Other Medicine and Health Sciences Commons^™

The Environment Of Interprofessional Education In Graduate Education: Exploring Professional Programs Of Occupational Therapy, Physician Assistant, And Physical Therapy, Allison R. Kaczmarek

Theses and Dissertations

Interprofessional education (IPE) is an educational approach of increasing popularity in professional schools for the preparation of a collaborative ready healthcare workforce. The accrediting bodies of professional education programs in occupational therapy (OT), physician assistant (PA), and physical therapy (PT) have incorporated standards for outcomes addressing IPE. Although they have endorsed the Health Professions Accreditors Collaborative (HPAC) consensus document on quality IPE, we do not have a contemporary snapshot of the IPE environments in the curriculum of their accredited programs. This dissertation, a collection of three distinct inquiries, has two aims: first, to provide a description of IPE as it …

Supplier Performance Scorecard Utilization In The Medical Device Manufacturing Healthcare Supply Chain, Justin Cardisco

Theses and Dissertations

The medical device manufacturing industry has a deficiency in determining how to improve supplier performance for the components and systems they purchase. Many complex medical devices require components from superb suppliers. But how does a medical device manufacturer (MDM) impartially assess supplier performance to know which suppliers to continuing with (or even boost purchase volumes) and which suppliers they should exit? This study describes which supplier-specific metrics are most important to medical device manufacturers (MDMs) so they can utilize this supplier performance scorecard backed by real-world inputs. This research will focus on five categories to measure MDM supplier performance (Quality, …

Multi-Modality Automatic Lung Tumor Segmentation Method Using Deep Learning And Radiomics, Siqiu Wang

Theses and Dissertations

Delineation of the tumor volume is the initial and fundamental step in the radiotherapy planning process. The current clinical practice of manual delineation is time-consuming and suffers from observer variability. This work seeks to develop an effective automatic framework to produce clinically usable lung tumor segmentations. First, to facilitate the development and validation of our methodology, an expansive database of planning CTs, diagnostic PETs, and manual tumor segmentations was curated, and an image registration and preprocessing pipeline was established. Then a deep learning neural network was constructed and optimized to utilize dual-modality PET and CT images for lung tumor segmentation. …

The Effects Of Gspt1 Degradation On Serum Calcium, Parathyroid Hormone, And Fibroblast Growth Factor 23 Concentrations In Human Cereblon Knock-In Mice, Kamran Ghoreishi

Theses and Dissertations

Test article CC-325 is a potent oral cereblon (CRBN) modulator that has shown potent G1 to S phase transition 1 (GSPT1) degradation and anti-tumor activity in pre-clinical models. One of the adverse effects associated with CC-325 was dose dependent hypocalcemia, which was determined to be an on-target toxicity.

To investigate the mechanism of hypocalcemia, we conducted a toxicity study in human cereblon (huCRBN) knock-in (KI) mice with CC-325. The huCRBN KI mice are transgenic mice engineered to express human cereblon that is capable of binding to CRBN and degrading GSPT1. Four groups of mice were treated with vehicle (0 mg/kg), …

Job Stress Effects On Job Satisfaction And Attrition In 9-1-1 Call Centers, Damarys Jaile Gilligan

Theses and Dissertations

In 9-1-1 call centers across the nation the personnel shortage has become a crisis. The nature of the job of a 9-1-1 telecommunicator is stressful due to the high volume of emergency calls. This applied dissertation was designed to learn if there is a relationship between job stress, burnout levels, and job satisfaction in 9-1-1 telecommunicators. This was a nonexperimental quantitative survey research with a correlational approach. The population was a nonprobability convenience sample recruited through the Survey Monkey Audience platform. Data was collected at one point in time. A total of 37 participants took part in the study. All …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

Effectiveness Of Pictorial Health Warning Labels For Indonesia's Cigarette Packages, Dien Anshari

Theses and Dissertations

Pictorial health warning labels (PHWL) on cigarette packaging is a key way to communicate with consumers about the harms from tobacco, particularly in the low- and middle-income countries that do not have the resources for effective mass media campaigns. Research is needed to determine the most effective PHWL content for Indonesia, a country with one of the largest populations of smokers in the world and amongst the weakest tobacco policy environments. This research aimed to determine the most effective PHWL content for Indonesia’s cigarette packages, including the social and psychological factors that may influence PHWL effects.

Data for this study …

The Experiences And Perceptions Of Behavioral Factors That Contribute To Successful Weight Loss In Male Bariatric Patients, Stephen P. Sowulewski

Theses and Dissertations

The purpose of this study was to examine the experiences and perceptions of behavioral factors that contribute to successful weight loss in male bariatric patients. By analyzing participant experiences and perceptions, this study contributes to a better understanding of which factors are most important in the postoperative phase of gastric bypass in males owing to successful weight loss. Although there is a tremendous amount of quantitative research within the bariatric population, there is a significant gap within the qualitative literature as it relates to male outcomes. As such, by conducting interviews with 10 postoperative male gastric bypass patients, this study …

A Targeted Approach To Increasing The African American Blood Donor Pool, Arnethea L. Sutton

Theses and Dissertations

A continuous need for blood products, specifically for those who require frequent transfusions, such as individuals with sickle cell disease, warrants the need for targeted interventions to increase blood donations from underrepresented populations. One population in particular, African Americans, only account for 1% of blood donors in the United States. Literature indicates numerous reasons why this population is underrepresented amongst donors, including fear, lack of knowledge about the blood donation, and specific to this population, lack of trust in the medical community. This study involves the development, implementation, and assessment of a targeted educational approach, incorporating the Theory of Planned …

