Medicine and Health Sciences Commons^™

Factors Of Dysphagia In The Overdose Population Post Extubation., Renee Brown

Electronic Theses and Dissertations

Post-extubation dysphagia (PED) has been studied in depth in a variety of populations including elective heart surgeries, trauma, critical illness, traumatic brain injury, and those requiring mechanical ventilation, but has not been researched in the overdose population (OD). This study aims to research factors of PED in the OD population. A retrospective study was conducted and found 24 participants who fit the inclusionary requirements. Correlation statistics were run between age and duration of intubation, age or duration of intubation and gender, and between intubation duration, age, and scores on Penetration-Aspiration Scale (P/A) (thin by cup and thin by straw). The …

Novel Inference Methods For Generalized Linear Models Using Shrinkage Priors And Data Augmentation., Arinjita Bhattacharyya

Electronic Theses and Dissertations

Generalized linear models have broad applications in biostatistics and sociology. In a regression setup, the main target is to find a relevant set of predictors out of a large collection of covariates. Sparsity is the assumption that only a few of these covariates in a regression setup have a meaningful correlation with an outcome variate of interest. Sparsity is incorporated by regularizing the irrelevant slopes towards zero without changing the relevant predictors and keeping the resulting inferences intact. Frequentist variable selection and sparsity are addressed by popular techniques like Lasso, Elastic Net. Bayesian penalized regression can tackle the curse of …

The Role Of Inter-Enlargement Propriospinal Neurons In Locomotion Following Spinal Cord Injury., Courtney Therese Shepard

Electronic Theses and Dissertations

The focus of this dissertation is to explore the functional role of two anatomically-defined pathways in the adult rat spinal cord before and after spinal cord injury (SCI). To do this, a Tet^On dual virus system was used to selectively and reversibly silence neurons with cell bodies at spinal segment L2 and projections to spinal segment C6 (long ascending propriospinal neurons, LAPNs) and neurons that originate in the C6 spinal segment and terminate at L2 spinal segment (long descending propriospinal neurons, LDPNs). This dissertation is divided into five chapters. Chapter One provides background information regarding spinal cord injury, locomotion, …

Converting Threats Into Opportunities Predicting Medical Error Reporting Behavior., Whitney Thomas Rogers

Electronic Theses and Dissertations

Medical errors are a public health epidemic and a major threat to patient safety. Estimates suggest they may be responsible for 210,000 - 440,000 preventable deaths per year. This would make medical errors the third leading cause of death in the United States. The societal burden of medical errors is steep, with the economic impact near $1 trillion. The purpose of this study was to use a theory-driven approach to better understand the reporting behavior of healthcare professional. Increased error reporting leads to heightened awareness of the precursors or conditions generating errors, which can then be corrected. In its most …

A Novel Approach To Hiv Prevention: Understanding Multi-Level Influences On Hiv Pre-Exposure Prophylaxis (Prep) Uptake And Outreach Among African Americans., Suur Debrah Ayangeakaa

Electronic Theses and Dissertations

This dissertation examined and provided basis for addressing factors related to HIV pre-exposure prophylaxis (PrEP) engagement, outreach, and uptake among high-risk African American youth groups in Louisville, KY. This qualitative dissertation study was designed through the lens of an interpretive framework of social constructivism which holds that multiple realities and interpretations exist and are socially constructed through the lived experiences of individuals and their interactions with others. Thus, lived experiences of various African American youth groups in Louisville as well as key informants of AIDS service organizations (ASOs) across the U.S. (including Louisville) were explored to develop a deeper understanding …

Tobacco Product-Derived Aldehydes: Effects On Circulating Angiogenic Cells & Implications For Cardiovascular Disease., Jordan B. Lynch

Electronic Theses and Dissertations

Cardiovascular disease (CVD) is the leading cause of death worldwide. Tobacco smoke is the most significant modifiable risk factor in CVD development and contains numerous toxic compounds, including aldehydes, which have been linked to CVD. Formaldehyde, acetaldehyde, acrolein, and crotonaldehyde have been identified as significant contributors to cigarette-induced health effects, but the mechanism of these effects is not well understood. These aldehydes are also found in aerosols produced by e-cigarettes (e-cigs). The goal of this dissertation was to explore the systemic, hematological, and endothelium-related effects of exposure to tobacco products and constituent aldehydes and to identify potential mechanisms of injury. …

