Medicine and Health Sciences Commons^™

Proactive Personality And Voluntary Turnover: The Moderating Effects Of Development And Perceived Career Opportunities, Amy F. Huber

Theses and Dissertations

The present thesis reports the research and quantitative examination of the relation

between proactive personality and voluntary turnover, as well as the moderating influences of participation in development activities and perceptions of available career opportunities. Zero- order correlations and moderated binary logistic regression are used to test the hypotheses within an archival data set of 295 participations from a multinational European organization. A significant correlation was found between proactive personality and participation in developmental activities. Additionally, participation in developmental activities was found to be a negative predictor of voluntary turnover. Results of the moderated logistic regression analysis showed that both …

The Relationship Between Relational Aggression And Sexual Satisfaction: Investigating The Mediating Role Of Attachment Behaviors, Melece Vida Meservy

Theses and Dissertations

The purpose of this study was to investigate the relationship between relational aggression and sexual satisfaction, as well as the mediating role of attachment on this relationship. Data came from the Relationship Evaluation Survey (RELATE) comprised of the matched-pair responses of 797 couples in serious dating, engaged, or married relationships. Results showed the greater the perceived relational aggression the lower the sexual satisfaction for both self and partner, regardless of gender. Additionally, it appears a more satisfying sexual relationship can occur when an individual experiences a secure attachment base and can feel confident that his/her relationship is safe. For both …

A Longitudinal Examination Of Parental Psychological Control And Externalizing Behavior In Adolescents With Adolescent Internalized Shame As A Mediating Variable, Iesha Renee Nuttall

Theses and Dissertations

The purpose of this study was to examine the relationship between parental psychological control and adolescent externalizing behavior with adolescent internalized shame acting as a mediating variable. Gender differences were also examined. Three hundred eleven two-parent families with an adolescent were included in this study, 154 were male adolescents (Mean age at wave 6 = 16.28 years, SD = .98) and 157 were female adolescents (Mean age at wave 6 = 16.21 years, SD = .99). Results indicate that parental psychological control for both mothers and fathers at wave 4 was positively related to adolescent externalizing behavior for both boys …

Implicit Family Process Rules Specific To Eating-Disordered Families, Mallory Rebecca Wolfgramm

Theses and Dissertations

Family environment is a significant factor in the development of eating disorders in young-adult females. Clinical experience, research and theories about eating disorders indicate that constrictive implicit process rules within a family are correlated with eating-disordered families. This study identified implicit family process rules that are unique to eating-disordered families and how well these rules predict membership in eating-disordered and non-eating-disordered families. One hundred and two families (51 eating-disordered and 51 comparison families) participated in the study. Mothers, fathers, young-adult female children, and siblings in each family completed the Family Implicit Rules Profile (FIRP). The design included cluster analysis of …

Establishing Sustainable Community Garden Interventions With Aid From Health Promotion Organizations, Rachel Joann Buenemann

Theses and Dissertations

Community garden interventions provide policy, system and environmental change at the community level to establish health behaviors, which act in contest to obesity risk factors. Limited research examines factors, which influence the sustainability of community garden interventions. Therefore, in this study, a sample of 10 Midwestern community gardens associated through funding from a health promotion organization in 2013, collected data through the interviewing and surveying of 10 garden administrators and surveying of 12 garden volunteers. The study identified garden benefits perceived by garden administrators and volunteers to include contributions to social justice, continued education, enhanced social cohesion, increased access to …

Do Healthcare Professionals With High Weight Biases Provide Different Quality Of Care To Obese Compared To Normal Weight Patients?, Justine Leigh Seymour

Theses and Dissertations

Though weight bias has been acknowledged in the health field, it is less understood if and how weight bias affects quality of care. The purpose of this study was to determine if weight bias exhibited by healthcare professionals (HCPs) impacts quality of healthcare provided to obese individuals. HCPs (n=220; 88% female, 87% nurses) in the Midwest region of the United States were recruited to complete an online survey. Participants completed the Attitude Towards Obese Persons scale (ATOP) to assess weight bias and responded to hypothetical patient scenarios to evaluate quality of care. A median split was calculated for ATOP scores …

Perceptions Of Nonclinical Competencies As An Organizational Response: Exploring The Influence Of Institutional. Task Environments, Organizational Factors And Interorganizational Relationships On Educators' And Employers' Perceptions Of Nonclinical Competencies In Newly Graduated Speech Pathologists, Paula H. Boaz

