Medicine and Health Sciences Commons^™

Relationship Between The Experience Of Perceived And Physician Diagnosed Arthritis And The Presence Of Dsm-Iv Criteria-Based Major Depression (Mdd) Among Older, Ryan Neil Schmidt

Theses and Dissertations

BACKGROUND: The purpose of this study was to explore both positive screened MDD and the perception of being depressed (P) and the likelihood of either increasing if the patient suffered from arthritis (P/E), either perceived or evaluated by a physician. The study explored the univariate, bivariate, and multivariate relationships between MDD and depression (P) to better describe influencing characteristics and their prevalence, as related to MDD and depression (P).

METHODS: The study examined a cross section of patients 65 years and older (n=8,205) within the National Epidemiologic Survey on Alcohol Abuse and Alcoholism (NESARC) [2001-02] sponsored by the National Institute …

Linking Obesity To Colorectal Cancer: Recent Insights Into Plausible Biological Mechanisms, Catherine Guffey

Theses and Dissertations

Obesity has emerged as a leading environmental risk factor for the development of CRC. However, the mechanisms underlying this relationship have not yet been fully explained. Recent literature has focused on 1) inflammatory processes, 2) adipokines, and 3) estrogen. Obesity-enhanced inflammation is largely orchestrated by increases in adipose tissue macrophages leading to the secretion of TNF-alpha, MCP-1, and IL-6, all of which are linked to CRC. Adiponectin is decreased with obesity and has been reported to be negatively associated with CRC, while leptin, which is increased, is positively associated with the disease. Estrogen has been shown to influence CRC, although …

Narrative Discourse In Aphasia: Main Concept And Core Lexicon Analyses Of The Cinderella Story, Emily Patricia Dillow

Theses and Dissertations

Discourse is a highly individualized and complex speech act essential for effective communication in daily life. Individuals with language disorders demonstrate impaired narrative ability and a resultant decline in functional communication (Webster, Franklin, & Howard, 2007). Discourse analysis is often time-consuming and impractical for everyday clinical use. Most informative discourse measures require specialized training to perform and are time-consuming. A clinically practical measurement is lacking. Standardized core lexicon and main concept lists for discourse tasks could allow clinicians to efficiently assess discourse skills and predict activity and participation limitations. This study presents the development and application of a core lexicon …

The Relationship Between Electronic Health Record Implementation And Outcomes Of Care For Three Cardiovascular Procedures, Deshia Ann Leonhirth

Theses and Dissertations

Background. The U.S. healthcare movement to improve quality and patient outcomes has prompted investigations into tools that can assist in these aims. Electronic health records (EHRs) are one tool proposed by the Institute of Medicine (IOM). The objective of this original dissertation research was to examine the relationship between electronic health record functionalities and two outcomes of care as proxies for quality: risk-adjusted mortality for abdominal aortic aneurysm (AAA) repair, coronary artery bypass grafting (CABG), and percutaneous coronary intervention (PCI) and log estimated cost-per-discharge. Methods. This study used 2009-2010 hospital inpatient administrative discharge data from the Nationwide Inpatient Sample (NIS), …

Illness-Related Diabetes Social Support And Glycemic Control Among Middle Aged And Older Adults, Favel Leah Mondesir

Theses and Dissertations

Objective

The objective of this study is to investigate the association between illness-related diabetes social support (IRDSS) and glycemic control (GC) among a racially diverse sample of middle aged and older adults. In gender-stratified models we examine whether the relationship between IRDSS and GC is modified by race/ethnicity. Additionally, we explore the association between eight individual types of IRDSS and GC.

Methods

We used the Health and Retirement Study (HRS) 2002 and the 2003 Diabetes Survey. The final analytic sample consisted of 914 study respondents. Gender-stratified multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence …

Characterization Of The Role Of Fro6 In Metal Homeostasis In Arabidopsis Thaliana, Margo Ellen Maynes

Theses and Dissertations

Iron deficiency is the most common human nutritional disorder in the world today, affecting approximately 2 billon people worldwide, almost a third of the world's population. For most of the world's population, plant foods serve as the major source of dietary iron. One approach that may contribute towards the solution of iron deficiency is the development of crop plants that contain higher levels of bioavailable iron. This project focuses on FRO6, a ferric chelate reductase in Arabidopsis thaliana that is thought to reduce apoplastic iron for transport across the plasma membrane in leaf cells. We hypothesize therefore that FRO6 controls …

The Role Of Host-Tumor Interactions In Liver Metastasis Of Colorectal Cancer, Yu Zhang

Theses and Dissertations

Colon cancer is the third most frequent cancer and the second leading cause of cancer deaths in the United States. Liver metastasis is the major cause of death in colon cancer. Successful metastases depend on productive collaborations between tumor cells and host-derived cells in the tumor microenvironment, target organ environments, and cells in the hematopoietic compartment.

