Medicine and Health Sciences Commons^™

Mri Image Regression Cnn For Bone Marrow Lesion Volume Prediction, Kevin Yanagisawa

Theses and Dissertations

Bone marrow lesions (BMLs), occurs from fluid build up in the soft tissues inside your bone. This can be seen on magnetic resonance imaging (MRI) scans and is characterized by excess water signals in the bone marrow space. This disease is commonly caused by osteoarthritis (OA), a degenerative join disease where tissues within the joint breakdown over time [1]. These BMLs are an emerging target for OA, as they are commonly related to pain and worsening of the diseased area until surgical intervention is required [2]–[4]. In order to assess the BMLs, MRIs were utilized as input into a regression …

Chemical And Polymer Characterization Of The Potential Modes Of Degradation Of An Injectable Nucleus Pulposus Replacement Device, Antonio G. Abbondandolo

Theses and Dissertations

HYDRAFIL™ is a poly(vinyl alcohol)/poly(ethylene glycol)-based hydrogel nucleus pulposus replacement device that is injected in situ and has demonstrated efficacy in lowering the prevalence and pain associated with back. In this work, we developed a method to analyze HYDRAFIL™ polymer composition using (TGA) and characterized intermolecular bonding interactions within the hydrogel through (FTIR). To function as a permanent implant for nucleus pulposus replacement, HYDRAFIL™ must be stable when exposed to a multitude of degradation pathways, namely, thermal, chemical, and mechanical. We subjected HYDRAFIL™ to accelerated thermal and chemical degradation pathways and described compositional, physical and chemical property changes using a …

Theta Burst Brain Stimulation In Painful Diabetic Neuropathy Patients: Investigating Neural Mechanisms, Bhushan Thakkar

Theses and Dissertations

Chronic pain (CP) is a significant contributor to disability and disease burden globally. In 2019, approximately 50.2 million adults (20.4% of the US population) experienced chronic pain, contributing to $560-635 billion in direct medical costs. In addition, the worldwide prevalence of diabetes mellitus has reached epidemic proportions and is set to increase to 629 million by 2045. Almost 50% of patients with diabetes present with diabetic neuropathy (DN), and one in five patients with diabetes presents with painful DN (pDN) which is the most common cause of neuropathic pain (NP) in the US. Symptomatic treatment is the mainstay of management …

Tummy Time In Infancy: Real-World Assessments And Associations With Developmental Outcomes In Early Childhood, Ketaki Inamdar

Theses and Dissertations

Tummy time or awake, supervised, prone play is an important developmental play position in infancy. Engaging in more than 15 minutes of tummy time per day is associated with a lower risk of plagiocephaly, lower body mass index, and achievement of higher motor scores in full-term and at-risk preterm infants. However, there are significant gaps in the measurement of tummy time in current literature. Conventionally used subjective parent reports have not been validated against gold standard direct observation, and the feasibility and real-world validity of objective solutions such as wearable sensors has not been examined in full-term and at-risk preterm …

Feasibility Of Delivering Fall Prevention Intervention For People With Intellectual Disability In Group-Homes, Poram Choi

Theses and Dissertations

Adults with intellectual disability (ID) have a higher rate of falls than the general population, and changing health behaviors through exercise program could enhance health and reduce falls in this population. However, the feasibility study of fall prevention based on the theoretical framework for adults with ID has not been explored to date. This study examined the feasibility of a home-based exercise intervention for people with ID living in a residential setting. We provided an 8 week intervention consisting of a training workshop for support workers and sessions for adults with ID devoted to behavior reward, education about fall prevention …

Dendrimer-Based Antibiotics For The Treatment Of Bacterial Biofilm In Cystic Fibrosis (Cf), Younan Ma

Theses and Dissertations

Pseudomonas aeruginosa (PA) is the predominant pathogen in chronic lung infections of cystic fibrosis (CF) patients. The most important mechanism of adaptation of PA to host defense and antibiotic treatment is the formation of biofilms within the mucus layer covering the lung bronchi. The effectiveness of antibiotics such as aminoglycosides is significantly attenuated by their limited penetration through thick mucus and embedded biofilm matrix in patients’ lung. Inhaled tobramycin (Tobra), which is the most commonly used antibiotics in the treatment of PA infections for CF patients, is usually found to be in very high concentration in patients’ lung, and yet …

