Medicine and Health Sciences Commons^™

Evaluating A Bystander Intervention Program On Reproductive Coercion: Using Quasi-Experimental Design Strategies To Address Methodologic Issues In Randomized Community Prevention Trials, Catherine P. Starnes

Theses and Dissertations--Epidemiology and Biostatistics

Community (or cluster) randomized trials are trials in which communities or groups of individuals (clusters) are randomized to receive the intervention of interest. Community randomized trials frequently more closely resemble a natural experiment than a randomized controlled trial (RCT) following intervention allocation. In particular, the effects of non-compliance can pose methodologic challenges in estimating the intervention effect which may require a quasiexperimental approach in order to minimize bias.

The motivating example to illustrate these issues is the Green Dot High School (GDHS) study. The GDHS study was a longitudinal, cluster-randomized controlled trial designed to assess the effectiveness of a bystander …

Exploration Of The Misuse, Abuse, And Diversion Of Gabapentin, Rachel Vickers Smith

Theses and Dissertations--Epidemiology and Biostatistics

Gabapentin is currently approved by the Food and Drug Administration (FDA) as an adjunctive anti-convulsant and an analgesic for post-herpetic neuralgia. Though gabapentin was initially presumed to have limited or no abuse potential, which may have contributed to its widespread off-label prescribing, there have been increasing anecdotal and published reports of its misuse by substance abusers in the community and penal system. However, to date, there has been limited systematic evaluation of the scope and risk of gabapentin misuse and its associated effects. This dissertation assesses the etiology and prevalence of gabapentin misuse, abuse, and diversion in a multi-faceted approach, …

Biventricular Finite Element Modeling And Quantification Of 3d Langragian Strains And Torsion Using Dense Mri, Zhanqiu Liu

Theses and Dissertations--Mechanical and Aerospace Engineering

Statistical data suggests that increased use of evidence-based medical therapies has largely contributed to the decrease in American death rate caused by heart disease. And my studies are about two applications of magnetic resonance imaging (MRI) as a non-invasive approach in evidence-based health care research. In my first study, the achievement of a pulmonary valve replacement surgery was assessed on a patient with tetralogy of Fallot (TOF). In order to evaluate the remodeling of right ventricle, two biventricular finite element models were built up for pre-surgical images and post-surgical images. In my second study, 3D Lagrangian strains and torsion in …

The Role Of Fat Grafting And Adipose-Derived Stem Cells In Breast Reconstruction, Krishna S. Vyas

Theses and Dissertations--Clinical and Translational Science

Fat grafting is a common surgical procedure that involves the transfer of fat from one area of the body to another in order to improve contour deformities, such as in breast reconstruction. Advantages of the technique include using autologous tissue rather than a foreign body and the added benefit of having liposuction to remove fat from an undesirable location. Although adipose tissue could be the ideal soft tissue filler, fat grafting is plagued by tremendous variability in long-term retention, with volume survival rates of 20-80%, resulting in suboptimal outcomes and repetitive procedures.

The mechanisms contributing to long-term fat graft survival …

Vocal Function Exercises For Normal Voice: The Effects Of Varying Dosage, Maria H. Bane

Theses and Dissertations--Communication Sciences and Disorders

The primary purpose of this investigation was to explore the effects of variable doses of home practice Vocal Function Exercises (VFEs) on attainment of pre-established maximum phonation time (MPT) goals in individuals between the ages of 18 and 25 with normal voice. A secondary purpose was to monitor for potentially toxic effects of high doses of VFEs. Three experimental groups completed a six-week VFE protocol and practiced twice daily. The low dose group performed each exercise once, the traditional group twice, and the high dose group four times. Results indicated significant change in VFE MPT for all three groups and …

The Effect Of Digital Media On Emergent Literacy Skills: A Systematic Review, Ciera B. Mills

Theses and Dissertations--Communication Sciences and Disorders

This review examines the effectiveness of digital media on emergent literacy skills, specifically alphabet knowledge, print awareness, and phonological awareness, on children birth to four. A systematic search of the literature identified 13 studies that met the pre-determined inclusion criteria. Two independent raters evaluated each study for methodological quality and assigned appropriate levels of evidence based on ASHA levels of evidence. Results found that specific features of digital media can lead to positive effects on emergent literacy skills. A checklist with the highlighted features was created to guide clinicians, parents, and others in making decisions about the true educational quality …