To identify the host-tumor interactions promoting liver metastasis and their molecular and cellular mediators, an orthotopic mouse model of liver metastasis of colon cancer was established that recapitulates all stages of tumor growth and metastasis. A highly metastatic mouse carcinoma cell line CT26-FL3 was …

Promoting Early Childhood Development Through Community Health Worker Interventions: Implementation And Measurement Issues In Rural Pakistan, Zaeem Haq

Theses and Dissertations

Appropriate nutrition and psychosocial stimulation during the first three years of life can have long-lasting effects on a child's health and development. However, not all children in the world receive adequate nutrition and psychosocial stimulation during this period. There has been enormous interest in developing the evidence on the most effective ways of implementing and assessing early childhood development (ECD) promotion interventions in resource poor settings. Despite the interest, the integration of ECD interventions into pre-existing public health programs, and assessment of these interventions in extended family, rural household environment have not been addressed.

The dissertation research presented here was …

The Effect Of Cancer Cachexia Severity And Eccentric Muscle Contractions On Selected Myofiber Metabolic Properties In Mouse Skeletal Muscle, Joshua Earl Mangum

Theses and Dissertations

Cancer cachexia is a complex syndrome that induces skeletal muscle wasting and dysregulation of skeletal muscle metabolism. Alterations in area of myofibers and myofiber metabolic properties can significantly impact the function of skeletal muscle. The purpose of this study was to examine the effect of cachexia severity and resistance exercise training on frequency and area of selected myofiber metabolic characteristics during cachexia-induced myofiber atrophy. Male ApcMin/+ (Min) mice were studied during the progression of cachexia (16-20 weeks of age) and stratified into groups based on the severity of cachexia. For the second study, male Min mice performed resistance exercise (RE) …

Impact Of Physical Activity In The Prevention Of Colorectal Cancer, Sarah Ashley Barnes

Theses and Dissertations

This review evaluates the current understanding of research on the impact of physical activity in the prevention of colorectal cancer. Current biological mechanisms implicated in physical activity and colorectal cancer risk reduction are blood glucose regulation, insulin sensitivity, leptin and adiponectin profiles, inflammation as well as secreted protein acidic and rich in cysteine (SPARC), an exercise induced myokine. Recent literature indicates that 30-60 minutes of moderate to vigorous activity a day is effective against colorectal cancer development, and there is convincing evidence of aerobic exercise as differently beneficial in recruiting mechanisms identified as preventative against colorectal cancer. This article provides …

Smokers' Neurological Responses To Imagery From Cigarette Package Warning Labels, Johann Fridrik Fridriksson

Theses and Dissertations

Tobacco use is the leading cause of preventable death in the United States. The Family Smoking Prevention and Tobacco Control Act was signed into law in 2009 and gave the U.S. Food and Drug Administration (FDA) the authority to implement pictorial health warning labels (HWLs) on cigarette packages. Multiple studies investigating self-reported affective, cognitive and behavioral impacts of HWLs suggest that the most effective warnings include imagery that depicts physical damage to the body due to smoking. However, self-report methods of assessment used in these studies may be biased. Far less is known about how HWLs directly modulate brain activity. …

Investigating Developmental Patterns Of Symptom And Impairment Change Among Youth With Adhd, Subthreshold Adhdand Youth Without Adhd, Lorie Love Geryk

Theses and Dissertations

Introduction. Despite a substantial prevalence of subthreshold Attention-Deficit/Hyperactivity Disorder (ADHD) and research indicating that many youth with this disorder have impaired functioning and negative outcomes, few studies have considered patterns of symptom and functioning change for youth with probable ADHD, subthreshold ADHD and youth without ADHD transitioning from childhood to adolescence. Additionally, we are not aware of any studies examining predictors of impairment severity among youth with subthreshold ADHD, and few studies have examined predictors of treatment utilization and patterns of symptom and functioning change based on medication status for youth with subthreshold ADHD compared to youth with ADHD. Methods. …

