Medicine and Health Sciences Commons^™

An Examination Of Food And Alcohol Disturbance Based On Sexual Orientation In A Sample Of Women Who Binge Eat, Alicia M. Moulder

Psychology Theses & Dissertations

Food and alcohol disturbance (FAD), characterized by disordered eating behaviors in the context of drinking alcohol to enhance intoxication, counteract alcohol’s calories, or both, is associated with increased risk of negative drinking consequences. Previously established as a phenomenon occurring in college students, research has begun to support that FAD may also occur in nonstudents. Three particularly vulnerable groups for FAD may include women, individuals with history of binge eating, as well as sexual minority individuals. Consequently, the goals of the current study were to elucidate differences in FAD engagement between sexual minority women (SMW) and heterosexual women using a sample …

The Role Of Policy Entrepreneurs In Understanding Oral Health Care Policy: A Case Study Approach Analyzing Multiple Streams Framework In Nc Oral Health Policy, Lori Gordon Hendrick

School of Public Service Theses & Dissertations

The United States Surgeon General has defined oral diseases as a “silent epidemic” that affects the most vulnerable citizens. More often, this includes those from low socio-economic backgrounds, children, elderly, and many members of ethnic minority groups. Although preventative and treatment modalities have improved over the past fifty years, some Americans continue to have little to no access to educational and preventative programs. The lack of access to dental care for all ages and oral health care literacy remains one of the largest health concerns for American citizens making it a “wicked problem”. Historically, raising Medicaid enrollment has failed to …

Intercellular Mitochondrial Transfer Contributes To Microenvironmental Fate Redirection Of Mammary Cancer Cells, Julie Sofie Bjerring

Biomedical Sciences Theses & Dissertations

The dynamic cellular microenvironment, made up of resident cells and various macromolecules, differs markedly across tissues in the body. The multidirectional signals that cells receive from this microenvironment, along with the signaling they send back, heavily influence their physiology and behavior. Recent important findings have further validated this notion as the mammary microenvironment has been shown to suppress tumor progression by redirecting cancer cells to adopt a normal mammary epithelial progenitor fate in vivo. However, the mechanism(s) driving changes in metabolic reprogramming and cancer fate redirection is understudied. The work presented in this dissertation focuses on exploring the impact of …

Real-Time Navigation System For Breast Cancer Surgery With Pre- And Intra-Operative Imaging Using Neural Networks, Motaz Alqaoud

Biomedical Engineering Theses & Dissertations

Breast cancer is one of the most frequently diagnosed malignancies in women worldwide, necessitating precise diagnosis and treatment. Breast-conserving surgery (BCS) is the primary treatment for nonpalpable cases, yet current approaches often lack accuracy due to the absence of real-time 3D imaging during surgery. This limitation impairs surgeons’ ability to visualize tumor locations, compromising outcomes and potentially leading to repeat surgeries with higher risks, undesirable cosmetic results, increased costs, and, in some cases, mastectomy. Thus, there is a critical need for a navigation system to facilitate accurate tumor excision in nonpalpable breast cancer through real-time patient-specific 3D tracking.

This study …

Self-Identifying Minoritized Doctoral Students’ Experiences Of Epistemic Injustice In Counselor Education And Supervision, Francisca Rivas

Counseling & Human Services Theses & Dissertations

The purpose of this qualitative study was to examine and understand how epistemic injustice (EI) is experienced by minoritized doctoral students in Counselor Education and Supervision programs. The primary researcher performed a phenomenological study examining the experiences of EI for minoritized CES students (n = 8). There were three female participants with an average age of 31, two male participants with an average age of 31, and three nonbinary/trans participants with the average age of 33. Five participants were BIPOC, one being an international student, and six participants were LGBTQPA+. Five participants held Ph.Ds. at time of their interview, having …

An Integrated Theoretical Socio-Technical Framework For Implementing Service Robots’ Integration In Healthcare, Sujatha Alla

Engineering Management & Systems Engineering Theses & Dissertations

Healthcare workers, either clinical or non-clinical, are obligated to serve patients. However, lack of a sufficient number of professionals leads to burnout, severe stress, and, consequently, decreased quality of services. In this context, very few countries have been successful in employing service robots to perform dull, dirty, and/or dangerous tasks related to patient wellbeing/healthcare, while most countries are still skeptical about it. As robotics advances, there is an opportunity for healthcare to take advantage of this technology to reduce personnel workload and to reduce the possibility of exposure to contagious pathogens. However, healthcare is a vulnerable environment and requires critical …

