2019 Theses and Dissertations

Permanent URI for this collectionhttps://hdl.handle.net/11274/13277


Recent Submissions

Now showing 1 - 20 of 137
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    The role of upstream activating factor in suppressing Pol II rRNA transcription in Saccharomyces cerevisiae
    (1/8/2020) Bhatt, Kushal; Conrad-Webb, Heather
    Ribosome synthesis is the most resource and energy – intensive process in all eukaryotic cells and is tightly coupled with growth rate. In addition, defects in synthesis and assembly of ribosomal RNA (rRNA) and ribosomal proteins result in G1 arrest and cell death (Bernstein & Baserga, 2004). As the rate limiting step in ribosome synthesis, rRNA transcription is tightly regulated on many levels. RNA polymerase (Pol I) transcribes the ribosomal DNA (rDNA) to generate a 35S ribosomal RNA (rRNA) precursor which is post-transcriptionally modified to mature 18S, 5.8S, 28S rRNAs (Warner, 1999). However, under chronic stress conditions when Pol I transcription is repressed, rRNA can also be synthesized by RNA polymerase II (Pol II) using a cryptic promoter overlapping the Pol I promoter. This phenomenon of rRNA synthesis by Pol II is termed as ‘polymerase switch’ (Conrad-Webb & Butow, 1995). Since this process is conserved throughout eukaryotes including humans and plants, this phenomenon may play a universal role in the regulation of rRNA. Because the Pol I transcription factor, upstream activating factor (UAF), is known to generate rDNA chromatin inhibitory to Pol II during non-stress conditions, we hypothesized that UAF inhibited the polymerase switch during normal nitrogen conditions and that this inhibition is released during nitrogen deprivation, facilitating the switch. During nitrogen deprivation, UAF steady state levels decreased 2-fold and UAF binding to the rDNA promoter also decreased. Consistent with our hypothesis, UAF subunits H3 and H4 are differentially modified upon nitrogen deprivation with an increase in H3K4 and H3K36 methylation and a decrease in acetylation at H4K5. Contributing to the inhibitory chromatin structure in non-stress conditions, Pol I interacting protein Hmo1 represses polymerase switch as determined by reporter gene assays; whereas, Sir2 does not influence the polymerase switch. Furthermore, transcriptional repressors binding to the Pol II rDNA promoter recruit Ssn6-Tup1 to further repress the Pol II mediated transcription. Thus, during non-stress conditions, UAF triggers the assembly of Pol II inhibitory chromatin and recruitment of HmoI. This inhibitory chromatin is enhanced by the recruitment of the Ssn6-Tup1 repressor. This work has enhanced our understanding of the Pol I regulation during stress conditions and the role Pol II rRNA synthesis plays in overall regulation of ribosome synthesis upon stress.
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    The effect of freeze dried whole raspberries on pain, joint flexibility, and inflammation in individuals with symptomatic knee osteoarthritis
    (1/9/2020) Khalid, Sana; Juma, Shanil
    Objective: The purpose of this study was to examine the effect of freeze dried whole raspberries on pain, joint flexibility, and inflammation in individuals with symptomatic knee osteoarthritis (OA). Methods: In this double-blind and randomized trial, a total of 63 men and women were recruited and placed into either a treatment group (raspberry powder) or placebo group (powder without raspberry) for a period of 4 months. The raspberry group (n=34) was given 35 grams of freeze dried whole raspberry powder daily. Participants were instructed to mix the raspberry powder in 10-12 oz of water, and to consume it within 5 minutes. The placebo group (n=29) consumed 35 grams of placebo powder mixed with 10-12 oz of water. The placebo group was given a powder that was of similar appearance and energy content as the raspberry powder, but without the raspberry content. At baseline, midpoint (60 days), and final (120 days) visits, demographic data including height, weight, and blood pressure (systolic and diastolic) were obtained. At each study visit, participants filled out the Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire to evaluate pain, stiffness, and difficulty in activity associated with knee OA. Range of motion testing was conducted using a goniometer during each study visit to assess joint flexibility. Additionally, an overnight fasting blood specimen was collected at each study visit to assess biomarkers of inflammation. Results: A total of 44 participants completed the study with a drop-out rate of approximately 30%. No significant changes in weight or BMI were observed in either group. A significant decrease in systolic and diastolic blood pressure was seen among the raspberry group at final visit compared to baseline. No changes in systolic or diastolic blood pressure were noted in the placebo group. Total WOMAC score as well as its subgroups (pain, stiffness, and difficulty performing daily activities) were significantly decreased at final visit compared to baseline in the raspberry group. In the placebo group, a significant decrease in stiffness was observed at final compared to baseline. There were no significant changes in total WOMAC score or its subgroups between the two groups. There were no significant changes in overall ROM scores in the raspberry or placebo groups. At midpoint visit, right knee extension was significantly less in the raspberry group than in the placebo group. There was also a significant decrease noted in right knee extension in the raspberry group at midpoint compared to baseline. A significant decrease in left knee extension was observed in the raspberry group at midpoint compared to baseline. No differences were observed in right knee flexion. However, there was a significant increase in left knee flexion in the raspberry group at final compared to baseline. For inflammation, no significant changes were witnessed among the pro-inflammatory (TNF-α, IL1β, IL-6) or anti-inflammatory biomarkers (IL-10, IL-4, IL13). However, slight changes were noted in some of these biomarkers. There was a slight decrease in IL-6 concentrations in the raspberry group at final timepoint, although not significant. Additionally, there was a slight increase in IL-6 concentrations in the placebo group at final compared to baseline. There was a decrease in IL-10 concentration in both the raspberry and placebo group at final in comparison to baseline. Conclusion: The findings of this study suggest that daily incorporation of whole raspberries can reduce pain, stiffness, and difficulty to perform daily activities. There was also a small, albeit not significant, improvement in joint flexibility in the knees. We did not observe any changes in the biomarkers of inflammation. Improvement in pain, stiffness, difficulty doing daily activities, and joint flexibility associated with consumption of raspberry may lead to an increase in overall quality of life in individuals with symptomatic knee OA.
