Medicine and Health Sciences Commons^™

Exploring Drivers Of Sex-Based Disparities In Relapsing Multiple Sclerosis, Stephanie K. Buxhoeveden

Theses and Dissertations

Females are three times more susceptible to relapsing multiple sclerosis (MS) and males typically have more severe disease, but the molecular underpinnings of these sex-based disease disparities are unknown and represent a critical knowledge gap.Subject Population: Blood samples from a demographically homogenous group of treatment naïve males and females with relapsing-MS and healthy controls. Research Design: Cross-sectional combinatorial omics pilot study. Instruments: Whole transcriptomic analysis with messenger RNA (mRNA) expression profiling using next generation sequencing (RNA-seq) and micro-RNA (miRNA) expression using NanoString technology. Aim 1) Identify and compare the actively expressed mRNAs in the transcriptome of males and …

The Splice Index As A Prognostic Biomarker Of Strength And Function In Myotonic Dystrophy Type 1, Marina Provenzano

Theses and Dissertations

Myotonic dystrophy type 1 (DM1) is a slowly progressive, multisystem disorder caused by a CTG repeat expansion in the DMPK 3’UTR that leads to global dysregulation of alternative splicing. The resulting decline in physical function is slow, and no reliable biomarkers exist for predicting disease progression; however, an RNA mis-splicing biomarker associated with weakness may have utility in predicting functional outcomes. Here we validate the Splice Index (SI) as a potential biomarker of DM1-associated strength and function. Muscle biopsies of the tibialis anterior were collected from DM1-affected individuals at baseline (n = 46) and 3-months (n = 34), along with …

The Role Of Notch1 Signaling In Regulating Neurogenesis In The Olfactory Bulb Following Traumatic Brain Injury, Sarah A. Baig

Theses and Dissertations

In the United States, more than 20.5 million adults over the age of 40 suffer from olfactory dysfunction, with TBI attributing to 5-17% of all olfactory dysfunction cases. Although often initially undetected and less conspicuous than other cognitive and behavioral impairments, olfactory dysfunction may have a significant negative impact on patients' quality of life and ability to accomplish activities of daily living, therefore the pathophysiology of these disorders should be understood. The production of neural stem cells enhances the repair and regeneration of the injured brain following a TBI. One of the primary endogenous neural stem cell generation sites in …

Intersectionality, Racial Discrimination And Oral Healthcare Utilization Among Black Adults In Baltimore City, Maryland, Briona M. Phillips

Theses and Dissertations

INTRODUCTION: Oral health is essential for overall well-being, yet disparities persist, particularly among marginalized populations including Black adults. Limited access to and underutilization of oral healthcare services exacerbate these disparities. Discrimination, both individual and systemic, acts as a significant barrier to accessing care, contributing to disparities in oral health outcomes. Individuals facing discrimination experience mistrust and fear within oral healthcare settings, leading to delayed or avoided care. Therefore, investigating and addressing discrimination among Black adults is essential for promoting equitable access to oral healthcare, improving overall oral health outcomes, and lessening existing disparities.

PURPOSE: The purpose of this dissertation was …

Health And Lifestyle Behavioral Changes To Prevent Myocardial Infarction (Mi): Mixed Methods Approach To Understand Secondary Mi Prevention, Naila Idreesa Saghir

Global Public Health | Senior Theses

Cardiovascular diseases are the leading causes of death globally and about 200,000 individuals experience their second myocardial infarction yearly. There is a lack of understanding about how lifestyle and behavioral changes can prevent secondary myocardial infarction a year in the United States. The objective of this study is to use a mixed methods approach to understand how individuals who have made lifestyle behavioral changes to prevent their secondary myocardial infarction. Surveys and interviews consisted of questions about the participants' health behaviors and health history. Demographics, background information, and lifestyle behavioral changes were measured using Qualtrics. Valid and reliable tools such …

Examining The Sleep Habits Of College Aged Individuals, An Intervention Study, Garrett Siebels

Global Public Health | Senior Theses

Background-

Sleep deprivation, characterized by insufficient or poor-quality sleep, is a prevalent public health issue. Recent statistics reveal that over 110 million Americans are suffering from sleep deficiency, and about 60% of college aged individuals suffer from sleep deprivation. Previous research suggests that theta wave therapy may help induce sleepiness. We aim to discover how these intervention strategies may contribute to improved sleep quality and overall well-being among college-aged individuals.