Development Of Rationally Designed Live Attenuated Vaccines For Lassa Fever And Venezuelan Equine Encephalitis., Dylan Macgregor Johnson

Electronic Theses and Dissertations

Lassa Virus (LASV) and Venezuelan Equine Encephalitis Virus (VEEV) are two single stranded RNA viruses belonging to the Arenavirus and Alphavirus families, respectively. Both are emerging pathogens without approved vaccines or treatments. VEEV is an important biothreat pathogen because it has been weaponized and is extremely infectious as an aerosol. VEEV causes biphasic febrile illness that can progress to a viral encephalitis with low mortality, but high morbidity. LASV causes a viral hemorrhagic fever, Lassa Fever (LF), which is endemic in West Africa, and responsible for between 100-500k annual infections with a 1-2% overall mortality rate. ML29 and VEEV TC-83 …

Mechanistic Insight Of The Role Of Nherf1 In Cisplatin-Induced Acute Kidney Injury., Adrienne M. Bushau-Sprinkle

Electronic Theses and Dissertations

Background. Acute kidney injury (AKI) develops in 30% of patients who receive cisplatin, a widely used chemotherapeutic agent. We previously showed that NHERF1 loss resulted in increased susceptibility to cisplatin nephrotoxicity. The overarching goal of this dissertation was to elucidate mechanisms of susceptibility to cisplatin-induced AKI, specifically the effects of NHERF1 loss on tubule cell metabolism, tubule cell mitochondrial function, and alterations in oxidative state and/or renal handling of cisplatin. Methods. 2-4 month male wild type (WT) and NHERF1 knock out (KO) mice were treated with either vehicle control or cisplatin (20 mg/kg dose IP) for 4, 24, and 72 …

Dual Role Of Antimicrobial Peptide Cathelicidin In Alcohol-Associated Liver Disease., Fengyuan Li

Electronic Theses and Dissertations

Patients with alcohol-associated liver disease (ALD) have high morbidity and mortality in its severe forms. One of the major features in different forms of ALD is the altered gut microbiota. Antimicrobial peptides (AMPs) play a crucial role in maintaining gut microbiota homeostasis. LL-37 (known as CRAMP in mouse) is the sole member of the human cathelicidin family and has piqued great research interest for its dual role in modulating microbiota and the immune response in metabolic diseases. Inflammasome activation is an important component of the liver pathophysiology in ALD and requires two signals for its full activation to induce the …

The Emerging Oral Pathogen, Filifactor Alocis, Disrupts Neutrophil Functions To Enhance Survival And Dysregulate Inflammation., Irina Miralda Molina

Electronic Theses and Dissertations

Periodontitis is an irreversible, chronic inflammatory disease where pathogenic microbial communities accumulate in the gingival crevice. Advances in culture-independent techniques have facilitated the identification of new bacterial species in periodontal lesions, such as the Gram-positive anaerobe, Filifactor alocis. Neutrophils are a major component of the innate host response, and the outcome of their interaction with F. alocis may be a determinant of oral health status. While neutrophil functions typically protect the host against periodontal disease, oral pathogens have adapted to evade or disarm neutrophil microbicidal functions while promoting mechanisms that drive inflammation, which also provides a source of nutrients …

Tobacco Smoke Exposures And Fertility-Related Outcomes Among Females Seeking Fertility Care, And The Interaction With N-Acetyltransferase 2 (Nat2).., T'Shura S. A. Ali

Electronic Theses and Dissertations

Cigarette smoke contains thousands of harmful substances and is one of the leading preventable causes of mortality and morbidity in the United States. Past studies examining tobacco smoke exposures on fecundability and pregnancy outcomes are inconsistent. NAT2 is an important enzyme in the metabolism of xenobiotic substances found within tobacco smoke. This preconception cohort study examines associations between active smoking and secondhand smoke exposure (SHSe) on fecundability and spontaneous abortion (SA), and explores a possible interaction with NAT2 acetylator status. A total of 223 women seeking fertility care were followed for up to 2.3 years. Preconception tobacco smoke exposures were …

A Feasibility Study On The Implementation Of A Web-Based Intuitive Eating Program In A University Setting, Jaime Gnau

Graduate Theses/Dissertations

This research reports on the feasibility of implementing a web-based intuitive eating (IE) program to employees through a university employee wellness department at Missouri State University (MSU). Barriers and facilitators to program participation were also identified and discussed.

