Medicine and Health Sciences Commons^™

Development Of Long-Acting Antiviral Drug Nanoformulations, Denise Cobb

Theses & Dissertations

Antiretroviral therapy (ART) has improved the quality and duration of life for people living with human immunodeficiency virus (HIV) infection. However, opportunities to improve its profile abound. ART is limited by putative viral reservoir penetrance, emergence of viral mutations, inherent toxicities, and regimen non-adherence. These highlight the need improved drug delivery schemes. Previously, our lab has demonstrated that targeting mononuclear phagocytes for antiretroviral drug delivery extends drug half-life and improves penetrance into viral reservoirs, addressing these limitations of ART. Herein, we developed synthetic and biologic antiretroviral (ARV) drug nanocarriers improve the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of ARVs through …

Biomedical Porcine Models For The Study Of Surgical Hemostasis, Hindlimb Ischemia, And Pancreatic Cancer, Shruthishree Aravind

Theses & Dissertations

Murine models have dominated the world of biomedical research and comparative medicine since their development in the early 1900s. [1] While they may be suitable models to study proteomics and genomics, they may not serve as effective translational models. [2-4] Murine models do not accurately model the pathophysiology of human disease and are limited by their size, application of medical imaging and intervention, which reduces their overall preclinical predictive value. [2-4]

Porcine models on the other hand, are slowly and steadily bridging the gap between murine models and human patients. [5] Pigs …

Adaptation Of Human Locomotion And Unilateral Limb Loading During Different Inclination Treadmill Walking, Yuhang Zhang

Theses & Dissertations

Human locomotion is adaptive in any external environment or different terrains, which has been widely investigated. For example, people can walk at different walking speeds in each leg on a split-belt treadmill. However, human locomotor behaviors are passively adapted during the split-belt treadmill walking. Therefore, the knowledge of how humans actively adjust the flexibility of locomotion is limited by using the split-belt treadmill. To address this gap, this study investigated the flexibility of locomotion by using a 4-lb ankle weight on the dominant leg to induce the asymmetric walking pattern when walking on the inclined, declined, and level treadmill. Twenty …

From Pipeline To Health Equity: A Case Study Of Health Profession Pipeline Students, Sonja F. Tutsch

Theses & Dissertations

Health equity arises from the social determinants of health. Access to culturally and linguistically competent health services is a major determinant of health. Despite health profession pipeline intervention efforts spanning more than 50 years, diversity in the health professions has not been achieved, and disparities in health among members of minority groups remain prevalent. Health profession pipeline programs came into existence to help grow minority representation among health professionals serving in underserved, disadvantaged, communities, where disparities in health are most prevalent. One underlying assumption was that minority students from underserved communities understand the needs of these communities best and are …

Characterization Of Di-Aryl Urea Compounds Against Acute And Chronic Toxoplasma Gondii, Austin Sanford

Theses & Dissertations

Toxoplasma gondii is an obligate intracellular parasite that has infected nearly 60 million individuals in the United States alone. Acute infection causes ill effects to the fetus in utero when mothers are primarily infected, and to immunocompromised individuals. Chronic infection consists of quiescent tissue cysts located primarily in brain tissue and is capable of reverting back to the acute stage causing severe toxoplasma encephalitis in immunocompromised individuals. Current treatments for acute infection are lacking while there are no approved treatments for the clearance of chronic infection. The aim of this research was to evaluate a family of di-aryl urea compounds …

Modification And Antichlamydial Activity Evaluation On Dysregulators Of Cylindrical Proteases, Jiachen Feng

Theses & Dissertations

Chlamydia trachomatis infection is the most commonly reported sexually transmitted disease in the United States and the world. This pathogen can cause long-term health problems including blindness, pelvic inflammatory disease (PID) and ectopic pregnancy, which can be life-threatening if left untreated. To this day, there is no chlamydia-specific drug on the market. The standard treatment uses broad-spectrum antibiotics, which may affect regular functions of the commensal microbiota and leads to the development of bacterial resistance. Recently, a series of compounds based on Activators of Self-Compartmentalizing Proteases (ACP) was reported to show antichlamydial activity. Based on that scaffold, we prepared 21 …

Mucin And Splice Variant Profiles Of Pancreatic Adenocarcinoma Predict Patient Survival And Subtyping, Christopher M. Thompson

