Medicine and Health Sciences Commons^™

Physical Health Care Use, Mental Health Care Use, And Resilience Among Formerly Incarcerated Adults In Southern California, Tamara Parker

Walden Dissertations and Doctoral Studies

Adults who have experienced incarceration face many challenges reentering society. The lack of physical and mental healthcare use has been shown to contribute to recidivism. This cross-sectional study using a multivariate linear regression examined the relationship between physical healthcare use, mental healthcare use, and resilience among formerly incarcerated adults in Southern California while controlling for age, gender and race. Physical healthcare use was defined as the frequency of appointments, having health insurance coverage, and having a usual place of care. Mental healthcare use was defined as needing and receiving mental health treatment. The study used the Resilience Theory to determine …

Nurse Educators’ Experiences With Medical Cannabis Education, Rachel Ann Parmelee

Walden Dissertations and Doctoral Studies

Medical cannabis is legal in more than half of the United States, and the National Council of State Boards of Nursing has provided guidelines indicating that nurses need to know about medical cannabis. However, most nurses report a lack of knowledge and education but believe that cannabis has therapeutic potential. The problem addressed in this study was the limited research on nurse educators’ experiences with medical cannabis education and its meaning for nursing education. The purpose of this hermeneutic phenomenological qualitative study, supported by an emergent framework, patterns of knowing, was to explore nurse educators’ experiences with medical cannabis education …

How Health Literacy Influences Rural West Virginians Knowledge Of Chronic Disease Prevention And Management, Summer Mitchell

Walden Dissertations and Doctoral Studies

Health literacy can be described as the understanding of own’s own health and understanding of health-related information (Shadid, 2022). In rural communities, health literacy is typically at a lower level than in urban communities. West Virginia is a mostly rural state and in addition to lower health literacy, chronic diseases are high in West Virginia. The target area for this study was rural Greenbrier County, West Virginia. The purpose of the study was to examine perceived barriers to health literacy in Greenbrier County, West Virginia, and how this affects understanding of chronic disease. Research questions focused on participants’ knowledge of …

Displaced: An Ethnography Of Language And Identity Loss, Ariel Caroline Wilsey-Gopp

Dissertations and Theses

Through ethnography and personal narrative, I explore the language and identity loss of one person, my father, in order to understand the complex issues surrounding the effects of symbolic and structural violence on language and identity development. Through personal narrative, fieldwork, and interviews, I tell the story of one person, born in wartime during Nazi occupied Serbia, and follow the guiding questions: how does language get lost and what are the effects? Drawing on methodology set forth by empirical ethnographical work as well as more recent theory around epigenetics and trauma, my research synthesizes into focus three pillars of understanding …

The Association Between Online Health Information Characteristics And Appropriate Trust In Informational Quality Among Patients With High Cardiovascular Risk, Lim Woei Xian

Student Works (2020-2029)

More patients are turning to the Internet to understand their health and make health decisions. However, the quality of online health information (OHI) is highly variable, and it may contain misinformation. Patients who lack the necessary skills to appraise OHI may trust poor-quality OHI. Thus, this study aims to examine the association between OHI characteristics and appropriate trust in patients with high cardiovascular (CV) risk. This is a secondary analysis from a quantitative cohort study of 270 patients from a primary care clinic in Kuala Lumpur, Malaysia. Patients recorded each OHI encountered over two months in a digital information diary …

Exploring Leadership In Physical Therapy: How Clarity, Connection, And Communication Influence Team Engagement, Burnout, And Achieving Organizational Objectives, Jason Collin

Dissertations

Purpose: The purpose of this mixed methods study was to identify and describe how highly effective PT leaders use the three competencies of HPTs (clarity, connection, and communication) to increase engagement, prevent burnout, and achieve organizational objectives. The second purpose of this study was to determine the degree of importance that highly effective PT leaders perceive the three HPTE core competencies impact their leadership for creating HPTs.