Parental Uncertainty In Illness Of An Infant And Perinatal Post-Traumatic Stress Disorder In The Nicu, Kathryn Jeanne Malin

Theses and Dissertations

Varying and conflicting risk factors for perinatal post-traumatic stress disorder (PPTSD) have been reported in the literature in parents after having an infant in the neonatal intensive care unit (NICU). Furthermore, relationships between feelings of parental uncertainty in illness of an infant in the NICU and PPTSD in parents have not been established. The purpose of this study was to (a) investigate the factor structure underlying parental perception of uncertainty scale (PPUS) in a sample of parents in the NICU; (b) describe how parental uncertainty in illness changes throughout the NICU course and after discharge; (c) evaluate if infant illness …

Roli I Infermierit Në Trajtimin E Pacientëve Me Djegie, Mirjeta Jakupi

Theses and Dissertations

Hyrje: Djegia është një dëmtim i lëkurës ose i indit tjetër i shkaktuar kryesisht nga trauma akute ose termike. Ndodh kur disa ose të gjitha qelizat në lëkurë ose inde të tjera shkatërrohen nga lëngjet e nxehta, mjetet e nxehta (djegiet e kontaktit), zjarri, rrezatimi, energjia elektrike, fërkimi ose kimikalet. Qëllimi i studimit eshte të përshkruaj rolin e infermierëve në kujdesin e pacientëve me djegie si dhe se çfarë praktikojnë aktualisht infemierët në menaxhimin e djegieve në mënyrë që të hartohen udhëzime mbi menaxhimin e djegieve.

Metodologjia: Metodologjia e punimit është deskriptive dhe retrospektive. Ky hulumtim është kryer …

Strategies And Devices For Improving Respiratory Drug Delivery To Infants And Children With Cystic Fibrosis, Karl Bass

Theses and Dissertations

Cystic Fibrosis (CF) is a degenerative disease, which causes thickening of the airway surface liquid and reduced mucociliary clearance, which provides an ideal habitat for bacterial infections. Early treatment of CF in children can prevent chronic infection, improve quality of life, and increase life expectancy. The most predominant bacteria found in CF-diseased lungs is Pseudomonas aeruginosa (Pa), which can be treated with inhaled tobramycin. Excipient enhanced growth (EEG) powder formulations are well suited for administering tobramycin to children, as the EEG approach provides minimal upper airway loss and targeted drug delivery. This method uses an initially small aerosol for high …

Biopsychosocial Variables Associated With The Development Of Chronic Low Back Pain In Healthcare Workers, Jena Pauli

Theses and Dissertations

ABSTRACT

Purpose: Worldwide the incidence and prevalence of acute low back injury with pain (ALBIP) is increasing in healthcare workers (HCW). Approximately 27% of ALBIP result in chronic low back pain (CLBP). The primary aim of this study was to identify biopsychosocial factors that contribute to the development of CLBP. A secondary aim was to examine the predictive value of reliable and valid screening instruments to identify individuals at highest risk for CLBP.

Significance: Low back pain is the second most commonly reported pain condition in the United States, one of the leading causes of sick leave and …

Relationship Of Demographic Characteristics Of Occupational And Physical Therapists Towards Their Knowledge And Attitude On Person-Centered Care In Skilled Nursing Facilities, Sadashiv R. Aggarwal

Theses and Dissertations

The study aimed to assess the relationship of specific demographic characteristics of occupational (OTs) and physical therapists (PTs) with their knowledge and attitudes towards principles of Person-Centered Care (PCC) in skilled nursing facilities (SNFs). The study further examined if knowledge and/or attitudinal differences exist between OTs and PTs towards PCC. The proposed descriptive study used the Person-Centered Care theory, which is a holistic (bio-psychosocial-spiritual) health care delivery approach. PCC delivers services that are respectful and individualized, allowing negotiation of care, and offering choice through a therapeutic relationship where persons receiving care are empowered to be involved in health decisions at …

Effects Of Patient Characteristics On Outpatient Rehabilitation Outcomes In Patients With Lumbar Impairments, Jenna Powers

Theses and Dissertations

Lumbar spine impairments affect an individual’s ability to perform activities of daily living, making it pertinent to understand the importance of rehabilitation and variables influencing clinical outcomes. The purpose of this study was to examine variables (demographics, health conditions, and biopsychosocial) that contribute to larger functional status (FS) improvement for patients with lumbar spine impairments seeking outpatient rehabilitation therapy. This study was a secondary data analysis of data collected by FOTO Inc. (Knoxville, TN, USA). A sample of 221,168 participants with lumbar spine impairments were analyzed. Correlations were performed to examine the strength of the linear relationship between variables of …