Theses & Dissertations

PDAC is a pancreatic epithelial malignancy and demonstrates aggressive progression and bleak patient prognosis. Despite decades of research, the evolution of novel diagnostics and intervention modalities for PDAC is stagnant. This dissertation explores the characteristic aberrant and elevated expression of mucins in PDAC. Beginning with the hypothesis that mucins are associated with disease aggressiveness, analysis of PDAC patient survival in TCGA revealed no associations between single mucin expression and patient survival. This led to the underlying issue of PDAC tumor cellularity since this disease demonstrates variability in the proportion of cancer cells within the tumor. Tumor purity assessed with the …

Secreted Mucin 5ac-Mediated Epithelial And Stromal Modulations Augment Pancreatic Cancer Aggressiveness, Koelina Ganguly

Theses & Dissertations

The mucosal layer that shields the epithelium of the body cavities is made up of high molecular weight, heavily glycosylated proteins called mucins that are broadly categorized into transmembrane and secreted members. Aberrant expression of secreted mucin MUC5AC has been implicated in lung, stomach, and colon cancer pathologies. MUC5AC is expressed de novo in the pancreas upon oncogenic insult, and its abundance in pancreatic tumor and circulation correlates to disease progression. However, few studies have explored beyond the diagnostic and prognostic significance of MUC5AC in pancreatic cancer (PC).

In this dissertation, we sought to investigate the mechanistic contribution of MUC5AC …

Multimodal Neuroimaging Of Hiv And Aging, Brandon Lew

Theses & Dissertations

HIV infection remains a significant contributor to disease burden, and with the success of antiretroviral therapies, the population of people with HIV is aging. A growing literature suggests a relationship between HIV-infection and a profile of age advancement, most notably in molecular studies of epigenetics. However, despite the widely-known high prevalence of HIV-related brain atrophy, functional deficits, and HIV-associated neurocognitive disorder (HAND), epigenetic age advancement has not been linked to HIV-related changes in neuroimaging metrics.

We applied three neuroimaging methods, structural MRI, resting state functional MRI, and resting state MEG, to study the brain structure and function of 121 virally-suppressed …

Neurocognitive Impairment In People Living With Human Immunodeficiency Virus (Hiv): Risk Factors And Mortality, Zaeema Naveed

Theses & Dissertations

Despite the widespread use of combination antiretroviral therapy (cART), HIV-associated neurocognitive impairment (NCI) persists in people living with HIV (PLWH) with clinical and public health implications. Studies have generated inconsistent results regarding etiological factors for NCI in PLWH and a brief user-friendly predictive tool is desirable in clinical practice to assess the probability of having NCI in PLWH. Furthermore, factors associated with clinically meaningful decline in neurocognitive status and survival disadvantage for patients with NCI are understudied in the post-cART era. The goal of this dissertation was to investigate factors associated with baseline NCI and neurocognitive decline and the association …

Clinical Consequences And Determinants Of False Positive Blood Cultures In Adult Hospitalized Patients, Sidra Liaquat

Theses & Dissertations

Blood cultures are the gold standard for detecting blood stream infections. However, in the US, 0.6-6% of all blood cultures get contaminated leading to adverse clinical outcomes such as unnecessarily prolonged hospital stay and antibiotic therapy. Using electronic medical records, we explored the clinical outcomes and patient-specific risk factors of contaminated blood cultures in an era where rapid blood culture testing was being utilized to provide blood culture results within hours. Rapid blood culture test results can help clinicians in early and more effective management of patients with contaminated blood cultures, thus improving clinical outcomes. We also studied the impact …

An Explanatory Sequential Mixed Methods Nutrition And Physical Activity Intervention Study On Changes In Knowledge, Self-Efficacy, And Outcome Expectations Of Fathers, Sarah Hortman

Theses & Dissertations

Overweight and obesity rates are a continuing concern resulting in poor health outcomes and annual healthcare costs in the billions of dollars. An upstream approach of health promotion is critical to change the focus from treatment and management to prevention of chronic disease. Preventing chronic disease through evidence-based health promotion practices incorporating educational interventions aimed at dietary and physical activity behaviors will preclude negative health outcomes including cardiovascular disease, type 2 diabetes, and hypertension.