Theses and Dissertations

The qualitative comparative case study had as its purpose to explore perceptions of nonclinical competencies as viewed through the lens of organizational theroy, vis-a-vis the perceptions of educators and employers and the environmental pressures placed on them through institutional and task environments, by organizational factors, and through interorganizational relationships. Knowledge and abilitites which are not clinical in nature, yet are essential in professional postitons, are termed nonclinical competencies. The literature on organizational theory and nonclinical competency in speech pathology was reviewed. A conceptual framework was developed from reviews of the related literature and was used as a guide to the …

The Association Between Clinical Recognition Of Depression And Unplanned Hospital Readmission Among Older Adults, Karen M. Jones

Theses and Dissertations

Purpose

The likelihood of a depression diagnosis may differ based on whether the patient was seen in an inpatient or outpatient setting. Depression has been associated with an increased risk of a 30-day readmission. The purpose of this study was to determine the level of agreement (concordance) between depression diagnosis as identified by inpatient and outpatient records and examine the relationship between depression diagnostic concordance and 30-day readmission.

Methods

Using universal administrative claims data from South Carolina, we examined inpatient and outpatient records. The analysis was restricted to Medicaid recipients aged 55 years and older with a primary admitting diagnosis …

Prevalence And Clinical Characteristics Of Teeth Extracted With A Diagnosis Of Cracked Tooth: A Retrospective Study, Riley B. Sturgill

Theses and Dissertations

The body of knowledge that exists regarding cracked teeth is limited. The purpose of this study was to determine the prevalence of cracks among extracted teeth. This retrospective longitudinal cohort study included patients of the Virginia Commonwealth University School of Dentistry that underwent extraction procedures over a 6 year period. The sample consisted of 20,408 patients and 40,870 teeth. Statistical analysis software was used to identify diagnoses of a crack, fracture, or split tooth prior to extraction of the tooth by analyzing the Electronic Health Record (EHR) (axiUm™, Version 6.03.03.1035, Exan Corporation, Vancouver, BC, Canada). There were 3,228 teeth …

The Impact Of Objective Quality Ratings On Patient Selection Of Community Pharmacies: A Discrete Choice Experiment And Latent Class Analysis, Julie A. Patterson

Theses and Dissertations

Background: Pharmacy-related performance measures have gained significant attention in the transition to value-based healthcare. Pharmacy-level quality measures, including those developed by the Pharmacy Quality Alliance, are not yet publicly accessible. However, the publication of report cards for individual pharmacies has been discussed as a way to help direct patients towards high-quality pharmacies. This study aimed to measure the relative strength of patient preferences for community pharmacy attributes, including pharmacy quality. Additionally, this study aimed to identify and describe community pharmacy market segments based on patient preferences for pharmacy attributes.

Methods: This study elicited patient preferences for community pharmacy attributes …

Smoking Behavior In Arab Americans: Acculturation And Health Beliefs, Roula Ghadban

Theses and Dissertations

Background: Arab Americans, a growing population in the U.S., tend to have high rates of smoking and low rates of smoking cessation. Arab Americans and their families are at a high risk for poor health outcomes related to smoking.

Objective: The purpose of this study is to better understand the smoking behaviors of Arabs in the U.S., using the two publishable manuscripts format. The first manuscript is a systematic review of the literature exploring the smoking behavior, prevalence and use among Arab Americans and examining studies addressing the effect of acculturation on this behavior. The second manuscript is a cross-sectional …

Identification Of Expression And Function Of The Glucagon-Like Peptide-1 Receptor In Gastrointestinal Smooth Muscle, Alexander T. May

Theses and Dissertations

In response to ingestion of nutrients, enteroendocrine L cells secrete the incretin hormone, glucagon-like peptide-1 (GLP-1), to enhance glucose-dependent insulin release. Therapies related to GLP-1 are approved for type 2 diabetes. The GLP-1 receptor (GLP-1R) is expressed in cells of the gastrointestinal tract and elsewhere. In pancreatic beta cells, GLP-1R are coupled to the Gs/cAMP/PKA pathway. The expression and function of GLP-1R in gastrointestinal smooth muscle are not known. Aim. To test the hypothesis that GLP-1 regulates smooth muscle function by acting on GLP-1R expressed on smooth muscle. Methods. Smooth muscle cells (SMC) were isolated and cultured. Expression of GLP-1R …