Critical Illness Survivors’ Perceptions Of Their Recovery: An Interpretive Phenomenological Inquiry, Kelly Calkins

Theses and Dissertations

Surviving critical illness with its physical, cognitive, and psychosocial morbidities is a growing clinical and research challenge and an important public health concern. Currently, there are few interventions for survivors of critical illness after hospital discharge. Potential interventions include rehabilitation services, Intensive Care Unit (ICU) diaries and ICU follow-up clinics, however, most survivors do not have access to these post-hospital interventions.

The purpose of this study is to gain a better understanding of how critical illness survivors experience their recovery, interventions they use, and what they perceive as facilitators and barriers to their recovery. A better understanding of these factors, …

Knowledge And Attitudes Toward Persons With Schizophrenia Among Hispanic University Students Enrolled In Mental Health And Non-Mental Health Disciplines, Manisha Sharma

Theses and Dissertations

The present study was designed to examine university students’ knowledge regarding schizophrenia and factors that can influence university students’ attitudes toward persons with schizophrenia. An attribution questionnaire ([AQ-27], Corrigan, Markowitz, Watson, Rowan, & Kubiak, 2003), the Error Choice Test ([ECT], Michaels & Corrigan, 2013), and the Social Desirability Scale ([SDS-13], Reynolds, 1982) were utilized to collect data from undergraduate students attending The University of Texas Rio Grande Valley (UTRGV), the largest U.S. Hispanic serving university located on the Texas-Mexico border. Descriptive and inferential statistics were utilized to analyze the survey data. Results indicated a non-significant relationship between students’ knowledge regarding …

Effects Of Divided Attention On Speech In Parkinson's Disease, Melissa Inkley

Theses and Dissertations

The effects of divided attention on speech in Parkinson's disease (PD) have been studied for a variety of tasks in recent years. Much of the previous research studied gait patterns while participants concurrently performed another task. There have been few studies regarding the effects of divided attention on speech in individuals with PD. The ability to communicate effectively relies in part on an appropriate rate of speech, vocal intensity, and fundamental frequency control. This study included 27 participants: 8 with PD, 12 neurologically healthy older (HO) adults, and 7 healthy younger (HY) adults. Each participant was given a list of …

Adults With Cystic Fibrosis: Self-Management And Health Outcomes, Amanda Rose Lambie

Theses and Dissertations

This dissertation is comprised of three manuscripts for publication reporting on adults living with cystic fibrosis, self-management behaviors and health outcomes. Chapter I explores what is known about adults living with cystic fibrosis (CF) and the factors impacting their self-management, including the complexities of a health maintenance regime required for survival while integrating and balancing the realities of adulthood. The review of literature provides direction for future research and implications for adult-focused CF studies. Chapter II is a manuscript describing the characteristics of prognostic survival models utilized in adult CF research and provides an overview of their development, validation, predictive …

An Innovative Use Of Technology And Associative Learning To Assess Prone Motor Learning And Design Interventions To Enhance Motor Development In Infants, Tanya Tripathi

Theses and Dissertations

Since the introduction of the American Academy of Pediatrics Back to Sleep Campaign infants have not met the recommendation to “incorporate supervised, awake “prone play” in their infant’s daily routine to support motor development and minimize the risk of plagiocephaly”. Interventions are needed to increase infants’ tolerance for prone position and prone playtime to reduce the risk of plagiocephaly and motor delays. Associative learning is the ability to understand causal relationship between events. Operant conditioning is a form of associative learning that occurs by associating a behavior with positive or negative consequences. Operant conditions has been utilized to encourage behaviors …

The Role Of Ceramide In Neutrophil Elastase Induced Inflammation In The Lungs, Sophia Karandashova

Theses and Dissertations

Alterations to sphingolipid metabolism are associated with increased pulmonary inflammation, but the impact of inflammatory mediators, such as neutrophil elastase (NE), on airway sphingolipid homeostasis remains unknown. NE is a protease associated CF lung disease progression, and can be found in up to micromolar concentrations in patient airways. While sphingolipids have been investigated in the context of CF, the focus has been on loss of cystic fibrosis transmembrane conductance regulator (CFTR) function. Here, we present a novel observation: oropharyngeal aspiration of NE increases airway ceramides in mice. Using a previously characterized mouse model of NE-induced inflammation, we demonstrate that NE …

