Medicine and Health Sciences Commons^™

Exploring Influencing Factors On The Adoption Of Non-Pharmaceutical Interventions During Pandemics: Covid-19 As An Example., Ahmed Abdulmohsen I Alobaydullah

Electronic Theses and Dissertations

Background: Pandemics are associated with loss of life, hospitalizations, and disruption to people’s social and economic lives. As the 2019 pandemic illustrates, COVID-19 can be prevented by pharmaceutical and non-pharmaceutical interventions (NPIs). Recommended measures such as wearing a mask, washing hands, social distancing, and self-quarantine have been proven to curb the spread of the coronavirus. Identifying the factors associated with adherence to NPIs is the first step in understanding which levers of change to pull when designing health promotion interventions such as health communication campaigns. This dissertation explores these factors and proposes a health communication framework during pandemics. Research Questions: …

Control Of Muscle Activation In The Lower Limbs During Leg Cycling After A Motor Complete Spinal Cord Injury., Jae Fish

Electronic Theses and Dissertations

Spinal cord injury (SCI) affects the central nervous system (CNS) causing muscle paralysis and autonomic dysfunctions throughout the body. Muscle activation after SCI is essential to facilitate functional recovery and may be produced via remaining input from supraspinal centers, the central pattern generators (CPG), or muscle stretch reflex responses. In this study, assisted leg cycling is evaluated as a tool to identify the neural structure control of muscle activation after motor complete SCI. Eight individuals with a complete or sensory incomplete SCI between C2 and T5 participated in the study. Participants completed leg cycling trials with and without supraspinal intention …

Modifiers Of The Effects Of Different Dimensions Of Social Support On Cardiac Rehabilitation Adherence., Melissa Amraotkar

Electronic Theses and Dissertations

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide. Cardiac Rehabilitation (CR) is a Class I, level A indication for treatment and prevention further complications of CVD. The attendance rate for CR in the U.S. is very low, especially among female patients. Dimensions of social support, sex of the support provider, and the quality of primary intimate relationship are associated with health-promoting behavior and may influence CR adherence in patients. Purpose: The purpose of this study was to examine the relationship between dimensions of social support and CR adherence, and whether these relationships were moderated by factors such …

Investigation Of Avaren-Fc's Therapeutic Potential Against Ovarian Cancer., Katarina Lee Mayer

Electronic Theses and Dissertations

This thesis describes the investigation of Avaren-Fc (AvFc), a novel lectin-based therapeutic fusion protein consisting of the recombinant Avaren lectin and the Fc region of human IgG1, against ovarian cancer. AvFc possesses selectivity toward tumor associated N-linked high-mannose-type glycans. The present study demonstrates AvFc’s in vitro activity against OVCA cell lines via antibody-dependent cell-mediated cytotoxicity and its ability to extend the survival of mice challenged with murine ID8 OVCA cells after repeated systemic administration. Furthermore, AvFc treatment in this model was found to increase the presence of peritoneal leukocytes, suggesting a shift toward an improved antitumor immune response. Another key …

Electrochemical Modulation Of Surface Plasmon Wave To Investigate Dna-Based Sensing Platforms And Detection Of Sars-Cov2., Anil Sharma

Electronic Theses and Dissertations

This study offers a thorough comparative analysis of optical and electrical signaling strategies for assessing the electrochemical properties of different redox-labeled DNA-based biosensing platforms. In addition, it illustrates the development of an optical interrogation technique with electrochemical modulation of surface plasmon waves (ECM-SPW) as a route for analyzing and implementing DNA-based hybridization sensors. For those quantitative analyses, we chose a model sensing platform composed of a methylene blue (MB)-modified single-stranded DNA (ssDNA) signaling probe and an unlabeled capture ssDNA probe that complements the signaling probe. Two types of signaling probes were employed in this work: one with MB attached to …

Preclinical Stability Assessment Of Epicertin, A Biotherapeutic Candidate For Ulcerative Colitis Mucosal Healing., Wendy Michelle Kittle

Electronic Theses and Dissertations

EPICERTIN is a biotherapeutic candidate for mucosal healing in ulcerative colitis (UC), a major type of inflammatory bowel disease (IBD). Despite the critical role of mucosal healing in achieving successful remission of UC, there are currently no targeted mucosal healing agents available. EPICERTIN has previously demonstrated epithelial repair and mucosal healing activity in colon epithelial cells, murine colitis models, and tissue explants from IBD patients, highlighting its therapeutic potential to meet this unmet need for UC patients. The development of appropriate chemistry, manufacturing, and controls (CMC) data will facilitate our ultimate goal to bring EPICERTIN to the clinic for a …

