphous form, while maintaining the benefit …

An Ethical Analysis Of Reproductive Justice In The Context Of The Egenics Movement In The United States, Bernetta Welch

Electronic Theses and Dissertations

The history of forced sterilization and the American cultural agreement with this practice robbed women of color of control of their own bodies, destinies, and communities. Negative eugenics as genetic proof of low intelligence, low possibility, and low productivity fed the system of compulsory sterilization even though the science proved faulty and incorrect. As advances in medical technology and genetic science increases, eugenics is making a return into the American psyche. Vulnerable populations which include women of color make reproduction and the subsequent control of their bodies vulnerable once again.

The Reproductive Justice Movement is a collaboration of organized women …

The Effect Of Functional Movement Control On Patient-Reported Outcomes In Individuals With Non-Arthritic Hip Pain, Ryan Mcgovern

Electronic Theses and Dissertations

Purpose: Both the single leg squat test and step-down test assess for deficiencies relating to the hip and surrounding musculoskeletal structures and could be useful in the evaluation of functional movement control for individuals with non-arthritic hip pain. The purpose of this study is to determine if individuals with non-arthritic hip pain that improve functional movement control during the single leg squat test and step-down test have better patient-reported outcomes than those that do not improve, following the implementation of a rehabilitation intervention and a standardized home-exercise program.

Subjects: Forty-six individuals (31 females; 15 males) with a mean age of …

The Effects Of Learning Mindfulness Based Stress Reduction On Psychosocial Variables And Hba1c In Adolescents With Type 1 Diabetes, Denise Van Sant - Smith

Electronic Theses and Dissertations

ABSTRACT

THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES

By

Denise E. Van Sant – Smith

Date: 4-5-2019

Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN

Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to …

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

An Exploration Of Factors Of Lgbt Cultural Competency Among Prospective Healthcare Professionals, Heather Isbell

Electronic Theses and Dissertations

Literature suggests there is a relationship between cultural competency and health outcomes as well as a perceived fear of discrimination LGBT individuals face when attempting to receive healthcare services. The aim of this study is to assess the level of LGBT CC (cultural competency) among prospective professionals who are expected to provide health care services and to explore factors that affect those attributes. Multiple linear regressions were conducted to test the effect of the following factors of LGBT CC: postsecondary experience, relations with LGBT individuals, and religion using a sample of 57 different healthcare students in a faith-based university during …

Comparison Of Post-Activation Potentiation Methods On Power And Sprint Acceleration, Aaron Piper

Electronic Theses and Dissertations

Post-activation potentiation (PAP) is a stimulus used to enhance performance by performing specific interventions prior to subsequent explosive movements. The purpose of this study was to determine the effect of different PAP methods on power and sprint acceleration in resistance trained, college-aged men and women. A total of 13 subjects participated in the study. After determining back squat 1 repetition max, subjects returned for testing on separate days to complete one of four interventions (dynamic resistance, weighted plyometric, isometric, or control) in a randomized order. A standardized warmup was given, followed by a baseline countermovement jump (CMJ) and 20-meter sprint. …

Factors Influencing Unmet Medical Need Among U.S. Adults: Disparities In Access To Health Services, Ahmad Khanijahani

Electronic Theses and Dissertations

Inequities in access to health services has negative consequences on individual well-being, and imposes financial and emotional burden on patients, families, health care systems, and the public. Inequities engendered from differences in socioeconomic status, health insurance coverage, race, and other characteristics can engender disparities. This study aimed to identify the potential predictors of unmet medical need among the civilian noninstitutionalized U.S. adults. Inability to receive needed medical care or receiving medical care after a delay, due to the associated costs, constructed unmet medical need. This study used a four-year (2014-2017) National Health Interview Survey (NHIS) data (sample size: 296,301 adults) …

A Deep Learning Approach To Diagnosing Schizophrenia, Justin Barry

Electronic Theses and Dissertations

In this article, the investigators present a new method using a deep learning approach to diagnose schizophrenia. In the experiment presented, the investigators have used a secondary dataset provided by National Institutes of Health. The aforementioned experimentation involves analyzing this dataset for existence of schizophrenia using traditional machine learning approaches such as logistic regression, support vector machine, and random forest. This is followed by application of deep learning techniques using three hidden layers in the model. The results obtained indicate that deep learning provides state-of-the-art accuracy in diagnosing schizophrenia. Based on these observations, there is a possibility that deep learning …

Defects In Fetal Mouth Movement And Pharyngeal Patterning Underlie Cleft Palate Caused By Retinoid Deficiency., Regina Friedl

