Medicine and Health Sciences Commons^™

Implementation Processes And Impacts Of School Store Policies In South Korea, Seul Ki Choi

Theses and Dissertations

With the concern of unhealthy school food environments, the South Korean government enacted two school nutrition policies to reduce unhealthy foods in school stores. The first policy banned on soft drinks sales in school stores enacted in 2007. The second policy restricted energy-dense nutrient-poor (EDNP) food sales in school stores enacted in 2009. This study aims to examine the changes in adolescents’ food intake and foods sold in school stores due to the two policies and to understand the policy implementation processes.

The Korea National Health and Nutrition Examination Surveys were used to examine trends in adolescents’ energy intake from …

Mysleep101©: An Educational Mobile Medical Application For Sleep Health In Primary Care, Sonya Cook

Theses and Dissertations

Insufficient sleep has emerged over the past few decades as a public health concern. As little as 1 to 2 hours of sleep loss can produce extreme fatigue and physiological drives similar to thirst and/or hunger which increases the risk of motor vehicle accidents, work related mistakes and injuries. Sleep restriction whether voluntary or involuntary has produced a culture of chronic sleep deprivation that can be seen throughout the population. Chronic lack of quality sleep has been shown to adversely affect cardiovascular health, cognitive function, memory, immune responses and hormonal regulation among other homeostatic functions. Sleep disorders represent the cause …

Spatio-Temporal Analysis Of The Occupational Fatal Victimization Of Law Enforcement Officers In The Us, Xueyi Xing

Theses and Dissertations

The models with constant coefficients of the covariates across space and time are commonly used in spatio-temporal analyses. However, the associations between risk factors and the outcome could have locally differential temporal trends in many cases. In this study, a Bayesian latent cluster modeling strategy is employed to identify potential spatial clusters in which locally specific sets of temporally varying coefficients of covariates are allowed. A state-level panel data of police officers occupational fatal victimization for the years 1979-2010 is used. To accommodate overdisperson and excess zeros, a negative binomial model and zero-inflated Poisson/negative binomial models are also utilized. A …

Morphogenic Effects Of Dopamine In Cultured Rat Hippocampal Astrocytes, Ashley L. Galloway

Theses and Dissertations

Dopamine is critical for processing of reward and addictive behaviors brought about by drugs of abuse. Scientific investigation of drugs of abuse and their effects on CNS function has traditionally been directed at understanding the role of neurons. However, astrocytes, which constitute approximately half of all human brain cells, play a dynamic role in many essential nervous system functions, including neurotransmission, ion homeostasis, and immune defense. Dopamine effects on astrocytes have been historically understudied, yet research indicates that astrocytes express dopamine receptors and are sensitive to dopaminergic activity. Importantly, astrocytes, comprise a morphologically heterogeneous population of cells, and a distinction …

The Roots Of Perspective In The American Context: News Media Discourse And Stakeholder Perspectives About The Supplemental Nutrition Assistance Program, Nicholas Younginer

Theses and Dissertations

The Supplemental Nutrition Assistance Program serves 46 million people but is controversial. The media is positioned to influence political and public opinions about SNAP policy. This study identifies the SNAP media discourse and investigates perspectives of SNAP participants and frontline workers about the program.

I employed a mixed-methods design with two aims. Aim 1 gathered 295 articles across six news outlets, semi-inductively coding the articles for characters, assignment of responsibility, and framing of the article. I then ran chi-square tests for difference between employed frame and responsibility and employed frame and political ideology.

Aim 2 collected a sample of 20 …

Healthcare Utilization And Expenditure Patterns Among Older Adults With Functional And Medical Decline, Ashley Shields Robertson

Theses and Dissertations

Purpose. As the aged population of this country grows, the U.S. healthcare system will face increased pressure to provide long-term care services and supports to increasing numbers of elderly Medicare beneficiaries. Studies have indicated that unmet long-term care need can lead to increased, unnecessary utilization of the healthcare system, thus further taxing the Medicare system. Little is known about how type of long-term care, as well as how long-term care policies—specifically payment policies—affect health care utilization. The objective of this original dissertation research was to examine the effects of place of residence (community versus residential long-term care facility) and …

Nursing Attitudes Towards Suicidal Patients In The Emergency Department: Assessment Interview Training, Belinda Beaver

Theses and Dissertations

This project sought evidence for the effectiveness of pedagogy in professional nursing continuing education and its effect on emergency department nurse attitudes towards patients seeking crisis intervention for suicide. Approximately 12 million emergency department (ED) visits annually were for patients suffering with mental illness and/or suicidal ideation. Emergency department staffs were often not adequately prepared to manage these problems. The purpose of this project was to examine the impact of an educational initiative on nurses’ attitudes about patients expressing suicidal ideation in the emergency departments 2 rural southeastern towns.