Socioecological Factors Associated With The Timing Of Prenatal Care Initiation In Kentucky And Beyond: An Exploratory Study., Melissa B. Eggen

Electronic Theses and Dissertations

Objectives: Early prenatal care is initiated in the first twelve weeks of pregnancy and is a known contributor to improved short- and long-term outcomes for women and infants. Despite its known benefits, many women do not initiate early prenatal care. The purpose of this dissertation was to explore the socioecological factors associated with the timing of prenatal care initiation in the United States and in Kentucky. Methods: Chapter Two of this dissertation used a scoping review methodology to identify barriers and facilitators related to first-trimester prenatal care initiation among women in the United States. Chapter Three of this dissertation used …

Examining The Relationship Between Mass Incarceration, Gender Norms, And Hiv Vulnerability For Formerly-Incarcerated Black Men Who Have Sex With Men And Women., Adrienne B. Smith

Electronic Theses and Dissertations

In 2018, Black Americans represented 42% of new HIV diagnoses, despite comprising only 13% of the population. Moreover, Black men accounted for three-quarters of new HIV cases in 2016, with Black gay/bisexual men contributing to the majority of incidence among Black Americans. Existing literature suggests that individual behavior alone cannot explain these racial inequities in HIV rates. This study aims to explore the role of the criminal legal system (CLS) as a structural determinant of health, given its historical racial implications that disproportionately affect Black Americans. Additionally, the study examines masculinity’s influence as a predictor of risky sexual behavior. This …

A Mixed Methods Investigation Of First-Year Medical Students' Competency Development In The Gross Anatomy Laboratory Context., Emily M. Porta-Miller

Electronic Theses and Dissertations

Competency-based medical education and competency assessment are common in the clerkship years of undergraduate medical education and in graduate medical education; however, they are less commonly included in the preclinical, or basic science, years of medical education. This study investigated the effects of a novel competency-based curricular thread which assessed Communication, Teamwork, and Professionalism competency development of first-year medical students in the gross anatomy lab context. The study employed a convergent parallel mixed methods approach. The quantitative phase used a pretest/posttest design with paired dependent t-tests to determine if students’ exhibited growth, stagnancy, or decline within any of the …

Assessing The Relationship Between Racism In Medicine, Medical Mistrust And Cardiovascular Disease Among Black American Adults., Osayande Agbonlahor

Electronic Theses and Dissertations

Cardiovascular disease (CVD) persists as the leading preventable cause of death and disability among Black Americans in the United States. Structural and psychosocial factors such as racism have been highlighted as a fundamental cause of persistent cardiovascular health disparities in the U.S. This study examined the associations between racism in medicine, medical mistrust and CVD among Black Americans using the Minority Stress Theory as a theoretical framework. This study evaluates the sociodemographic differences in the quality of care received among Black Americans. Data from the Health Information National Trends Survey, 2022 and the Consumer Assessment of Healthcare Provider and Systems …

Reimaging Safety After Sexual Violence: A Qualitative Exploration Of Survivors' Experiences With Formal And Informal Crisis Response Networks., Hallie Ruth Decker

Electronic Theses and Dissertations

Sexual violence (SV) is a highly prevalent public health and human rights concern impacting communities across the United States. SV is associated with a myriad of adverse physical, reproductive, sexual, mental, behavioral, financial, and social health outcomes which may be acute or chronic. Health challenges associated with post-traumatic stress and post-traumatic stress disorder are particularly common among victims and survivors of SV. Engagement in early psychological/psychosocial intervention strategies may prevent or reduce PTSD-related symptomatology after experiencing an SV encounter. Despite the availability of crisis response and support options to support individuals who have experienced SV, significant barriers exist across social …

"They Are Who We Thought They Were": The Influence Of White Supremacist Discourse On Voter Suppression And Black Health., Tanisha Howard Lewis

Electronic Theses and Dissertations

Political systems in the United States have contributed to health outcomes in the through the historic and legal doctrine related to race and racism, segregation, housing, employment, and education. In recent years, significant attention has been given to theorizing the political determinants of health and what it means in the overall conversation about health equity. The equity implications of the political determinants of health are innumerable because they are the origin point of the structural determinants of health and the primary drivers of the social determinants of health, which span from environmental conditions to food security. The focal determinant of …

