Medicine and Health Sciences Commons^™

Barriers To Immunity: Understanding Covid-19 Vaccine Uptake In Africa, Emilia Blechschmidt

Honors Theses

This thesis examines the factors influencing COVID-19 vaccine uptake across African countries, with a focus on structural, informational, and behavioral barriers to immunization. Drawing on cross-country data, the study analyzes how access to transportation, reliable information, and healthcare resources shape vaccination rates, alongside the effect of demographics and institutional factors in shaping individual perceptions of risk and vaccine safety.

The findings emphasize that the broader strength and preparedness of national health systems strongly influence vaccine uptake. Countries that demonstrated higher coverage of routine childhood immunizations, such as polio and hepatitis B, also tended to perform better in COVID-19 uptake efficiency …

Imagined Afterlives: Anti-Black Medical Violences In Contemporary Black Arts, Katie Schadler

Honors Theses

“Imagined Afterlives: Anti-Black Medical Violences in Contemporary Black Arts” is a multi-genre exploration that studies the following works: Venus (1996) by Suzan Lori Parks, Get Out (2017) by Jordan Peele, and Dawn (1987) by Octavia Butler. I respectively study an experimental play, a psychological horror film, and a speculative novel to understand how Black creatives are depicting and responding to anti-Black violences, particularly medical violences. This work brings together Black art spanning from the late 1980s to 2017 as well as historical events and figures from the eighteenth century all the way to a not-so-distant future. While these works defamiliarize …

Evaluating The Impact Of Glidant And Predicting Tablet Sticking Using Powder Rheology, And Tablet Compression Technologies, Bhavin Vishnubhai Parekh

Selected Full-Text Dissertations 2020-

Two-thirds of all pharmaceutical formulations are delivered orally, and more than half are in the form of a tablet. Tablets are the most popular in terms of both the marketed products and the volume of manufacturing. On the other hand, tablet sticking is an extremely expensive and time-consuming problem that must be addressed. Because of limited tabletpressing cycle runs and incomplete information, trying to predict the sticking propensity of a new formulation has been extremely difficult during early-development batches. A model of drugs, ketoprofen, Acetaminophen, and salicylamide, was used to predict the effect of glidants (Aerosil® 200, Talc, and Syloid® …

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

Theses and Dissertations--Educational, School, and Counseling Psychology

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …

Ultrasound-Derived Liver Composition And Metabolic Flexibility Under Exercise Stress, Rhodes Van Houten

All Master's Theses

Metabolic Associated Fatty Liver Disease (MAFLD) is characterized by abnormal liver fat accumulation in conjunction with metabolic syndromes. MAFLD affects 33% of individuals worldwide, though little is known about how increased liver fat impacts physiological responses to exercise. This study aimed to analyze the relationship between liver composition and metabolic flexibility during a graded exercise test.  Body composition was analyzed via dual-energy X-ray absorptiometry. Liver ultrasound was evaluated for echogenicity, where elevated mean gray volume (MGV) indicates abnormal liver tissue. Rates of fat (FATox) and carbohydrate (CHOox) oxidation (g/min), respiratory exchange ratio (RER), and blood lactate concentrations ([LA^-], …

Examining The Effects Of Virtual Nature Exposure And Video Immersion On State Hope With Nature Relatedness As A Covariate, Zachary Arneson

All Master's Theses

Previous work in the field of environmental psychology has shown that virtual nature exposure can produce many psychological benefits for the viewer. Within this literature, however, there has been no examination of the effects of virtual nature exposure on levels of state hope, a goal-directed positive psychological construct made up of two types of thought: agency and pathways. Additionally, there has been no direct examination of the effect of immersion level of the virtual nature exposure on psychological measures. To fill this gap in the literature, the current study examined the effects of virtual nature exposure and video immersion on …

Adolescent Girls’ Experiences Of Digital Dating Abuse Through Social Media: A Scoping Review, Kiara E. Rodriguez

Social Work Theses

Teen dating violence (TDV) is a prevalent adverse childhood experience with lasting psychological and behavioral consequences. As adolescents increasingly engage with social media, with 95% of teens aged 13-17 reporting using it, digital spaces have become a significant context in which dating abuse can occur. Digital dating abuse (DDA) refers to patterns of abusive behaviors that are directed toward a dating partner through digital technologies, including social media and mobile phones. Despite the growing role of social media in adolescent relationships, research on how adolescent girls experience DDA in these contexts remains limited. The central question for this scoping review …