Early Intervention System Contextual Factors Contributing To Treatment Attendance And Clinical Outcomes, Anthony Eldridge

Theses and Dissertations

Early Intervention Programs (EI) are an established method of addressing and treating earlier childhood developmental problems that involves a system of complex processes which families must navigate to secure and maintain care. Extensive wait times and multiple service providers burdensome caregivers which may impact treatment engagement. Telehealth offers some clinical utility for improving EI service provision. However, little is known how system contextual factors predict a child’s Part B Eligibility and level of engagement with treatment. The primary aim of this study is to describe the effect that wait time, number of service providers, number of treatment services, and treatment …

Integrating Data-Driven And Mechanism-Driven Modeling In Drug Discovery And Hepatotoxicity Evaluation, Xuelian Jia

Theses and Dissertations

The pharmacological activities and hepatotoxicity significantly influence the success or failure of new drugs during drug discovery and development. Traditional experimental methods, such as animal models, are costly and time-consuming for chemical testing. There is a great need to develop in vitro and computational modeling to help identify the pharmacological activities and hepatotoxicity potential in the early stage of drug discovery and safety evaluation. In this dissertation, new computational models and associated modeling frameworks were described for predicting the biological profile and hepatotoxicity of chemicals. Firstly, a novel data mining and Quantitative Structure-Activity Relationship (QSAR) workflow was developed to construct …

A Dosimetric Comparison Of Treatment Techniques For Stereotactic Body Radiotherapy For Pancreatic Patients, Kameron Lemley

Masters Projects

Stereotactic body radiotherapy (SBRT) is utilized in radiation therapy to deliver ablative radiation doses to tumor volumes while achieving high conformity and minimal dose to surrounding critical structures. This treatment technique allows for faster dose fall-off which allows tighter treatment margins. SBRT for pancreatic cancer has been investigated for its efficacy and has proven to be an effective treatment choice for neoadjuvant radiation therapy. Since pancreatic cancer is extremely aggressive with a high mortality rate, it is important to have a treatment option that can reduce cost and increase convenience for the patient while simultaneously providing a conformal treatment plan. …

Relationship Between Opioid Treatment And Nonpharmacological Chronic Pain Management Interventions And Perceived Effectiveness Of Managing Chronic Pain In African American Adults, Bona Eze

Walden Dissertations and Doctoral Studies

Chronic pain impacts all areas of life for most Americans, but the issue is particularly salient among African Americans (AAs) as they face adverse pain outcomes. There is little understanding of pain management strategies used by AAs to inform pain management recommendations. The purpose of this study, guided by the COM-B model and biopsychosocial theory, was to determine if there were a relationships between opioid treatment and perceived effectiveness of managing chronic pain in AA adults who are 18 years and older as well as between nonpharmacological interventions (physical therapy, chiropractic care, talk therapy, self-management program, yoga, massage) and perceived …

The Relationship Between The Clinical Scales Of The Personality Assessment Inventory And Bmi Reduction In Bariatric Surgery Patients, Douglas Lytz

Doctor of Psychology (PsyD)

Since the National Institute of Health recommendation in 1991, most bariatric clinics and insurance companies across the United States now require psychological evaluations for patients before receiving bariatric surgery (Marek & Heinberg, 2016). Clinicians are now using various objective personality measures and other assessment tools during comprehensive evaluations to help make recommendations to surgeons and clinical staff about patient suitability for weight loss surgery. Previous studies suggest that specific demographics and clinical elevations on objective personality assessments may predict the reduction of body mass index (BMI) in patients after bariatric surgery (Oltmanns et al., 2020; Hoyt & Walter, 2022a). This …

Health Risk Factors Of Female African American Informal Caregivers For Alzheimer’S Disease Patients In Low-Income Communities, Rosaline Elaine Elliott

