Medicine and Health Sciences Commons^™

Exploring The Differences Between Adult Cancer Survivors And Their Caregivers' Social Support, Self-Efficacy For Physical Activity, Physical Activity Behavior, And Quality Of Life, Fedricker Diane Barber

Nursing Theses and Dissertations

Less than 20% of cancer survivors meet recommended physical activity (PA) guidelines. Research reporting positive impact of social support on PA in cancer survivors has not included their caregivers' PA. A review of the literature examining social support and PA in cancer survivors supported including caregivers in developing strategies to increase PA in cancer survivors. The purposes of this study were: (1) to explore the differences and relationships between adult cancer survivors' and caregivers' social support, self-efficacy for physical activity (SEPA), PA, and quality of life (QOL), and (2) understand cancer survivors and caregivers' perception of social support in PA …

Effect Of Telephone Counseling On Physical Activity Among Older Adult Cancer Survivors, Ellen C. Mullen

Nursing Theses and Dissertations

The elderly population, especially those with cancer coupled with low health literacy, is at high risk for poor health outcomes. Telephone counseling has been shown to be effective in improving health behaviors among other populations, but it has not been studied for older adult cancer survivors. The purpose of this mixed methods study was to examine the effectiveness of telephone counseling on physical activity among older adult cancer survivors (n=50). The relationship between health literacy level and perceived changes in physical activity was assessed. Based on existing literature and Orem's Theory of Self-care, the following hypotheses were tested: H1: Telephone …

The Lived Experience Of Fathers Whose Children Are Diagnosed With A Genetic Disorder, Mary T. Rivard

Nursing Theses and Dissertations

Parenting a child with a genetic disorder requires overcoming numerous obstacles. The purpose of this study was to understand the experience of fathers whose children have been diagnosed with a genetic disorder. By gaining insight into a father's reactions and needs, nurses will be better able to provide anticipatory guidance, emotional support, assistance with stressor identification, development of coping mechanisms, and problem solving strategies to assist him in coping with his child's condition.

Vulnerability And Adaptation For Traumatic Brain Injury Survivors, Amy Johnson

Nursing Theses and Dissertations

Many of the over 5 million survivors of traumatic brain injury (TBI) with related disabilities living in the community do not have support for their unmet needs. Adapting to life after TBI is difficult because of cognitive, emotional, and behavioral complications. Nurses and other healthcare professionals have the opportunity to promote positive outcomes for persons with TBI. However, to increase the depth and breadth of that support, nurses need a base of knowledge that includes an understanding of the TBI survivors' needs, vulnerabilities, and obstacles to adaptation. TBIs result in physical, psychological, developmental, and emotional losses. The needs that ensue …

Diffuse Traumatic Axonal Injury Within The Visual System: Implications For Visual Pathway Reorganization, Jiaqiong Wang

Theses and Dissertations

Traumatic brain injury is a major health problem with much of its morbidity associated with traumatic axonal injury (TAI). To date, significant insight has been gained into the initiating pathogenesis of TAI. However, the specific anterograde and retrograde sequelae of TAI are poorly understood because the diffuse nature of TAI complicates data analysis. To overcome this limitation, we subjected transgenic mice expressing yellow fluorescent protein (YFP) within the visual system to central fluid percussion injury, and consistently generated diffuse TAI within the optic nerve that could easily be followed in the organized YFP positive fibers. We demonstrated progressive axonal swelling, …

Using Systematic And Engaging Early Literacy Instruction And Digital Books To Teach At-Risk Kindergarteners To Read Target Words, Audra Marie Hales

Theses and Dissertations

The purpose of this study was to examine the effects of using Systematic and Engaging Early Literacy (SEEL) intervention activities that incorporate digital books to teach kindergarteners to read. The study used a single-subject-multiple-baseline-across-behaviors design to compare kindergarten students' reading of comparable CVC words before and after intervention. Four students at-risk for reading difficulties were chosen for the study based on their performance on assessments and their teachers' recommendations. Students were divided into two dyads and received intervention three times a week for 25 minutes for approximately six weeks, or 18 total sessions. Baseline assessment data was collected prior to …

The Psychosocial Effects Of Beryllium Sensitization And Chronic Beryllium Disease, Jeffrey Robert Miller