Understanding The Early Stages Of Development Of A Global Health Partnership, Wendy Raquel Gonzalez Navarrete

Theses and Dissertations

Maternal and child undernutrition contributes to more than one-third of child deaths. Global Health Partnerships (GHP) have emerged as a response to undernutrition and other pressing health problems. GHPs promote joint decision-making among donors, multilateral agencies, and country partners. Despite their positive impact on health problems, GHPs have generated unintended negative effects on country partners. This study aimed to understand the factors, strategies, and processes conducive to the establishment of an effective GHP in the context of a cooperative regional effort to reduce undernutrition and improve maternal and child health in eight countries in Latin America, Regional Health Initiative (RHI). …

Improving The Diagnostic Accuracy Of Failure-To-Rescue, Amelia Marie Joseph

Theses and Dissertations

The ability to successfully rescue patients from complications has been shown to be a good measure of quality care processes in hospitals. Failure-to-rescue (FTR) has been defined using secondary International Classification of Disease (ICD-9 CM) codes. Studies of FTR using these codes have demonstrated satisfactory accuracy when compared to clinical events documented in the medical record. However, a subset of the original codes for FTR, thought to be sensitive to nursing care, have failed to show the same level of accuracy. This study examined the possibility of using clinica lpredictors to identify failure-to-rescue.

Secondary analysis of a previous dataset was …

The Use Of Ultrasound As An Adjunct To X-Ray For The Localization And Removal Of Soft Tissue Foreign Bodies In An Urgent Care Setting, Stacy Lane Merritt

Theses and Dissertations

Embedded soft tissue foreign bodies are common complaints of patients presenting to rural urgent care centers. The removal of soft tissue foreign bodies present challenges for the healthcare provider when objects are radiolucent and cannot be identified on readily available diagnostic imaging modalities such as plain radiographs (X-rays). Ultrasound has been introduced in the literature as a useful adjunct to X-rays for the localization and removal of soft tissue foreign bodies. The purpose of this research utilization project was to report the use of bedside ultrasound by healthcare providers as an adjunct to X-ray for the localization and removal of …

A Qualitative Study Of An Urban Community Garden: Creating Healthier Neighborhood Environments, Lauren Workman

Theses and Dissertations

Neighborhoods influence population level health; the places where people live, work, and grow are an essential setting for health promotion interventions. In efforts to create healthier neighborhood environments, there is a movement to better understand neighborhood social characteristics. The neighborhood social environment potentially includes social relationships (including trust and cohesion), networks, norms, and the resources that may be generated from relationships. In addition, more work is needed to learn about how people may become engaged in neighborhood initiatives. Community gardens are a 1) potential strategy to promote health at community and individual levels 2) mechanism to involve community members in …

Fishing And Fish Consumption Patterns In The Gullah/Geechee Sea Island Population, Jamelle Heyward Ellis

Theses and Dissertations

The Gullah/Geechee (G/G) people are descendants of West African slaves who remained in seclusion on the Sea Islands of South Carolina, North Carolina, Georgia, and Florida until the end of the Civil War in 1865. In addition to retaining their unique cultural language, they also remain largely a fishing subsistence population. Decades of urban development have reduced the G/G population's access to traditional fishing locations and have increased exposures to environmental contaminants in some bodies of water that are frequently fished by the G/G. Approximately 98.4% of SC rivers and streams and 77.6% of lakes have been assessed for aquatic …

Emergency Department Triage Acuity Ratings: Embedding Esi Into The Electronic Medical Record, Candace Whitfield

Theses and Dissertations

A need for improvement in the triage process was identified in the ED of a southeastern healthcare facility. Lewin's Change Theory guided the implementation of an evidence-based quality improvement project (QIP) to improve the efficiency of the triage process using and embedded Emergency Severity Index (ESI) triage acuity-level assistant template in the electronic medical record (EMR). The target interventions were ED throughput times, the number of patients left without being seen (LWOT), and RN satisfaction.