Walden Dissertations and Doctoral Studies

By 2050, 152 million people worldwide, primarily low-income populations, will have Alzheimer's disease (AD). African American (AA) women informal caregivers are primary caregivers in low-income neighborhoods, and they suffer from burnout and poor health, including physical and mental fatigue, despair, anxiety, hypertension, and stressors that can lead to heart attacks, strokes, or premature mortality. The Informal Caregiver Integrative Model (ICIM) theoretical framework was used to survey 120 participants using SurveyMonkey was administered to collect data for this cross-sectional quantitative study. The multiple hierarchical regression analyses revealed caregiving appraisal had no significant impact on burnout. A higher quality of the caregiver-care …

3d Bioactive Thiol-Norbornene Hydrogels For Guiding Stem Cell Mechanosensing And Differentiation, Arielle Gsell

U-RISE Undergraduate Theses

Hydrogels are soft, highly hydrated polymeric networks commonly used as biomaterial scaffolds in tissue engineering. To mimic the extracellular matrix of tissues, hydrogels can be chemically modified to incorporate either bioactive molecules such as peptides, or physically modified with crosslinkers to alter hydrogel stiffness and degradation. Hydrogels with defined characteristics can be synthesized using chemical reaction schemes such as photo-click chemistry, which offers spatial and temporal control over biochemical and physical properties. The goal of this thesis is to leverage thiol-norbornene click chemistry, a subtype of photo-click chemistry, to develop 3D hydrogels with biochemical and biophysical cues that guide mesenchymal …

Development Of A Haptic System For Robot-Assisted Femur Fracture Surgery, Fayez H. Alruwaili

Theses and Dissertations

Robot-assisted surgery has emerged within the field of surgical technology, driven by the need for greater accuracy and speed in the ongoing evolution of healthcare. This advancement has influenced numerous areas requiring enhancements to achieve optimal surgical results. However, surgical robotics tends to lack the surgeon’s connection to the operation, creating a gap in the intuitive skill set required for successful operations. The gap is seen through the lack of sense of touch, which may result in tissue damage and additional injury when the robot interacts with the patient. Furthermore, challenges faced during femur fracture surgery have positioned robot-assisted surgery …

Comparing Costs And Predictors Of Low-Value Healthcare Service Use Among Primary Care Nurse Practitioners In The Southwest United States, Sara B. Nugent

Nursing ETDs

Low-value healthcare services (LVHSs) are unsupported by current evidence, associated with harmful patient outcomes, and equate to over $100 billion in wasteful spending annually. The aims of this descriptive, comparative study were to establish baseline prevalence and costs associated with LVHS use among primary care nurse practitioners (NPs), and to test the influence of different geographical regions and patient populations. A secondary data analysis of the Merative™ MarketScan® 2021 databases was conducted. LVHS prevalence was lower or fairly equal to that of other studies, and direct claim costs were very-low cost. Extremely high low-value lumbar radiographic imaging claim costs were …

Examining Daily-Self Weighing As A Stand-Alone Intervention For Obesity Management, Ashley Parish

All ETDs from UAB

Obesity is an epidemic that has substantial implications for both individuals with the disease as well as the healthcare system in the United States. Individuals with obesity are at increased risk for developing associated co-morbid conditions such as cardiovascular disease, type 2 diabetes, and some forms of cancer, which can affect quality of life and lead to mortality. There are many health behavior interventions which target weight loss, maintenance of weight loss, or weight gain prevention in those with obesity; however, interventions have unique barriers that can vary based on personal, environmental, and social factors. Primary care (PC) settings, which …

Childbirth, Later-Life Cardiovascular Disease, Mortality, And Health-Related Quality Of Life In Postmenopausal Women, Zailing Xing

USF Tampa Graduate Theses and Dissertations

Introduction: The associations between childbirth and future maternal cardiovascular disease (CVD) and mortality have been inconclusive. Limited studies have focused on the association between childbirth and HRQoL. Objective: We aimed to examine the long-term effects of parity and age at childbirth on women's CVD and mortality based on propensity score matching. Methods: This study used data from the Women’s Health Initiative study (1993-2022). We used propensity score matching to produce matched samples, then employed multilevel Cox proportional hazard models for hazard ratios (HRs) to estimate the associations of parity and age at childbirth with CVD and mortality. We used mixed-effects …