Methods-

Participants were recruited using convenient sampling, then randomized into the intervention group and control group. Individuals self-reported demographics, baseline information and initial Pittsburgh Sleep Quality Index (PSQI) scores using …

Bird’S Nest Drawing: Exploring The Attachment Of Left-Behind Children In China, Ziyi Su

Expressive Therapies Dissertations

To explore the attachment of left-behind children (LBC), this mixed-methods study analyzed the Bird’s Nest Drawings (BND) and narratives from 117 fourth graders from Shaanxi and Gansu, China. Overall, the BND of LBC showed less secure-attachment features. These distinctions can be seen in several pictorial elements, and manifest differently across gender groups and rural versus urban groups. Drawings and narratives revealed eight underlying themes of absence, longing, and support from parent and peer attachment. Children creatively communicated complex emotions and attachment experiences through the metaphor of the bird’s nest, ranging from abandonment, loneliness, and vulnerability, to coping, hope, and resilience. …

Characterizing The Relationship Between The Presence Of Depression Risk, Post-Traumatic Stress Disorder, And Benzodiazepine Use To Get High, Julia Kollitz

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

Aim: To determine if there is a relationship between depression risk, post-traumatic stress disorder (PTSD), and engaging in benzodiazepine misuse.

Methods: A secondary cross-sectional analysis was conducted on data from a sample of people who use drugs (n=743). Depression risk was assessed via the Center for Epidemiological Studies-Depression scale. Meeting DSM-IV criteria for PTSD was identified using the Mini International Neuropsychiatric Interview (MINI). We used simple and multivariable logistic regression models to estimate the association between mental health factors of interest and benzodiazepine misuse, defined as self-reported benzodiazepine use “to get high” in the past six months.

Results: Of the …

A Case Study In Program Evaluation: A Prospective Program Evaluation Of Timely Reporting And Action Of An Infectious Disease Outbreak, Destiny Cozart

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

Methicillin-resistant Staphylococcus aureus also known as MRSA is an infection of a staph bacteria. High school athletes are at risk of contracting MRSA through skin to skin contact and/or MRSA contaminated equipment. This case study uses the CDC's six-step framework for program evaluation to measure the effectiveness of the online training modules designed to increase the knowledge of staff and stakeholders about MRSA and infectious disease outbreaks. The findings from this evaluation will advise the potential change(s) implemented in training modules, ultimately to enhance competency for decision makers and prevent MRSA and infectious disease outbreak amongst high school athletic programs.

Prevalence Of Hpv16 E6 Antibodies And Oral Hpv Among Men Living In Kentucky, Christopher O. Otieno

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

ABSTRACT

Objective: The incidence of human papillomavirus-driven oropharyngeal cancer (HPV-OPC) is surging in the United States, particularly in the southeast and Appalachia. The reason for this increase is unknown. We evaluated the prevalence of two markers of increased risk, HPV16 E6 antibodies and oral HPV infection, among men in Appalachian and non-Appalachian Kentucky.

Methods: This study was nested within an ongoing HPV-OPC screening study of healthy men aged 45+ residing in urban (non-Appalachian) and rural (Appalachian) Kentucky and included the first 1,581 participants with either HPV serologic and/or oral HPV testing. Blood and oral rinse samples were collected at enrollment. …

Dental Outreach In Academic Dental Settings, Tisha Clayborn

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

Creating an effective outreach program in a dental academic setting involves a strategic approach combining educational objectives and community service. This Dental Outreach Program Guide aligns with organizational objectives, contributes to community well-being, and serves as a model for future outreach initiatives in academic dental settings. This program utilizes the PRECEDE-PROCEED planning model to design and evaluate an oral health strategy. This program aims to outline a strategic plan incorporating evidence-based decision-making, data-driven metrics, and a comprehensive roadmap for successful implementation.