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    Beyond hearing: Nurses' active empathetic listening behaviors from the voice of the patient
    (1/8/2020) Myers, Karen K., MSN; Krepper, Rebecca
    The purpose of this study was to distinguish between effective and ineffective nurse active empathetic listening (AEL) behaviors as perceived by adult inpatients from an acute care hospital. Nurse communication and more specifically, nurse listening is at the core of nurse-patient interaction and influences quality, safety, and patient experience. Nurse listening from the patient’s perspective is poorly understood with a large gap in nursing science. A non-experimental two-group comparison descriptive study was conducted to determine if there was a difference in AEL behaviors as perceived by patients for nurses who listened (n=194) and those who did not (n=50). The two groups were identified based on the response to an initial filter question. A total of 244 medical and surgical patients responded to survey instruments (biographical data form; AEL survey) sent either to their home address or via email at a minimum of 15 days post discharge from a large acute care facility. No statistical difference was found between the demographics of the two groups. An independent t-test (α=.05) revealed a statistically significant difference in the two groups perception of listening behaviors for those who listened and those who did not based on total score, subscales (sensing, processing, and responding) and each of 11 AEL items. The AEL behavior most frequently identified by all participants as most important to them as a patient was “My nurses understood how I felt.” The Cronbach’s alpha calculated for the AEL scale’s total score and subscales exhibited strong reliability. In conclusion, the findings of this study begin to narrow the gap in nursing science related to nurse listening behaviors from the perspective of the patient. Through a better understanding of nurse listening, practice changes can be implemented to impact quality, safety, and the patient experience.
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    The effect of freeze-dried whole raspberry powder on gait performance, mobility, and serum biomarkers of cartilage metabolism in symptomatic knee osteoarthritis
    (1/6/2020) Poindexter, Melissa Ann; Juma, Shanil
    Objective: The purpose of the study was to investigate the effects of freeze-dried raspberry consumption on gait performance, mobility assessed by physical activity, and serum biomarkers of cartilage metabolism (YKL-40, insulin growth factor-1, insulin growth factor binding protein- 3, and hyaluronic acid) in individuals with current symptomatic knee osteoarthritis. Methods: A double-blinded, randomized placebo-controlled study design was used with evaluations at baseline (before treatment intervention), midpoint (8 weeks), and after intervention (16 weeks). Sixty-three participants (both men and women) with self-reported mild to moderate degree of pain in the knee due to symptomatic OA were recruited. Participants were randomized into two groups, either placebo (n=29) or treatment group (n=34). The treatment group consumed 35 grams of freeze-dried raspberry powder mixed with 10-12 ounces of water, consumed daily. The placebo group consumed 35 grams of a control powder similar in color, fiber, carbohydrates, and calories. Anthropometric measurement of height, weight, blood pressure, and leg length were obtained at baseline, midpoint, and final visit. Additionally, participants filled out the International Physical Activity Questionnaire (IPAQ) at each visit. Finally, gait analysis was performed using the GAITRite® system at each visit. Overnight fasting venous blood was collected at each visit to assess markers of cartilage metabolism (YKL-40, IGF-1, IGFBP-3, and hyaluronic acid). Treatment effects were analyzed using repeated measures ANOVA. Results: A total of 44 participants completed the study with an attrition rate of 30%. Average sitting time, measured by minutes per day, showed a progressive decrease from baseline to end of the study in the raspberry group, where the placebo group showed a consistent level for the duration of the study. The raspberry group showed an increase in house-related physical activity, measured by metabolic equivalents (METs), whereas no significant changes were observed in the placebo group. For cartilage metabolism markers: hyaluronic acid, IGF-1, IGFBP-3, and YKL-40, the raspberry group showed consistent biomarkers throughout the study without significant changes. The placebo group showed a progressive increase in IGFBP-3 and YKL-40 throughout the duration of the study, markers which are associated with advancing degradation of cartilage. IGF-1 and hyaluronic acid showed no significant changes over time in the placebo group. At a normal walking cadence, the placebo group showed a significant increase in cadence, velocity, right and left leg single support percentage, and right and left leg step length; additionally, with a decrease in right and left leg single support percentage and right and left leg cycle time, suggesting an improvement based on the placebo effect. The raspberry group showed improvement with an increase in cadence and a decrease in right leg cycle time at a normal walking cadence. However, at a fast walking cadence, only the raspberry group showed significant improvements, whereas the placebo showed no significant improvements. The raspberry group increased in cadence, velocity, and left leg single support, while decreasing in left and right leg double support percentage and left and right cycle time. Conclusions: The findings of this study suggest that incorporation of whole raspberries may increase physical activity, improve gait performance, and prevent further cartilage degradation; therefore improving quality of life in individuals with symptomatic knee OA.