Doctoral Dissertations

The purpose of this study was to develop and validate a theoretical model that explains the psychosocial effects of beryllium sensitization (BeS) and chronic beryllium disease (CBD). Sequential, mixed research methods were used. The study population was current and former workers from Department of Energy laboratories and manufacturing facilities who have either BeS or CBD. A theoretical model based on uncertainty in illness and psychosocial adjustment to illness theories was developed. It was hypothesized that uncertainty had a negative effect on health quality of life unless mediated by the ability to make psychosocial adjustments to illness. Qualitative study results supported …

“I’Ve Accomplished Something Here” The Lived Experience Of Employed Breastfeeding Mothers: A Phenomenological Analysis, Jennifer Diane Stewart-Glenn

Doctoral Dissertations

Abstract

The purpose of this study was to describe the experience of employed breastfeeding mothers. Using a phenomenological approach based on the works of Merleau-Ponty, the researcher completed 13 interviews in which mothers with experience working full-time while breastfeeding were asked to describe their experiences. The interviews were transcribed verbatim and analyzed using a hermeneutical approach developed by Pollio and applied to nursing research by Thomas. Each interview was examined within the context of all the interviews to identify themes found throughout.

While participants’ experiences were grounded in the unsupportive world of the workplace, aspects of their experience became figural …

Verification Of The Accuracy Of Electronic Mandibular Movement Recording Devices: : An In Vitro Investigation, Joshua Heath Balch

Theses and Dissertations (ETD)

One goal of restorative dentistry is to truly capture maxillomandibular relationships that accurately reproduce mandibular border movements and that would prescribe the best occlusal interface. Registration of horizontal and sagittal movements of the patient allows maximum cusp height and fossae depth with proper placement of occlusal ridges and grooves. The goal is to develop an occlusion that is interference free and entails the concepts of organic occlusion. Methods to transfer patient information to a highly adjustable articulator include mechanical recorders, mechano-electronic recorders and optoelectronic recorders. The purpose of this study is to verify the accuracy of electronic mandibular movement recording …

How Do Psychiatric Healthcare Workers Prevent The Use Of Restraint And Seclusion?, Kelly A. Carlson

Doctoral Dissertations

The purpose of this grounded theory method study was to understand the complex, interactive, and interrelated processes that psychiatric healthcare workers engage in to prevent the use of restraint and seclusion. Without supporting evidence of therapeutic validity, restraint and seclusion are commonly used by psychiatric healthcare workers to control disruptive patients. The Substance Abuse and Mental Health Services Administration issued a call for the elimination of restraint and seclusion use in psychiatric care settings in 2003. Workplace violence, another major public health concern, is both a cause and effect of the restraint and seclusion use. Individuals continue to be needlessly …

Listening To The Voices Of Emerging Adults: The Experience Of Living With Phiv, Constance D. Hill

Theses and Dissertations

The purpose of this descriptive study was to explore the research question: "As an emerging adult what is your everyday experience of living with PHIV?" The purposive sample consisted of six emerging adults living with perinatally acquired HIV (PHIV), who are 18-29 years of age, speak English, and live in the greater Chicago area.

This was an exploratory study using a participatory action approach of photovoice. Photovoice methodology combines photography and participatory action to provide images and the participants' interpretations of their everyday health realities. Five themes which describe the everyday experience of living with PHIV emerged from the thematic …

Childhood Obesity And The Relationship To Well-Child Visits, Nancee Croatt Wozney

Theses and Dissertations

Trends during the past 20 years have revealed a dramatic increase in childhood obesity in the United States. At present, approximately nine million children over 6 years of age are considered obese (Institute of Medicine [IOM], 2011). According to (American Academy of Pediatrics [AAP], 2009) the protocol for obesity care for youth is to monitor the body mass index (BMI) routinely (at least annually) and offer appropriate counseling and guidance to children and their families. A report in the literature indicated that the number of children attending yearly well-child visits that include measurement of BMI is well below the AAP …

A Systematic Framework For Radio Frequency Identification (Rfid) Hazard Mitigation In The Blood Transfusion Supply Chain From Donation To Distribution, Natalie Simone Rahming