The family environment is an important consideration in the prevention of chronic disease including obesity. Parents are role models for their children, including fathers who are …

Examination Of Access, Utilization, And Barriers To Care Among Special Populations In The United States, Jed R. Hansen

Theses & Dissertations

Utilizing healthcare services is a complex phenomenon in the United States. While system-level barriers and facilitators of care, along with individual consumer choices, are known to affect access and subsequent use of services, the interaction among the factors that lead to utilization remains unknown. Examining access and utilization of healthcare services using a consumer framework incorporating both access barriers and facilitators and consumer-level dimensions that affect choice in seeking care may inform access and utilization research. The purposes of this dissertation were 1) to explore the presence of facilitators and barriers to care in ambulatory healthcare locations for non-emergent care …

Acute Physiological And Perceptual Responses To Unilateral Versus Bilateral Walking With Blood Flow Restriction, Sage Donaldson

Honors Theses

The use of blood flow restriction (BFR) has skyrocketed in popularity in the past few years as a therapeutic modality. Studies have shown that the application of BFR at 20-30% of maximal oxygen consumption (VO_2max) yields similar improvements in cardiovascular fitness, muscle mass, and strength when compared with traditional exercise at 60-90% of VO_2max. The substantially lower workload accompanying BFR allows for more tolerable workloads in special populations, such as those recovering from musculoskeletal injury. Because previous studies regarding BFR have mainly focused on bilateral BFR, it is unclear how unilateral BFR compares to bilateral BFR. …

Effect Of Aerobic Exercise With Blood Flow Restriction On Substrate Utilization And Energy Expenditure, Nathen Andrews

Honors Theses

The purpose of this study was to examine the effects of intermittent blood flow restriction (BFR) compared to low- (LIIE) and high-intensity interval exercise (HIIE) on energy expenditure (EE) and substrate utilization. Participants randomly performed each interval exercise protocol, and then rested for a three-hour period, in which EE and substrate utilization were measured. Total EE was different between BFR (321.6 ± 30.1 kcals), HIIE (254.5 ± 33.5 kcals), and LIIE (287.1 ± 25.5 kcals). Fat oxidation (FatOx) in BFR (1hr = 0.14 ± 0.01 g / min, 3hr = 0.11 ± 0.01 g / min) was greater than LIIE …

Manduca Sexta As An Animal Model Of Muscle Aging, David Melanson

Honors Thesis

Aging has a multisystemic effect on an organism’s functional physiology and quality of life. One such effect is the progressive loss of muscle mass, strength, and function, known as sarcopenia. A thorough investigation to the multiple factors that contribute to sarcopenia is required. Models are used to dissect the mechanistic understanding of the muscle aging process. Manduca sexta is emerging as a novel and complementary muscle aging model because their flight muscles are metabolically and functionally similar to vertebrate skeletal muscle. Manduca sexta is already a prominent invertebrate model organism in neurobiology, immunology, developmental research, and flight mechanics because of …

Caregiver Perceptions Of Environmental Modifications For Sensory Processing, Jaimie Lynn Smith

Occupational Therapy Capstone Presentations

This capstone project explored in-depth clinical practice skills in sensory based therapy along with caregiver perceptions of sensory environmental modifications. In person and telehealth treatment sessions focused on the achievement of sensory based goals. A three-part continuing education course was also completed to expand knowledge and understanding of sensory environmental modifications and strategies that were family friendly. The main project was to gain an understanding of caregiver perceptions of sensory environmental modifications. This was accomplished through interviews with families that focused on sensory aspects of the environmental, completion of Participation and Sensory Environmental Questionnaire, and feel-good menus. After environmental recommendations …

Complex Conditions Of The Hand: A Resource For Rural Therapists, Jay D. Cooper

Occupational Therapy Capstone Presentations

The purpose of this project was to address multiple disparities in the complex treatment of upper extremity conditions and injuries in the rural therapy setting with an accessible educational resource. These disparities include the lack of continuing education specifically targeted at the rural healthcare setting, the barriers to unique occupation-based treatment which occupational therapists are obligated to administer, and the need to provide information regarding hand therapy protocols to bridge the communication gap between hand specialists and rural therapists. The project was completed at the Monument Health Orthopedic and Specialty Hospital in Rapid City, SD, in an outpatient hand therapy …