The Role Of Pxr And Ikkβ Signaling In Cardiometabolic Disease, Robert N. Helsley

Theses and Dissertations--Pharmacology and Nutritional Sciences

Cardiovascular disease (CVD) is the leading cause of death worldwide and is partially attributed to perturbations in lipid metabolism. Xenobiotics, such as pharmaceutical drugs and environmental chemicals, have been associated with increased risk of CVD in multiple large-scale human population studies, but the underlying mechanisms remain poorly defined. We and others have identified several xenobiotics as potent agonists for the pregnane X receptor (PXR), a nuclear receptor that can be activated by numerous drugs as well as environmental and dietary chemicals. However, the role of PXR in mediating the pathophysiological effects of xenobiotic exposure in humans and animals remains elusive. …

Effects Of Mammalian Target Of Rapamycin Inhibition On Circuitry Changes In The Dentate Gyrus Of Mice After Focal Brain Injury, Corwin R. Butler

Theses and Dissertations--Physiology

Post-traumatic epilepsy is a common outcome of severe traumatic brain injury (TBI). The development of spontaneous seizures after traumatic brain injury generally follows a latent period of little to no symptoms. The series of events occurring in this latent period are not well understood. Additionally, there is no current treatment to prevent the development of epilepsy after TBI (i.e. antiepileptogenics). One cell signaling pathway activated in models of TBI and in models of epilepsy is the mammalian target of rapamycin (mTOR). mTOR activity is sustained for weeks after the initial insult in models of TBI, and the inhibition of mTOR …

Development And Application Of Gadolinium Free Cardiac Magnetic Resonance Fibrosis Imaging For Multiscale Study Of Heart Failure In Patients With End Stage Renal Disease, Tori A. Stromp

Theses and Dissertations--Physiology

Cardiac magnetic resonance (CMR) is a powerful tool to noninvasively image ventricular fibrosis. Late gadolinium enhancement (LGE) CMR identifies focal and, with T1 mapping, diffuse fibrosis. Despite prevalent cardiac fibrosis and heart failure, patients with end stage renal disease (ESRD) are excluded from LGE. Absence of a suitable diagnostic has limited the understanding of heart failure and obstructed development of therapies in the setting of ESRD. A quantitative, gadolinium free fibrosis detection method could overcome this critical barrier, propelling the advancement of diagnostic, monitoring, and therapy options. This project describes the development of a gadolinium free CMR technique and application …

Protein Kinase A And Epac Mediate Chronic Pain After Injury: Prolonged Inhibition By Endogenous Y1 Receptors In Dorsal Horn, Weisi Fu

Theses and Dissertations--Physiology

Inflammation or nerve injury sensitizes several populations of nociceptive neurons in the dorsal horn of the spinal cord, including those that express the neuropeptide Y (NPY) Y1 receptor (Y1R). Our overall hypothesis is that after tissue or nerve injury, these Y1R-expressing neurons enter a state of latent sensitization (LS) that contributes to vulnerability to the development of chronic pain; furthermore, LS is under the tonic inhibitory control of endogenous Y1R signaling. First, we evaluated the intracellular signaling pathways that become activated in Y1R-expressing neurons and participate in LS. To do this, we established behavioral models of inflammatory or neuropathic pain, …

Regulation Of Uv-Protective Pathways Downstream Of The Melanocortin 1 Receptor In Melanocytes, Erin M. Wolf Horrell

Theses and Dissertations--Physiology

Malignant cutaneous melanoma is the deadliest form of skin cancer, and a majority of melanoma diagnoses are a result of exposure to ultraviolet (UV) radiation. UV radiation causes DNA damage, which if not repaired correctly via nucleotide excision repair (NER) can result in mutations and melanomagenesis. The melanocortin 1 receptor (MC1R) is a G_s protein coupled receptor located on melanocyte plasma membranes and is involved in protecting the skin from UV induced damage. MC1R signaling results in the activation of two protective pathways: 1) induction of eumelanin synthesis downstream of micropthalmia-associated transcription factor (MITF) and 2) acceleration of NER …