Theses and Dissertations

The RFID Consortium is developing what will be the first FDA-approved use of radio frequency identification (RFID) technology to identify, track, manage, and monitor blood throughout the entire blood transfusion supply chain. The iTraceTM is an innovative technological system designed to optimize the procedures currently employed when tracing blood from the donor to the recipient. With all novel technologies it is essential to consider not only the advantages, but also the potential harms that may come about from using the system. The deployment of the iTraceTM consists of two phases: 1) Phase One - application of the iTraceTM from the …

Pumilio Proteins Regulate Translation In Embryonic Stem Cells And Are Essential For Early Embryonic Development, Katherine Elizabeth Uyhazi

Yale Medicine Thesis Digital Library

Embryonic stem (ES) cells are defined by their dual abilities to self-renew and to differentiate into any cell type in the body. This vast potential is precisely controlled by spatial and temporal gene regulation at transcriptional, post-transcriptional, and epigenetic levels. Recent studies have revealed several transcription factors that are essential for stem cell self-renewal and pluripotency, but the role of translational control in ES cells is poorly understood. Translational control is a fundamental mechanism of gene regulation during early development, and likely explains the discrepancies between the transcriptome and proteome profiles of stem cells and their differentiated progeny. Pumilio proteins …

Moving Toward Leadership: A Case Study Of Latina Adolescents And Effective Communication, Isela Estrada

Creative Arts Therapies Theses

The problem addressed in this study is the need for Latina adolescents to develop effective communication and leadership skills that will support their success in U.S. culture and society. This thesis is a case study of two Mexican-American adolescents who participated in a twelve-session leadership program at a dance studio. The goal of the study was to test the effectiveness of Rena Kornblum’s (2002) Disarming the Playground curriculum as a social skills program to improve leadership, effective communication skills, and group cohesion. This study included video footage of the adolescents engaging in movement-based role-play scenarios, which was examined using qualitative …

Mindful Bodies: The Use Of Guided Meditation With Dance/Movement Therapy In Addiction Treatment, Melissa A. Sanchez

Creative Arts Therapies Theses

Body-based approaches, such as dance/movement therapy (DMT), in addiction treatment can be anxiety provoking for those seeking sobriety. Strengthening the relationship between therapist and client using compassionate methods, such as guided meditation, prior to DMT sessions has, in the experience of this researcher, helped establish a safe environment in which to experience DMT. Using guided meditation as a method of creating comfort within the body aided in achieving the goal of enhancing one’s awareness of emotions, thoughts and sensations through the use of body-based methods.

Increasing self-awareness of emotions and physical sensations is an important step on the road to …

Doing It Alone: Supporting A Single Mother Through Authentic Movement (An Artistic Inquiry), Lucrecia Platt

Creative Arts Therapies Theses

The purpose of this study was to take an in-depth look at the human experience of single motherhood and how authentic movement, a body based movement practice used in dance/movement therapy, can play a role in supporting one single mother cope and navigate through mental, emotional, and physical struggles. This study documented my experience, illuminating the relationship between single motherhood and authentic movement. Heuristic methodology was used to collect data and took the form of personal journals. This data documented my authentic movement experience.

The creative process method of artistic inquiry was then used to help further analyze my experience …

Development Of A Novel Technique For Predicting Tumor Response In Adaptive Radiation Therapy, Rebecca Marie Seibert

Doctoral Dissertations

This dissertation concentrates on the introduction of Predictive Adaptive Radiation Therapy (PART) as a potential method to improve cancer treatment. PART is a novel technique that utilizes volumetric image-guided radiation therapy treatment (IGRT) data to actively predict the tumor response to therapy and estimate clinical outcomes during the course of treatment. To implement PART, a patient database containing IGRT image data for 40 lesions obtained from patients who were imaged and treated with helical tomotherapy was constructed. The data was then modeled using locally weighted regression. This model predicts future tumor volumes and masses and the associated confidence intervals based …

Pepsin And Amylase In Oral And Tracheal Secretions Of Patients With Standard Versus Continuous Subglottic Suctioning Endotracheal Tubes, Katherine Allen

HIM 1990-2015

The aspiration of oral and gastric substances is a well-known risk for ventilator associated pneumonia (VAP) in the intubated, mechanically ventilated (MV), patient of the intensive care unit (ICU) population. The gastric biomarker pepsin and the oral biomarker salivary amylase have been identified as evidence of aspiration prior to the manifestation of acute pulmonary illness. In an effort to decrease the risk for aspiration, several evidence based nursing practices are in place. Actions include 30 degree head of the bed positioning, oral care, suctioning, and circuit change interval protocols, as well as the administration of medication with the objective of …