Ai, Experimental-Based Discovery And Preclinical Ind-Enabling Studies Of Selective Bmx Kinase Inhibitors For Development Of Cancer Therapeutics, Rwan Wael Elsanhoury

Selected Full-Text Dissertations 2020-

The current work aims to design and provide a preliminary IND-enabling study of selective BMX inhibitors for cancer therapeutics development. BMX is an emerging target, more notably in oncological and immunological diseases. In this work, we have employed a predictive AI-based platform to design the selective inhibitors considering the novelty, IP prior protection, and drug-likeness properties. Furthermore, selected top candidates from the initial iteration of the design were synthesized and chemically characterized utilizing 1H NMR and LC-MS. Employing a panel of biochemical (enzymatic) and cancer cell lines, the selected molecules were tested against these assays. In addition, we used artificial …

Development Of A Semi-Mechanistic Pharmacokinetic-Pharmacodynamic Model For Beta-Lactam Antibiotic Combination Against Enterococcus Faecalis Based On Time-Kill Assays To Predict Drug Disposition And Guide Dosing Strategy In A Severe Renal Impairment Population, Ruhma Zia Khan

Selected Full-Text Dissertations 2020-

Bacterial resistance to antibiotics continues to be a global health problem, limiting antibacterial therapy against infective endocarditis caused by Enterococcus faecalis. To overcome increasing resistance, dual beta-lactam therapy has been advocated as an alternative regimen for treatment – the synergistic activity against E. faecalis demonstrated to be effective. Currently, ampicillin plus ceftriaxone is the standard of care, but the practical application of this therapy is limited by ampicillin’s poor stability in solution at room temperature. A synergistic combination of penicillin plus ceftriaxone shows promise due to penicillin’s superior stability at ambient temperature, but ceftriaxone’s potential to cause hepatoxicity further limits …

When Speech Speaks Louder Than Truth: Language Variation And Credibility In The Courtroom, Melanie E. Spinnie

Graduate Theses/Dissertations

This study aims to investigate how linguistic variation affects perceptions of credibility in courtroom settings. It focuses on how jurors, judges, and other individuals in the legal system may exhibit bias (consciously or unconsciously) based on how a defendant or witness speaks-- this could include speech disorders as well as differences in dialect, accent, and speech style. Through review of relevant literature, review of a relevant historical case, conducting a survey, and conducting a semi-structured interview, this study explores whether certain speech patterns or characteristics are disproportionately associated with negative judgments during legal proceedings, such as reduced credibility and trustworthiness. …

Early-Life Dietary Habits And Parental Support Among Female Collegiate Soccer Athletes, Christina Uribe, Kate Alvarez, Ryan Harding

Loma Linda University Research Reports

This study examined the relationship between early-life dietary habits, perceived parental support, and collegiate competition level among female soccer athletes. Current and former NCAA Division I, II, III, and junior college athletes completed an anonymous retrospective survey assessing dietary behaviors, meal patterns, parental nutrition support, and sport-related factors. Of the 112 surveys received, 81 complete responses were included in the analysis. Participants had a mean age of 23.0 ± 3.8 years. Higher levels of collegiate competition were associated with more supportive home nutrition environments during childhood and adolescence. Significant associations were identified for parental encouragement to eat full meals before …

Assessing The Scope Of Knowledge And Decision-Making Patterns Regarding Healthy Eating During Pregnancy In Pregnant Female Adults In Southern California, Raegan Soffel

Loma Linda University Research Reports

While recognizing the link between prenatal nutrition and maternal-fetal health, this investigator-initiated study seeks to identify pregnant women's understanding of prenatal nutrition guidelines and the influences on their dietary choices. Thirty-eight eligible women completed an online, anonymous surveying assessing the scope of knowledge and decision-making patterns of healthy eating during pregnancy. The average knowledge score among the participants was 6.05/14. There was no significant difference in the knowledge scores among pregnancy periods or among total number of pregnancies. Perceptions of nutrition guidance in prenatal care, factors influencing eating behaviors, and primary sources of nutrition information were explored. The findings may …

Comparing Perceived Ideal Protein Intake In Plant-Based Versus Meat-Based Diet Consumers, Gysel Avendano, Saya Iwanaga

Loma Linda University Research Reports

High-protein diets have gained significant popularity in both social media and public discussion and more recently, a significant rise in protein consumption has been observed. Existing research has reported differences in actual protein intake across dietary patterns, with animal-based diets generally associated with higher total protein intake compared to plant-based diets. This growing focus on protein raises important questions about perceived ideal protein intake and the factors that shape it.