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    Examining the association between acculturation indicators and metabolic syndrome among Hispanic adults
    (11/4/2019) Quezada, Alejandra; Massey-Stokes, Marilyn
    The purpose of the study was to examine the relationship between acculturation indicators and metabolic syndrome (MetS) among Hispanic adults living in the Dallas-Fort Worth metropolitan area in Texas. MetS is a pressing public health problem, and Hispanics have the highest prevalence among all ethnic groups in the United States (35.4%). MetS is a cluster of five risk factors (blood pressure, waist circumference, high-density lipoprotein cholesterol, fasting blood glucose, and triglycerides) that increase a person’s risk of developing cardiovascular disease and diabetes. Currently, Hispanics are the second-largest ethnic group in the United States, and more than one-third of the U.S. Hispanic population is foreign-born. As immigrants and subsequent generations are exposed to the mainstream U.S. culture, the process of acculturation impacts their lifestyle behaviors and health. Acculturation indicators (nativity, duration in the United States, and scores from the Short Acculturation Scale for Hispanics) and the five MetS markers were assessed among 128 adult participants. Logistic regression modeling was conducted to predict MetS status (present/not present) by acculturation indicators and covariates (sex, age, and education). Additional analyses were conducted to assess the relationship between each individual MetS marker, acculturation indicators, and the identified covariates. For every one-unit increase in a participant’s duration in the United States (measured in years), the likelihood of having abnormal blood pressure increased by 6% and the likelihood of having abnormal blood glucose increased by 5%. Results indicate increasing exposure to the mainstream American culture negatively impacts health risks and status among Hispanics. The primary treatment for MetS is lifestyle modification that includes regular physical activity, healthy eating, and weight loss. Health care providers can aid in reducing MetS prevalence by raising awareness of the condition and associated risk factors among their patients as well as recommending lifestyle modification to reduce their risk. Study results can aid health educators in planning, implementing, and evaluating health communication campaigns and health education/promotion programs to prevent MetS among Hispanics. Further examination of what changes occur in health behaviors that increase risk of MetS would provide further insight into why duration in the United States is associated with elevated blood pressure and elevated fasting blood glucose levels.
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    A retrospective study to identify unique contributors to falls in hospitalized adult hematology patients
    (1/10/2020) Mbango, Catherine; Toms, Robin
    A fall may be defined as an event that results in a person coming to rest inadvertently on a lower level surface or an unplanned descent to the floor with or without injury. Fall prevention is a concept associated with hindering a fall from happening through advance care planning or action. The body of knowledge on falls, risk factors, consequences, and prevention originates from studies of older persons who have experienced a fall. The medical community has made several efforts toward fall risk assessment with an emphasis on prevention of the reoccurrence of falls, but this approach could potentially skew attention away from initial fall prevention efforts. The purpose of this retrospective case-control study was to identify unique contributors to falls in hospitalized adult cancer patients with a hematologic diagnosis. Falls in this population are a great safety concern for nurses and other healthcare providers. Patients with hematologic disorders are at an increased risk of sustaining an injury due to their low platelet counts resulting from chemotherapy and radiation treatments. Patient falls, and patient falls with injury are healthcare outcome measures that are currently being used to evaluate the quality of hospital nursing care, and are an integral part of the National Database of Nursing Quality Indicators (NDNQI). The Centers for Medicare and Medicaid Services no longer reimburses hospitals for in-hospital falls with injury, therefore, placing a greater burden on nursing staff to ensure patient safety through the development of nurse-driven fall prevention strategies, and the implementation of risk reduction plans of care. A total of 94 electronic medical records, which served as the primary sources of data were reviewed in this study and data on ten independent variables and one dependent variable were analyzed. Simple logistic regression between continuous variables and one dependent variable, and cross-tabulation between categorical variables and the dependent variable was used to analyze study results. Stepwise logistic regression was utilized for the final analysis of data. The relationship between fall incident and fall risk assessment score on admission was significant, X2 (1) = 6.153, p<.013, Cramer’s V = .256. Additional research is planned for generalizability.