Methodology: The mixed methods study identified and described eight PT leaders’ perceptions of how they use clarity, connection, and communication to build and sustain HPTs. PT leaders were selected through purposive and snowball …

The Impact Of Continuous Glucose Monitor Education On Primary Care Providers Prescribing Behavior, Heather Tyson

Doctor of Nursing Practice Projects

Continuous glucose monitors (CGMs) estimate glucose levels in the interstitial fluid, updated every few minutes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, CGMs are used by patients with Type 1 diabetes. However, research demonstrates that patients with Type 2 diabetes can also benefit from their use. The primary function of CGMs is to enhance glucose management, provide emergency alerts, and reduce the need for frequent fingerstick evaluation, promoting better long-term health. CGM use has lowered hemoglobin A1C levels in the primary care setting. This is due to the correlation between frequent glucose monitoring and increased …

Evaluating The Efficacy Of Diabetes Nurse-Led Health Coaching Intervention For Type 2 Diabetes At Aga Khan University Hospital, Nairobi: A Randomised Controlled Study, Jane Mugo

MSc in Advanced Practice Nursing

Background: Type 2 Diabetes (T2DM) has placed a significant burden on both healthcare systems and individuals living with the disease. However, it is preventable through health promotion strategies. Healthy behavior changes, which improve disease outcomes, highlight the importance of supporting and sustaining self-efficacy in diabetes self-management.

Objective: This study aimed to test the effectiveness of a nurse-led health coaching program on diabetes control for individuals with T2DM with HbA1c >6.5% specifically on glycated haemoglobin (HbA1c) levels as compared with standard diabetes care only.

Methodology: The study adopted a randomized controlled trial (RCT) with two groups: an intervention group receiving the …

Knowledge, Attitude, And Practices Of Nurses Providing End-Of-Life Care At Aga Khan University Hospital, Nairobi County, Eunice Wanjiku Kariuki

MSc in Advanced Practice Nursing

Introduction: End-of-life care is an essential aspect of healthcare, and nurses play a vital role in its provision. Due to the growing population, there has been an increase in the number of people in need of End-of-life care, and nurses must be adequately prepared to meet the complex and diverse needs of patients and their families. However, many studies suggest that many nurses feel unprepared to provide quality end-of-life care, and there is a need for further investigation of the factors that contribute to their preparedness.

Methods:The study was conducted at a level 6 teaching and referral hospital, in …

Sex-Specific And Regional Analysis Of Heart Disease Prediction Using Machine Learning Algorithms: Insights From The Uc Irvine Public Heart Disease Datasets (Cleveland And Long Beach), Jonathan Asanjarani

Dissertations, Theses, and Capstone Projects

For this capstone project, I investigated how well machine learning models can predict heart disease, while also studying how the patient’s gender affects these predictions, as well as determining how well the same model performs across different regions. This project utilizes two clinical datasets from the publicly accessible UCI Machine Learning Repository under the collection "Heart Disease." This repository is composed of data from patients across four distinct locations, capturing varying levels of heart disease severity. These datasets are part of a collection of databases, open to the public, and can be used by anyone looking to conduct empirical analysis. …

Vertex-Based Analysis Of Cerebral Blood Flow And Fractional Amplitude Of Low-Frequency Fluctuations (Cbf-Falff) Coupling In Moderate-To-Severe Traumatic Brain Injury During The First Year Post-Injury, Vaidehi Hemkumar Patel

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) is known to involve damage in the neurovascular unit. TBI may disrupt the brain’s neurovascular coupling–the relationship between cerebral blood flow and neural activity–that can lead to cognitive and functional impairments. This study attempted to non-invasively investigate neurovascular coupling in patients with moderate to severe TBI (msTBI) during the first year post-injury using a combined metric of cerebral blood flow (CBF) and fractional amplitude of low-frequency fluctuations (fALFF), a proxy for spontaneous neural activity. Using arterial spin labeling (ASL) and functional MRI sequences, CBF and fALFF were measured in 29 msTBI patients 3-, 6- and 12-months …

Improving Outcomes Of Depression Through Implementation Of Depression Screenings At A College Health Center, Shelby Leigh Hanigan