Comparison Of Specific Jaw Position Measurements On A Static And Dynamic Virtual Patient., Payton Lofton

Electronic Theses and Dissertations

This study aimed to compared the differences in jaw position measurements in protrusive and open/close positions on a static virtual patient created using 3dMD System to those from a dynamic articulation of a virtual patient (MODJAW) as well as measurements between the Cadiax and MODJAW. Six fiducial surface markers were placed on a volunteer subject’s face and dynamic facial scans of protrusive and open/close jaw movement acquired and exported. A CBCT scan was also acquired. The mandible and maxilla were segmented and loaded into Vultus and aligned to the facial scan using the fiducial markers. Results were compared using a …

Rockin’ Rehab: Novel Rocking Chair For Children With Spinal Cord Injury To Enable Trunk Muscle Activation And Detect Muscle Activation Patterns., Johnathan Jay George

Electronic Theses and Dissertations

Introduction: Activity-based locomotor training improves trunk control in children with spinal cord injury (SCI), and there is need for additional activities to allow these children to activate trunk muscles. The purpose of this research was to design, fabricate, and evaluate a rocking chair for children with SCI, and to investigate the activation of muscles during use. Sensorization of the chair to confirm muscle activation is also explored. Methods: Quality Function Deployment (QFD) design methodologies identified and ranked needs and features for the rocking chair. A design was developed and evaluated via finite element analysis. The chair was fabricated and tested …

Biofeedback Using Virtual Reality, Conscious Interoception, And Breathing Exercises Modulates Blood Pressure And Heart Rate Variability In People With And Without Cervical Spinal Cord Injuries., Rachel Torres

Electronic Theses and Dissertations

There is an immediate need for fast-acting blood pressure (BP) modification without the side effects of pharmaceutical interventions for people with cervical spinal cord injuries (SCI), who often suffer from dangerous increases and decreases in BP.^1,2 First, we compared mental to virtual reality (VR) imagery with the addition of breathing exercises and guided interoceptive attention, investigating participants’ ability to volitionally change their BP and heart rate variability (HRV), alternating three-minute stimulating and relaxing training cycles in 17 noninjured (NI) participants and 14 participants with SCI. Second, we trained 13 people with SCI and seven NI control participants for one …

Acute Mechanical Circulatory Support In The Cardiovascular Icu: Investigating The Effects Of An Interactive Cardiovascular Dynamics Simulation Program On Nursing Clinical Judgment., Casey Saulman

Electronic Theses and Dissertations

Introduction: Education on acute mechanical circulatory support (AMCS), a therapy used in the cardiovascular intensive care unit (CICU) to manage cardiogenic shock (CGS) is limited for CICU nurses. There is a need to explore clinical judgment in CICU nurses and provide innovative learning experiences that foster judgment when managing AMCS. Methods: This mixed methods feasibility study investigated the effects of an interactive cardiovascular dynamics simulation program on CICU nurses’ knowledge, clinical reasoning, and clinical judgment. Semi-structured interviews explored the participants’ perceptions of the learning experience. Results: Twenty-one nurses completed the cardiovascular dynamics simulation program. The majority were white (85.7%), female …

The Role Of Microrna-152 In The Pathogenesis Of Diabetic Cardiomyopathy, Joy Olaoluwa Gbadegoye

Alternative Theses and Dissertations (AETDs)

Diabetes mellitus, one of the world’s fast-growing diseases, is characterized by high death rates from cardiac complications named diabetic cardiomyopathy (DCM). DCM is a heart disease that occurs in both type 1 and 2 diabetes mellitus patients. Many management options have been explored in the management of DCM, including ACE inhibitors, beta-blockers, etc.; however, limited success has been recorded from these. MicroRNAs, recently discovered gene regulators, have been reported to be associated with various physiology and pathological processes in the mammalian body. These include cell proliferation, cell death, senesis, carcinogenesis, diabetes, and heart failure, among others. Various miRs have been …

Promoting The Integration Of Direct-To-Consumer Genetic Testing Results Into Clinical Practice, Kanesha Glenn

All Dissertations

In recent years, individuals have become interested in what insights direct-to-consumer genetic testing (DTCGT) can offer about their health. These individuals are recommended to discuss their concerns with a healthcare professional, yet most primary care professionals do not have a genetics-focused practice. This dissertation comprises five chapters to describe the integration of DTCGT results into a patient visit. Chapter I discusses the expanding demand between patients with questions about their DTCGT results and the health professionals who have been tasked to interpret these results. Chapter II is a systematic literature review that identifies what health professionals think about results from …