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    Effects of RhoA and Rac1 prenylation on Alzheimer's disease proteins
    (12/2/2019) Chabayta, Rawand Khaled
    Alzheimer’s disease (AD) is a progressive neurodegenerative disease characterized by brain extracellular amyloid plaques and intracellular neurofibrillary tangles.  amyloid (Aβ) plaques are produced from the cleavage of amyloid precursor protein (APP) by β-amyloid cleavage enzyme (BACE1) and -secretase. Intracellular neurofibrillary tangles are formed from the hyperphosphorylation of tau accomplished by increased kinase and/or decreased phosphatase activity. Clinically, the cholesterol-depleting drugs, statins, which also decrease the isoprenoid production, are associated with decreased incidence of AD. Geranylgeranyltransferase I activity adds a 20-carbon geranylgeranyl group (a type of prenylation) to proteins and its activity decreases with age or AD. This enzyme prenylates Rho guanosine triphosphatases (GTPases), including RhoA and Rac1. Some evidence indicates that dysregulation of Rho GTPase or activation or prenylation is associated with altered AD pathological markers A or tau. Here, we investigated how altered prenylation of Rac1 or RhoA affects AD pathological makers. We hypothesized that overexpressing Rac1 or RhoA that cannot be prenylated would increase APP and tau by increasing their processing secretases and kinases. To address this, we overexpressed emerald green fluorescently protein (EmGFP)-tagged prenylatable (wild-type) Rac1 or RhoA or non-prenylatable Rac1 or RhoA and measured APP, A, BACE1, -secretase, tau, phosphorylated tau, and levels of one kinase that phohsphorylates tau, glycogen synthesis kinase 3 (GSK3β), and activation of BACE1. In whole cell lysates of B35 neuroblastoma cells, overexpressing prenylatable or non-prenylatable Rac1 did not alter APP, A BACE1, presenilin 2 (the active subunit of  secretase), or GSK3β levels. However, APP levels in membranes were decreased by overexpressing either prenylatable or non-prenylatable Rac1, with the latter decreasing membrane-associated APP less than overexpressed wild-type Rac1. Cells overexpressing prenylatable or non-prenylatable RhoA increased total levels of tau, but only overexpression of wild-type RhoA increased levels of tau phosphorylation. We interpret results showing increased Rac1 and decreased RhoA prenylation increases tau phosphorylation to indicate a possible contribution to neurofibrillary tangle formation. However, since altering Rac1 or RhoA prenylation did not affect Aβ formation and evidence indicates that Rho GTPases function both upstream and downstream of AD marker production, RhoA GTPase prenylation, regardless of activation, may result from AD marker production instead of synthesis regulation.
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    Drug release kinetics and blood-brain barrier crossing efficacy of polymer encapsulated magnetic nanocarriers
    (1/9/2020) Sebastian, Sumod; Hynds, DiAnna L.
    Spinal cord injury (SCI) causes neuronal death and leads to permanent loss of motor and sensory functions. Treatment of SCI is challenging as axon regeneration from damaged neurons is limited by their intrinsic inability to regenerate as well as by the presence of extrinsic growth inhibitory molecules at the injury site. Moreover, targeting therapeutics to damaged CNS neurons is difficult due to the presence of the blood brain or blood spinal cord barrier (BBB/BSCB). This increases the demand for developing new treatment strategies for SCI. Unique properties of nanomaterials make them promising for targeted drug delivery to CNS neurons. We have developed a polymer encapsulated magnetic nanocarrier (PE-MNC) system for targeted and controlled drug delivery across the BBB. PE-MNCs were synthesized by precipitation polymerization method and tested for their biocompatibility in neurons. Drug loaded nanocarriers were tested for their release kinetics and targeted drug delivery to neurons in culture. We have also tested their size dependent BBB crossing efficacy in the presence and absence of an external magnetic field as well as induced hypoxia. We found that the physicochemical properties of PE-MNCs are ideal for their in vivo applications. Specifically, PE-MNCs possess superparamagnetic behavior in the presence of an external magnetic field and a higher LCST value. Increasing doses of PE-MNC treatment for up to 96 h did not detrimentally affect the neuron morphology. These nanocarriers exhibited a 50-70 nm volumetric reduction at physiological temperatures and released 80% of the imbibed drugs in a controlled manner. Moreover, they could induce neurite outgrowth on inhibitory substratum by delivering outgrowth promoting drugs to cortical neurons. We have used two different sizes of PE-MNCs for transport studies across bovine brain microvascular endothelial cell in vitro BBB model. In the presence of an external magnetic field, irrespective of their size, PE-MNCs were transported across a hypoxic in vitro BBB model. We conclude that PE-MNCs have the potential to deliver therapeutics to severed neurons across BBB following SCI.
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    RhoA and Rac1 prenylation: Effects on serine/threonine signaling for actin polymerization
    (1/9/2020) Raut, Namrata; Hynds, DiAnna L.
    RhoA and Rac1 are small guanosine triphosphates (GTPases) that regulate cytoskeletal rearrangements, cell polarity and axon guidance and signaling pathways. Alteration of the subcellular localization or activation of Rho GTPases is implicated in several neurological conditions. Rho GTPases are activated by binding to guanosine triphosphate (GTP) and is thought to require translocation to the plasma membrane by the addition of an isoprenoid moiety (geranylgeranyl) to the protein. However, previous experiments indicate that RhoA or Rac1 can be activated in the cytosol, without translocation to the plasma membrane. Based on this and evidence the Rho GTPases are centrally located in signaling pathways regulating actin dynamics, it was hypothesized that overexpressing non-geranylgeranylatable RhoA or Rac1 would decrease the actin filament content in neuronal growth cones by altering the location of actin regulating molecules. In particular, it was hypothesized that non-geranylgeranylatable RhoA or Rac1 would decrease the activity of actin filament promoters (i.e association of WAVE with the ARP2/3 complex and activation of JNK and ERK), and inactivation of the actin-depolymerizing protein cofilin. Overexpressing non-geranylgeranylatable (EmGFP-RhoAC190A), but not wild-type RhoA (EmGFP-RhoA), increased activation of ERK in the cytosol and increased association of WAVE with the ARP2/3 complex at the membrane, compared to cells overexpressing only the empty vector (EmGFP). However, overexpressing neither RhoA construct affected actin dynamics. Overexpressing wild-type Rac1 (EmGFP-Rac1), but not non-geranylgeranylatable Rac1 (EmGFP-Rac1C189A), increased the actin filaments content in growth cones compared to neurons expressing only EmGFP, concomitant with an increase in JNK activation. Overexpression of EmGFP-RacC189A decreased JNK activation and increased WAVE/ARP2/3 complexing, compared to cells expressing wild-type Rac1 or EmGFP alone. Studies with signaling molecule inhibitors indicated significant cross-talk between signaling pathways, which is altered by overexpressing wild-type or non-geranylgeranylatable forms of RhoA or Rac1. The results suggest that altering the subcellular localization of RhoA or Rac1 changes the activation of signaling molecules that regulate actin dynamics in neuronal growth cones. Elucidating the signaling cascades of the active GTPases may identify the distinct functions of these GTPases in the cytosol and can be used as novel targets to facilitate axon regeneration in neurodegenerative and neurological conditions.