The primary objective is to compare perceived ideal protein intake among Southern California adults consuming meat-based versus plant-based diets. Additionally, we explored the influence of protein-related knowledge, beliefs, values, information …

Exploring The Relationship Between Bmi Classification And Levels Of Food Noise, Edmarie Billosillo

Loma Linda University Research Reports

Rising rates of obesity in the United States necessitates an understanding of the multitude of factors that contribute to it. Recently, “food noise” has emerged as a topic of interest in this space. The current survey-based observational study aimed to understand the relationship between Body Mass Index (BMI) and levels of food noise. The results indicate a significant association between BMI and food noise levels and a connection between a history of disordered eating and food noise levels. Additionally scores on the Food Noise Questionnaire (FNQ) and the Food Cravings Questionnaire - Trait – reduced (FCQ-R-r) were found to be …

The Effects Of Vestibular Dysfunction On Cognition, Sai Puneeth Kothuru

Honors Theses

Virtual Reality (VR) systems are being used more in education, entertainment, and research, but can produce motion sickness that could temporarily disrupt cognitive functioning. This study examined whether exposure to a VR roller coaster experience leads to short-term changes in cognitive flexibility, attention, spatial orientation awareness, and anxiety compared to a control condition. Participants were randomly assigned to a VR condition or a computer-based 2D viewing condition with identical roller coaster visual content. Participants completed three testing blocks: baseline, after exposure, and after a 10-minute recovery period. Cognitive flexibility and attention were assessed using the Trail Making Test (TMT), and …

Microgravity-Induced Alterations In Left Atrial Hemodynamics And Thrombogenic Risk: Insights From Healthy And Atrial Fibrillation Models, Grace M. Hoeppner

Dissertations, Master's Theses and Master's Reports

Background: Microgravity exposure alters cardiovascular loading, yet its impact on left atrial flow dynamics and thrombotic risk remains poorly understood. This study investigates how spaceflight-relevant microgravity-induced changes in cardiac outflow affect left atrial hemodynamics in healthy individuals and patients with atrial fibrillation.

Methods: Patient-specific left atrial models were generated for three healthy individuals and three AF patients. Computational fluid dynamics (CFD) simulations were performed using each patient’s baseline mitral outflow waveform and two modified waveforms representing short- and long-duration post-flight cardiac loading changes derived from echocardiographic observations. Hemodynamic metrics included left atrial velocity, time averaged wall shear stress, oscillatory shear …

Belting In Musical Theatre: Vocal Pathologies, Injuries, And Pedagogical Implications, Kaylee Piatt

Theses and Dissertations--Music

Belting has become one of the most defining and contested vocal styles in contemporary musical theatre. Valued for its dramatic immediacy, speech-like intensity, and ability to cut through amplified orchestration, belting is frequently associated with heightened injury risk and pedagogical controversy. This thesis examines the relationship between belting, vocal pathology, and pedagogy through an interdisciplinary lens that integrates voice science, clinical literature, and professional performance practice. Rather than framing belting as an inherently harmful or stylistically aberrant technique, this study conceptualizes belting as a functional vocal coordination shaped by physiological mechanisms, cumulative vocal load, and occupational demands.

Drawing on existing …

Bariatric Surgery Impacts Immune Cell Metabolism And Function Dependent On Metabolic Status, Samantha N. Hart

University of Kentucky Doctoral Dissertations

Type 2 Diabetes (T2D), one of the top ten causes of death worldwide, is fueled by chronic inflammation. T2D is considered a metabolic disease, and there is a great push to target metabolic and associated inflammatory pathways to ameliorate the disease & its comorbidities i.e., obesity and cardiovascular disease. Thus far, clinical trials of anti-inflammatory drugs have had modest impacts on T2D and have not led to changes in clinical practice. This may in part be due to a gap in knowledge in the mechanism(s) driving obesity-associated chronic inflammation. I posit that metabolic abnormalities in immune cells in those with …

Engineering Plga Nanoparticle Size To Modulate Immune Responses After Spinal Cord Injury, Daniel J. Kolpek