Non-Invasive Positive Pressure Ventilation (Nppv) Its Uses, Complications, & Implications Within Nursing Practice In Acute Care Settings, Alexis Marano

HIM 1990-2015

The use of noninvasive positive pressure ventilation (NPPV) in acute care settings has drastically increased within the past 20 years. Research has indicated that NPPV is equally as effective as traditional mechanical ventilation(MV) in treating acute exacerbations of chronic pulmonary obstructive disease (COPD) and cardiogenic pulmonary edema. Furthermore, the risk of complication from NPPV is much lower than MV, in terms of ventilator-associated pneumonia and sepsis. It is imperative for the nurse to understand the various indications, interfaces, and potential complications associated with NPPV use. In addition to treating acute exacerbations of COPD and cardiogenic pulmonary edema, NPPV has been …

Pepsin And Salivary Amylase Biomarkers Of Microaspiration In Oral And Tracheal Secretions Of Intubated Patients, Aurea Middleton

HIM 1990-2015

Introduction: The presence of an endotracheal tube (ETT) increases the risk for microaspiration of secretions around the ETT. Biomarkers of pepsin and salivary amylase may be used to identify microaspiration in intubated patients because of their naturally occurring presence in the stomach or oral cavity and non-occurrence in the respiratory tract. Microaspiration may be difficult to detect until pulmonary complications, such as lung injury or infection, occur. This study assessed the presence of pepsin and salivary amylase in oral and tracheal secretions of ventilated adults. Method(s): This is a secondary analysis of data collected from 11 critically ill, adult patients …

Protecting The Hand: .Quantifying Pressures Involved In Daily Living Activities With Tools, Kelly Cotter, Trisha Thompson, Amanda Ward

Hand and Upper Extremity

This study utilized individuals with no known hand joint pathologies and analyzed the pressure exerted on varying spoon handle diameters during a simulated self-feeding exercise. This was done in an effort to determine which spoon handle diameter required the least amount of pressme. Individuals with no known hand joint pathologies were selected in order to prevent any inaccuracy of results due to underlying co-morbidities. Methods: The Novel Pliance-X hand sensor was wrapped around 15 mm, 25 IDDl, and 40 mm spoon handles. The participants were asked to complete a self-feeding exercise. The self-feeding exercise was simulated by scooping quarters from …

Trim24-Regulated Estrogen Response Is Dependent On Specific Histone Modifications In Breast Cancer Cells, Teresa T. Yiu

Dissertations & Theses (Open Access)

In this dissertation, I discovered that function of TRIM24 as a co-activator

of ERα-mediated transcriptional activation is dependent on specific histone

modifications in tumorigenic human breast cancer-derived MCF7 cells. In the first

part, I proved that TRIM24-PHD finger domain, which recognizes unmethylated

histone H3 lysine K4 (H3K4me0), is critical for ERα-regulated transcription.

Therefore, when LSD1-mediated demethylation of H3K4 is inhibited, activation of

TRIM24-regulated ERα target genes is greatly impaired. Importantly, I

demonstrated that TRIM24 and LSD1 are cyclically recruited to estrogen

responsive elements (EREs) in a time-dependent manner upon estrogen

induction, and depletion of their expression exert corresponding time-dependent

effect …

Regulation Of The Heat Shock Response By Thiol-Reactive Compounds In The Yeast Saccharomyces Cerevisiae, Yanyu Wang

Dissertations & Theses (Open Access)

Cells govern their activities and modulate their interactions with the environment to achieve homeostasis. The heat shock response (HSR) is one of the most well studied fundamental cellular responses to environmental and physiological challenges, resulting in rapid synthesis of heat shock proteins (HSPs), which serve to protect cellular constituents from the deleterious effects of stress. In addition to its role in cytoprotection, the HSR also influences lifespan and is associated with a variety of human diseases including cancer, aging and neurodegenerative disorders. In most eukaryotes, the HSR is primarily mediated by the highly conserved transcription factor HSF1, which recognizes target …

The Contribution Of Poly(Adp-Ribose)Polymerase-1 Activity In The Nucleotide Excision Repair Pathway, Brenee S. King