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    Exploring hematology oncology nurses experiences of moral distress using a grounded theory approach
    (1/2/2020) Buitrago, Joaquin A; Freysteinson, Wyona M.
    Moral distress is historically defined as occurring when an individual knows the right thing to do, but due to institutional or interpersonal constraints, is unable to do it. Moral distress is associated with increased burnout and turnover for healthcare professionals and potentially even adverse outcomes for patients, all of which are costly for healthcare systems. Moral distress is most prominent in emergency room, intensive care and oncology nurses, with most studies focused on nurses in the emergency and intensive care settings. While moral distress has been broadly defined for oncology nurses there is a dearth of information specific to hematology-oncology nurses, for whom extended length of stay related to treatment and related toxicities may influence the contributing factors to their experience of moral distress, distinct from those experienced by emergency and intensive care nurses. This qualitative study applied a Grounded Theory approach to explore hematology-oncology nurses’ experience of moral distress. The use of constant comparison techniques within this methodology allowed for exploration and identification of patterns of moral distress in this unique nursing population and relationships between those patterns. These insights informed what contributing factors to moral distress may be similar to or distinct from those experienced by nurses in other specialties. The identification of these contributing variables informs more robust theoretical models and can guide the development of interventions specific to the hematology-oncology nursing community.
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    School nurse-led asthma intervention for elementary school-age children living with asthma
    (12/13/2019) Isik, Elif; Fredland, Nina
    The purpose of this study was to examine the effectiveness of a theoretically based school nurse-led asthma intervention on symptoms, asthma self-management with peak flow meter usage, daily activities, and school absences in elementary school-age children between the ages of seven and twelve. A randomized controlled, two-group, repeated measures design (pre-test, post-test, and follow-up test) was used. This study was conducted from September 2018 to June 2019 in eight public primary schools. A computer-generated randomization process was used to assign 73 subjects to the treatment or control group. The treatment group participated in a school nurse-led asthma intervention program comprised of six weekly 30-minute group lessons. The control group continued to receive usual asthma care. Data collection for both experimental and control group occurred at three time points: at baseline, six-week, and 12-week. The treatment group had statistically significant differences in reported symptoms (p < .001), asthma control with a peak flow meter usage (p < .001), and fewer interruptions in their daily activities (p < .001) immediately post-intervention at 6-weeks and at 12-weeks in comparison to the control group. Although school absences were not statistically significant, the treatment group missed fewer school days than control group. The school nurse-led asthma intervention for elementary school-age children was effective to increase asthma self-management with peak flow meter usages, decrease interruptions in daily activities, and improve symptom management. This study supports the notion that elementary school-age children should have the opportunity to practice self-monitoring and setting goals for asthma self-management with the guidance of school nurses. Self-management is a complex process, especially for children, which necessitates professional contribution and guidance. School nurses can provide essential learning steps and continuity of care for school children. The study findings have the potential to motivate school health leaders and nurses to replicate studies and seek evidence to translate research into practice.
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    Hypothyroidism and skeletal muscle: An in vitro model of investigating impaired pathways of muscle health
    (12/4/2019) Guerin, Gena D.; Duplanty, Anthony A.
    Hypothyroidism is a prevalent metabolic condition in the United States primarily affecting women. Individuals treated for hypothyroidism commonly report symptoms including skeletal muscle (SKM) pain, fatigue and intolerance to exercise even while under treatment. Exercise is an alternate intervention with potential benefits offsetting hypothyroidism due to overlapping thyroid hormone and exercise signaling pathways. The purpose of the study was to investigate the effects of hypothyroidism on SKM metabolism, myogenesis, mitochondria and cellular homeostasis and assess whether an exercise intervention could reduce the detriments caused by intracellular low thyroid hormone availability. An in vitro human SKM cell culture low availability of thyroid hormone model was utilized to represent hypothyroidism. The exercise mimetic, formoterol, was used to provide “exercise” stimulation. This experiment was conducted during the mid- and late stages of myogenesis. The model included three conditions (n = 6), control (CON), thyroid hormone depleted (ThD), and thyroid hormone depleted with three-hour acute formoterol treatment (ThD+F). Skeletal muscle myocytes were differentiated for four or six days in low thyroid hormone media with the ThD+F group stimulated with formoterol for three hours. Extraction of total RNA was performed on days four and six followed by qPCR for gene analysis. Gene expression was assessed for the following categories: (a) thyroid hormone metabolism, (b) myogenesis, (c) mitochondrial homeostasis, and (d) cellular homeostasis. The  CT method was used to normalize the data followed by two-way repeated measures ANOVA. Significance was set at p < .05. The low availability of thyroid hormone and formoterol treatment significantly impacted the expression of genes related to thyroid hormone metabolism, myogenesis, mitochondrial homeostasis, and cellular homeostatic function in skeletal muscle cells. The intracellular low thyroid hormone availability was compounded by the formoterol treatment leading to decreases in gene expression associated with myogenesis, reactive oxygen species mediation, and metabolism in the skeletal muscle myocytes. Exercise may cause deleterious effects on skeletal muscle in individuals with hypothyroidism. Further research is warranted to determine the safety and prescription of exercise for those with hypothyroidism.