Signaling Components Involved In The Hormone Induced Translocation Of Enac In Cultured Adult Human Fungiform (Hbo) Taste Cells, Deanna Hojati

Theses and Dissertations

The amiloride-sensitive epithelial Na⁺ channel, ENaC, is the Na⁺-specific salt taste receptor in rodents. Compared to rodents, human salt taste perception is amiloride-insensitive. In rodents the ENaC is composed of aβg-subunits. Whereas humans express an additional subunit, the d-ENaC subunit. ENaC in human taste cells is composed of aβg-subunits or dβg-subunits, with the latter being amiloride-insensitive. Currently, it is not known if dβg-ENaC expression and trafficking is regulated by hormones and their downstream intracellular signaling effectors. The aim of this study is to investigate if arginine vasopressin (AVP), aldosterone, and cAMP regulate d-ENaC expression and trafficking in …

Determinants Of Hospital Administrators' Choice Of Anesthesia Practice Model, Maribeth L. Massie

Theses and Dissertations

Hospital administrators are being held accountable by patients, insurers, and other stakeholders in evaluating their overall hospital performance to reduce costs and improve efficiency. With the move to alternative payment models and value-based purchasing, hospital administrators must understand the economic viability and value that their specialty services bring to their facility.

The purpose of this study was to identify the determinants New England acute care hospital administrators’ utilize in making the choice of anesthesia practice model for their facility.

A quantitative, exploratory study of factors hospital administrators use when choosing an anesthesia practice model utilizing a non-experimental, correlational research design …

Analyzing The Phenotypic Effect Of Three Candidate Genes Associated With Nonsyndromic Craniosynostosis Using A Zebrafish Model, Megan A. Hept

Theses and Dissertations

In normal cranial suture development, the cranial sutures close at predetermined periods of development to allow the brain the capability to grow in a malleable environment. However, in craniosynostosis, cranial sutures prematurely fuse before birth which can lead to a wide range of developmental issues and complications. Craniosynostosis can be categorized as nonsyndromic which involves the sole fusion of one or more of the cranial sutures, or syndromic in which cranial sutures fuse as well as other abnormalities associated with a genetic disorder. Past research has identified three candidate genes that could be possible disease causing mutations in nonsyndromic sagittal …

Eye Movement Control: An Index For Athleticism, Brittany L. Oshea

Theses and Dissertations

Athletic potential is one of the most complex human traits. An elite athlete is produced from a complex interaction of an innumerable number of traits exhibited by the athlete. However, it’s not clear whether these traits are innate, allowing the athlete to excel, or, alternatively, are a consequence of practice. To be successful, athletes rely heavily on sensory information from the visual and vestibular systems. This study investigated the relationship eye movement control has with innate athleticism by comparing the saccadic and Vestibulo-Ocular Reflex (VOR) responses of former, no longer practicing, elite athletes against their age and gender matched counterparts …

Altered Axon Initial Segment Structure And Function In Inflammatory Disease, Kareem C. Clark

Theses and Dissertations

Axonal pathology is a key contributor to long-term disability in multiple sclerosis (MS), an inflammatory demyelinating disease of the central nervous system (CNS), but the mechanisms that underlie axonal insults remain unclear. While most axonal pathologies characterized in MS are a direct consequence of myelin loss, we propose that axonal pathologies also occur independent of demyelination. In support of this idea, we recently reported that mice that develop experimental autoimmune encephalomyelitis (EAE), a model commonly used to mimic the pathogenesis of MS, exhibit a structural and functional disruption of the axon initial segment (AIS), a subdomain of the axon that …

Impact Of Chemotherapy On Nicotine Dependence, Yasmin Alkhlaif

Theses and Dissertations

Although cigarette smoke has been implicated in a causal relationship with various types of cancers, around 62% of all cancer patients are current smokers, recent quitters, or former smokers. While most patients who are smokers are motivated to quit after cancer diagnosis, 25 -30% of these patients continue to smoke. Furthermore, most quitters relapse after 2-3 years of post-chemotherapy. This represents a major health concern since several clinical studies revealed that perpetuation of smoking in cancer populations attenuates patient's well-being and quality of life. Smoking may impair healing, attenuate the efficacy of chemotherapy, increase the disease complications and diminish survival …