Influence Of Muscle Strength On Mobility In Critically Ill Adult Patients On Mechanical Ventilation, Audrey R. Roberson

Theses and Dissertations

Patients in the intensive care unit (ICU) setting are prone to develop muscle weakness and the causes are multi-factorial. Muscle strength in adult, critically ill patients on mechanical ventilation decreases with immobility. The influence of muscle strength on different muscle groups and its influence on progressive mobility in the adult, critically ill patient on mechanical ventilation has not been examined. Identifying muscle strength in this patient population can benefit overall muscle health and minimize muscle deconditioning through a progressive mobility plan. The objective of this dissertation was to describe muscle strength in different muscle groups and to describe the influence …

Influence Of Contextual Factors And Self Efficacy On Self- Management In Parents Of Children With Cystic Fibrosis, Erin B. Booth

Theses and Dissertations

Cystic Fibrosis, a life threatening autosomal recessive genetic disease, is characterized by a defective gene resulting in the production of thick mucus that obstructs the lungs and pancreas. CF requires intensive management performed at the home. An initial pilot study was performed to describe knowledge of CF related diabetes (CFRD) in adults with CF. The findings of this study, which demonstrated that adults with CF lacked sufficient knowledge about CFRD confirmed the need to explore additional factors of self-management guided by a theoretical framework. The second study presented in this dissertation used the Individual and Family Self-Management Theory (IFSMT) to …

Internet-Based Behavior Of It Professionals: Implications For Online Ergonomic Education To Prevent Work-Related Musculoskeletal Disorders, Priyadarshini Pattath

Theses and Dissertations

INTERNET-BASED BEHAVIOR OF IT PROFESSIONALS: IMPLICATIONS FOR ONLINE ERGONOMIC EDUCATION TO PREVENT WORK-RELATED MUSCULOSKELETAL DISORDERS

By Priyadarshini Pattath, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Director: Dr. Robin Hurst, Assistant Professor of Adult Learning, Teaching and Learning,

School of Education

The purpose of this study was to explore the preferences of medium of ergonomic education and views about self-directed online training modules to prevent musculoskeletal disorders in computer professionals and understand their perspectives and experiences about online health information seeking using a …

Effects Of Two Gait Tasks On Language Complexity In Parkinson's Disease, Betty Ann Marquardt

Theses and Dissertations

The effects of dual tasking in Parkinson's disease (PD) have been studied for a number of years. Previous research has generally focused on changes in gait patterns while another task has been performed concurrently. Very few studies have focused on the impact of a concurrent task on speech or language. Language is key for communication: to express wants and needs, to maintain familial relationships, and for social interaction. Thirty-seven individuals participated in the study: 10 with PD, 14 neurologically healthy older (HO) adults, and 13 healthy younger (HY) adults. The participants were given a list of topics to consider and …

Emerging Pathogens In Cystic Fibrosis Patients At Virginia Commonwealth University Medical Center (Vcumc), Emily M. Hill

Theses and Dissertations

Cystic fibrosis (CF) is an autosomal recessive disorder affecting 70,000 individuals worldwide. This disease is characterized by the buildup of mucus in the airways leading to chronic lung infections resulting in pulmonary failure and death in 95% of CF patients. Routine surveillance of CF pathogens using traditional microbiology culture guides management and treatment of CF patients. Molecular profiling studies have revealed emerging pathogens that may play a role in CF lung disease by either directly causing infection or upregulating the virulence factors of classic CF pathogens, such as P. aeruginosa; however, routine CF culture protocols have not been modified …

The Lived Experiences Of An Injured Athlete And Members Of A Performance Management Team During Injury Rehabilitation: An Interpretative Phenomenological Analysis, Courtney Wynne Hess

Theses and Dissertations

In response to an ever growing understanding of the biopsychosocial nature of health and well-being, multidisciplinary and interdisciplinary approaches to rehabilitation have grown in acceptance over the past decade. Studies that have explored the effect of these two approaches have found them to be effective in improving rehabilitation outcomes (McAlister et al., 2001; Tur et al., 2003). Although they have been shown to be objectively effective, the impact that these approaches have on the lived experiences of the team employing them, and the athlete or patient they serve, is not well understood. As such, the purpose of the current study …