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    The perception of nursing, pharmacy technician, and paramedic students participating in interprofessional simulation: A mixed methods study
    (12/13/2019) Bell, Rhonda; Fredland, Nina
    The purpose of this study was to understand the effectiveness of IPE-Sim as a learning methodology. Interprofessional education (IPE) provides a collaborative approach to educating students from different health-related programs. However, rigorous studies are limited about the effectiveness of simulation-enhanced IPE (IPE-Sim) as an educational methodology supporting interprofessional teams, role recognition, and collaborative practice. A mixed methods design was used to study the complex phenomenon of the effectiveness of IPE-Sim in promoting interprofessional teams, role recognition, and collaborative practice. The quantitative investigation was conducted using a randomized, two-group experimental design with repeated measures while the qualitative exploration was based on hermeneutic phenomenology of interpreting the meaning of the lived experience by interviewing participants. To better understand this phenomenon, the datasets were collected simultaneously, analyzed, and converged to determine congruence, or incongruences, associated with the phenomenon. A total of 60 students participated in the study. The hypothesis indicated the experimental group would score   higher on the SPICE-R2 scores than the attention control group at both time two (T2) and time three (T3). The significance occurred at T2 between the treatment group (M = 44.23, SD 4.36) and the attention control group (M = 41.27, SD 5.70) and not at T3. Therefore, the hypothesis was partially met. Overall, a significant effect was noted for time in both groups. Ten students participated in the individual interviews following the second simulation. The structural analysis as proposed by Lindseth and Norberg (2004) guided the interpretation of the qualitative data as the meaning units and themes yielded a comprehensive understanding of the phenomenon. Congruency was noted as both datasets confirmed the participants valued collaboration, learning about each other’s roles, and appreciated working in an interprofessional team. Nurses are an integral member of the healthcare team. The National League for Nursing (2016) encouraged nurse educators to develop meaningful IPE strategies to help students from different professions collaborate effectively, while providing team-based care to improve patient outcomes. This study supports the importance of providing opportunities for students in healthcare fields to learn with one another, as they learn about one another in collaborative practice.
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    Parental coaching: An exploration of how parents perceive the effects of their comments on child performance
    (12/16/2019) Raper, Nathalie; Ladd, Linda, Ph. D.
    The purpose of this qualitative study was to take a phenomenological approach to explore the perceptions of what role parents of athletes believe they serve by reflecting on the cognitions (words) they have expressed during “parental coaching.” Cognitive behavioral theory was used to guide this study. The following research questions were explored: How do parents perceive their acts of parental coaching in relation to the effect it has on their child athlete? What role do parents believe they serve in relation to their child athlete and their sport? What do parents believe “parental coaching” means, and what are their thoughts regarding how they measure up with that definition? Does a parent’s coaching behavior vary depending on situational aspects (games vs practice)? What effect do parents believe they have on their child’s mindset, performance, and overall enjoyment of the sport? Do parents believe there are any consequences to their “parental coaching”? Twenty structured interviews were completed by parents of athletes. Data obtained was transcribed, coded and triangulation was used to determine credibility. In this study, five themes were identified: Parent as Life Coach, Support and Encouragement, Daughter’s Receptiveness Parent’s Financial Commitment to Results and Parenting Differences by Gender . Under Parent as Life Coach, a sub theme of Timing was found. Parents in this study believed their parental coaching to be less related to the act of coaching in the specific sport and more related to being a Life Coach. Commentary related to the child’s performance was also enhanced or reduced based on timing. Support and Encouragement was found to be a way in which parents universally defined parental coaching and was prevalent when discussing a parent’s overall role. Daughter’s Receptiveness was a defining factor in the amount of commentary a parent had with their child and what was said. Lastly, themes of Parent’s Financial Commitment to Results and Parenting Differences by Gender were presented organically. Many parents noted the importance of their expectations being met due to the amount of money that was invested in the sport. Parents also noted the delivery of information was different when it came from the father.