Competitive Food Policy Implementation In Kentucky Schools, Paula Gisler

Theses and Dissertations--Nursing

This study was designed to explore the literature on competitive food policy implementation (CFPI); examines demographic and school factors associated with CFPI; and explores the experiences of school leaders and staff in CFPI using a proposed theoretical framework to guide the research. Competitive foods are those sold in vending machines, a la carte settings, fundraisers, class parties and other venues which compete with foods offered through the national school lunch and breakfast programs. Competitive foods have traditionally been of low nutritional value and high energy density. CFPI may be effective in reducing student calorie intake and BMI. However, evaluation of …

Co-Morbid Symptoms Of Depression And Anxiety And Bio-Behavioral Response To Stress In Patients With Heart Failure, Abdullah S. Alhurani

Theses and Dissertations--Nursing

Heart failure (HF) is a major public health problem throughout the world. It accounts for one death certificate among nine in the United States. Heart failure and sudden death combined are responsible for the largest number of deaths in America. The total costs of HF in the United States are estimated to be $37 billion each year. Despite substantial medical and surgical advances related to treatment of HF, it remains a very costly condition with high mortality and morbidity rates. Although biological factors contribute to high morbidity and mortality in HF, there are many unexplored psychosocial factors that also likely …

Differential Gene Expression In Equine Cartilaginous Tissues And Induced Chondrocytes, Emma N. Adam

Theses and Dissertations--Veterinary Science

Degenerative joint disease, or osteoarthritis, is a major cause of lameness and morbidity in horses, humans, and dogs. There are no truly satisfactory cures for this widespread problem and current treatments all have limitations or unwanted side effects.

New cell-based strategies to repair joint surface lesions have generated a high level of interest, but have yet to achieve the full restoration of articular cartilage structure and function. Currently used therapy cells include autologous chondrocytes and adult mesenchymal cells such as bone marrow derived cells and adipose derived cells. Unfortunately, the resultant repair tissue is biomechanically inferior fibrocartilage. A critical gap …

Comparison Of Quick Methods For Determining Body Composition In Female Collegiate Athletes And Obese Females, Mandee E. Martin

Theses and Dissertations--Nutrition and Food Systems

The Body Mass Index (BMI) is a tool used broadly by public health agencies to assess weight in populations. However, when differentiating between fat mass and fat free mass the formula (BMI = weight in kilograms/height in meters2) is not applicable. Research suggests that evaluating body fat percentage and adipose tissue deposition may provide a nuanced indication of overall health, making it more accurate on an individual basis. This study evaluated four methods (Body Mass Index, waist circumference, A Body Shape Index, and Waist to Stature Index) that assess body composition and their ability to predict body fat percentage in …

Evaluation Of Diet Composition Of Pediatric Cancer Survivors As A Need For Nutrition Counseling, Sean O'Nan

Theses and Dissertations--Nutrition and Food Systems

Prior research has shown that pediatric cancer survivors face a multitude of longterm effects from treatment of their disease. Many of these conditions can be treated or managed through proper nutrition, however patients of the DanceBlue Kentucky Children's Hospital Hematology/Oncology Clinic do not see a registered dietitian. This study looked at food and drink consumption of the past 30 days by the patient using the NHANES Dietary Screener Questionnaire to see if they met nutrition recommendations as outlined by the 2015‐2020 Dietary Guidelines for Americans. Results from the study found that off‐treatment pediatric cancer survivors (n=21) failed to meet …

Promoting Healthy Home-Cooked Family Meals: Evaluation Of A Social Marketing Program Targeting Low-Income Mothers, Mollie Y. Dawahare

Theses and Dissertations--Nutrition and Food Systems

Objective: Evaluate how a social marketing approach compares to traditional nutrition education curriculum for promoting behavioral changes related to eating and food.

Design: Nonequivalent comparison group, entry-exit design. Participants from 12 Kentucky counties assigned either comparison or pilot group. Comparison group received traditional nutrition education curriculum and pilot group received the social marketing program, Cook Together, Eat Together (CTET) curriculum. EFNEP’s Behavior Checklist and 24-Hour Dietary Recall were administered at entry and exit of the 8-week programs.

Participants: Females (18-72 years of age) from families eligible to receive SNAP benefits (n=64 comparison group participants, n=60 pilot group participants).