The Impact Of The Ohana Mana Challenge On Native Hawaiian And Pacific Islander Children, Kristin Kay Van Tassell

Theses and Dissertations

In this four-week, family-focused pilot intervention study, researchers studied the impact of culturally relevant nutrition and activity sessions on eleven children from eight Native Hawaiian and Pacific Islander (NHPI) families. Mixed methods were used in analysis. In their favorite meal drawings, children included more fruits and vegetables at week four than week one, which was consistent with their self-reported intake of healthy foods that were new to them. From week one to four, mean total scores increased on the nutrition and exercise knowledge exercise questionnaire and the physical activity self-efficacy tool; however, the mean total score decreased on healthy diet …

Effects Of Progressive Lens Eyeglasses On Gait Performance Factors Among Young And Middle-Aged Groups, Autumn Marie Milanowski

Theses and Dissertations

Background: It is estimated that over 85% of adults over the age of 45 develop a condition called presbyopia (Holden et al., 2008). Multifocal lenses (MfLs) are used to functionally adapt to this condition to allow for convenient near and distance vision. However, this causes vision distortion in the lower part of the visual field at ground level while walking. Since safe ambulation relies on the lower visual field to detect obstacles (Marigold et al., 2008), and vision acts as a moderating factor for increased fall rates as individuals age (Heasley et al., 2005), there is a need to investigate …

Mandibular Symphyseal Distraction Osteogenesis (Msdo): Association With Temporomandibular Dysfunction (Tmd) Symptoms, Sheldon Bates

Theses and Dissertations

Background: Transverse mandibular discrepancies are often overlooked during orthodontic treatment. MSDO is a treatment to address this issue, but much debate exists over the long-term implications on the temporomandibular joint (TMJ). Few studies have sample sizes sufficient to draw clear conclusions about the impact of MSDO on TMJ health. Materials and Methods: This study evaluated private practice records including 49 MSDO patients and 57 traditionally-treated controls. The subjects were assessed by TMD exams that evaluated jaw pain and discomfort using visual analog scales, range of motion for opening, right and left lateral, and protrusive movements, and the presence of clenching, …

The Effect Of Oral Care On Intracranial Pressure In Critically Ill Adults, Christina Szabo

Theses and Dissertations

A major goal in the care of patients with neurological problems is to prevent or minimize episodes of increased intracranial pressure (ICP). Elevations in ICP in response to nursing interventions have been acknowledged since the 1960’s when ICP monitoring was first introduced in the clinical setting. Until recently few studies have specifically examined the effect of oral care on ICP and oral care and other hygiene measures were combined or not specified, prohibiting a direct interpretation of the influence of oral care alone on ICP. The purpose of this study was to describe the relationship between routine oral care interventions …

Overexpression Of Serum Response Factor In Astrocytes Improves Neuronal Plasticity In A Model Of Fetal Alcohol Spectrum Disorders, Arco P. Paul

Theses and Dissertations

Neuronal plasticity deficits underlie many of the neurobehavioral problems seen in Fetal Alcohol Spectrum Disorders (FASD). Recently, we showed that third trimester alcohol exposure lead to a persistent disruption in ocular dominance (OD) plasticity. For instance, few days of monocular deprivation results in a robust reduction of cortical regions responsive to the deprived eye in normal animals, but not in ferrets exposed early to alcohol. This plasticity deficit can be reversed if alcohol-exposed animals are treated with a phosphodiesterase type 1 (PDE1) inhibitor during the period of monocular deprivation. PDE1 inhibition can increase cAMP and cGMP levels, activating transcription factors …

Use Of Procalcitonin As A Biomarker Of Bacterial Infection In Acute Liver Failure And Acute Liver Injury, Jody Balko

Theses and Dissertations

Infections in patients with acute liver failure (ALF) and acute liver injury (ALI) are a frequent occurrence. Because ALF and ALI patients share many of the same clinical features as patients with severe sepsis and septic shock, identifying an infection based upon clinical manifestations is extremely difficult. Bacterial culture and sensitivity reports require 24 to 72 hours to be finalized after the need for a culture is suspected and obtained. During this time period, ALF and ALI patients are either not receiving required antibiotic therapy, receiving antibiotic therapy that is not required or not appropriate for the infecting bacterial pathogen, …