The project question was; in two different rural community emergency departments …

High-Throughput Sequencing-Based Approaches For The Identification And Development Of Molecular Targets For Cancer Therapy, David Joel Oliver

Theses and Dissertations

Effective cancer treatment depends on the development of therapeutics that efficiently eliminate the disease without significant reduction to quality of life. Targeted therapeutics achieve these goals, but their long-term efficacy is limited by the ability of cancers to become resistant to these therapies over time. The identification of new therapeutic targets is crucial for the future of cancer treatment. In this work we present functional identification and characterization of novel targets for cancer therapy.

Loss-of-function screens are a well-founded approach for the functional identification of new therapeutic targets, and, in combination with high-throughput sequencing technology, can now be performed at …

Relationships Of Chronotype, Social Jetlag, Sleep, Physical Activity And Diet With Mood, Perceived Stress, Obesity, Blood Pressure And Prostate Cancer, Daria M. Mcmahon

Theses and Dissertations

Background: Chronotype, social jetlag, poor sleep, proinflammatory diet, and low physical activity have been associated with increased risk of chronic diseases: obesity, diabetes, cardiovascular disease, depression and cancer. Yet the relationships between these factors have not been extensively investigated in prospective studies.

Methods: Two studies were conducted. The first study followed 390 healthy men and women ages 21-35 for two years. Social jetlag [SJL] and sleep measures (total sleep time [TST], sleep onset latency [SOL], wake after sleep onset [WASO]), sleep efficiency [SE]), were derived from physical activity personal (armband) monitoring. The participants wore the armband for 4-10 …

The Effect Of Arsenic On Type 2 Diabetes And Inflammation, Kayla Penta

Theses and Dissertations

Arsenic, a ubiquitous environmental contaminant, has been shown to cause a number of health effects. At high concentrations the inorganic form is a well-known toxin, but at lower concentrations the effects range from various cancers, to cardiovascular disease and type 2 diabetes. At higher concentrations of arsenic (500- 1000μg/L) there have been epidemiological studies conducted demonstrating an increased risk in the development of type 2 diabetes with this exposure. At lower levels of arsenic exposure (<500 μg/L) the epidemiological results are inconclusive. Arsenic is also an immunotoxicant, meaning that it will cause changes in the immune response. The changes in the immune response will vary depending on a number of variables, including amount of arsenic exposure, forms of exposure and route of exposure. We wanted to determine if arsenic could modulate the immune system, and if this change could lead to an increase in susceptibility to type 2 diabetes development. We chose to examine this in C57BL/6 and db/+ mice – two non-susceptible strains. After 8 weeks (4 weeks old to 12 weeks old) of low dose inorganic arsenic exposure (50 μg/kg or 500 μg/kg) we evaluated changes in body composition, glucose tolerance and immune response. We saw that there were differences based on sex, genotype and treatment group present after the 8-week treatment period in body composition, while there were minimal changes in glucose tolerance. Finally, the immune response showed great variability depending on sex, genotype and treatment group. This project has demonstrated that while we are trying to compare differences in in vivo and epidemiological studies to find a link between arsenic and type 2 diabetes, there may be deeper levels of complications based on individual variability to arsenic exposure.

Sustainability Of Food And Nutrition Security Policies During Presidential Transitions: Integrating Socio-Political And Nutritional Sciences, Jessica Liana Escobar-Alegría

Theses and Dissertations

Presidential transitions are uncertain periods in which relationships among power, accountability, and electoral support of a democratic process do not hold. Transitions challenge collaboration towards implementing policies contributing to food and nutrition security (FNSP). Sustaining these policies during transitions is critical for reaching long-term goals. Knowledge gaps remain on how to perform strategic multisectoral work during transitions to maximize FNSP sustainability.