Methods included the implementation of education interventions for all ED RNs that included a presentation, use of ESI algorithm badges for each nurse, and weekly …

The Effect Of Radiation On Myofiber Properties In Mouse Skeletal Muscle, Dennis K. Fix

Theses and Dissertations

Radiotherapy has been proven as an effective and necessary treatment for cancer. The dose given is dependent on cancer type and location. It has been previously established that skeletal muscle is the most radiation tolerant tissue in the body. With that being said there is a current gap in the literature that is missing the effect of radiation doses on the histological properties of skeletal muscle. The overall purpose of this study is to determine the effect that a single unfractionated dose of 16Gy radiation has on histological properties of myofibers when compared to 4 fractionated doses of 4Gy . …

Evaluation Of Mass Media Campaigns To Change Smokers' Knowledge, Attitudes, And Behaviors In China And Taiwan, Li-Ling Huang

Theses and Dissertations

Research in high income countries (HICs) suggest that anti-smoking television advertisements are most effective if they contain emotionally evocative graphic messages or personal testimonials that depict serious consequences from smoking. The ability to effectively translate these messaging strategies to low- and middle-income (LMICs) countries outside of Western cultures remains understudied. It is critical to determine which smoking cessation messages work best in LMICs because they increasingly bear the global burden of tobacco-related disease. To date there is limited evidence on the efficacy of tobacco control mass media campaigns and the relative effectiveness of different tobacco control messaging strategies in China …

Foot Assessment In The Dialysis Unit, Karen Robertson

Theses and Dissertations

ABSTRACT In 2010 the number of patients requiring renal replacement therapy in the United States increased by 1% to 593,086. This number was comprised of 593,086 in center hemodialysis patients, 179,361 functioning kidney transplants, and 29,773 peritoneal dialysis patients.

A principal difficulty in the end stage renal disease (ESRD) population is lower extremity amputation from vascular complications and nonhealing wounds. The incidence of nontraumatic lower extremity amputation among the end stage renal disease population in the United States is ten times higher when compared to the general public. Mortality rates for ESRD patients following amputation are elevated with less than …

Postnatal Depression In Mexico: Healthcare Provider Conceptualizations And Policies In The Public Health Sector, Jean Marie Sims Place

Theses and Dissertations

Background: The World Health Organization (WHO) and the United Nations Population Fund (UNFPA) highlight education and training for healthcare providers and the development of a policy framework as core strategies to address maternal mental health in low- and middle-income countries. This research critically examines these strategies with respect to postnatal depression in Mexico. The research 1) addresses how healthcare providers in Mexico conceptualize postnatal depression, and 2) assesses the policies that exist in Mexico regarding postnatal depression, which will inform the next steps for policy development. The research informs appropriate healthcare provider education and training, as well as the next …

Race, Ethnicity, And Differential Perceptions Of Sexual Victimization (Assault), Kaleea Regina Lewis

Theses and Dissertations

The purpose of this pilot study is to ascertain how a sample of female college students perceives a hypothetical victim of a fabricated sexual assault. Participant perceptions of the sexual assault were explored through three distinct parameters: (1) victim responsibility attributes, (2) levels of trauma suffered due to the experience, and (3) levels of social support. This study addressed the two following research questions: (1) how does the hypothetical sexual assault victim's race and ethnicity affect how the study parameters are assessed and (2) how do participants perceive a hypothetical sexual assault victim, when presented in different races and ethnicities, …

Prevention Of Skin Breakdown In The Pediatric Intensive Care Unit, Lydia H. Palmer

Theses and Dissertations

Skin breakdown occurs when one or more layers of the skin have been disrupted (McLane et al., 2004; National Pressure Ulcer Advisory Panel, 2007). While some literature uses the terms skin breakdown and pressure ulcer interchangeably, these are actually two distinct conditions and pressure ulcers are encompassed in the definition of skin breakdown (Kuller, 2001; Lund, 1999; Suddaby et al., 2006). The consequences of skin breakdown in the pediatric population can include increased cost of treatment, infection, increased morbidity and mortality as well as psychological consequences from resulting alopecia or scarring (Schindler, 2010; Willock & Maylor, 2004). Development of skin …