University of Kentucky Doctoral Dissertations

Spinal cord injury is a severe and debilitating condition that often results in lifelong complications, including paralysis. Many of these chronic outcomes are driven by a sustained inflammatory response at the injury site, which limits tissue regeneration and functional recovery. As a result, therapeutic strategies that modulate this immune response have gained significant interest. Polymer based nanoparticle therapies have emerged as a promising approach due to their ability to interact with and influence immune cell behavior. Importantly, the physicochemical properties of nanoparticles can be precisely tuned to optimize these effects. Among these properties, size has been shown to influence key …

Exploring The Impact Of Group Art Therapy On Sense Of Belonging In Early Adolescents: A Mixed Methods Study, Carol Chu

Art Therapy | Master's Theses

During adolescence, peer relationships strongly influence development and emotional well-being. In addition, Adlerian theory emphasizes social interest and the importance of connectedness within the social environment. This mixed methods study explores the impact of a four-session group art therapy intervention in a middle school setting on young adolescents’ sense of belonging. Seven students in the seventh and eighth grade from a public middle school in Sacramento County participated in the study. Quantitative data were collected at two time points in the study, before and after the intervention, using the Sense of Belonging Scale (SBS). All seven participants demonstrated an increase …

Developing Curcumin Analogues For Treating Breast Cancer, Tulasi Laxmi Nutalapati

Theses, Dissertations and Capstones

Breast cancer is still one of the most common types of cancer and one of the most common causes of cancer-related deaths in women around the world. Despite significant advances in early detection and treatment strategies, drug resistance, systemic toxicity, and poor outcomes in aggressive subtypes continue to limit the overall effectiveness of cancer therapy. Natural compounds have become promising anticancer agents because they can target many different things and are not very toxic. Curcumin has shown promise as an anticancer drug, but it cannot be used in the clinic because it does not absorb well, breaks down quickly, and …

The Effects Of Childhood Maltreatment On Executive Functioning: The Difference Between Cumulative Trauma, Abuse Severity, And Neglect, Kelly Krehbiel

Master's Theses or Doctor of Nursing Practice

Childhood maltreatment is prevalent in the United States with around 558,899 children being victims of abuse in 2022 (U.S Department of Health & Human Services, 2024). Neglect is the most common form of abuse with around 74 percent of abused children being neglected; however, neglect tends to be the least researched form of abuse. Childhood maltreatment has long-term effects on a person’s mental, physical, and cognitive health. Previous research suggests that childhood maltreatment leads to severe deficits in executive functioning skills such as working memory and cognitive flexibility. Executive functioning skills are important for almost every aspect of life including …

Increasing Mental Health Literacy In An African Immigrant Community In The United States, Dominic T. Nchamukong

Master's Theses or Doctor of Nursing Practice

Abstract

Introduction: The aim of this quality-improvement project was to assess the impact of an educational intervention on mental health literacy, attitudes, stigma, and help-seeking behaviors among members of an African immigrant community in Maryland.

Framework: The Health Belief Model (HBM) guided implementation of the project. The intervention was delivered using HBM constructs to promote increased mental health literacy.

Methods: The study was conducted in four phases: pre-project preparation, recruitment, educational intervention, and post-intervention evaluation. The six-week program was delivered both online and in person. Participants completed pre- and post-surveys measuring knowledge, attitudes, stigma, and willingness to seek professional mental …

Protecting Your Largest Organ: A Journey In Skin Cancer Education, Prevention, And Early Detection, Krista Schneider

Master's Theses or Doctor of Nursing Practice

Rates of skin cancer diagnoses continue to increase globally, making skin cancer one of the most commonly diagnosed malignancies. Despite rising incidence, many individuals lack knowledge of risk factors, warning signs, and effective prevention strategies. This quality improvement project aimed to improve skin cancer awareness by providing targeted skin cancer education to young adults enrolled at a university in the Midwestern United States. Conducted from August 18 to December 1, 2025, this project followed the Plan-Do-Study-Act framework. Educational presentations were delivered to students enrolled in freshman seminar courses over a two-day period, accompanied by distribution of digital flyers and pamphlets. …

Bridging The Gap In Patient Attendance: A Dnp-Led Quality Improvement Project To Reduce No-Show Rate By Implementing Text Message Reminders, Charles D. Rogers