This study aimed to examine what determines FNSP sustainability during presidential transitions and responded to the questions: How do policy actors define sustainability? What are the mechanisms determining policy sustainability? What are the implications of terminal logic behavior (TLB) …

Contextualizing Multilayered Sexual Subjectivities Of Heterosexual Black Female Undergraduate Students At A Predominantly White Institution In The South, Amarachi Rossana Anakaraonye

Theses and Dissertations

This study uses an intersectional theoretical framework to examine Black college women’s sexual health by focusing on how they engage in sexual decision making within their social contexts. This qualitative study analyzed 20 individual in-depth interviews of Black female undergraduate students, ages 18-22, who attend a predominantly white institution (PWI) in the Southeastern United States. The themes that emerged from qualitative data analysis include Black female undergraduate students’ perceptions of the sexual culture of their campus and the protective strategies they employ to navigate the sexual culture in order to achieve and/or maintain physical, emotional, and social well-being. Key findings …

Stimuli Responsive Nanoparticle For Cancer Targeted Therapy, Huacheng He

Theses and Dissertations

Nanoparticle is the particle with a size in the range from several nanometers to hundreds of nanometers. It has been extensively used for cancer diagnosis and therapy. However, it is still a great challenge to fabricate nanoparticles with spatiotemporally controllable delivery of anticancer drugs to tumors and with high therapeutic efficacy. This thesis mainly focuses on the development of stimuli responsive nanoparticles for cancer targeted therapy. These nanoparticles either response to internal stimuli such as pH and redox potential or external stimuli like temperature and light could effectively target tumors and control the release of anticancer drugs there to improve …

The Association Between Physical Activity And Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria, A. Paige Anderson

Theses and Dissertations

The purpose of this study is to add more research and evidence to the mechanisms surrounding periodontal disease, periodontal microorganisms, and physical activity. The main objective of this study is to evaluate and explore the association between physical activity and serum IgG antibodies, which are grouped into four distinct clusters, formed from species specific 19 periodontal antibody titers. This cross sectional study divided physical activity into three categories: adequately physically active, inadequately physically active, and inactive based on MET scores. Certain models were adjusted for confounders including age, sex, race/ethnicity, income-to-poverty ratio, years of formal education, smoking, alcohol intake, BMI, …

Sleep Disorder Trends, Epigenetic Markers, And Genetic Variation Of Circadian Genes In Adenomatous Polyp Formation, Melannie Alexander

Theses and Dissertations

Introduction: Sleep disturbances and sleep quality have fluctuated over time in the United States (US). Virtually every physiological process follows a circadian pattern, and cellular processes (i.e., cell proliferation, DNA damage response, and apoptosis) are often disrupted by sleep disturbances and other factors, potentially giving rise to adverse health outcomes such as cancer. Additionally, both genetic variation and epigenetic patterns within clock genes, which may affect sleep quality, also may increase one’s risk for developing cancer. The role of sleep disturbances in the formation of adenomas, precursor lesions to colorectal cancer (CRC), has been explored previously; however, little is …

Enhancing Parent-Child Communication And Promoting Physical Activity And Healthy Eating Through Mobile Technology: A Randomized Trial, Danielle E. Schoffman

Theses and Dissertations

Background

Although rates of pediatric and adult obesity remain high in the U.S., finding scalable and engaging ways to disseminate obesity prevention and treatment for families has been challenging. The purpose of the Motivating Families with Interactive Technology (mFIT) study was to test the feasibility, acceptability, and effectiveness of two remotely-delivered family-based health promotion programs for improvements physical activity (PA), healthy eating, and parent-child communication and relationship quality.

Methods

Parent-child (child age 9-12 years) dyads enrolled in a 12-week mobile intervention to increase physical activity and healthy eating, which included weekly email newsletters and the use of pedometers. Dyads were …

Influence Of Built Environment On Physical Activity Outcomes Among African Americans In Community-Based Obesity Intervention Studies, Amanda Sue Thomas

Theses and Dissertations

More than sixty-five percent of people in the U.S. are considered overweight or obese. African-Americans in the U.S. have a higher risk of obesity than any other racial group. One way to reduce this statistic is physical activity. Recreational green spaces (parks) can serve as an avenue to complete the 150 min/wk of recommended physical activity for adults by the ACSM. Data from SISTAS and HEALS interventions, that recruited overweight/obese African-Americans from Columbia and Florence, SC, was used to assess the association of recreational green space (parks) around a residence and physical activity. Physical activity measures of RAPA questionnaire (self-report), …

Determining The Validity Of A Web-Based, Self-Rating Checklist Assessment Of Vocabulary Knowledge, Sheida Abdi

Theses and Dissertations

The purpose of this study is to examine the validity of a web-based, self-rating checklist of vocabulary knowledge. One hundred fifty-nine participants took two norm-referenced assessments in addition to one of three conditions of a developed self-rating checklist. Each condition employed a different combination of follow-up questions (synonym generation to verify participants’ self-ratings) and feedback for student responses (whether or not synonyms are correct). Condition 1 did not provide any follow-up questions or feedback, Condition 2 included follow-up questions and feedback, and Condition 3 presented follow-up questions but no feedback. Results show that participants moderately overestimated vocabulary knowledge. Moderate-to-high statistically …