The Association Of Apathy With Functional And Cognitive Impairment In Individuals With Biomarker Confirmed Alzheimer’S Disease Pathology, Megan Engeland

Yale School of Medicine Physician Associate Program Theses

Objectives: Apathy is one of the most common neuropsychiatric symptoms in patients with Alzheimer’s Disease (AD) and has been shown to be associated with greater impairments in daily functional and cognitive status. Previous studies have used subjects with a clinical diagnosis of AD, without biomarker information, and did not control for potential confounding factors. Design: To evaluate the prevalence of apathy in a biomarker informed cross-sectional study of AD and the association of apathy with functional and cognitive status. Setting: Data used in this study was obtained from the Yale Alzheimer’s Disease Research Unit (ADRU) database. Participants …

Resuming Anticoagulation In High Thrombotic Risk Patients After Traumatic Intracranial Hemorrhage, Elijah Adams

Yale School of Medicine Physician Associate Program Theses

Background: The purpose of this study was to examine whether patients, previously on anticoagulation (AC) therapy who have sustained traumatic intracranial hemorrhage (tICrH), had less composite thrombotic or hemorrhagic events from earlier resumption of AC therapy compared to patients resumed later. Methods: In this retrospective observational study, we explored the median time to AC resumption in patients who were admitted for tICrH. The median was used as the cutoff point for defining early vs. late resumption of AC. Patients were categorized into early if resumption occurred between 14 and 23 days, late if resumption occurred between 24-120 days, and never …

The Association Between Race And Obesity After Controlling For Dietary Behaviors Among Adolescents, Jasmine Nicole Williams

Walden Dissertations and Doctoral Studies

Childhood obesity has become a critical global public health concern due to its significant, long-term impact on overall quality of life and physical health. Despite efforts, there is a lack of information that includes all races and ages to combat childhood obesity. This study addressed the association between race and obesity after controlling for dietary behaviors among adolescents in Georgia, using quantitative cross-sectional data from the 2021 Youth Risk Behavior Surveillance System (YRBSS). Guided by the social ecological model, the research investigated how demographic factors and dietary behaviors influence obesity rates. Specifically, the study explored the association between age, race, …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

DNP Qualifying Manuscripts

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Screening, Brief Intervention, And Referral To Treatment For Pregnant Women, Rebekah Feeney

Dissertations

Abstract

Background: In the United States, 10-20% of pregnant women reported using drugs during pregnancy. Current recommendations are to screen for drug use in all patients and provide a brief intervention and referral to treatment. The purpose of this quality improvement project was to evaluate the impact of implementing a standardized screening, brief intervention, and referral to treatment (SBIRT) protocol for first-trimester pregnant patients who are seen in the obstetrical department.

Methods: The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) screening tool was administered to first-trimester pregnant women, 13-45 years of age, seen in the obstetrical department from …

Screening For Depression Post Acute Coronary Syndrome, Alyssa Graham

Dissertations

Background: Acute coronary syndrome (ACS) and depression have profound impacts on patient outcomes. Patients who experience ACS are at increased risk of developing depression, which is associated with an increased risk of death and recurrent cardiac events. The evidence following ACS events promotes routine depression screening. The purpose of this project was to identify early depression in patients 65-99 years of age who had a recent diagnosis of ACS during their hospitalization.

Methods: This quality improvement (QI) project was a prospective descriptive observational design implementing a depression screening protocol to evaluate post-ACS referrals within 7-14 days of screening from February …

Nanofiber-Hydrogel Composite Scaffold Fabrication Methods For Peripheral Nerve Regeneration, Jacob Lee Carter

Theses and Dissertations

Nerve graft conduits (NGCs) are a rapidly advancing field for treating peripheral nerve injuries that aim to guide the growth of regenerating axons across damaged gaps. A more effective NGC can be manufactured by combining the use of nanofibers to act as guidewires within a 3-D hydrogel that imitates the extracellular matrix of nerve tissue. Several methods have been developed to embed aligned nanofibers in an ordered architecture within a hydrogel matrix. The first method involves layer-by-layer additive manufacturing to create NGCs with rows of polycaprolactone (PCL) nanofibers surrounded by a gelatin methacrylate (GelMe) hydrogel in a 3-D structure. A …