K+ Channels And Beta3 Adrenergic Receptors As New Pharmacological Targets For Overactive Bladder Treatment, Serge Amani Yao Afeli

Theses and Dissertations

Overactive bladder (OAB) is a pathophysiological condition which is characterized by the urinary bladder's failure to achieve proper storage of urine. OAB has a tremendous impact on the patient's quality of life by disturbing his sleep, work, and sexual activity. About 17% of Americans are affected with this disease and most patients experience symptoms of urgency, frequent urination, and abnormally elevated detrusor smooth muscle (DSM) contractility. Despite, numerous attempts to treat the disorder in the past with antimuscarinics and now with beta3 adrenergic receptors (beta3-AR agonists), OAB still remains a serious public health issue because the long term efficacy of …

Bioassay Guided Fractionation Of American Ginseng. A Hexane Fraction Of American Ginseng Suppresses Colitis And Associated Colon Cancer. Mechanism Of Action., Deepak Poudyal

Theses and Dissertations

Inflammatory Bowel Disease (IBD) [Ulcerative colitis (UC) and Crohn's Disease (CD)] is a group of chronic disorders of unknown etiology characterized by inflammation in the gastrointestinal tract associated with a high colon cancer risk. UC is characterized by periods of active disease ("flare-ups"), followed by periods when the disease is inactive ("remission"). The end result is an abnormal immune response with repeated episodes of colonic inflammation. Conventional treatment of UC by aminosalicylates, TNFα inhibitors, and steroids have modest effects, and come with a high risk of side effects including dyspeptic symptoms, gastric ulceration and sometimes hospitalization and deaths. Because of …

Insects As Indicators Of Environmental Stress, De Anna Estella Beasley

Theses and Dissertations

In the face of climate change-related events and anthropogenic disturbances, understanding the impacts of these events on species richness, abundance and distribution is important for us to mitigate biodiversity loss and better predict consequences for the environment and for human life. Insects are excellent models for understanding the consequences of environmental stress due to the sensitivity of their development and behavior. The overall focus of my dissertation research is the investigation of fluctuating asymmetry and oviposition behavior as indicators of environmental stress. My research includes a meta-analysis of published literature, and empirical research that was part of a collaborative initiative …

A Critical Review Of Endometriosis Pathology, Brittany Lauren Cureton

Theses and Dissertations

Endometriosis is a complex, multifactorial, reproductive disorder present in approximately 10-15% of adult women between the ages of 25-35. This disorder occurs when endometrial glands and stroma grow ectopically on the surface of the ovaries, pelvic peritoneum, fallopian tubes, and the uterus. Endometriosis causes varying degrees of painful symptoms and infertility in infected individuals. Three main theories of endometrial accumulation attempt to explain the etiology of this elusive disease. There have been various staging of endometriosis symptoms that attempt to standardize classification as well as predict pain and infertility. Angiogenesis, necessary to the survival of endometrial tissue, along with immune …

Best Practice Guideline For Managing Interstitial Cystitis In Adult Women, Amanda Thomas Langford

Theses and Dissertations

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic disease characterized by symptoms of urinary urgency, frequency, bladder pain, and chronic pelvic pain in the absence of known pathology. Selection of appropriate treatments depended on the severity of the patient's symptoms and patient's preference. This review found that it is important for providers and patients to set realistic goals for symptom improvement when starting a new treatment.

The purposes of this project was to 1) conduct a substantive literature review on treatment guidelines for IC/PBS, 2) analyze the literature for comparing oral pharmacological interventions and behavioral interventions for IC/PBS, and 3) …

Development Of Proteomic Characterization And Speciation Techniques Utilizing Tryptic Peptides With Maldi-Tof Ms And Lc-Esi Ms-Ms, Jennifer Marie Kooken

Theses and Dissertations

The characterization of microbes which can be opportunists and pathogens (e.g., methicillin resistant Staphylococcus aureus (MRSA)) is important in understanding and potentially treating diseases caused by various bacterial species. Common genera found in the human skin micro-biome include Micrococcus and Staphylococcus, but there only a limited number of tests to differentiate these genera and/or species. My research reflects methods development from distinguishing one closely related genera from another and then expanded to species identification. Tryptic peptides were analyzed by MALDI TOF MS and the mass profiles compared with those of a reference strain in both genus and species identification. Aconitate …