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    Differences in ball flight parameters and in kinematics between two golf swing styles
    (11/25/2019) Kanwar, Kiran D.; Mann, Mark David
    This study compared golfers’ body and club kinematics with two swing styles (existing swings and The Optimal Performance Swing – TOPS), and two clubs (9- and 6-iron). The aims were to assess whether: (1) body kinematics associated with required TOPS positions and with performance, (2) club movements associated with ball direction and ball trajectory, (3) kinematics associated with low back pain – difference between thoracic and pelvic rotations at the top of the backswing (X-Factor); crunch range (difference between trail side lateral flexion at the top and at impact) and spinal forward tilt at address, would improve with the use of TOPS. Existing and TOPS swings were analyzed, and four TOPS training sessions were provided. Eleven Qualisys cameras collected kinematic data at 400 fps. Fifteen golfers (ages 18-73, handicaps +2 to -20), five females and ten males, participated. They performed ten shots per club, per swing style, and the five with the highest club speed were used for further analysis. Three 2 x 2 repeated measures multivariate analyses of variance were used to test the hypotheses. Significant main effects of TOPS across both clubs respectively were: a shallowing of club angle of approach (4.84 ± 1.9° vs 2.55 ± 2.21°) and a more in-to-out path (0.13 ± 4.3° vs 3.53 ± 4.33°), as well as a thorax that was more rotated to face away from target at address (4.71 ± 4.61° vs -18.66 ± 7.31°) and impact (9.72 ± 9.09° vs -3.15 ± 7.93°), and had less lead side lateral flexion at the top of the backswing 32.71 ± 5.46° vs 24.12 ± 5.53°). Three important variables associated with low back pain - X-Factor (-45.27 ± 14.55° vs -36.8 ± 8.48°), crunch range (52.22 ± 9.6° vs 42.12 ± 7.74°), and thorax forward tilt at address (36.01 ± 6.99° vs 30.47 ± 6.02°) - were all reduced with TOPS. TOPS could be used for approach shots with the iron clubs by golfers requiring better direction and trajectory of ball flight, consistency of club speed, and a reduction in some kinematics associated with low back pain.
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    The impact of spinal stabilization exercises on pain, disability, and physical functional after lumbar spinal fusion
    (11/8/2019) Sawyer, Kathryn; Roddey, Toni S.
    Lumbar spinal fusion (LSF) surgery is one of the most commonly performed procedures for degeneration of the lumbar spine. Though minimally invasive surgical techniques have been developed in an attempt to reduce muscle injury, some damage is unavoidable. Research on postoperative rehabilitation has not kept pace with the increased utilization of LSF in the United States over the past three decades, and there is a lack of high-quality evidence to answer questions regarding the optimal timing, duration, and type of rehabilitation to implement following surgery. Spinal stabilization exercises target the muscles that corset the lumbar spine to improve functional control of the trunk. Initiation of a spinal stabilization program early after LSF may reduce loss of muscle function, potentially improving clinical outcomes following surgery. The purpose of the three studies was to explore spinal surgeons’ perceptions of rehabilitation after LSF, investigate deep abdominal muscle performance during spinal stabilization exercises, and compare the effectiveness of early initiation of a spinal stabilization program to the current standard of care on outcomes after surgery. Spinal surgeons participated in one-on-one interviews to discuss their opinions on postoperative recovery. Data was assessed with content analysis, coding and triangulation. Findings indicated that surgeons prefer a rehabilitative program that includes cardiovascular activity, trunk stabilization exercises performed with the lumbar spine in a neutral position, and reinforcement of body mechanics. Next, five low-load, neutral spine stabilization exercises were tested with ultrasound imaging. Two one-way repeated measures ANOVAs were calculated to compare resting and contracted measurements of the transversus abdominis and internal oblique muscles. Results of this study were incorporated into a randomized, prospective clinical trial comparing the effects of early initiation of a spinal stabilization exercise program to standard of care after LSF. Participants randomized to the control group followed standardized guidelines for cardiovascular activity. Participants randomized to the intervention group received instruction in performance of a daily spinal stabilization exercise program. Four separate 2x3 mixed ANOVAs were used in data analysis. Results indicated that the program did not have either a positive or negative impact on pain, disability, or physical function up to six months postoperatively.
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    The influence of parenting factors and child resilience on mental health in children with type 1 diabetes
    (12/4/2019) Carroll, Nicole; Vittrup, Brigitte
    The purpose of this study was to compare parent-reported measures of child resilience, child mental health, parent stress, and parenting self-efficacy between a group of parents of children diagnosed with type 1 diabetes (T1D) (ages of 6-12 years old) and a group of parents with typically-developing children without chronic illness (ages of 6-12 years old). The four hypotheses were as follows: 1) Parents of children diagnosed with T1D will have higher levels of stress than parents of children without T1D. 2) Children diagnosed with T1D will have higher levels of parent-reported child mental health issues than children without T1D. If hypothesis 1 is supported, then the influence of parent stress will be included in this analysis. 3) The relationship between a diagnosis of T1D and parent-reported child mental health issues is moderated by the child’s level of parent-reported psychological resilience. 4) The relationship between a diagnosis of T1D and parent-reported child mental health issues is moderated by the parent’s level of parenting self-efficacy. For hypotheses 1 and 2, it was found that parents of children with T1D reported significantly higher amounts of both parent stress and parent-reported child mental health issues than comparison group parents. However, once the effect of parent stress and parenting self-efficacy had been accounted for, there was no longer a significant difference in child mental health issues. For hypotheses 3 and 4, while the individual predictor of child group status (type 1 diabetic, comparison group) significantly affected the outcome variable, neither of the moderating variables of child resilience or parenting self-efficacy significantly influenced the relationship between child group status and amount of child mental health issues. In conclusion, the moderating variables of child resilience and parenting self-efficacy were found to not significantly affect the amount of child mental health issues differently based on whether the child had been diagnosed with type 1 diabetes or had no chronic illness.