Background: Ten IE principles present an evidence-based strategy for reducing incidence of weight cycling and improving one’s relationship with food and self, and reducing health risks associated with chronic dieting and weight regain. Offering web-based programming reduces barriers to program enrollment but is also associated with high rates of attrition.

Methods: The program was developed utilizing the PRECEED-PROCEDE model with application of …

Elucidating The Developmental Defects In Zebrafish Associated With The Cardiac Drug Verapamil, Blake Stephan Justis

Graduate Theses/Dissertations

Birth defects are abnormalities in a developing organism that lead to a malformation in structure or function. Over half of birth defects have no determined cause; however, known causes occur by genetic anomalies, exposure to environmental agents (a.k.a. teratogens), or multifactorial reasons. To explain the unknown causes of birth defects, an area of focus in this study is to identify potential teratogens. Identifying these teratogens, is key to preventing future birth defects. An obvious source of teratogens in pregnant women would be that of pharmaceuticals. Thus, a main goal of this study is to identify drugs that cause birth defects. …

Effects Of Alternative Chemotherapeutic Agents On Thyroid Cancer Cell Line Ml-1, Husref Rizvanovic

Graduate Theses/Dissertations

Though differentiated thyroid carcinomas have decent prognosis when detected early, radioactive iodine (RAI) resistant and advanced thyroid cancers are still difficult to treat with existing therapies. Better therapeutic agents are needed. Studies have shown that aggressive thyroid cancers (ML-1) express the extracellular matrix protein, matrix metalloproteinase (MMP-2). MMP-2 has been linked to metastasis and aggressiveness of several cancers and has been shown to play a crucial role in tumor invasion. Chlorotoxin is a selective MMP-2 receptor agonist, and Saporin is a well-known ribosome-inactivating protein used for anti-cancer treatment; however, these two agents have never been studied when conjugated together. I …

The Effectiveness Of Implementing A Collaborative Mental Health Approach On Quality Of Life For Individuals Of Low Socioeconomic Status, Tyler Z. Tooley

Graduate Theses/Dissertations

The ultimate purpose of this study is to provide insight and education to mental health clinicians, politicians and the general public of the numerous effects poverty has on mental health, in addition to the most beneficial ways to combat those insidious effects. The specific barriers met by individuals of low socioeconomic status severely affect psychological and physical health, as well as social and environmental relationships, which therefore diminish overall quality of life. The aim of this study is to examine the effectiveness of implementing a collaborative mental health approach for low income individuals on length of engagement in services and …

Ontime Self-Initiated Mobility, Katherine Sanders

OTD Capstone Projects

The project took place at Vanderbilt's Pediatric Rehabilitation, specifically in their pediatric seating and mobility clinic. The focus of the project was the Explorer Mini which is the first exploratory device for infants 12-36 months old. The research team created an literature-based introductory protocol on how to introduce the device to the child. My section specifically focused on the preparatory stage which is the very first stage and when the child explores the device before being put in it. I also created numerous handouts for the seating and mobility clinic along with reference cards for how to use the Explorer …

Polycystic Ovary Syndrome, Subfertility And Vitamin D Deficiency, Arfa Azhar, Fatima Abid, Rehana Rehman

Department of Biological & Biomedical Sciences

Polycystic ovarian syndrome (PCOS) is the most common endocrine female disorder, affecting 4-18% women of reproductive age. The prevalence of PCOS in South Asian women, especially in Pakistani women, is much higher (52%) as compared to white population (20 - 25% in UK). In Pakistan, vitamin D status displays 31.2% vitamin D insufficiency, 53.5% vitamin D deficiency, and 15.3% normal vitamin D values. Vitamin D deficiency, though very common in the general population, is even more prevalent in PCOS patients, seen in approximately 67-85%, which further correlates to their related comorbidities. A lot of researches have to be directed to …

The Society For Immunotherapy Of Cancer Statement On Best Practices For Multiplex Immunohistochemistry (Ihc) And Immunofluorescence (If) Staining And Validation., Janis M Taube, Guray Akturk, Michael Angelo, Elizabeth L Engle, Sacha Gnjatic, Shirley Greenbaum, Noah F Greenwald, Cyrus V Hedvat, Travis J Hollmann, Jonathan Juco, Edwin R Parra, Marlon C Rebelatto, David L Rimm, Jaime Rodriguez-Canales, Kurt A Schalper, Edward C Stack, Cláudia S Ferreira, Konstanty Korski, Ana Lako, Scott J Rodig, Emanuel Schenck, Keith E Steele, Michael J Surace, Michael T Tetzlaff, Katharina Von Loga, Ignacio I Wistuba, Carlo Bifulco, Society For Immunotherapy Of Cancer (Sitc) Pathology Task Force.