Quality Over Quantity: Positive Interactions During Family Meals In Food-Insecure Households Compensate For The Negative Impacts Of Household Chaos On Child Emotional Well-Being, But Not Diet Quality, Tiara Nicόl Rosemond

Theses and Dissertations

Family meals are important family activities that have many positive nutritional and emotional benefits for children. Positive family meal experiences may provide opportunities for children to strengthen emotional bonds, leading to a sense of security and, fostering improved children’s self-regulation of healthier food intake and emotional well-being. Unfortunately, children in food insecure households experience higher amounts of chaos, lower diet quality, and worry about having enough to eat compared to children in food-secure households, all of which may affect both family meal frequency and interpersonal quality. Yet, the relationships between food insecurity, household chaos, and family meal frequency and interpersonal …

The Role Of Epidermal Stem/Progenitor-Like Cells In Hpv-Mediated Pre-Neoplastic Transformation, Yvon L. Woappi

Theses and Dissertations

The role of epidermal basal stem cells in dysplasia is a matter of great interest in the human papillomavirus (HPV)-driven cancers. To assess the relationship between “stemness” and HPV-mediated transformation, we made use of 3-D suspension culture and fluorescence activated cell sorting (FACS) to purify stem/progenitor-like cells from primary normal human keratinocyte (NHKc) cultures. We found that NHKc cells derived from multicellular keratinocyte spheroids were enriched for a basal subpopulation of epidermal stem-like cells, that could be maintained for prolonged time in culture and used to conduct transfection experiments with full-length HPV16 DNA. Thus, by using these stem cell enrichment …

The Influence Of Prenatal And Early Life Factors On Bmi Z Scores And The Risk Of Being Obese In Early Childhood, Junxiu Liu

Theses and Dissertations

Childhood obesity is a serious public health challenge. The underlying causes behind the rising levels of childhood obesity might be driven by prenatal and early life factors. Recently, several studies have examined the association between gestational weight gain (GWG) and the risk of obesity in the pediatric population. Findings on the association of both inadequate and excessive GWG with offspring obesity are inconsistent and vary by maternal prepregnancy body mass index (BMI) status. Inconsistent findings also exist for the association of GWG and BMIZ as a continuous outcome. Nevertheless, existing studies mainly focus on the BMIZ upper centiles using logistic …

Deciphering The Interacting Regions And Functions Of The Rad51d-Nono Protein Complex During Dna Damage Response, Latarsha Porcher

Theses and Dissertations

Genomic instability is one of the major components represented in the “Hallmarks of Cancer.” DNA interstrand crosslinks and double-stranded breaks are two of the most severe causes of genomic instability. Homologous recombination (HR) plays a major role in resolving both types of DNA lesions, requiring a homologous template and the RAD51 paralog complex of proteins. One member of this complex is the RAD51D ovarian cancer susceptibility gene product. To better elucidate RAD51D modifications and functions, several protein interaction screens were performed, and one of the novel proteins identified was NONO (a.k.a. p54nrb). Decreased expression of either RAD51D or NONO conferred …

Differences In Resting-State Functional Connectivity Of Chronic Migraine, With And Without Medication Overuse Headache, And The Effectiveness Of Sphenopalatine Ganglion Block As A Treatment For Repairing Dysfunctional Connectivity., Kaitlin Krebs

Theses and Dissertations

Chronic Migraine (CM) is a debilitating neurological condition that occurs when the migraine frequency progresses to a chronic state of more than 15 headache days per month. The overuse of analgesic medication (MOH) is one of the most prominent risk factor of this chronification and little is known about why it is a cause. The repetitive inhibition of the Sphenopalatine Ganglion is one promising treatment that is used to treat chronic migraine. The purpose of this study is to determine if a specific pattern of disruption is present for chronic migraine, both with and without medication overuse headache, and if …

The Informational And Emotional Support Needs Of Grandparents Of Children With Pompe Disease, Natasha Lousie Rudy

Theses and Dissertations

The complex roles and experiences of grandparents of children with various diagnoses have been described, but previous studies have not investigated the roles and experiences of grandparents of children with treatable, Mendelian conditions such as Pompe disease. The availability of treatment and heritable nature of Pompe introduce the possibility for unique grandparent roles, experiences and needs. This is a particularly timely investigation given the advent of newborn screening for Pompe. This study aimed to characterize grandparents’ roles and involvement, identify grandparents’ information and emotional support needs, and explore the psychosocial impact felt by grandparents of children with Pompe. An online …