Electronic Theses and Dissertations

Cleft palate is a common birth defect. Etiologic mechanisms of palate cleft include defects in palate morphogenesis, mandibular growth, or spontaneous fetal mouth movement. Cleft palate linked to deficient fetal mouth movement has been demonstrated directly only in a single experimental model of loss of neurotransmission. Here, using retinoid deficient mouse embryos, we demonstrate directly for the first time that deficient fetal mouth movement and cleft palate occurs as a result of mis-patterned development of pharyngeal peripheral nerves and cartilages. Retinoid deficient embryos were generated by inactivation of retinol dehydrogenase 10 (Rdh10), which is critical for production of …

The Influence Of Premarital Counseling On Marital Satisfaction For African-American Couples, Christian Brown

Electronic Theses and Dissertations

Many factors influence marital satisfaction (Ayub, 2010). Some couples prepare themselves with premarital counseling and try to help increase the likelihood of marital satisfaction. When looking at African-American couples, should researchers assume that some African-American couples take premarital education to increase their marital satisfaction? Prior literature has stated that premarital counseling has decreased marital discord and increased marital satisfaction (Parker, 2007). This study will be a qualitative study using a phenomenological design. The researcher collected data from seven participants. Once the interviews were completed, the researcher was able to analyze the data by identifying common themes as well as capturing …

Glycine Receptor Expression Across Identified Retinal Ganglion Cell Types., Ian Scot Pyle

Electronic Theses and Dissertations

Retinal ganglion cells (RGCs) represent the culmination of all retinal signaling and their output forms the substrate for vision throughout the rest of the brain. About 40 different RGC types have been defined by differences in their visually evoked responses, morphology, and genetic makeup. These responses arise from interactions between inhibition and excitation throughout the retinal circuit (Franke et al., 2017; Masland, 2012; Sanes & Masland, 2015; Werblin, 2011). Unlike most other areas of the central nervous system (CNS), the retina utilizes both GABA and glycine inhibitory neurotransmitters to refine glutamatergic excitatory signals (Franke & Baden, 2017; Werblin, 2011; C. …

The Self-Efficacy Of Biological Mothers And Foster Mothers Caring For Infants Prenatally Exposed To Drugs Or Treated For Nas : Examination Of Potentially Influencing Factors., Megan Kathleen Sherehiy

Electronic Theses and Dissertations

This study sought to identify demographic risk and protective factors that may relate to parental self-efficacy in biological and foster mothers caring for infants prenatally exposed to opioids. The study also examined whether participation in treatment for biological mothers and in training for foster mothers was associated with parental self-efficacy. Forty-nine women (21 biological mothers and 28 foster mothers) were surveyed. Measures included demographic, treatment, and training information. A single-item, self-report measure was used to assess satisfaction with support from friends using an item from the World Health Organization Quality of Life-Bref scale (Skevington, Lotfy, & O'Connell, 2004). The Karitane …

Inspiratory Muscle Recruitment During Swallow And A Comparison Across Airway Behaviors., Allison V. English

Electronic Theses and Dissertations

During swallow, a negative esophageal pressure is present that, along positive pressure from the tongue, which works to move the bolus through the pharynx into the esophagus. This negative esophageal pressure is thought to be produced via recruitment of chest wall inspiratory muscles (diaphragm and parasternal). This current study aimed to examine respiratory muscle recruitment across behaviors which have known inspiratory muscle activity (eupnea, augmented breath and cough) and compare to swallow. It was hypothesized that there would be no significant difference in amplitude and muscle recruitment over 75 ms between swallow and eupnea, but cough and augmented breath would …

Uncovering The Stories Behind The Numbers : A Case Study Of Maternal Death Surveillance And Response In Goma, Democratic Republic Of Congo., Baraka Muvuka

Electronic Theses and Dissertations

Globally, 303 000 women die each year from preventable causes related to pregnancy, with the Democratic Republic of Congo (DRC) having the tenth highest maternal mortality rate. Maternal Death Surveillance and Response (MDSR) is a surveillance-action cycle that aims to eliminate preventable maternal mortality by linking actionable data on maternal deaths with multi-level actions. While countries are increasingly adopting MDSR, there are research gaps on its implementation, outcomes, and best practices in developing countries including the DRC. This study assessed MDSR implementation in Goma Health Zone (HZ), DRC, specifically its structure, process, quality, outcomes, and influencing factors. A qualitative case …

Novel Mechanisms And Biomarkers In Alcohol-Induced Organ Injury., Christine E. Dolin

Electronic Theses and Dissertations

Background. Ethanol (EtOH) consumption is known to affect multiple organs; this is unsurprising, as the concentration of EtOH in the blood at relevant doses reaches the millimolar range. The overarching goal of this dissertation was to elucidate mechanisms of alcohol-induced organ injury, specifically the effects of alcohol on the hepatic extracellular matrix (ECM) proteome, the alcoholic hepatitis (AH) plasma peptidome, and the effects of alcohol on the renal cortex proteome and transcriptome. Methods. Mice were pair-fed ethanol-containing liquid diet chronically, and then some mice were administered lipopolysaccharide (LPS). Liver sections from these mice were processed in a series of increasingly …

