Medicine and Health Sciences Commons^™

Changes In Young Adults’ Perspective On Ageism After Participating In A Virtual Nutrition Education Program With Older Adults, Julianne Hensley

Electronic Theses and Dissertations

The growing older adult population has led to increased ageist tendencies among younger generations. Previous research suggests that ageism is associated with cognitive and physical decline among older adults. This mixed-methods research project examined changes in ageist perceptions among graduate student facilitators and undergraduate nutrition ambassadors after participating in a training that included information about healthy aging, addressing ageism, and communicating with older adults. Results from a secondary data analysis of pre-test/post-test data and thematic analysis of semi-structured interviews with facilitators of Socially Nutritious, a virtual nutrition education program for older adults, indicate that ageist perceptions decreased after the …

Supplemental High-Tech Augmentative And Alternative Communication Experiences: A Study On Graduate Student Self-Efficacy, Confidence, And Knowledge With Pre-Service Training, Emily Sikes

Master's Theses

Providing assessment and intervention with high-tech augmentative and alternative communication is within the scope of practice of American Speech-Language Pathologists (SLPS). Therefore, SLPs should be able to properly identify and implement assessment, intervention, and caregiver coaching strategies in this area of practice. Due to the lack of confidence ratings of current SLPs in providing assessment and intervention in AAC that is found in current research, this study was designed to find plausible solutions for which confidence ratings can be increased beginning at the graduate level of a Speech-Pathology Master’s program. The researchers sought to answer the following questions: “Do students …

How Speech-Language Pathologists Account For Self-Determination Across The Progression Of Dementia, Emilee Mcgahee

Master's Theses

Dementia diagnoses are continuing to increase, with the number of diagnoses expected to reach 231 million globally by 2050 (World Alzheimer’s Report, 2019). With this comes a greater need for Speech-Language Pathologists (SLPs) who are able to best treat those who are diagnosed. Providing person-centered and strengths-based treatment approaches for people with dementia (PWD) has been proven to increase positive engagement responses while decreasing negative engagement responses (Skrainer et al., 2007). The primary objective of this research study was to assess treatment approaches used by SLPs in dementia care setting, along with how SLPs provide person-centered dementia treatment throughout the …

Gestalt Language Processing In Accredited Communication Sciences And Disorders Programs, William Harris

Master's Theses

The language development and usage of autistic individuals has become a controversial topic in many of the disciplines and professions providing support to these individuals. As a result, two theories of language processing have been proposed. Analytical language processing suggests that children process and develop language from its most simple form, a phoneme, to its most complex form, a word or phrase. However, the theory of gestalt language processing proposes that some children may instead extract larger, more complex language such as whole words and phrases first and break it down to the simpler language. Gestalt language processing is often …

Molecular Mechanisms Of Opioid Use Disorder In Human Brain Models, Emily Mendez

Dissertations and Theses (Open Access)

Opioid use disorder (OUD) is a national and global public health crisis with no end in sight. While studies from animal models hint at widespread epigenetic and transcriptomic alterations of opioid drugs, the molecular consequences of long-term exposure to opioid drugs in human brain is still unclear, and human-centered translational models are necessary to discern the human cell type-specific effects of OUD.

Using postmortem brain Brodmann area 9 (BA9) from the UTHealth Brain Collection for Research on Psychiatric Disorders, I identified angiogenic gene networks perturbed in the RNA and protein of OUD subjects, as well as downregulation of many neuron-correlated …

The Impact Of Habit Formation On Healthcare Workers: An Occupational Therapy Approach To Well-Being, Hillary Littlefield Msot, Otr/L

All Student Scholarship

Occupational therapists have an opportunity to act as consultants in their healthcare systems to provide education, resources and guidance to interdisciplinary team members. This concept aimed to provide evidence to support an occupational therapy-based program focused on incorporation of healthy habits and routines into one’s daily life as a means to improve nursing altruism, quality of life and perception of one’s successes and value in their occupation. Pre- and post- survey data was utilized to evaluate the effectiveness of an occupational therapy-based initiative that provided 1:1 and group coaching to a population of acute care nurses as an evaluation of …

Mindfulness For Middle School Students Receiving Adapted Physical Education Services: Quality Improvement Program, Kaila Mangrum