Total Hip Arthroplasty Outcomes In A Patient With Moderate To Severe Scoliosis: A Case Study, Rachael Dobbs

Physical Therapy Scholarly Projects

Introduction. The purpose of this case study is to discuss the role of physical therapy in patients who have moderate to severe scoliosis and plan to or have undergone a total hip arthroplasty. In evaluating the case of a female with moderate to severe scoliosis who recently underwent a total hip arthroplasty, it will be determined if physical therapy intervention was successful in improving her symptoms and reducing the risk of further complications.

Case Description. Patient is a 70-year-old female who presents to physical therapy evaluation several weeks post total hip arthroplasty. The patient has comorbidities of osteoarthritis and moderate …

Inpatient Physical Therapy Management Of A Patient Sustaining Multiple Fractures And A Hemorrhagic Temporal Lobe Contusion Due To An Absent Seizure And Fall: A Case Report, Kylie M. Helgeland

Physical Therapy Scholarly Projects

Introduction: A case report for the acute care assessment and treatment of a patient after a seizure and fall that resulted in multiple fractures and a temporal lobe contusion. Every injury has an impact on a patient’s mobility and their ability to perform activities of daily living. Physical therapists need to see each injury and understand how each one can affect the patient and have a barrier on their recovery.

Case description: A 59-year-old female who fell down 3 stairs during an absent seizure resulting in multiple fractures and a temporal contusion. The patient presented with impairments of motor planning, …

The Effects Of Palm Cooling On Power, Strength, And Endurance: An Investigative Study, Klye Henningsgard, Riley Mattheis, Shawn Stolz

Physical Therapy Scholarly Projects

Modern day athletes are continuously searching for ways that they can find a competitive advantage over their peers. This study aimed to assess if palm cooling was effective in increasing power, strength, and/or endurance during exercise. After completing a warmup, 24 participants (11 males,13 females; age 22.75 ± 1.36) were assessed on two separate occasions where they performed three separate exercises: vertical jump to analyze power, isometric knee extension to analyze strength, and Queen’s College Step Test to analyze endurance. On the first day of testing, participants were randomly assigned into a cooling or non-cooling group. Thus, completing all three …

The Correlation Between The Season Of Birth And Early Childhood Development In Healthy Children: Evidence From Midwest Region Of The United States, Paige E. Argent, Emma R. Botker, Anna L. Kiffmeyer, Victoria K. Maiz, Alexis N. Pettersen

Physical Therapy Scholarly Projects

Background and Purpose: While many different factors may affect early childhood development, one significant factor is the season of birth. The purpose of this study was to evaluate the correlation between the season of birth and early childhood gross motor development in healthy children ages 0-5 years old in the greater Midwest area.

Methods: Parents of 372 children completed self-reports on their children’s gross and fine motor development using the Ages and Stages Questionnaire (ASQ). Parents were provided with an online survey version of the ASQ. Data was based upon closed-ended questions and analyzed using the percentages of responses …

Inpatient Rehabilitation And Clinical Decision Making Of A Patient With Severe Stroke And Acute Kidney Injury: A Case Report, Kassandra G. Anshutz

Physical Therapy Scholarly Projects

Background and Purpose: Cerebrovascular accidents (CVA) are common and are estimated to affect around 795,000 people in the United States every year. Cerebrovascular accidents can be detrimental to one’s health and have a wide range of complications including death and decreased independence. Current evidence-based practice supports exercise and movement through physical therapy to restore function and independence. However, current guidelines do not exist for patients with acute kidney injury during stroke recovery.

Case Description: In this case study, we examine a 63-year-old male with a diagnosis of acute ischemic stroke further complicated by severe rhabdomyolysis. Upon initial evaluation and examination, …

Nutrigenetic And Dietary Factors Impacting The Relationship Between Linoleic Acid And Apolipoprotein B, Gregory Nacarelli

All Dissertations

This dissertation investigates the relationship between the omega-6 fatty acid, linoleic acid (LA), and the cardiovascular disease (CVD) risk marker apolipoprotein B (apoB). ApoB is considered to be the most important causal marker of CVD. However, the impact of LA on CVD risk has been subject to debate within the scientific literature, with various studies showing LA can decrease or increase apoB concentrations. To foster more clarity regarding this relationship, we first investigated all dietary, macronutrient, micronutrient, and nutrigenetic factors that impact concentrations of apolipoproteins via a narrative analysis approach. We found that more Westernized diets containing more processed foods, …

Proof-Of-Concept For Converging Beam Small Animal Irradiator, Benjamin Insley

Dissertations and Theses (Open Access)

The Monte Carlo particle simulator TOPAS, the multiphysics solver COMSOL., and

several analytical radiation transport methods were employed to perform an in-depth proof-ofconcept

for a high dose rate, high precision converging beam small animal irradiation platform.