Fall 2023 Covid-19, Influenza, And Respiratory Syncytial Virus Vaccine Uptake In Kentucky, Abigail Dial

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

Fall 2023 COVID-19, Influenza, and Respiratory Syncytial Virus Vaccine Uptake in Kentucky

Background: In the fall of 2023, vaccine recommendations included updated COVID-19 and influenza vaccines, as well as a new vaccine and immunization for respiratory syncytial virus (RSV). Vaccine co-administration, the administration of more than one vaccine in one vaccination session, is safe and effective for COVID-19, influenza, and RSV vaccines and can improve vaccine uptake for all recommended vaccines (Bonanni, et al., 2023; CDC, 2023). The COVID-19 pandemic altered the landscape for locations where people receive vaccinations, and it may be beneficial to public health to have …

Art-Based Autoethnographic Study Of A Senior Professional Woman Of Color's Journey, Raceal Mcwhorter

Art Therapy | Doctoral Dissertations

This proposed dissertation study is a visual autoethnographic qualitative study of the recalled lived experiences of a senior woman of color's journey to become a spiritual art therapist professional during the 20th to 21st Century in the United States of America. This study interprets the memories of events in my lifetime, looking back through the lens of a spiritual mental health art therapist practitioner. The adverse effects of the legacy and enforcement of silence on women and black people. I hope that by describing my lived experiences and felt sense -- and illustrating my arduous journey to overcome societal racism, …

Screening For Unhealthy Alcohol Use: Implementation Of Screening And Brief Intervention (Sbi) In Primary Care Using The Audit-C, Sarah Bell

DNP Projects

Background: In 2021, the NIAAA reported that alcohol use disorder affected 29.5 million Americans. Alcohol Screening and Brief Intervention (SBI) is an evidence-based prevention strategy, recommended by the USPSTF, to reduce alcohol consumption. Unfortunately, less than 50% of patients receive advice from their provider about the harms of excessive alcohol use. This study aimed to implement an effective SBI process in a rural primary care setting utilizing the Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) tool while addressing known barriers to proper implementation.

Methods: Donabedian's Structure-Process-Outcome (SPO) framework for Quality Assessment guided this quality improvement design. Intervention planning included considerations …

Guardians Of The Community: A History Of Provident Hospital, 1891-1950, Lenie Annoh Adolphson

Graduate Research Theses & Dissertations

Established in 1891 in Chicago, Illinois, Provident Hospital was born out of the urgent need to combat racial discrimination and segregation. Provident Hospital stood as a beacon of hope for nearly a century, serving as one of the few healthcare facilities open to Chicago’s Black population. Dr. Daniel Hale Williams’s vision of an interracial hospital was a powerful symbol of unity, brought to life through the collaborative efforts of Black physicians, White philanthropists, Black women’s clubs, and community members. However, this vision was continually challenged by interference from White donors, increasing spatial segregation, intensifying poverty following the Great Migration, and …

Adult Attachment As Moderating Variable For Parental Burnout, Janell Mccann

Graduate Research Theses & Dissertations

In recent years, research in family sciences has focused on the impact of stress on parents, leading to parental burnout risks. This study aimed to explore how adult attachment relates to parental burnout and if it moderates the link between parenting stress and burnout. Attachment theory suggests secure attachment can protect against parenting stress, while anxious and avoidant attachment may worsen its effects. In order to examine the effect of adult attachment in the development of parental burnout, parenting stress was measured using the Balance of Risks and Resources, parental attachment was measured using Experiences in Close Relationships (Revised), and …

Analyzing Sex Differences In Human Performance Through 3d Isotonic Resistance, Jacob M. Cunha

University of the Pacific Theses and Dissertations

Appraisal of scientific literature and understanding continues to grow in the domain of human performance. The effects of sex on concentric resistance training and power output are not well understood. Recent advancements in technology permit more precise measurements of force output and the kinematic changes elicited by training stress. A unique device in capturing kinematic performance output is Proteus Motion. The machine produces an external magnetic load through a protruding apparatus connected to a gyrosphere, which in turn captures concentric movement through all three planes of movement (sagittal, coronal, transversal). The aim of this study is to investigate power output …

Deconstruction Of Body Representation Of The Back In Healthy Back Pain-Free Individuals And People With Chronic Low Back Pain, Simon Pratt

Theses

Changes in various body representations have been increasingly investigated and subsequently posited to be potentially important factors in the development and maintenance of chronic low back pain. Three main domains of body representation are considered here: body model, body schema (comprising superficial and postural schema), and body image. Most studies informing our contemporary understanding of these body representations have been undertaken in areas such as the hand and forearm, with a comparative dearth of studies performed on the low back. Consequently, this thesis consists of a comprehensive investigation of body representation initially in healthy back pain-free individuals and then in …

Uncovering The Link Between Diabetes And Pulmonary Hypertension, Nishant Nundlall

Theses

Background

Diabetes is a common disorder in the general population with most studies focusing on its role on the left ventricle and coronary artery disease, however it effects on pulmonary hypertension (PH) have not been fully studied. There is a pressing need to more completely explore the cardiovascular impacts of diabetes. The impact of diabetes might vary according to the various forms of PH, their predominant contribution is likely to be in PH due to left heart disease (group II, the most common form of PH).