Master's Theses or Doctor of Nursing Practice

Missed medical appointments contribute to revenue loss, workflow inefficiencies, increased staff burden, and reduced patient access to care in primary care settings. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the impact of an automated text message (SMS) reminder system on no-show rates in a privately owned, medium-sized family practice in a rural setting, aiming to reduce the baseline no-show rate of 11.4% to 10% or less. Guided by the Model for Improvement and the Plan-Do-Study-Act (PDSA) framework, automated SMS reminders were sent 48 hours prior to scheduled appointments. Existing 24-hour phone call reminders were maintained. Formative assessments …

Acceleration Battery Predictive Model Utilizing Field-Based Testing, Peterson Bohannon

Master's Theses or Doctor of Nursing Practice

Sprint performance is a foundational determinant of success across multiple track and field events, yet many of the biomechanical and physiological factors underlying performance are typically assessed using laboratory-based tools that are not accessible to most coaches. The purpose of this study was to develop and evaluate a practical, field-based testing model capable of predicting 60 m sprint performance and identifying key performance determinants in sprint and jump athletes.

A cohort of 40 collegiate track and field athletes (ages 18–24) completed a comprehensive testing battery including 30 m acceleration, 30 m fly sprint, standing long jump, standing five-bound, vertical jump, …

Metabolomics Driven Discovery Of Bioactive Natural Products Leads From Marine And Terrestrial Sources For The Development Of Analgesics, Sahar Mofidi Tabatabaei

University of Kentucky Doctoral Dissertations

Natural products remain a rich source of structurally diverse bioactive compounds for drug discovery, particularly for pain therapeutics. However, the chemical complexity of natural product extracts presents significant challenges for the efficient identification and prioritization of bioactive metabolites. This dissertation integrates untargeted LC-MS/MS-based metabolomics, molecular networking, classical natural products chemistry, and neurobiological assays to accelerate the discovery of analgesic lead compounds targeting the emerging pain-associated receptor σ₂R/TMEM97.

An untargeted metabolomics workflow was developed to systematically profile complex biological extracts and guide bioactive compound isolation. High-resolution LC-MS/MS data were analyzed using molecular networking (GNPS/GNPS2) to visualize chemical space, dereplicate known metabolites, …

Hardin Health Link: A Community-Integrated Paramedicine (Cip) Program In Hardin County, Kentucky, Samantha Jones

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Rural and mixed rural–urban communities face persistent disparities in access to timely emergency medical services (EMS), contributing to preventable morbidity and mortality from time-sensitive conditions such as cardiovascular disease, stroke, and injury. Hardin County, Kentucky, reflects these challenges due to its geographically dispersed population, high burden of chronic disease, and variability in EMS response times. This capstone proposes Hardin Health Link, a Community-Integrated Paramedicine (CIP) program designed to expand the traditional role of EMS providers through in-home health assessments, chronic disease monitoring, post-discharge follow-up, medication reconciliation, and connection to clinical and social services.

Guided by an evidence-informed framework, the program …

Stronger Starts: Advancing Maternal And Infant Health In Breathitt County, Kentucky, Madisyn Smith

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal and infant health outcomes remain significantly poorer in rural Appalachian communities, where structural and socioeconomic barriers limit access to timely and comprehensive care. Kentucky reports elevated rates of preterm birth and infant mortality, with counties such as Breathitt County facing challenges including limited obstetric services, transportation barriers, and high poverty rates. These factors contribute to delayed prenatal care, fragmented services, and increased risk of adverse outcomes.

The Stronger Starts Initiative is an evidence-informed public health program designed to improve maternal and infant health outcomes through a coordinated, multi-level approach. The program integrates nurse-led home visiting, telehealth obstetric consultations, community-based …

Rapid Response To Recovery: Expand Integrated, Technology-Enabled Crisis Care, Madison Chandler

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Behavioral health challenges in rural communities continue to place significant strain on healthcare systems, particularly through repeated reliance on emergency departments for crisis care. Nelson County, Kentucky, reflects this pattern, with higher reported rates of poor mental health and limited access to behavioral health providers. This paper proposes the Beacon Behavioral Health Response Program, a community-based, multidisciplinary crisis intervention model designed to improve access to timely care and strengthen continuity of support. The program combines mobile crisis response—delivered by a licensed clinical social worker and a peer support specialist—with a technology-enabled component using the Luma AI-supported mental health platform. Together, …