Electronic Theses and Dissertations

Depression is a common phenomenon. Depression and suicidality are a problem on university campuses. This quality improvement Doctor of Nursing project aimed to establish the importance of routine depression screenings within a college health clinic. The purpose of this project was to determine if implementing routine depression screenings at a university health clinic will or will not increase the number of counseling referrals when compared to the absence of depression screenings in place within an identified timeframe. This protocol screened for depression in college-aged students and suggested care to those students who screened positive. It also led an interprofessional team …

Exploring Vestibular Rehabilitation Self-Efficacy In Entry-Level Physical Therapy, Colin Hulls

Graduate Theses, Dissertations, and Capstones

Vestibular rehabilitation, commonly performed by physical therapists, aims to improve the function and quality of life of individuals experiencing dizziness, vertigo, or disequilibrium. Vestibular curricular variation across physical therapy programs may lead to discrepancies in the self-efficacy of entry-level physical therapists to manage this population. The purpose of this study was to examine self-efficacy in vestibular rehabilitation in entry-level physical therapy and identify facilitators and barriers to its development. An online, cross-sectional survey design was utilized for quantitative and qualitative data collection, including a modified version of the Physiotherapist Self-Efficacy (PSE) Questionnaire, from new graduates and students preparing to graduate. …

The Role Of Social Support In Protecting Against Perinatal Depression Among Egyptian Women, Radwa Raafat Abdelshafi

Theses and Dissertations

Perinatal Depression (PND) is a global public health issue affecting many women as they transition to motherhood, and carrying detrimental consequences for both mothers and infants. Research in low and middle-income countries shows higher PND prevalence rates than in high-income and Western countries. In addition, social support has been shown to strongly protect or reduce the impact of PND. This study aimed to address a gap in research on PND in Egypt, and to build an understanding of the social support ecological system of new mothers. A survey was conducted with 81 first-time middle-class mothers living in Greater Cairo between …

Determinants Of Physicians' Brain Drain In Egypt, Mennatallah Elbeheiry

Theses and Dissertations

Egypt is enduring a significant shortage of physicians, despite the annual graduation of approximately 10,000 medical students from its 27 medical schools. In 2016, the physician density was alarmingly low, with only one doctor per 12,285 people. This shortage is exacerbated by a physicians’ brain drain, as Egypt is a leading exporter of physicians to countries like the United Kingdom and Australia. As of 2020, the Egyptian Medical Syndicate reported 212,835 registered physicians, yet 56 percent of them work abroad, and only about 62,000 are actively employed in public hospitals, serving a population of over 110 million. The government’s efforts …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Behavioral And Neuroactivational Correlates Of Psychosocial Stress-Induced Cocaine Seeking In The Rat, Nicole Hinds

Theses and Dissertations

Abstract Nicole Maria Hinds BEHAVIORAL AND NEUROACTIVATIONAL CORRELATES OF PSYCHOSOCIAL STRESS-INDUCED COCAINE SEEKING IN THE RAT 2024 Molecular Cell Biology & Neuroscience Doctor of Philosophy Cocaine Use Disorder is characterized by a high risk for relapse that can persist over extended periods of abstinence. Psychosocial stressors are well-established to promote drug craving and relapse in humans but have rarely been employed in preclinical relapse models. Consequently, the underlying neural circuitry by which these stressors drive cocaine seeking has not yet been thoroughly explored. This project aimed to identify brain regions recruited during psychosocial stress-induced cocaine seeking in rats, with a …

Exploring The Role Of Cyclin D1 In Regulating Thermogenic Program In Brown Adipose Tissue, Chengrui Qiu

Biomedical Sciences ETDs

Abstract Adipose tissue plays a multifaceted role in regulating metabolic health and contributing to the pathophysiology of various diseases. Brown Adipose Tissue (BAT), a vital organ that senses different environmental cues such as cold stress and diet and then undergoes non-shivering thermogenesis in mammalian animals, enhancing energy expenditure to combat obesity. In our recent published study, we found that the mechanistic target of rapamycin complex 1 (mTORC1) signaling pathway exhibits doubleedge effects in regulating thermogenic function, with opposite role in BAT and white adipose tissue (WAT). To further investigate the molecular mechanisms underlying the dual role of mTORC1 in thermogenic …