Structure-Activity Relationship Studies Of Bupropion And Related 3-Substituted Methcathinone Analogues At Monoamine Transporters, Abdelrahman R. Shalabi

Theses and Dissertations

The khat plant, catha edulis, has been abused for some time in the Middle East and the African horn for its short-term stimulant effects. However, it was not until 1975 when cathinone, β-ketoamphetamine, was identified as the major stimulant component of khat. Structural analogues of cathinone, synthetic cathinones, are new psychoactive substances available on the clandestine market of numerous countries including the USA. Abuse of these new illicit stimulants is a worldwide growing health concern which necessitates the investigation of the pharmacological properties of these new drugs of abuse. The abuse liabilities of these compounds seem to be related …

Investigating The Relationship Between Emotional Intelligence And Cultural Intelligence To Attitudes Towards Team-Based Learning In Undergraduate Pre-Health Profession Students, Kevin A. Harris

Theses and Dissertations

Improving patient outcomes has long been the rationale supporting calls to reform health care delivery systems and health profession education programs (Greiner, 2002; Institutes of Medicine, 2001, 2004; O’Neil & Pew Health Professions Commission, 1998). In 2003, the Institute of Medicine shared its vision statement for health professions education, asserting that “[a]ll health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches and informatics” (Knebel & Greiner, 2003, p. 3).

Despite the importance placed on teamwork in health sciences education, little attention has been devoted to understanding underlying factors …

Evaluation Of Volumetric Change Of Periapical Lesions After Apicoectomy As A Measure Of Postsurgical Healing Utilizing Cone Beam Computed Tomography, Eshwar Arasu

Theses and Dissertations

The aim of this study was to evaluate whether volumetric changes in persistent periapical lesions can be detected in follow-ups six months to five years after apicoectomy using cone-beam computed tomography. Patients with a previous treatment history of apicoectomy and for whom a pre-surgical CBCT scan was taken between November 2010 and December 2015 were invited to participate in the study. A post-surgical CBCT image of the treated tooth was obtained at the recall visit. Volumetric and linear measurements of periapical lesions on initial and postoperative CBCT images were performed using DiThreshGUI software and two calibrated examiners—a board-certified endodontist and …

Orthodontists' And Parents' Perspective Of Occlusion In Varying Anterior-Posterior Positions: A Comparative Study, David H. Lindsey

Theses and Dissertations

Objective: The purpose was to compare orthodontists’ and parents’ perception of orthodontic treatment outcomes in the anterior-posterior (AP) dimension. Assessment of treatment time and compliance were also investigated.

Material and Methods: Parallel surveys for orthodontists (n=1000) and parents (n=750) displayed occlusions from 3 mm Class III (Cl III:3) to 3 mm Class II. Participants rated occlusal relationships on a 100 mm VAS from least to most acceptable (0-100).

Results: 233 orthodontists (23%) and 243 parents (32%) responded. Orthodontists (mean=93.9, 25.9) and parents (mean=80.7, 40.9) rated Class I (Cl I) occlusion most and Cl III:3 least acceptable. No significant difference was …

Thyroid Hormone As A Method Of Reducing Damage To Donor Hearts After Circulatory Arrest, William P. Adams

Theses and Dissertations

There is a chronic lack of donor hearts to meet the need for heart transplant both in the US and worldwide. Further, the use of available hearts is limited by the short period between collection and implantation during which the heart can be safely preserved ex vivo. Using mid-thermic Langendorff machine perfusion, we have been able to preserve the metabolic function of a healthy heart for up to 8 hours, twice the limit for current static cold storage. We have also been able to preserve the metabolic function of a damaged DCD Heart collected 30 minutes after cardiac arrest …

A Comparison Of Moderate Oral Sedation Drug Regimens For Pediatric Dental Treatment: A Pilot Study, Ojas A. Parikh

Theses and Dissertations

Purpose: Compare moderate oral sedation of pediatric patients using Hydroxyzine and Meperidine with either Diazepam or Midazolam in management of pediatric dental patients.

Methods: Randomized, double-blind, crossover pilot study of patients 3 to 7 years of age requiring two sedation visits. Frankl and Houpt behavior scores recorded at injection time, initiation of treatment and 100% oxygen at end of treatment. Postoperative phone call surveys conducted within eight hours and within 24 hours of discharge. Wilcoxon Signed-Rank tests, Fisher’s Exact Chi-squared test and 0.10 significance level.