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    The decision-making experiences of caregivers regarding feeding tube placement in community dwelling adults
    (11/8/2019) Muoki, Deltra Catrece; Cesario, Sandra
    Despite the increase in feeding tube placement as people live longer with chronic illness, the research is scarce regarding how to care for the caregiver of individuals with chronic illnesses especially with percutaneous endoscopic gastrostomy feeding tubes (PEG). This study aims to explore the caregiver’s experience regarding decision-making for PEG feeding tube placement in community dwelling adults. PEG feeding tubes are placed when individuals are unable to orally consume adequate nutrition. PEG feeding tubes ensure that individuals are able to meet their nutritional needs, but they can be accompanied by complications and other challenges that may affect daily living. Subsequently, caregivers may be involved in order to help manage care, which could lead to caregiver burden if there is lack of support. The National Institute of Nursing Research’s recent movement towards relieving caregiver burden and enhancing quality of life support the importance of this study. A descriptive phenomenological study was conducted at six post-acute care rehabilitation and skilled nursing facilities in Houston, Texas and the surrounding areas. Caregivers had some role in the decision-making for PEG feeding tube placement and intended to spend at least 4 hours per day providing direct care. Purposive sampling, data collection, and data analysis using Colaizzi’s method was conducted simultaneously. The transcripts were read and re-read with significant themes and meanings placed into a word document. They were then categorized into subthemes and placed in an excel spreadsheet for identification of overlapping themes. Although all participants expressed there was no regret in the decision to place a PEG feeding tube because it was a necessity and best for the patient, they expressed concerns about lack of education that was provided before and after PEG feeding tube placement as well as concerns about the complications. The findings suggest the need for support and adequate preparation from nurses in order to relieve caregiver burden and improve care.  
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    Identity and the ethos of survivance in selected novels of Louise Erdrich
    (11/4/2019) Kirkpatrick-Matherly, Kellie L.; Bridges, Phyllis
    The word “survivance” is a portmanteau of the words “survival” and “defiance.” Gerald Vizenor coined the term for the rhetorical theory he created in the 1970s to encourage the preservation of Native American culture, particularly through literature, while resisting colonial dominance. Contemporary Native American authors often create literature of survivance by reimagining traditional storytelling techniques, incorporating their native languages into their writing, and participating in their unique tribal communities, all of which are entwined with the concept of identity. This dissertation offers with an explanation of Survivance Theory and its applications. Through this theoretical lens, the following chapters explore Louise Erdrich’s use of storytelling techniques, subversion and subterfuge, and religion in three of her novels: Tracks, Four Souls, and The Last Report on the Miracles at Little No Horse. The final chapter centers on contemporary tribal writers and their responsibility to the Native American community.
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    Role of progesterone in sexual receptivity and orofacial pain
    (11/8/2019) Hornung, Rebecca Sharon; Averitt, Dayna L.; Uphouse, Lynda
    Two understudied disorders that are challenging to treat, sexual dysfunction and orofacial pain, are more prevalent in women and can be impacted by the gonadal hormone’s estrogen and progesterone. Estrogen’s effects on women’s health are well-known, but much less is known about progesterone. The data in this dissertation indicates progesterone may be beneficial in alleviating these two major issues in women. The major drug prescribed for depression increases brain serotonin levels resulting in sexual inhibition, which likely occurs via the serotonin 1A receptor (5-HT1A) as agonists inhibit sexual behavior. Interestingly, progesterone protects against sexual inhibition by an unknown mechanism that may involve the intracellular progesterone receptor (iPR). Here we hypothesized that progesterone’s attenuation of 5-HT1A receptor-induced sexual inhibition involves the iPR. Also, progesterone may be beneficial for alleviating temporomandibular joint disorder (TMD) pain, which is 3-4x more common in women. TMD pain dissipates during pregnancy and after menopause but reemerges for some post-menopausal women prescribed estrogen replacement therapy. Here we hypothesized that therapeutic doses of progesterone in female rats undergoing estrogen replacement would attenuate inflammatory pain behaviors of the temporomandibular joint (TMJ). Ovariectomized, estradiol-primed female rats injected with an iPR antagonist before or after progesterone, then injected with a 5-HT1A receptor agonist had sexual receptivity parameters measured to determine if progesterone’s attenuation of 5-HT1A receptor-induced sexual inhibition involves the iPR. To determine progesterone’s effect on TMD pain, female rats were tested for basal sensory thresholds at the TMJ then injected with complete Freund’s adjuvant (CFA) to trigger inflammation in the TMJ. Mechanical allodynia (developed touch sensitivity) was confirmed then rats were ovariectomized and reassessed for allodynia following various estrogen and progesterone treatment paradigms. This dissertation reports that progesterone acting at the iPR can attenuate 5-HT1A receptor-induced sexual inhibition (Chapter II), progesterone can rapidly attenuate estrogen-evoked TMD pain behaviors (Chapter III), and orofacial sensory neurons contain progesterone-metabolizing enzymes and receptors (Chapter IV). Overall, adjunctive progesterone treatment may provide beneficial gender-based therapies for women facing serotonin-induced sexual dysfunction or post-menopausal women experiencing a return in TMD pain following estrogen treatment.