UNLV Theses, Dissertations, Professional Papers, and Capstones

Middle school students with disabilities are often isolated from their peers with decreased opportunities for participation, struggle with social emotional regulation, and self-efficacy. This has been evident among students with various disabilities who are from various age groups receiving special education services including adapted physical education (APE). Research has shown mindfulness amplifies learning and promotes a positive environment that supports children’s overall wellbeing. This quality improvement project focused on developing an occupational therapy centered mindfulness program to enhance social participation, self-efficacy, and social-emotional regulation. Data collection occurred pre and post program from specialized program teacher assistants (SPTAs) using the School …

Optimization Of Vagus Nerve Stimulation (Vns) And The Use Of Cervical Vns As A Treatment For Heart Failure With Reduced Ejection Fraction, Misty Owens

Electronic Theses and Dissertations

Vagus nerve stimulation (VNS) is a promising neuromodulatory therapy under investigation for a range of disorders, including heart failure, gastric dysmotility, and migraine. Two primary forms of VNS are currently investigated: cervical VNS (cVNS), involving surgically implantation to activate vagal afferents in the cervical branch in the neck and transcutaneous auricular VNS (taVNS) which subcutaneously stimulates the auricular branch in the outer ear. The nucleus of the solitary tract (NTS) serves as a relay-station receiving 90% of vagal afferents, enabling connections with higher-order brain regions and other brainstem nuclei like the spinal trigeminal nucleus (Sp5) and locus coeruleus (LC), facilitating …

Investigating The Role Of The Gut Microbiota On Immune Checkpoint Inhibitor-Mediated Colitis, Taylor Halsey, Robert Jenq

Dissertations and Theses (Open Access)

Immune checkpoint inhibitors (ICIs) have been revolutionary in the fight against cancer by recruiting the host immune system as an agent for attack on malignant cells. Unfortunately, immune-related adverse events (irAEs), including ICI-mediated colitis (IMC), are common side effects that result from immune cell mediated damage on healthy tissues. Recent studies have highlighted a role for the gut microbiota in modulating ICI-mediated anti-tumor responses, but less is known regarding how the gut microbiota may impact on irAEs. Considering that the gastrointestinal tract harbors thousands of unique microbial species, many of which are known to modulate the immune system, microbes and …

Acute Pain Prediction In Oral Cavity And Oropharyngeal Cancer Patients Receiving Radiation Therapy, Vivian Salama

Dissertations and Theses (Open Access)

Oral-Cavity and oropharyngeal cancers (OC/OPC) are types of head and neck cancers that are increasing in incidence domestically. Radiation therapy (RT) is crucial in OC/OPC management. Pain is a common and challenging symptom for most patients during therapy, as nearly all patients undergoing locoregional RT in OC/OPC require analgesia for acute iatrogenic pain. Moreover, about 45% of long-term survivors report chronic pain, with more than 10% exhibiting severe chronic pain. Pain control is challenging due to the multifactorial clinical, molecular, and cellular etiology of cancer/therapy pain, as well as variation in pain assessment and the non-uniform management of pain between …

Patient Understanding Of Fetal Sex Versus Gender In The Context Of Routine Cell-Free Dna Screening, Mindy Kolodziejski

Dissertations and Theses (Open Access)

Non-invasive prenatal testing (NIPT) is the current standard of care to screen for fetal aneuploidy using cell-free DNA (cfDNA). NIPT screens for sex chromosome aneuploidies (SCAs) and in doing so, can predict fetal chromosomal sex. Despite sex and gender being distinct concepts, many patients refer to NIPT as “the gender test” and elect testing in order to find out predicted fetal sex and assume gender. Our study aimed to evaluate and describe patient understanding of sex and gender in the context of receiving routine prenatal genetics education (PGE) on NIPT. A survey was developed with the goal of assessing patient …

Evaluation Of An End-To-End Radiotherapy Treatment Planning Pipeline For Prostate Cancer, Mohammad Daniel El Basha, Court Laurence, Carlos Eduardo Cardenas, Julianne Pollard-Larkin, Steven Frank, David T. Fuentes, Falk Poenisch, Zhiqian H. Yu

Dissertations and Theses (Open Access)

Radiation treatment planning is a crucial and time-intensive process in radiation therapy. This planning involves carefully designing a treatment regimen tailored to a patient’s specific condition, including the type, location, and size of the tumor with reference to surrounding healthy tissues. For prostate cancer, this tumor may be either local, locally advanced with extracapsular involvement, or extend into the pelvic lymph node chain. Automating essential parts of this process would allow for the rapid development of effective treatment plans and better plan optimization to enhance tumor control for better outcomes.