In the first aim of this work, a novel carbon nanotube-based compact X-ray tube optimized for

high output and high directionality was designed and characterized. In the second aim, an

optimization algorithm was developed to customize a collimator geometry for this unique Xray

source to simultaneously maximize the irradiator’s intensity and precision. Then, a full

converging beam irradiator apparatus was fit with a multitude …

Utilizing Biomimicry To Design Sustainable Architecture, Virginia Hammond

Architecture Undergraduate Honors Theses

Nature has an integral relationship with architecture and serves as a sustainable role model and inspiration for designers. The process of biomimicry in architecture has the potential to produce more sustainable design solutions and foster a connection between humans and nature. Existing biomimetic design projects have varying strengths and weaknesses as examples of the process. Utilizing guidelines and references from key leaders in biomimetic design consultancy (Biomimicry 3.8), selected case studies are assessed for their ability to demonstrate the benefits of this design strategy. Using these evaluations, the case studies are diagrammed and critiqued to determine how new projects could …

The Pam-1 Aminopeptidase Protects Against Neurodegeneration In Caenorhabditis Elegans, Caleb Coil

Honors College Theses

The deteriorating effects of neurodegenerative conditions seem inescapable for many as they age. The experimental exploration of the molecular and cellular mechanisms responsible for neurodegeneration is aided using animal models. For instance, genetic screens have identified the puromycin-sensitive aminopeptidase (PSA) as a novel effector of neurodegeneration, as mutations in PSA in fruit flies result in perturbations of neuron anatomy and an accelerated onset of neuron death. We have tested the hypothesis that PAM-1, the Caenorhabditis elegans ortholog of PSA, plays a similar role in governing neurodegeneration in nematodes. Genetic strains were created that express the green fluorescent protein (GFP) in …

Evaluating The Epidemiological, Hormonal, And Psychosocial Sex-Based Differences In Sports-Related Concussion Outcomes, Samantha Kanny

All Dissertations

Sports-related concussions (SRCs) affect approximately 3.8 million athletes in the United States per year. A multitude of risk factors including age, sex, concussion history and prior medical conditions have been observed to significantly increase sports-related concussion symptom burden. Researchers have posited many reasons to explain sex-based differences in SRC outcomes, often categorized by biological characteristics or sociocultural factors, however, females are vastly underrepresented in sports-related concussion research, making it difficult to understand the true mechanisms underlying SRC sex-based differences. The goal of this dissertation is to help fill the current gap in knowledge on sex-based differences in sports-related concussion outcomes. …

Incorporating Music Into Pediatric Occupational Therapy, Abby Kays

Occupational Therapy Capstone Presentations

Music in therapy research currently focuses on the role of music therapy in children with behaviors, mood, and social/communication difficulties. However, limited research exists on the role of music in occupational therapy. The purpose of the capstone project was to use music-focused occupation-based interventions with children to improve social/communication skills, mood, and behaviors at a pediatric outpatient clinic. A literature review was completed on the objectives listed above to determine the need of the project. The theoretical foundation of the project is the Ecology of Human Performance Model, focusing on the unique contexts of each child. Music was used in …

Promoting Life Skills Through An Occupation-Based Program For Youth In The Juvenile Justice System, Maggie L. Dejong

Occupational Therapy Capstone Presentations

Youth who have experienced trauma are at risk for negative developmental changes to their brain, which may lead to poor health outcomes, involvement in the juvenile justice system, and early death. This population may experience a lack of occupational engagement, decreased self-regulation strategies, and difficulty forming life skills that are necessary for carrying out everyday tasks. Having trauma-informed awareness in the contexts of these individuals is essential when providing care and meeting their needs. The doctoral capstone project aimed to promote life skills through an occupation-based program for youth in the juvenile justice system. Current literature supports the need for …