Thus far, most studies have offered a focussed perspective with data from specialised referral …

Optimising Care For Musculoskeletal Conditions To Reduce Burden On Hospital Emergency Department And Orthopaedic Services, Piers Truter

Theses

Worldwide health care systems are under increasing pressure due to aging amongst ever growing populations with increasing co-morbidity and treatment options (WA DoH, 2019). Furthermore, how people choose to engage with health care and access and literacy for health information is also changing, as is understanding of the factors associated with good health outcomes. These changes are driving evolution in health care delivery. There is a need for high quality and sustainable models of care accompanied by judicious evaluation of impact in terms of health services deliverables and the consumer experience of care. This thesis explores the feasibility and applicability …

The Impact Of Treatment Dosage On Cognitive-Linguistic Outcomes Of Patients With Aphasia: An Investigation Of Three Service Delivery Models, Adele J. Derendinger

Graduate Student Theses, Dissertations, & Professional Papers

This study addresses the gap in literature by directly comparing the effectiveness of Intensive Comprehensive Aphasia Programs (ICAPs) and modified ICAPs (mICAPs) to usual care service delivery models for people with aphasia. Through a prospective study design, cognitive-linguistic function change scores across different service delivery models were examined. The findings reveal significant within-group improvements in cognitive-linguistic function for participants in ICAPs, with some improvement seen in mICAPs and usual care conditions. Intensive models demonstrated greater improvement compared to non-intensive usual care models, particularly evident in the Western Aphasia Battery – Revised and the Boston Naming Test – Second Edition. …

Perspectives On Using Pharmacogenomics To Guide Tobacco Cessation: Survey Results From An American Indian Community, Daniela Mariana Wall

Graduate Student Theses, Dissertations, & Professional Papers

Pharmacogenomics research has predominantly focused on populations of European ancestry, limiting the application for diverse populations such as American Indian and Alaska Native (AIAN) communities. Our community-centric study aims to understand perspectives of utilizing pharmacogenomics to guide tobacco cessation in an AIAN community using a survey with qualitative and quantitative components. We assessed participant (n=273) tobacco usage and cessation history, pharmacogenomics knowledge, and perceptions of utilizing pharmacogenomics in the context of tobacco cessation. We found that the majority of participants (92%) were aware of risks associated with tobacco usage and believe it to be a problem within their community (76%). …

The Influence Of Relational Frames On Climate Purchasing And Policy, Lauren Rose Hutchison

Graduate Theses/Dissertations

Evaluative conditioning refers to the effect that occurs when two stimuli are paired together, resulting in a change in the evaluation or function of one of the stimuli. Evaluative conditioning has been researched in various fields of study, such as advertisement and public administration, but synthetization efforts of these results with a relational frame theory approach, and vice versa, have been limited. This thesis used de-identified data from prior approved research to integrate and discusses two manuscripts that provide a relational frame theory perspective to evaluative conditioning effects. Study 1 extends a previous experiment by Matthews et al. (2022) through …

Effect Of P2y2 Receptors On Leukocyte Behavior Under Acute Inflammation In Transgenic Male Mice In Vivo, Corynn D. Knight

Graduate Theses/Dissertations

P2Y₂ receptors, G-protein coupled receptors and transmembrane proteins, are present on most cells in the body and hold a wide variety of roles. Previous research indicates that under resting conditions, P2Y₂ receptors suppress the movement of leukocytes but it is unknown how inflammation will alter this in the body. The objective of this project was to determine the effect of P2Y₂ receptors on leukocyte behavior in vivo under acute inflammation using Intravenous Microscopy (IVM) in post-capillary venules of the cremaster skeletal muscle. Lipopolysaccharide was injected into the scrotum of transgenic male mice to cause localized acute inflammation. …