Advanced Practice In Aquatic Therapy: Exploring Occupational Therapy In An Aquatic Environment, Brenna K. Barash

Occupational Therapy Capstone Presentations

Properties of water have been utilized as a therapeutic treatment method for the past 100 years (Becker, 2009). Aquatic-based occupational therapy services are used as an adjunct to traditional land-based occupational therapy intervention (Franken et al., 2013). The OTS developed a 14-week capstone project with assistance provided by faculty and site mentors. The purpose of this capstone project was to develop aquatic-based intervention skills and explore the use and benefits of aquatic-based occupational therapy in patient care. To facilitate appropriate outcomes, three learning objectives with numerous project deliverables were developed. In order to demonstrate competence and understanding of aquatic-based occupational …

Exploring Occupational Therapy With Athletes Using Principles Of Lifestyle Redesign® To Support Academic Success And Life Balance., Michaela M. Dendinger

Occupational Therapy Capstone Presentations

Occupational therapists have a range of skills that can benefit a variety of populations. Despite these skills, occupational therapy has limited exploration within the field of athletics. The capstone project gave insight to the services occupational therapy can provide to the student-athlete population. Through the lens of Lifestyle Redesign®, the Student-Athlete Wellness Program was created to support student-athlete academic success and life balance. Following a needs assessment an online program was developed. The program was provided to students and athletes a University in the Midwest U.S. The program attracted 21 student-athletes and five students. Limited participation in surveys provided difficulties …

Creating Inclusive Classroom Environments Through Education And Coaching, Leah Hagen

Occupational Therapy Capstone Presentations

The aim of this capstone project was to educate teachers on inclusive practices and strategies to create an inclusive classroom environment for students with disabilities and at-risk needs. An educational workshop including eight hours of asynchronous pre-recorded modules and four one-hour synchronous sessions was created. The workshop covered the following topics: Introduction to inclusion, accommodations and modifications, assistive technology, supporting sensory needs, supporting physical needs, supporting academic and learning needs, supporting social, emotional, and behavioral needs, virtual inclusion, empowering students, and creating an inclusive classroom environment. Optional inclusive classroom coaching sessions were offered to promote implementation of inclusive practices and …

Spinal Muscular Atrophy Carrier Screening: Current Practice And Perceived Barriers In A Midwestern Women’S Health Care Clinic, Elyssa Gray Lewis, Heather Said, Kaeli Samson, Sara Fisher

Capstones: Genetic Counseling

Purpose: Spinal muscular atrophy (SMA) carrier screening has been universally recommended to be offered to all women of reproductive age by the American College of Obstetricians and Gynecologists since 2017. This quality improvement study surveyed women's healthcare providers at a single clinic within an academic institution to evaluate practices and assess barriers to offering SMA carrier screening to patients. Methods: Certified nurse midwife, internal medicine, obstetrician/gynecologists, nurse practitioners, residents, and maternal fetal medicine providers were invited to participate in a survey comprised of multiple choice, Likert scale, and open-ended questions. Full participation included 26 out of 54 providers in …

Implementation Of A Nurse-Led Family Centered Engagement Intervention For Caregivers Of Extremely Premature Infants In The Neonatal Intensive Care Unit, Emily Keenan, Michaela L. Ranallo, Kathleen A. Walsh, Haley Chapko, Tiffany A. Moore

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this feasibility study was to examine the implementation and usefulness of an intervention for extremely premature infant (EPI) caregivers.

Results: One caregiver and five nurses provided feedback with a mean score of 4.4 out of 5 pertaining to helpfulness.

Conclusions: Implementation of the Caregiver’s Guide was feasible and was positively received by NICU nurses and caregivers. We recommend implementing a revised version of this tool based on nurse and caregiver feedback. The delivery of education should be divided between dayshift and nightshift nurses so that one nurse is not responsible for providing all the information. The …

Fire Service Covid-19 Infection Prevention And Control Policy Comparison, Saaddedine Dichari

Theses & Dissertations

To date, there have been over 2.7 million deaths and more than 126 million cases attributed to the COVID-19 pandemic (JHU, 2021). This pandemic has affected nearly every aspect of daily life. Among those impacted are U.S. firefighters, as they provide many services beyond simply extinguishing structure fires and are frequently dual certified as emergency medical technicians. Many of the victims of this pandemic have relied on first responders to provide them with emergency medical care and hospital transport. When caring for these infected patients, firefighters have an increased risk of exposure and must be provided with adequate …