The Influence Of Single-Leg Isometrics On Ground Interactions During A Baseball Swing, Thomas Johnson

Doctorate in Kinesiology

Sports science plays a vital role in modern athletics, with metrics like GRF serving as key performance indicators, particularly in baseball. This study investigated the effects of a single-leg fast-ramping isometric exercise targeting hamstring activation on vGRF at the lead leg during a baseball swing. Ten male participants (mean age 15.7 years, SD = 1.42) participated in a randomized within-subject experimental design. GRF was measured at toe touch, heel plant, and contact using a pressure plate (Sensors Edge) and synchronized video. The intervention involved a 90/90 hip lift to stabilize the lumbopelvic complex, aiming to enhance GRF. Pre- and post-intervention …

The Experience Of Transition To Self-Management For Saudi Adolescents With Type I Diabetes, Aeshah M. Almulhim

Dissertations

In Saudi Arabia (SA), between 2011 and 2021, there has been a 108% increase in death rates due to diabetes. Every year, around 3,800 Saudi children and adolescents under the age of 19 are diagnosed with Type I Diabetes (TIDM). Saudi adolescents with TIDM have less glycemic control than adults and younger children. If left untreated, inadequate glycemic control may hasten the onset of diabetes complications and early death. As adolescents with TIDM grow older, they are expected to take on more independence in Self-Management (SM) of their diabetes. The poor clinical outcomes of adolescents with diabetes, the onset of …

Evaluating Sympton Clusters In First-Time Ischemic Stroke Survivors Who Discharge From The Hospital To Home, Paula De La Pena

Dissertations

The purpose of this study was to examine symptoms and relationships between those symptoms in first-time ischemic stroke survivors who discharge home after their initial stroke. Current measurement of recovery after stroke places emphasis on the physical aspects of recovery when current literature suggests that other, more subtle symptoms may be equally contributory to recovery. This descriptive, exploratory research study was conducted via a secondary analysis of both structured and unstructured data in a study cohort of 115 first-time ischemic stroke survivors from a tertiary academic medical center in the Midwest. Unstructured clinical notes were analyzed for the presence of …

Investigating The Role Of Endothelin-1 In Reactive Astrocytosis, Candace Betancourt-Szymanowska

Master's Theses

Glaucoma is a progressive optic neuropathy which results in blindness for many patients, even with treatment. Endothelin-1 (ET-1) is a vasoactive peptide known to be aberrantly upregulated in the eyes of individuals with glaucoma. Optic nerve head astrocytes (ONHA) are the resident glial cell of the optic nerve head and are among the first cell types to undergo changes to a reactive phenotype. In this thesis, we investigated the role of ET-1 overexpression and its putative role in eliciting a reactive phenotype in ONHA by inducing lentiviral-mediated over-expression of EDN1. ONHA transduced with EDN1 (ONHA ET-1) were verified to be …

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …

Evaluation Of Financial Risk Protection Provided By Private Health Insurance In Malaysia, Ng Rui Jie

Student Works (2020-2029)

Private health insurance (PHI) has emerged as an alternative health financing option to public health financing, with the goal of achieving and maintaining universal health coverage. Despite its growing prominence, there is ongoing debate about the extent to which PHI contributes to financial risk protection. In Malaysia, the prevalence of PHI coverage has increased due to factors such as an expanding affluent demographic, government encouragement, and challenges in public healthcare delivery. However, there have been very limited studies assessing the financial risk protection provided by PHI in Malaysia, making this a critical gap that this research aims to address. To …

Developing Real-Time, Online Beam Control Of Uhdr Irradiators To Facilitate Flash Translational Investigations, Austin M. Sloop

Dartmouth College Ph.D Dissertations

The field of radiation oncology seeks novel techniques to increase the therapeutic ratio to treat malignancies while minimizing damage and toxicities in healthy tissues. While it was observed that delivering therapeutic doses at high dose rate could elicit lower biological effects over a half-century ago, the field of ultra-high dose rate (UHDR) radiation therapy (colloquially known as FLASH RT) has seen a resurgence in recent years due to an alignment of accelerator capability, dosimetric advances, and improved biotechnological techniques. This has opened the door to studying potential underlying mechanisms such that we may leverage the effects of FLASH tissue sparing …