Articles, Abstracts, and Reports

OBJECTIVES: The interaction between the immune system and tumor cells is an important feature for the prognosis and treatment of cancer. Multiplex immunohistochemistry (mIHC) and multiplex immunofluorescence (mIF) analyses are emerging technologies that can be used to help quantify immune cell subsets, their functional state, and their spatial arrangement within the tumor microenvironment.

METHODS: The Society for Immunotherapy of Cancer (SITC) convened a task force of pathologists and laboratory leaders from academic centers as well as experts from pharmaceutical and diagnostic companies to develop best practice guidelines for the optimization and validation of mIHC/mIF assays across platforms.

RESULTS: Representative outputs …

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

Twenty-Seven Questions For Writers & Journalists To Consider When Writing About Covid-19 & Hiv/Aids, Alexandra Juhasz, Pato Hebert, Theodore Kerr, Diana Cage

Publications and Research

The desire to compare COVID-19 and HIV/AIDS is understandable. The response to HIV provides an inspiring road map for how to save lives. For over four decades, starting in the early 1980s, activists, scientists, politicians and cultural producers have been working alongside one another resulting in life saving developments—and goals not yet achieved. Since the late 1990s, HIV has become a manageable chronic illness for those with access to life saving medicine, housing, food, and social support. Meanwhile, stigma, discrimination, and criminalization directed at people living with HIV continue, based on social difference, access to resources and community, and an …

Outpatient Physical Therapy Management Of A Patient With Tibia Fracture And Secondary Normal Pressure Hydrocephalus -- A Case Report, Kevin Hansen

Physical Therapy Scholarly Projects

Background and Purpose: Falls are a major health care concern for the older adult. Injmies related to falls in the geriatric population are not uncommon. Furthermore, individuals with brain disorders are going to be even more susceptible to falls. The purpose of this study was to examine the outpatient physical therapy (PT) rehabilitation of a patient who fell and sustained a right tibial fracture with a past medical history of a brain disorder.

Case Description: This case report describes the outpatient PT management of a patient who presented with a right tibia shaft fracture, post-operative right tibia intramedullary …

Traumatic Hip Dislocation In High School Athlete Case Report, Mckenzie Klocke

Physical Therapy Scholarly Projects

Background and Purpose: Traumatic hip dislocations occur when the head of the femur is forced out of the acetabulum causing disruption to the musculature, vasculature, and other tissue surrounding the hip joint. Although dislocations are not the most prevalent injury to the hip, they are a severe injury and require immediate medical attention, as well as rehabilitation post reduction. There is a lack of literature regarding physical therapy treatment of traumatic hip dislocations, especially in the adolescent population. The purpose of this case study is to describe the athletic youth population most affected by traumatic hip dislocations and to offer …

Physical Therapy Rehabilitation Following A Thoracic To Sacroiliac Spinal Fusion: A Case Report, Ragen Wilson

Physical Therapy Scholarly Projects

Background and Purpose. This case study described the 9 week outpatient physical therapy rehabilitation process of a 75 year old female following a posterior thoracic spine (T9) to sacroiliac (S 1) spinal fusion as a result of adult degenerative scoliosis and prolonged back pain (Type 1 ). The purpose of this case report was to describe the overall outpatient physical therapy management of this post-operative fusion.

Description. The patient presented to physical therapy with decreased mobility, decreased function, decreased balance, lower extremity strength deficits, pain, and loss of independence.

Intervention. Initially, treatment occurred in a therapeutic pool and then progressed …

The Collaboration Of Music Therapy And Physical Therapy: A Case Study For Rehabilitation Treatment Of A Patient With Chronic Stroke, Kaci Hemmesch, Taylor Kunz

Physical Therapy Scholarly Projects

Background and Purpose: Strokes are the fifth leading cause of death in the United States and nearly 800,000 people suffered from a stroke last year alone. Even though two-thirds of those people had survived, many of the survivors were left with a number of activity limitations and participation restrictions. The research is extensive in the realm of physical therapy interventions and how it can help with those disabilities, but truly lacks the knowledge behind the effects of a collaboration of music therapy with physical therapy.