The first objective of this work, to automate the treatment …

Cord Blood-Derived Invariant Natural Killer T Cells As A Platform For Allogeneic Chimeric Antigen Receptor Cell Therapy, Maison Grefe

Dissertations and Theses (Open Access)

Chimeric antigen receptor (CAR) T cells have revolutionized the treatment of hematopoietic malignancies achieving >50% complete response rates in numerous refractory/relapsed B cell malignancies. However, there are challenges that hinder CAR-T efficacy and bar the broader use of this therapy in patients. One approach to address these challenges is to create a safe allogeneic CAR cell product by using cells that do not cause graft versus host disease (GvHD). Invariant natural killer T (iNKT) cells are an ideal candidate as they are restricted to the monomorphic CD1d protein in contrast to HLA restricted αβ-T cells and therefore are safe in …

Inclusion Of Adoption As A Pregnancy Management Option In Prenatal Genetic Counseling Practice, Emma Billings

Dissertations and Theses (Open Access)

Prenatal genetic counselors are essential to providing education, psychosocial support, and guidance on pregnancy options to patients who receive a fetal diagnosis of an anomaly or genetic condition. Therefore, genetic counselors should be well-educated on comprehensive pregnancy management options consisting of parenting, abortion, and adoption. The landscape of adoption education in genetic counseling practice was last characterized in 2010 by Perry and Henry, revealing substantial variability in both the inclusion of adoption-specific education in genetic counseling program (GCP) curricula and the discussion of pregnancy options with patients in prenatal practice. As a result, the authors published a call to action …

Methods For The Prediction Of Osteoradionecrosis Resulting From Head And Neck Cancer Radiation Therapy, Brandon Reber

Dissertations and Theses (Open Access)

Head and neck cancer (HNC) is the sixth most diagnosed cancer worldwide with over 600,000 patients diagnosed every year. One of the primary methods to treat HNC is through radiation therapy (RT). While RT is effective at treating HNC, late toxicities resulting from treatment can occur months to years post-treatment and can cause debilitating quality of life changes for HNC survivors. One of these late toxicities is osteoradionecrosis (ORN), which is the death of bone due to radiation. For HNC, the mandible is commonly affected and can cause challenges chewing, swallowing, and physical appearance changes. Several factors indicate the pressing …

Retinoid X Receptor As A Mediator Of Post Stroke Recovery By Reversing Age-Associated Phenotypes Of Microglia/Macrophages, Shun-Ming Ting

Dissertations and Theses (Open Access)

After stroke, microglia (MG) and blood-derived macrophages, together (MF), clear dead cells and cellular debris in the infarcted brain through phagocytosis. However, the phagocytic capability of MF declines with age. Age-related changes in MF phenotype also include overactive inflammatory responses to stroke-induced brain injury, altogether resulting in poor recovery after stroke. Retinoid-X-receptor (RXR) is a pleiotropic transcription factor. Our studies suggest that RXRa enhances MF phagocytic functions, reduces inflammatory responses, and improves post-stroke recovery. To establish phenotypes of aging MF, MG were MACS-sorted from the brains of young adults (2-4 months old) and aged (18-20 months old) mice for transcriptomic …

Impact Of Genetic Counseling On Patient Empowerment After Diagnosis Of Fetal Anomaly, Carley Brueckner

Dissertations and Theses (Open Access)

Approximately 3-5% of pregnancies are affected by fetal anomalies, often leading to structural and functional differences that impact infant health and mortality. When anomalies are identified on prenatal ultrasound, genetic counseling (GC) and genetic testing may be offered to investigate the potential for a possible syndromic cause. Genetic counselors provide education on the chance for a genetic etiology, available testing options, potential changes in medical intervention related to an identified etiology, and psychosocial counseling and resources. Regardless of a patient’s testing decision, genetic counseling should include psychosocial counseling to support and empower patients in a time of prognostic uncertainty and …

Epiregulin As A Novel Target For Antibody-Drug Conjugate Development For The Treatment Of Colorectal Cancer, Joan Jacob

Dissertations and Theses (Open Access)

Antibody-drug conjugates (ADCs) are a fast-growing class of molecularly targeted therapies with 13 currently approved and over a 100 in clinical trials. ADCs consist of a monoclonal antibody (mAb) conjugated to a potent cytotoxic payload to selectively target tumor antigens highly expressed on the cell surface. ADC development has been limited in colorectal cancer (CRC) by the lack of novel and effective therapeutic targets. Epiregulin (EREG), is an epidermal growth factor receptor (EGFR) ligand that is highly expressed in CRCs of different subtypes and mutational statuses with low expression in normal tissues. Here, we have characterized the role of EREG …