Transcleral Chemotherapeutic Delivery By Fibrin Sealant In The Treatment Of Retinoblastoma, Christopher Himes

Master's Theses

Retinoblastoma is the most common intraocular cancer in children, accounting for roughly 9,000 new cases each year—claiming the lives of up to 70% of cases in certain regions of the world. While modern retinoblastoma treatments in developed countries have significantly reduced mortality rates, post-treatment consequences such as vision loss, off-site organ dysfunction, and secondary metastases remain unmet clinical needs. Past studies have confirmed transscleral delivery as an efficacious means to achieve high intraocular drug concentrations possibly superior to the standard systemic regimen of vincristine, etoposide, and carboplatin (VEC) for tumor suppression. This led to several studies exploring the use of …

Customized Feminine Hygiene Wash Containing Postbiotics From Lactobacillus Spp. To Treat Urinary Tract Infections (Uti), Veena G. Nair

Theses and Dissertations

Probiotics, which support host health by maintaining normal microbial flora, offer a promising approach for preventing recurrent infections. To evaluate the prophylactic potential of vaginal probiotics against urinary tract infections (UTIs), we conducted a study on 54 healthy South Indian women aged 18–40 who visited the Obstetrics and Gynaecology outpatient clinic at Trichy SRM Medical College and Research Centre between June and July 2022. Vaginal swabs were collected following ethical guidelines, and commensal microbiota were isolated for probiotic characterization, with the broader objective of developing a customized feminine hygiene wash enriched with vaginal postbiotics.

Lactobacilli cell-free supernatant (CFS) demonstrated potent …

Exploring The Lived Experiences Of Persons Living With Hiv Who Are Homebound Due To One Or More Comorbidities Within A Southern State Using Photovoice, Anthony Alyn "Deek" Cunningham

All ETDs from UAB

At the end of 2022, there were 1,109,418 adults and adolescents with HIV in the United States and the six dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands (CDC, 2024). Due to ongoing advances in medications and treatments, people who have been diagnosed with HIV are living longer and healthier lives, making this a chronic health condition. Yet, there are gaps in the literature that focuses on this population growing older and aging in place. This dissertation investigated the lived experiences of individuals fifty years and older …

Insights Into Rett Syndrome: Social Behavior, Bdnf-Trkb Signaling, And Dendritic Spines, Destynie Medeiros

All ETDs from UAB

Rett syndrome (RTT) is a neurodevelopmental disorder primarily affecting females, caused by pathogenic variants in the X-linked MECP2 gene, which encodes the transcriptional modulator Methyl-CpG binding protein 2 (MeCP2). RTT is characterized by motor deficits, loss of speech, autistic features, and intellectual disability. A key gene regulated by MeCP2 is BDNF, encoding the neurotrophin brain-derived neurotrophic factor (BDNF). BDNF levels are lower in multiple brain regions of Mecp2-deficient mice, and experimentally increasing BDNF levels improves several RTT phenotypes in mouse models. Due to BDNF's low blood-brain barrier permeability, we tested LM22A-4, a brain-penetrant small molecule ligand of TrkB receptors, on …

Molecular Mechanism Of Congenital Cataract Caused By G91 Deletion In Cryβa1, Akosua Konadu Boateng

All ETDs from UAB

The Deletion of Glycine 91 is a mutational hotspot in the CRYβA1 gene (mutant named βA3ΔG91), which causes autosomal dominant congenital nuclear cataracts in several ethnically diverse populations worldwide. Previous in-vitro studies of recombinant βA3ΔG91 protein revealed that this mutation results in defective protein folding, reduced solubility, and oligomerization with other crystallins. While βA3/A1-crystallin is primarily known as a structural protein in the lens, it also plays a role in autophagy regulation in the retinal pigment epithelium (RPE) by controlling endolysosomal acidification through the V-ATPase proton pump. This study employs a novel βA3ΔG91 knock-in mouse model to investigate the pathogenic …