Investigating Predictive Relationships Between Speech-Language Pathology Graduate Students' Sense Of Classroom Community, Perceived Learning, And Perceived Anxiety., Emily B. Schantz

Electronic Theses and Dissertations

Mental health is an all-encompassing term that focuses on a person’s ability to achieve work-life balance inclusive of positive mental health and mental ill-health. Current trends suggest an overall increase in mental ill-health for undergraduate and graduate students. McMillan and Chavis’ sense of community theory provided the theoretical framework for this study. This study aimed to examine whether speech-language pathology graduate students’ sense of classroom community and perceived learning predict anxiety levels while controlling for demographic variables. Three-hundred-sixteen master’s level speech-language pathology students completed an online survey containing the Generalized Anxiety Disorder Questionnaire, Perceived Learning Scale, and Classroom Community Scale. …

The Q Rule In Bacteriodetes And The Identification And Characterization Of Porphyromonas Gingivalis Glutaminyl Cyclase., John Andrew Houston

Electronic Theses and Dissertations

Background: Porphyromonas gingivalis, a major pathogen associated with chronic periodontitis, secretes variety of proteins, majority of which begins with glutamine. Several of these proteins were found with pyroglutamate (pGlu) at N-terminus suggesting the presence of this posttranslational modification pathway in P.gingivalis. The observation that N-terminal glutamine is over-represented as the first amino acid after signal peptide cleavage, and subsequent confirmation of pGlu formation on the nascent protein via mass spectrometry, led us to conclude that an enzyme must be present as the executor of this reaction. Hypothesis: PG2157 is a glutaminyl cyclase and is responsible for the cyclization of …

Alterations In Rhythmic Licking Behaviors Following Fibrosis In The Rat Mylohyoid Muscle., Brittany Fletcher

Electronic Theses and Dissertations

Muscle injury is a common side effect of radiation treatment for head and neck cancer. To increase understanding of muscle injury related dysfunction, we investigated the effects of oral swallowing function after cryoinjury to mylohyoid muscle in rats. The hypothesis is that injury to the mylohyoid delays the temporal licking pattern, resulting in aberrant drinking behaviors. Six rats received bilateral mylohyoid injuries by applying a 3mm cryoprobe. Licking behavior was measured by electrophysiological recordings of rhythmic tongue movements in a ten-minute drinking session taken pre-and post-injury (one-and two-weeks). Lick frequency and total licks per cluster decreased significantly one-and two-weeks post-injury …

Evaluation Of The Health And Exposure Histories Of A Community Surrounded By Industry And Industrial Waste : A Mixed Methods Approach., Lindsay Koloff Tompkins

Electronic Theses and Dissertations

Environmental pollution is not distributed equally across members of society. Low-income individuals are more likely to live near waste sites and other sources of pollution, and, therefore, face greater exposure to environmental health hazards. One such community in Louisville, Kentucky, the Riverside Gardens neighborhood, consists of approximately 300 homes that are surrounded on three sides by industry and industrial waste, including a remediated Environmental Protection Agency Superfund site, a former coal-burning power plant and coal ash storage site, and multiple chemical, rubber, and plastic manufacturing companies. Residents have reported elevated rates of cancer and other chronic diseases and have requested …

Polydrug Use Among People Who Use Opioids, National Survey On Drug Use And Health 2002 To 2017., Diana Kuo Stojda

Electronic Theses and Dissertations

Introduction: Mortality due to overdose has been increasing since 2010 in the U.S., with an increase in the reported use of heroin and co-use of heroin and prescription opioids. Trends and correlates of polydrug use need to be analyzed to propose policies to reduce overdose risk. The overall objective of this study is to characterize high-risk polydrug groups among people who use opioids (PWUO) to understand the patterns of co-used substances and overdose risk factors. Methods: Publicly available data from the 2002-2017 National Survey on Drug Use and Health were analyzed to obtain weighted prevalence rates and trends …

The Shape Study : The Survey Of Health And The Perceived Environment Study., Colette Patrice Davis

Electronic Theses and Dissertations

Introduction: Few studies have considered how an individual’s perception of their built environment may be a risk factor for being overweight or obese. Adolescents may be particularly vulnerable in the context of “impoverished environments”, which they may perceive to be difficult, dangerous, resource deficient, and unaesthetic. This study aids in clarifying how the built environment influences the risk of obesity among adolescents residing in a neighborhood in Louisville, KY. Objective: The overall objective was to conduct a cross-sectional epidemiologic pilot study among adolescents aged 12-17 years residing in West Louisville, Kentucky to evaluate the association between perceptions of …