Interrogating Therapeutic Resistance To Oncogenic Krasg12c-Based Therapies In Colorectal Cancer, Oluwadara Coker

Dissertations and Theses (Open Access)

Colorectal cancer is the second leading cause of cancer-related deaths and the third most common cancer in the United States. Although KRAS is mutated in 50% of patients with metastatic CRC (mCRC), it has historically been a challenging therapeutic target. The recent approval of novel covalent inhibitors selective for KRASG12C mutation have entered the clinic, which has not only marked a major milestone in cancer drug discovery but has also intensified efforts to directly target other KRAS mutations that have also successfully entered the clinic. However, treatment-associated resistance mechanisms have long threatened to attenuate clinical benefit through either adaptive or …

Molecular Basis Of Cell Membrane Adaption Against Daptomycin In Enterococcus Faecalis, April Nguyen

Dissertations and Theses (Open Access)

Daptomycin is a last-resort lipopeptide antibiotic that disrupts cell membrane (CM) and peptidoglycan homeostasis (Grein et al., 2020a; Müller et al., 2016a). Enterococcus faecalis has developed a sophisticated mechanism to avoid daptomycin killing by redistributing CM anionic phospholipids away from the septum. The CM changes are orchestrated by a three-component regulatory system, designated LiaFSR, with a possible contribution of cardiolipin synthase (Cls) (Cesar A Arias et al., 2011a; Khan et al., 2019b; Palmer et al., 2011a; Panesso et al., 2015a; Reyes et al., 2015a). However, the mechanism by which LiaFSR controls the cell membrane response and the role of Cls …

Dissecting The Relationship Between Mucin 5ac And The Lung/Gut Microbiome In The Pathogenesis Of K-Ras Mutant Lung Cancer, Maria T. Grimaldo

Dissertations and Theses (Open Access)

Non-small cell lung cancer, including its most common subtype, lung adenocarcinoma (LUAD), is the leading cause of cancer-related deaths worldwide. In LUAD patients, KRAS mutations are the most common oncogenic driver alteration. Given KRAS is upstream to many signaling pathways involved in cell survival and cytokine production, interventions against KRAS-mutant lung cancers are prone to develop acquired resistance. Thus, there is a need to develop alternate targeting strategies and test combination therapies for improved intervention. Previously, we have found that KRAS-mutant LUAD (KM-LUAD) patients whose tumors harbor high expression of Mucin 5 AC (MUC5AC), a main airway secretory mucin, have …

Development Of Systems For Processing And Managing Donations For The William A. Burnard Warming Center, Landon Corbett

Undergraduate Honors Capstone Projects

Structure is important for any organization to have success and grow. Thus, having a good inventory system can make a huge difference. This project set out to investigate and develop a system that would be able to monitor incoming donations, inventory levels, and items given away to guests. The inventory method needed to be as automated as possible because the warming center volunteers were already busy with other responsibilities.

While many softwares were researched, my proposed solution was created with a combination of Google Sheets and Google Forms, as it is free and can be customized to the specific needs …

Locally Injectable Peptide Hydrogel For Conversion Of Temozolomide And Codelivery Of Sirna In Glioblastoma Multiforme Treatment, Megan Pitz

All Dissertations

Traditional treatment methods for glioblastoma multiforme (GBM) are largely unsuccessful, with a 5-year survival rate of 5.6%. Temozolomide (TMZ), the only chemotherapy FDA-approved for GBM treatment, is a hydrophobic prodrug that is stable in an acidic pH and begins converting to its active form at a physiological pH of 7.4. However, complete conversion of TMZ is observed only at a higher pH, and only about 30% of administered TMZ reaches the central nervous system. Therefore, there is a need for new treatment methods that maximize TMZ delivery to and efficacy at the tumor site. Self-assembling peptides are a unique class …

Going, Going, Gone: The Influence Of Job And Home Demands And Resources On Emergency Department Nurse Turnover, Jordan Gail Smith

All Dissertations

Nurse turnover, which challenged healthcare organizations even before the pandemic, reached alarming rates across hospitals worldwide during COVID-19. Due to the unprecedented and stressful nature of the pandemic, recent investigations have focused primarily on exploring job demands and nurse turnover intentions. While job demands are critical to understanding turnover, this narrow scope ignores the possible influence of other factors such as job resources and demands and resources external to the work domain. This study utilized archival qualitative data from a longitudinal survey of Emergency Department clinicians to analyze research questions and hypotheses. The first aim of this study was to …

Challenges Beyond Addiction: Maternal Experiences With Postpartum Substance Use Disorder Recovery And Perspectives Of Reproductive Healthcare Providers, Leah Holcomb

All Dissertations

Substance use disorders (SUD) impact millions of pregnant and postpartum people in the United States. With the increasing rates of perinatal substance use and the risk of overdose and death during the postpartum period, understanding overall functioning and the needs of postpartum persons is critical for informing interventions to reduce the impact of substance use within the perinatal period. The goal of this research is to explore the needs of postpartum people navigating SUD recovery.