Intervention: …

Evaluation Of A Diabetes Self-Management Program For Hispanics In Lexington Kentucky: A Pilot Study, Miguel A. Gamboa Oropeza

Theses and Dissertations--Nutrition and Food Systems

Hispanics are more affected by diabetes than non-Hispanic whites and they tend to experience more severe complications. Research shows that although self-management is poor among ethnic minorities, it is even more so among Hispanics. The “Taking Ownership of Your Diabetes” (TOYD) program has been shown to be successful in helping individuals manage their diabetes. However, no work has been conducted with Hispanic audiences in Kentucky. TOYD program allows individuals to modify lifestyle risks and solve problems related to diabetes management. The program was translated from English to Spanish. Hispanics males and females between ages 19 to 75 years …

Online Self-Testing Resources Prepared By Peer Tutors As A Formative Assessment Tool In Pharmacology Courses, Melinda E. Lull, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Objective. To assess the effectiveness of optional online quizzes written by peer tutors in a pharmacology course for doctor of pharmacy students.

Methods. Online quizzes were written by peer tutors for second-year pharmacy students. Quizzes reflected the material taught during lecture and were in a format similar to that of the examinations. Data related to performance on each quiz and each examination were collected throughout the semester. At the end of the semester, students and peer tutors were surveyed to gather information on the utility and success of the quizzes.

Results. Students taking online quizzes performed significantly better on examinations …

An Analysis Of Psychologist Postdoctoral Psychopharmacology Training Materials For Critiques Of Neurobiological Hypotheses Of Depression's Etiology, Critical Analyses Of The Dsm's Rigor, And For Consumer/Survivor/Ex-Patient Content., Chris William Nicholas Rowe

Antioch University Dissertations & Theses

There is widespread agreement that neurobiology plays a role in psychological distress and that psychiatric diagnosis and associated psychopharmacological interventions can be helpful. However, there are also unresolved issues surrounding the limits of empirical support for current diagnostic criteria, shortcomings in neurobiological explanations of psychopathology, and unanswered questions about the mechanism, safety, and efficacy of psychiatric medications. This has implications for treatment errors which can precipitate negative socio-economic and health consequences, particularly for vulnerable groups like the Consumer/Survivor/Ex-Patient (c/s/x) population. It is for these reasons that the training psychologists receive to prescribe should, in addition to integrating the critiques of …

Distress Among Psychologists: Prevalence, Barriers, And Remedies For Accessing Mental Health Care, Kimberly Patterson-Hyatt

Antioch University Dissertations & Theses

This study completed a critical review of psychologists’ mental health by developing a conceptual analysis based on the current empirical literature of the mental health needs of clinical psychologists. Distress among psychologists was explored by examining the following domains: (a) examining the prevalence of mental illness and psychological distress that exist among them, (b) examining the barriers they encounter to seeking treatment when experiencing this distress, and (c) reviewing current interventions and integrating remedies for access to mental health care that best meets psychologists’ needs. Results included several themes within each domain shaping a contextual picture of some of the …

Black And White Multiracial Adult Womens' Experience Of Their Physical Appearance: A Qualitative Descriptive Phenomenological Analysis, Vanessa Geissler

Antioch University Dissertations & Theses

According to the 2010 United States Census 1.8 million people self-identified as multiracial Black, and of that 1.8 million, 45% self-identified as Black and White. Multiracial individuals are a growing population in the United States, and by year 2050 an estimated 21% of the entire population will be multiracial. Irrespective of these statistics, research among this population is limited. Further research is warranted because existing literature has identified an increased emphasis on multiracial individual’s physical appearance. Questions such as, “What are you?” or labels such as exotic, beautiful, fascinating, or other, are a few examples of how this population is …

A Culture That Fosters Concussions: Does Increased Education Lead To More Accurate Reporting Of Concussions?, Michael Heptig

PCOM Psychology Dissertations

With over 1.7 million incidents reported annually, concussion has become the most common class of traumatic brain injury (TBI) in the United States (Bazarian, Zhu, Blyth, Borrino, & Zhong, 2012). As staggering a statistic as this may be, many believe it fails to represent the true number of concussions because the non-reporting of symptoms has been commonplace among athletes (Khurana & Kaye, 2012; Williamson & Goodman, 2006). The aim of this study was to determine those factors that influence the reporting of concussion symptoms. Specific variables that were examined include the amount of concussion education provided (determined by requisite amount …

Premedical Programs Newsletter, January-February 2016, University Of Dayton

Pre-Health Resource Center Campus Communications

Newsletter for students, staff, and faculty in the premedical and predental programs.