A Phenomenological Study: Foster Care Youth Aging Out Of The System, Guy Thompson

Theses and Dissertations

The purpose of this applied dissertation was to explore the lived experiences of teens aging out of foster care, in an effort to better understand their needs. While the child welfare system is geared towards family preservation, reunification, and adoption, most young adults transitioning from the foster care system are not reunited with family members or are only reunited as a last resort. Unfortunately, every year, thousands are leaving the support of the foster care system, unprepared. Youth departing the child welfare system are not gradually transitioned into becoming self-sufficient. They do not have an effective support system available if …

Radioprotective Cerium Oxide Nanoparticles: Molecular Imaging Investigations Of Conps’ Pharmacokinetics, Efficacy, And Mechanisms Of Action, Philip R. Mcdonagh Iii

Theses and Dissertations

Cerium oxide nanoparticles (CONPs) are being investigated for several anti-oxidant applications in medicine. One of their most promising applications is as a radioprotective drug, an area of research in need due to the severe side effects from radiation therapy. In this work, the potential of CONPs as a radioprotective drug is examined using four criteria: favorable biodistribution/pharmacokinetics, low toxicity, ability to protect normal tissue from radiation damage, and lack of protection of tumor. The mechanisms of action of CONPs are also studied. Biodistribution was determined in radiolabeled CONPs with surface coatings including citrate, dextran T10-amine (DT10-NH₂), dextran T10-polyethylene …

“I Just Need To Get Myself Supervised:” Exploring Transformative Learning In The Development Of Professionalism Among Physicians In The First Year Of Graduate Medical Education, Elizabeth P. Marlowe

Theses and Dissertations

The study explored the learning experiences of first-year resident physicians during the first year of graduate medical education. The experiences of four intern physicians in the first year of residency training at an urban academic health system provided the site for the research. An exploratory case study research design was employed to examine the learning experiences of these new physicians. A qualitative approach was used to analyze data from interviews and ethnographic observations. The findings of this research study provide evidence surrounding how and what these physician trainees learned regarding professionalism during the first year of residency training.

The findings …

Irreversible Zinc Block Of The Swelling-Activated Chloride Current In Di Tnc1 Astrocytes, Noah Belkhayat

Theses and Dissertations

The swelling-activated chloride current, commonly referred to as ICl,swell, is an outwardly-rectifying anion current that plays an important role in cell volume regulation, among other capacities. Despite several decades of research, the molecular identity of the channel responsible for this chloride current remains controversial. Recent indications that key endogenous sulfhydryl groups are capable of modifying the current led us to assess the effects of several divalent cations, including zinc, on ICl,swell. Zinc is known to tightly associate with sulfhydryl groups such as in zinc finger proteins. We found that extracellular zinc irreversibly inhibited ICl,swell at a site downstream in the …

Probing Allosteric, Partial Inhibition Of Thrombin Using Novel Anticoagulants, Stephen S. Verespy Iii

Theses and Dissertations

Thrombin is the key protease that regulates hemostasis; the delicate balance between procoagulation and anticoagulation of blood. In clotting disorders, like deep vein thrombosis or pulmonary embolism, procoagulation is up-regulated, but propagation of clotting can be inhibited with drugs targeting the proteases involved, like thrombin. Such drugs however, have serious side effects (e.g., excessive bleeding) and some require monitoring during the course of treatment. The reason for these side effects is the mechanism by which the drugs’ act. The two major mechanisms are direct orthosteric and indirect allosteric inhibition, which will completely abolish the protease’s activity. Herein we sought an …

Provision Of Hospital-Based Palliative Care And The Impact On Organizational And Patient Outcomes, Marisa L. Roczen

Theses and Dissertations

Hospital-based palliative care services aim to streamline medical care for patients with chronic and potentially life-limiting illnesses by focusing on individual patient needs, efficient use of hospital resources, and providing guidance for patients, patients’ families and clinical providers toward making optimal decisions concerning a patient’s care. This study examined the nature of palliative care provision in U.S. hospitals and its impact on selected organizational and patient outcomes, including hospital costs, length of stay, in-hospital mortality, and transfer to hospice. Hospital costs and length of stay are viewed as important economic indicators. Specifically, lower hospital costs may increase a hospital’s profit …