This dissertation investigates postpartum maternal functioning within the context of early SUD recovery, as well as the comfort of reproductive healthcare providers (RHPs) to care …

Examining Current Capacity Of Healthcare Systems: Identifying Potential Adaptations For Children And Youth With Special Healthcare Needs, Caitlin Koob

All Dissertations

Children and youth with special healthcare needs (CYSHCN) are a growing proportion of the pediatric population, accounting for 23% of children in South Carolina (SC). Children with medical complexity (CMC) are a subgroup of CYSHCN who experience the most complex conditions and comprise

This dissertation investigates equitable healthcare access, service quality, and health and well-being among CYSHCN and their families, within the context of SC’s healthcare system. Three studies make up this dissertation, focusing on various aspects of healthcare access and experiences of CYSHCN and their families.

Physiological Adaptations Following A Strength Endurance Training Block Performed With Accentuated Eccentric Loading Or Traditional Resistance Training, Alex Long

Electronic Theses and Dissertations

Physiological adaptations were investigated following a strength-endurance (S-E) block prescribed with accentuated eccentric loading (AEL) or traditional resistance training (TRAD). Recreationally trained participants (n = 11 males, 6 females, age = 23.2 ± 4.2 yrs, body mass (BM) = 81.3 ± 22.2 kg, height = 172.1 ± 10 cm) completed a four-week block of concurrent resistance, sprint, and change of direction training. Participants were assigned one of two training conditions, AEL (n = 9) or TRAD (n = 8). Training was identical, except AEL performed 110% eccentric overloading every 1^st, 3^rd, 5^th, 7^{th …}

Investigating Self-Perception Of Speech And Motivation For Return To Intervention For Post Cochlear Implantation In Young Adults, Madison Henry

Electronic Theses and Dissertations

Introduction: Cochlear Implants (CI) are designed to address severe to profound hearing loss. When implantation occurs after language develops, it is referred to as post-lingual (PL) implantation. Currently, no interventions have been identified to address the communication challenges that young adults with PL-CIs may face after they complete post-CI rehabilitation services. This study analyzes if an individualized intervention plan is beneficial for a person with PL-CIs when experiencing changing communication demands in the transition to college or the workforce. Methodology: Baseline assessments were conducted; the results of which allowed for the establishment of four co-constructed goals. These goals were targeted …

Healthcare Provider’S Perceptions On Feeding Difficulties And Educational Practices In Infants With Neonatal Opioid Withdrawal Syndrome (Nows), Katelyn White

Electronic Theses and Dissertations

This study examined healthcare professionals’ perceptions on feeding difficulties experienced by infants with NOWS, the involvement of SLP in care, knowledge and experience levels of professionals, and trends in education and follow up care. A 34-question survey was developed to obtain data from participants involved in the care of exposed infants using the secure webbased RedCap™ platform. Nonparametric inferential statistics and descriptive analysis were used to interpret data. Feeding difficulties in infants exposed were reported by all respondents with SLP involvement reported by 42.2%. Results found that 51.9% of respondents were confident in their ability to educate families about feeding …

Exploring Available Information On The Gut-Brain Axis And Alzheimer’S Disease For Clinicians Making Dietary Recommendations: A Scoping Review, Megan Gibson

Electronic Theses and Dissertations

Abstract: Alzheimer’s Disease (AD) is a complex neurodegenerative disease that requires interprofessional collaboration. Pharmacological options are currently ineffective, increasing the need for preventative strategies to combat the rise of AD. Considerations of gut-targeted interventions have increased as a key component in the prevention of AD, based on the understanding that the state of the gut microbiome can impact cognitive function through the pathway known as the gut-brain axis.

Methods: This scoping review explored information on the gut-brain axis in persons with AD. A comprehensive search was conducted in November 2023. Forty reviews and 13 human studies were analyzed.

Results: There …