Effectiveness Of Simulation In The Education Of Rns Transitioning Into The Operating Room, Cortney Ann Lupo

Walden Dissertations and Doctoral Studies

RNs who are new to the operating room (OR) must gain confidence and clinical reasoning skills to care for individuals undergoing surgery. Training in the OR is stressful but using simulation for training RNs new to the OR may improve clinical reasoning and confidence. The purposes of this two group, repeated measures study, guided by National League of Nursing/ Jefferies simulation theory and Benner’s novice to expert theory, were to determine if there was a difference in (a) clinical reasoning levels of RNs new to the OR who received simulation compared to clinical reasoning levels of RNs new to the …

Animation As Therapy For Mental Health Treatment Across Diverse Populations And Contexts, A Literature Review, Daneile Tabana

Expressive Therapies Capstone Theses

Scientific research has explored and identified the beneficial relationship between health and creative expression, recognizing art therapy as a source of healing. Animation has been newly recognized as an art therapy medium with potential for therapeutic healing and increased psychological well-being. This review of the literature on animation therapy explores the history of the modality’s interaction with the population observed and the effects of animation on the cognitive processes, discusses current theoretical orientations and treatment options for treating a range of conditions that affect mood, thinking, and behavior with animation therapy, and considers culturally informed and client-centered practices alongside traditional …

Role Of Customized Visual And Multifactorial Interventions In Preventing Falls Among Individuals With Visual Impairment In South India, Ramya S

Theses and Dissertations

Falls are the second leading cause of unintentional injuries and extensively studied among the elderly. Hence, intervention studies for falls prevention are restricted to the elderly with or without visual impairment (VI). Even among studies with VI, strategies for treatable VI are widely explored. Hence this study aimed to understand falls and interventions that may reduce falls in all the age groups especially among those with untreatable VI.

This mixed methods study included identification of subjects aged ≥ 18 years with VI from clinical records of Medical Research Foundation, Chennai and details of previous history of falls were enquired over …

Application Of Process Mining Algorithms To Surgical Training: A Study Of Healthcare Settings, Fazla Rabbi

Student Theses and Dissertations

Healthcare professionals must be experts at carrying out complex surgical procedures to fulfill their responsibilities. The aim of the medical treatments is fewer complications, shorter hospital stays, and a better patient experience. They often report on problems with surgical processes, skipped procedures, and lengthy transition times. The event log data allows process mining methods to deliver professionals with understandable findings using Petri Net. This study identifies the parallels and discrepancies between the pre-and post-stages and their respective frequency on each typical Central Venous Catheter (CVC) installation activity, where pre-stage they were given a briefing, and in post-stage they had hands-on …

Beyond Chronic Fatigue: Studying The Role Of Neuroinflammation, Glutamate, And Glutamine, Indonesia Alohn Jordan

All ETDs from UAB

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, multifaceted disease characterized by persistent, severe fatigue lasting six months or longer that is not relieved by rest. An estimated 20 million people worldwide suffer from ME/CFS. ME/CFS has long been suspected to be a post-viral illness, as viral infections can stimulate inflammatory cytokine production. Millions of coronavirus disease 2019 (COVID-19) patients are also predicted to develop persistent symptoms that mimic ME/CFS symptomology after the resolution of the acute infection, referred to as Post-Acute Sequelae of COVID-19 (PASC). Inflammatory mediators produced by sustained microglia activation have been shown to lead to illness …

Oral Administration Of Alpha-Cyclodextrin Corrects Diabetes Induced Retinopathy And Bone Marrow Pathology By Modulation Of The Gut-Retina Axis., Yvonne Adu-Agyeiwaah

All ETDs from UAB

Diabetic retinopathy represents a common complication of diabetes, exerting a significant financial burden globally across nations, particularly impacting the working-age population and thereby affecting productivity. Extensive investigations have unveiled its multifaceted etiology, implicating a convergence of diverse causative factors. Notably, seminal studies such as the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study have underscored the pivotal role of cholesterol dysregulation and dyslipidemia in the pathogenesis of diabetic retinopathy. This dysregulation stems from an imbalance characterized by heightened cholesterol production coupled with deficient cholesterol efflux or removal mechanisms. Liver X receptors (LXRs), ligand-activated nuclear receptors function in transcriptional …