Biomedical Sciences ETDs

Exposure to ultraviolet radiation (UVR) promotes the formation of UVR-induced, DNA helix distorting photolesions such as (6-4) pyrimidine-pyrimidone photoproducts (6-4 PPs) and cyclobutane pyrimidine dimers (CPDs). Effective repair of such lesions by the nucleotide excision repair (NER) pathway is required to prevent DNA mutations and chromosome aberrations. Poly(ADP-ribose)polymerase-1 (PARP-1) is a zinc-finger protein with well documented involvement in base excision repair (BER). PARP-1 is activated in response to DNA damage and catalyzes the formation of poly(ADP-ribose) subunits (PAR) that assist in the assembly of DNA repair complexes at sites of damage. In this dissertation, I present evidence for PARP-1 contributions …

Prenatal Alcohol Exposure Alters Histamine H3 Receptor Modulation Of Glutamate Release And Long-Term Potentiation In The Rat Dentate Gyrus, Rafael Varaschin

Biomedical Sciences ETDs

Children with Fetal Alcohol Spectrum Disorder exhibit long lasting behavioral impairments, such as learning disabilities, problems in executive functioning and memory deficits. Currently, there are no rationally designed, clinically available pharmacological tools to circumvent prenatal alcohol-induced cognitive deficits. Recently, using a rat model of voluntary drinking during pregnancy, Savage and collaborators (2010) showed that the inverse agonist of histamine H3 receptors reverses fetal ethanol-induced deficits in learning and memory, without further increasing cognition in control rats. These differential effects and the notion that H3 receptors reside in presynaptic nerve terminals to inhibit neurotransmitter release, led to the hypothesis that fetal …

Design, Calibration, And Evaluation Of Depth-Of-Interaction-Capable Pet Detector Modules, Chad J. Bircher

Dissertations & Theses (Open Access)

High-resolution, small-bore PET systems suffer from a tradeoff between system sensitivity, and image quality degradation. In these systems long crystals allow mispositioning of the line of response due to parallax error and this mispositioning causes resolution blurring, but long crystals are necessary for high system sensitivity. One means to allow long crystals without introducing parallax errors is to determine the depth of interaction (DOI) of the gamma ray interaction within the detector module. While DOI has been investigated previously, newly available solid state photomultipliers (SSPMs) well-suited to PET applications and allow new modules for investigation. Depth of interaction in full …

Differential Activity Of The Kras Oncogene By Method Of Activation: Implications For Signaling And Therapeutic Intervention, Nathan Ihle

Dissertations & Theses (Open Access)

Despite having been identified over thirty years ago and definitively established as having a critical role in driving tumor growth and predicting for resistance to therapy, the KRAS oncogene remains a target in cancer for which there is no effective treatment. KRas is activated b y mutations at a few sites, primarily amino acid substitutions at codon 12 which promote a constitutively active state. I have found that different amino acid substitutions at codon 12 can activate different KRas downstream signaling pathways, determine clonogenic growth potential and determine patient response to molecularly targeted therapies. Computer modeling of the KRas structure …

Living In Harmony: Health Perspectives Of Hispanics In Rural East Tennessee., Erin E. Bailey

Undergraduate Honors Theses

The purpose is to promote culturally competent care among healthcare providers by identifying and describing how Hispanics in East Tennessee view health and what they do to prevent illness. A focus group of six to ten Hispanics of mixed genders over age eighteen moderated by a native Spanish-speaking interpreter. Questions explored how Hispanics define health and sickness, health maintenance practices, and alternative medicines and practices. Results were interpreted from Spanish to English to be analyzed. The Circle in Which You Live was described by members as consisting of relationships, physical health, and peace of the mind and soul. In Shutting …

Supervision And Education As A Factor Of Self Efficacy In Novice Therapists, Natalie D. Dewitt

Graduate Theses

The hypothesis of this exploratory study is aimed at examining novice therapist’s self- efficacy towards counseling, observing self efficacy modifications during practicum, and creating implications for future therapists. There were 20 participants surveyed using the Counselor Self Efficacy Scale, as well as questions generated towards the education experience as well as the supervision experience. A Pearson’s correlation was conducted comparing the supervision and education experience, there was a negative correlation, resulting in the education experience decreasing as the supervision experience increased. A r-test was conducted and the difference in means was consistent with the Pearson correlation confirming higher supervision scores.