Results: 25 subjects completed 35 sedations. Eight participants completed both treatments and demonstrated significantly higher …

Evaluation Of The Regional Drug Deposition Of Nasal Delivery Devices Using In Vitro Realistic Nasal Models, Mandana Azimi

Theses and Dissertations

The overall objectives of this research project were i) to develop and evaluate methods of characterizing nasal spray products using realistic nasal airway models as more clinically relevant in vitro tools and ii) to develop and evaluate a novel high-efficiency antibiotic nanoparticle dry powder formulation and delivery device. Two physically realistic nasal airway models were used to assess the effects of patient-use experimental conditions, nasal airway geometry and formulation / device properties on the delivery efficiency of nasal spray products. There was a large variability in drug delivery to the middle passages ranging from 17 – 57 % and 47 …

Orientia Tsutsugamushi Secretes Two Ankyrin Repeat-Containing Effectors Via A Type 1 Secretion System To Inhibit Host Nf-Κb Function, Sean M. Evans

Theses and Dissertations

Scrub typhus is a potentially fatal infection that threatens one billion persons in the Asia-Pacific region and is caused by the obligate intracellular bacterium, Orientia tsutsugamushi. How this organism facilitates its intracellular survival and pathogenesis is poorly understood. Intracellular bacterial pathogens utilize the Type 1 (T1SS) or Type 4 secretion system (T4SS) to translocate ankyrin repeat-containing proteins (Anks) into the host cell to modulate host cell processes. The O. tsutsugamushi genome encodes one of the largest known bacterial Ank libraries as well as Type 1 and Type 4 secretion systems (T1SS and T4SS), which are expressed during infection. In …

Nitrosative Stress Sensing In Porphyromonas Gingivalis: Structure And Function Of The Heme Binding Transcriptional Regulator Hcpr, Benjamin R. Belvin

Theses and Dissertations

Porphyromonas gingivalis, a Gram negative anaerobe implicated in the progression of periodontal disease, is capable of surviving and causing infection despite high levels of reactive nitrogen species found in the oral cavity due to its efficient nitrosative stress response. HcpR is an important sensor-regulator that plays a vital step in the initiation of the nitrosative stress response in many Gram negative anaerobic bacteria. We employ a combination of X-ray crystallography, SAXS, resonance Raman spectroscopy, UV-Vis spectroscopy, and molecular biology techniques to better understand this key regulator. Knockout of the hcpR gene in W83 P. gingivalis results in the inability of …

Evaluation, Treatment, And Education In The Hospice Setting By Initiating A Formalized Pain Card, Alyssa M. Soprano

Theses and Dissertations

The purpose of this DNP quality improvement project was to evaluate the use of a formalized pain card that Nurse Practitioners could use to assist clients and caregivers in making the decisions necessary for safe and effective pain management with improving outcomes by using the Brief Pain Inventory Form for measuring: 1) decreased pain, 2) increased pain, 3) pain relief. The appraised evidence suggested that there was a need for a policy standard for patients to notify when pain is unrelieved despite exhausting all other efforts to control pain (Glowacki, 2015). Forty-one (n=41) hospice patients were surveyed pre and post …

Pediatric Genetic Counselor Perspective On Serving The Foster Care Population And The Integration Of Genetic Information Within The Health Passport, Angela Rose Douglas

Theses and Dissertations

Many states within the foster care system have adopted a document referred to as the health passport, which provides a condensed summary of a child's health history. This passport is intended to remain with the child as he/she moves between placements to improve communication between foster parents, caseworkers, and medical professionals. This exploratory research study examines the foster care system's utility of a child's health passport and opportunities for improvement through an online survey of the pediatric genetic counselor population. First, counselor perspectives on serving foster children were gathered and summarized into themes. Major elements and/or obstacles of counseling the …

Exploring Spatial Patterning And The Impact Of Obesogenic Built Environments For Youth Obesity, S. Morgan Hughey

Theses and Dissertations

Youth obesity is a major public health concern due to an array of physical, social, and psychological health consequences. Residential location, often referred to as ‘place’, has continued to emerge as a key health determinant with studies showing that where a child lives impacts their health. Environments where it is easy for individuals to have low levels of physical activity – either by discouraging active behavior or promoting sedentary behavior – and easy for individuals to consume unhealthful foods – either by the limited availability of healthful foods or increased availability of unhealthy foods – have been coined ‘obesogenic’. Additional …