Cervical Cancer Education & Prevention For Women In The Philippines, Kate Isabel Juanillo

Nursing | Senior Theses

Although cervical cancer is preventable, it continues to pose a significant health concern in the Philippines as evidenced by high cervical cancer diagnosis rates. The purpose of this quantitative study is to investigate low cervical cancer screening rates and the effectiveness of educational interventions in increasing awareness and screening rates. A literature review will examine topics such as low cervical cancer screening rates, cervical cancer screening methods, and barriers. This research proposal involves a quasi-experimental study that investigates education as an intervention for increasing cervical cancer awareness and cervical cancer screening rates. Fifty Filipino women will be randomly assigned to …

The Effect Of Nursing Education On The Utilization Of Kangaroo Mother Care And Weight Gain Of Preterm And Low Birth Weight Infants, Jhenalynn Valete

Nursing | Senior Theses

Aim: The goal of this quantitative study is to investigate if educating nurses about the significance of KMC will increase its utilization and promote weight gain in low birthweight and preterm infants. Additionally, it aims to find the optimal duration of KMC required to maximize health outcomes for the infant. This research proposal aims to provide nursing professionals with valuable insights, allowing them to effectively educate parents on practices that promote maximal weight gain in neonates.

Background: This is a cost-effective and natural way to enhance health outcomes such as temperature regulation, weight gain, respiratory function, pain mitigation, …

Breastfeeding Support In Your Pocket: Evaluating The Impact Of A Mobile App On Maternal Success, Maygan Brandt

Nursing | Senior Theses

Background: Breastfeeding has well-known benefits for both the nursing infant and the birthing parent. It bolsters the newborn immune system, and reduces the risk of future health conditions in both parties. Due to these advantages, several health organizations internationally recommend exclusive breastfeeding until 6 months of age. However, only a fraction of infants in the United States meet this goal each year. Improved rates and duration of exclusive breastfeeding will lead to better long-term health outcomes for patients. The use of smartphone applications for breastfeeding education and support has not been thoroughly researched. Objective: This thesis explores the feasibility of …

Exploring The Physiology Of Clostridioides Difficile: Selenium-Dependent Catabolism Of Host-Derived Nutrients, Michael A. Johnstone

Graduate Thesis and Dissertation 2023-2024

Clostridioides difficile is a bacterial pathogen that causes pseudomembranous colitis and the majority of antibiotic-associated diarrheal cases. Broad-spectrum antibiotic usage disrupts the normal gut microbiota and thereby compromises colonization resistance, the main defense against C. difficile infection. Treatment options are limited to vancomycin, fidaxomicin, and the fecal microbiota transplant. Addressing the scarcity of these therapeutics, we documented two explorations in C. difficile drug discovery: (i) evaluation of antibacterial and toxin-suppressing activity of (+)-puupehenone and similar derivatives, and (ii) clarification of a discrepancy in the hypothesized mechanism of auranofin against C. difficile. A better understanding of how C. difficile colonizes …

(Plant)Ing Traditional Roots: Exploring An Impact Of Environmental Shifts On Traditional Phytotherapy Practices In The Cusco Region Of Perú, Nicole Elizabeth Wilmot

Undergraduate Honors Theses

This thesis investigates the potential outcomes of environmental shifts on plant-based medical practices in the Cusco region of Peru. Located in the Andes mountain range, at a high elevation, the environment varies immensely, specifically in the various types of native plants in the region. Historically, using plants as natural forms of medicine or healthcare has been deeply rooted in many indigenous communities, traditions, and cultures globally. Environmentally, there have been potential changes and shifts in temperature, water, and soil that affect the nutrition and health of plants to maintain their beneficial properties. Due to various factors, adaptations or shifts to …

Impact Of Nursing Student-Staff Nurse Interactions In Clinical Settings: A Literature Review, Elizabeth Joffe

Senior Honors Theses and Projects

Nursing students receive education and experience from clinicals where they are supported by clinical instructors. These instructors rely on staff nurses to provide much of the hands-on education, thus causing the staff nurses to have an influence on the students. The aim of literature review is to understand current research and findings in regard to the impact staff nurses have on nursing students while in the clinical learning environment. This literature review utilized multiple online databases. Searches were conducted on articles from 2016 to 2024 with specific key terms such as student-staff nurse relationships, clinical learning, belonging, incivility, and positive …