Biophysical Sources Of 1/F Noises In Neurological Tissue, Alan Paris

Electronic Theses and Dissertations

High levels of random noise are a defining characteristic of neurological signals at all levels, from individual neurons up to electroencephalograms (EEG). These random signals degrade the performance of many methods of neuroengineering and medical neuroscience. Understanding this noise also is essential for applications such as real-time brain-computer interfaces (BCIs), which must make accurate control decisions from very short data epochs. The major type of neurological noise is of the so-called 1/f-type, whose origins and statistical nature has remained unexplained for decades. This research provides the first simple explanation of 1/f-type neurological noise based on biophysical fundamentals. In addition, noise …

Student Athletes And Factors That Determine Their Social Support Circle, Elizabeth Anne Gelhaus

Graduate Theses/Dissertations

Research has shown that the risk of athletic injury increases with increased psychological stress and that social support can help reduce risk of injury. Collegiate athletic trainers spend a considerable amount of time with and build unique relationships with the athletes on whom they work with. However, no research is available on specific factors that cause an athlete to turn to an athletic trainer for social support. An electronic survey was developed and sent to 938 local collegiate athletes to determine if, how, and why student athletes utilize athletic trainers for social support. The results from this study found that …

A Biomechanical Comparison Between Expert And Novice Manual Materials Handlers Using A Multi-Joint Emg-Assisted Optimization Musculoskeletal Model Of The Lumbar Spine, Denis Gagnon, André Plamondon, Christian Larivière

Études primaires

Expertise is a key factor modulating the risk of low back disorders (LBD). Through years of practice in the workplace, the typical expert acquires high level specific skills and maintains a clean record of work-related injuries. Ergonomic observations of manual materials handling (MMH) tasks show that expert techniques differ from those of novices, leading to the idea that expert techniques are safer. Biomechanical studies of MMH tasks performed by experts/novices report mixed results for kinematic/kinetic variables, evoking potential internal effect of expertise. In the context of series of box transfers simulated by actual workers, detailed internal loads predicted by a …

Subject-Specific Biomechanics Of Trunk: Musculoskeletal Scaling, Internal Loads And Intradiscal Pressure Estimation, F. Ghezelbash, A. Shirazi-Adl, N. Arjmand, Z. El-Ouaaid, A. Plamondon

Études primaires

Development of a subject-specific computational musculoskeletal trunk model (accounting for age, sex, body weight and body height), estimation of muscle forces and internal loads as well as subsequent validation by comparison with measured intradiscal pressure in various lifting tasks are novel, important and challenging. The objective of the present study is twofold. First, it aims to update and personalize the passive and active structures in an existing musculoskeletal kinematics-driven finite element model. The scaling scheme used an existing imaging database and biomechanical principles to adjust muscle geometries/cross-sectional-areas and passive joint geometry/properties in accordance with subjects’ sex, age, body weight and …

Exploring Test Anxiety In Bsn Nursing Students, Annette Marie Keller

Graduate Theses/Dissertations

Test anxiety is a phenomenon that was identified through research in the domains of education and psychology during the 1950s – 1960s. As test anxiety and its effects have been identified and addressed in nursing programs, the same treatment modalities have been applied without evidence that nursing students experience test anxiety in the same manner as other students. The purpose of this study was to describe test anxiety as experienced by BSN nursing students using the sequential explanatory mixed methods design in an effort to gain insight into the anxiety experience of nursing students. A sample of 73 junior and …

Fruit And Vegetable Availability, Nutrition Education And Access Amongst Food Pantries In California, Maine, Mississippi And South Dakota, Sarah L. Fowler

All Graduate Theses, Dissertations, and Other Capstone Projects

This descriptive study explored the views of food pantry directors in four states regarding pantry fruit and vegetable stock and supply, nutrition education offered, and current practices and perceived barriers to providing access to food pantries to low-income individuals and families in need. This study examined these variables by surveying staff at the food pantries who have direct contact with the individuals and families who utilize the pantries. All survey responses were collected utilizing Qualtrics software and then analyzed in SPSS. There were 87 respondents from four different states, California, Maine, Mississippi, and South Dakota.

The reporting for both fresh …