Introduction Of Strong For Surgery Pre-Surgical Checklist For Elective Procedures​, Dylan Defauw

Doctor of Nursing Practice Projects

Nearly one-third of hospitalized patients experience preventable harm or adverse effects related to the care they received, often due to preventable surgical complications. Thorough preoperative assessment and management of risk factors can lessen this risk. The purpose of this quality improvement project was to increase knowledge and prepare staff for use of the preoperative tool Strong for Surgery (S4S) in a general surgery clinic in a rural hospital in southern Illinois. Support for each of the key components of the Strong for Surgery pre-surgical checklist was reviewed in the literature; these include nutrition, smoking cessation, glycemic control, medication management, safe …

Culturally Appropriate Health Education: Translation Of A Parturient Pain Relief Options Pamphlet Into French And Spanish, Francis Minor, Austin Cook

Doctor of Nursing Practice Projects

The rise of immigration worldwide introduces a diverse, multicultural population of patients seeking healthcare in the United States. Barriers to communication, both spoken language and culturally associated communication norms, limit immigrant women’s ability to seek, gain access, and follow through with perinatal care. In order to provide safe, effective, and culturally sensitive care, recognition of language and cultural differences of all individuals must be considered when providing patients with educational materials (Perera et al., 2012; Plumbaum et al., 2014). The aim of this project was to translate an existing pain relief options pamphlet into French and Spanish in order to …

Pediatric Concussion Clinic: A Needs Assessment, Carrie West

Doctor of Nursing Practice Projects

Abstract

Pediatric Concussion Clinic: A Needs Assessment

Concussions are a mild traumatic brain injury by a biomechanical force to the head. Concussion rates among youth are as high as 33 million per year worldwide. Most children recover within 4 weeks post injury; however, 30% of patients have delayed recovery. Recent studies have shown that evaluation by a concussion specialist within 1 week of injury results in quicker recovery. The purpose and goal of this project was to determine if there was a need for establishing a pediatric concussion clinic at Southern Illinois University Medicine. Study participants included pediatric providers from …

Developing A Peer Mentoring Program For Srnas, Morgan E. Fitterer, Miranda Portwine

Doctor of Nursing Practice Projects

Faculty of a nurse anesthesia program at a Midwestern University requested evidence of the impact a peer mentoring program could make in reducing stress levels for SRNAs. To better tailor a peer mentoring program, surveys were developed and distributed to the university’s SRNAs and to program directors of CRNA programs across the country.

Based on the literature, a survey was developed and distributed to 81 SRNAs at this university to evaluate their stress and their perceptions of the impact of peer mentoring on stress. Another survey was developed and distributed to 118 program directors to learn if they have a …

The Importance Of Providing Multimodal Analgesia: A Literature Review Of Nonpharmacologic Pain Treatments, Miriam Swartzentruber

Senior Honors Theses

Pain is a central aspect of the human experience. While painful stimuli can be beneficial in alerting the brain to the fact that there is something wrong, left untreated, pain can cause devastating long-term effects on the individual, both physically and mentally. Pain has traditionally been either undertreated or managed solely using pharmacologic methods, with less thought given to the importance of supplementing therapy with nonpharmacologic interventions. By incorporating nonpharmacologic methods of pain management into nursing care, patients can be provided with holistic treatment that improves patient outcomes, decreases healthcare costs, avoids future complications, and improves overall quality of life.

Quantifying Fear Of Falling By Utilizing Objective Body Sway And Muscle Contraction Measures, Chenfan Gui

Theses & Dissertations

Fear of falling (FOF) is a psychological condition that can lead to increased morbidity and mortality in the elder population. However, the subjective and multidimensional nature of FOF resulted in the limitations of existing FOF measurements, which could influence the quality of those studies. The present study aimed to quantify FOF by using objective center of pressure (COP) trajectories and muscle contraction of the lower extremity to compensate for those limitations. Nineteen young healthy adults (24 years ± 2.47) were recruited in the present study. Subjects were required to watch three 360-degree videos, one control video and two roller coaster …