Hemodynamic Regulation Of Cardiac Valve Development, Vinal Menon

Theses and Dissertations

It is well established that valvulogenesis is a result of a complex interplay between genetic and environmental factors. Hemodynamics is one such environmental stimulus that is well documented to influence the development of heart valves. Using advanced imaging modalities, such as optical coherence tomography, investigators have better understood the effects of altering hemodynamic loads in the embryonic (avian) heart. However, the field of valvulogenesis is currently stagnant with a paucity of studies aiming to understand the molecular mechanisms influenced/affected by hemodynamic stimuli. Deciphering these pathways is critical from a valve development perspective, but also becomes vital as potential therapeutic targets, …

Prospective Assessment Of Health Disparities And Injury Risk Factors At Basic Combat Training At Ft. Jackson, Kristin Lescalleet

Theses and Dissertations

Numerous recruits for Basic Combat Training (BCT) for the Army fail to complete the course due to injury and time lost. This study was designed to provide a more thorough list of risk factors involved in injury and attrition through real-time data analysis throughout a cycle of BCT. Throughout BCT, a researcher was placed in the Battalion Aid Station (BAS) and recorded the reason for the visit, whether it was a new or existing condition, injury location, medical history, and how long this injury has been an issue. Several risk factors were tested: sex, age, and ethnicity/race. It was found …

Non-Steroidal Anti-Inflammatory Drug Effects On Core Temperature, Hydration, Gastrointestinal Distress, And Performance In Exercising Humans, Dawn Marie Emerson

Theses and Dissertations

Naproxen is a commonly used non-steroidal anti-inflammatory drug designed to relieve pain and inflammation. Due to potentially adverse effects on the gastrointestinal (GI) tract, cardiovascular and immune system, and renal function, naproxen may negatively affect thermoregulation, fluid and electrolyte balance, and performance during exercise, particularly in the heat. Therefore, the purpose of this study was to determine the effects of naproxen on core temperature (Tc), inflammation, hydration, GI distress, and performance during cycling in a hot environment. We utilized a double-blind, randomized and counterbalanced, cross-over design to determine the effects of naproxen (dose = 3 220 mg naproxen sodium pills) …

Transcriptional And Post-Transcriptional Regulation Of Nrf2 In The Heart By The Deubiquitinase Cyld, Bryan J. Mathis

Theses and Dissertations

The cylindromatosis (CYLD) is a K63-linked deubiquitinase (DUB) that has been linked to the regulation of multiple physiological or pathological processes, such as neural development, inflammation and fibrosis. However, a novel paradigm for CYLD has been recently postulated; namely that of CYLD as a mediator of cardiac disease. Nuclear factor, erythroid-2 related factor 2 (Nrf2), a master antioxidant transcription factor, has been shown to suppress cardiac pathological remodeling and dysfunction via downregulation of reactive oxygen species formation (ROS). It is normally regulated by Kelch-like ECH associated protein 1 (Keap1). However, the regulatory link between CYLD and Nrf2 in the diseased …

Comparison Of The Effects Of Energy Flux On Metabolic Conditions And Satiety In Young Adults, Molly Madison Demello

Theses and Dissertations

Within the United States, 68% of all adults have been classified as overweight to obese, as defined by 25 kg/m2 ≤ BMI ≤ 35 kg/m2. Research has shown that overweight/obese individuals can still gain health benefits through participation in aerobic activity without losing weight. These improvements include improved glucose control, CRF, HDL and quality of life. More research is necessary to understand the health benefits associated with a chronic aerobic intervention under weight stable conditions. We therefore examined the health benefits of an aerobic 6-month intervention under weight stable conditions on body composition, cholesterol and measurements of appetite and satiety …

Markerless Lung Tumor Trajectory Estimation From Rotating Cone Beam Computed Tomography Projections, Shufei Chen

Theses and Dissertations

Respiration introduces large tumor motion in the thoracic region which influences treatment outcome for lung cancer patients. Tumor motion management techniques require characterization of temporal tumor motions because tumor motion varies patient to patient, day to day and cycle to cycle. This work develops a markerless algorithm to estimate 3 dimensional (3D) lung-tumor trajectories on free breathing cone beam computed tomography (CBCT) projections, which are 2 dimensional (2D) sequential images rotating about an axis and are used to reconstruct 3D CBCT images.

A gold standard tumor trajectory is required to guide the algorithm development and estimate the tumor detection accuracy …

An Investigation Of Nurbs-Based Deformable Image Registration, Travis J. Jacobson

Theses and Dissertations

Deformable image registration (DIR) is an essential tool in medical image processing. It provides a means to combine image datasets, allowing for intra-subject, inter-subject, multi-modality, and multi-instance analysis, as well as motion detection and compensation. One of the most popular DIR algorithms models the displacement vector field (DVF) as B-splines, a sum of piecewise polynomials with coefficients that enable local shape control. B-splines have many advantageous properties in the context of DIR, but they often struggle to adequately model steep local gradients and discontinuities. This dissertation addresses that limitation by proposing the replacement of conventional B-splines with a generalized formulation …

A Comparative Study Of Murine Mast Cell Progenitors, Shirley K. Desimone

Theses and Dissertations

This thesis is a comparative study of variables affecting differentiation and proliferation of progenitor cells from various embryonic and fetal tissue sites as they differentiate into mast cells. Embryonic stem cells from gestation day 4.5 (d4.5) differentiated exclusively into mast cells when cultured in semi-solid media with stem cell factor (SCF) and Interleukin-3 (IL-3). The same was true of d8-1 1 yolk sac cells and d8-1 1 cells from the embryo itself. However, culture with SCF and IL-3 of cells from dl4 fetal livers differentiated into mast cells, cells of the erythrocyte lineage and a few "macrophages" which may have …