Case Description: This case study follows an 85-year-old woman with lasting chronic impairments from a …

Review Of The Status Of Oncologic Physical Therapy In North Dakota: A Definitive Study, Sarah Biberstine, Arianna Larson

Physical Therapy Scholarly Projects

Background and Purpose. Physical therapy is often reported as an under-utilized resource in oncology care. When utilized, physical therapy intervention addresses multi-dimensional symptoms experienced by individuals with a cancer diagnosis. This study examines the following questions: What is the status of physical therapy in North Dakota’s oncology team? What is the working knowledge of the physical therapist on oncologic rehabilitation? Do professional programs provide adequate knowledge to evaluate and treat oncologic patients and their symptoms? The purpose of the study is to determine if the physical therapy intervention received by individuals in North Dakota with a current of previous diagnosis …

The Effectiveness Of A 7-Week Fall Prevention Program For Community Dwelling Older Adults, Karlee Mccloud, Kayla Sendelbach

Physical Therapy Scholarly Projects

Background: Every year millions of adults over the age of 65 experience a fall. Falls cost healthcare and individuals financial distress, decrease self-confidence, and can cause injuries. Balance and strength deficits contribute to increasing an individual's fall risk. Studies have shown the efficiency of community-based exercise and education programs on reducing the risk of falling. The Stepping On Program utilizes a group setting to educate on falls and risks, strength and balance exercises, home safety, vision, coping after a fall, and community mobility. Stepping On is an evidence-based fall prevention program that has been proven to reduce falls by 31 …

The Effect Of Barefoot Running On Navicular And Pelvic Drop: A Randomized Controlled Trial, Sarah Bunde, Christopher James, Kathryn West

Physical Therapy Scholarly Projects

Background and Purpose: Gaining knowledge of the change in navicular drop of the foot and pelvic movement in response to barefoot running training may allow sports medicine professionals, coaches, athletes, and others in the healthcare field to decrease the amount of injuries that may be caused by these motions. The effects of rearfoot strike pattern (RFSP) versus a forefoot strike pattern (FFSP) in determining the impact on navicular drop and pelvic movement is lacking in literature. Due to the increased correlation of hip movement and lower extremity injuries, the purpose of this study was to determine if barefoot running with …

Emg Analysis Of Latissimus Dorsi, Middle Trapezius, And Erector Spinae Muscle Activity During Return To Neutral Phase Of Spinal Rotation, Stephen Erlandson, Nathan Hasunuma, Landon Uetz

Physical Therapy Scholarly Projects

Purpose/Hypothesis: Rotation of the spine is a common movement used to perform activities of daily living and sports performance, and contributes to a large percentage of low back injuries. Performance of spinal rotation for the rehabilitation and prevention of future back injuries should be considered, as low back pain is the second most common reason for a physician visit. Muscles that are involved in rotation of the spine have been studied, but the Latissimus Dorsi (LD) has limited research on the influence of spinal rotation. The LD muscle is one of the largest back muscles and influences many movements of …

A Case Report: Factors Influencing The Care Of A Critically Ill Patient In The Icu Following Medical Management Of A Benign Parasagittal Meningioma, Lucas Keller

Physical Therapy Scholarly Projects

Background and Purpose. Primary brain tumors will affect 23,890 adults in the US in 2020. Many of these patients will require an intensive care unit (ICU) if resection is the chosen course of treatment. Early mobility has been shown to reduce negative effect of ICU stays in patient ability and long-term outcomes.

Case Description. This report describes the 4-week inpatient physical therapy management of a 69-year-old female who is 6 months post left cerebrovascular accident (CVA) and presented to the ICU with shortness of breath, severe continuous frontal headaches, and a reduction of regained strength from her CVA in …

Safe Patient Handling – A Case For National Legislation, David O. Oba

Dissertations and Theses (Open Access)

Introduction: This study examined the effectiveness of Safe Patient Handling (SPH) legislations in difference states across the country. In January 2006, the state of Texas legislated the Safe Patient Handling and Movement Practices Act which required all hospitals and nursing homes to implement safe patient handling and movement program. To date, 10 other states have enacted law or regulations to control work-related musculoskeletal disorders (MSDs) among healthcare workers (HW). Despite the effectiveness of these policies in the individual states, MSDs remain prevalent among HW nationwide. Hence, the call for national legislation. Methods: Using the state-level incidence rate data from the …