RSS 1.0Theses and Dissertations
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Determination of Optimum Volumetric Area Projection for Cannulated Screw Internal Fixation of Femoral Neck Fractures in Porcine Animal ModelsFemoral neck fractures not only carry a higher mortality rate amongst elderly individuals, they also pose a significant social and economic burden as a result of perioperative and postoperative costs. Depending on the severity of fracture and patient candidacy, orthopedic surgeons may opt for joint arthroplasty or open reduction internal fixation methods such as percutaneous cannulated screw fixation (PCSF). There is currently no general consensus on the optimum screw configuration for femoral neck internal fixation using the PCSF method. This research aims to investigate the biomechanical stability of three-screw and four-screw configurations of either prismatic or pyramidal volumetric projections in porcine animal models, evaluating the maximum axial load and shear stress sustained prior to failure of bone as a material to provide conclusive data to improve fracture fixation longevity and patient quality of life following surgery. Thirty two porcine femora were cleaned of soft tissue, measured, and potted in epoxy resin prior to fracture generation and fixation. Testing protocols involved ramp, cyclic fatigue, and failure testing to obtain data on maximum axial force and failure shear forces. Rectangular base pyramids configurations sustained the highest maximum axial force on average prior to failure, followed by rectangular base prism, triangular base prism, and triangular base pyramid configurations. Shear stress data revealed that the rectangular base prism configuration sustained the most shear stress prior to failure, followed in descending order by the rectangular base pyramid, triangular base prism, and triangular base pyramid configurations. Single factor ANOVA analysis of the maximum axial force and maximum shear stress found a p value of p < 0.119 and p < 0.256, respectively, and unpaired t test data for the same parameters revealed no statistical significance between any sets of the groups. For future studies, it should be expected that a control group is established to provide baseline data for comparison, experimental groups have a sample size of at least 30 specimens, and analysis of failure rate of each configuration to make definitive conclusions regarding the biomechanical stability of triangular base pyramid, triangular base prism, rectangular base pyramid, and rectangular base prism percutaneous cannulated screw fixation methods.
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EXPLORING THE MOTIVATION OF ELEMENTARY GIFTED LEARNERS USING MATHEMATICAL PROBLEM-POSINGGifted students' often go unchallenged in the classroom, and this lack of tailored instruction can lead to decreased motivation, which, in turn, influences underachievement, which is a significant concern since these children, theoretically, should be our highest achievers. This 4-week (i.e., eight instructional days) semi-randomized, pre-test/post-test experimental design study tested a mathematical problem-solving intervention to evaluate its effects on gifted students’ motivation in mathematics. Fourth and fifth grade gifted students were semi-randomly placed into groups for mathematical instruction using business-as-usual, Traditional Problem-Solving (TPS), or Mathematical Problem-Posing (MPP) pedagogical approaches. Twenty-nine gifted students took the Children’s Academic Intrinsic Motivation Inventory (CAIMI; Gottfried, 2006) at pre-test (i.e., before instruction) and again at post-test to measure any potential changes in their learning motivation in mathematics using raw scores. A one-way analysis of covariance (ANCOVA) was conducted to explore the mean difference between groups (i.e., TPS/MPP instruction) on one continuous dependent variable (i.e., post-test motivation scores) while controlling for pre-test motivation scores (i.e., covariate). After controlling for pre-test scores, there was no statistically significant difference between groups in students’ motivation scores, F(1, 26) = .057, p = .813, although students’ motivation scores increased in both groups. Limitations, such as the duration of the intervention, are discussed along with implications for future research, which include repeating the study with a larger sample and for a longer duration.
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SARS-COV-2 SPIKE PROTEIN EXACERBATES CEREBRAL THROMBOEMBOLIC COMPLICATIONS IN HACE2 MICEPurpose: COVID-19 doubles the risk for acute ischemic stroke in patients with cardiovascular disorders, yet the molecular mechanisms are unclear and remain unresolved medical challenges. We hypothesize that SARS-CoV-2 spike protein exacerbates stroke and neurovascular complications via increasing coagulation and decreasing fibrinolysis by disrupting the renin-angiotensin-aldosterone system (RAAS) balance. Methods: MCA/FeCl3 thromboembolic model was induced in humanized ACE2 knock-in mice. hACE2 mice were treated with Losartan, an angiotensin receptor blocker, after one day of SARS-CoV-2 spike protein injection. Cerebral blood flow was measured using a Laser speckle imager. Infarct size was compared using TTC stain. Vascular contribution to cognitive impairment and dementia (VCID) were assessed using a Novel object recognition test. D-dimmer, Tissue factor -3 (TF-III), and Plasminogen activator inhibitor-1 (PAI-1) were measured using ELISA and Western blot to assess coagulation and fibrinolysis. Human brain microvascular endothelial cells (HBMEC) were exposed to hypoxia with/without SARS-CoV-2 spike protein to mimic stroke. HBMEC was analyzed for coagulation factors, inflammation, and RAAS balance. Results: SARS-CoV-2 spike protein increased neuronal death and decreased cognitive function after MCA/FeCl3 thromboembolic occlusion. hACE2 mice subjected to SARS-CoV-2 spike protein showed diminished cerebral blood flow compared to control groups. SARS-CoV-2 spike protein increased coagulation factors (increased TF-III) and decreased fibrinolysis (increased PAI-1) in hACE2 and HBMEC. Losartan reduced spike protein-induced infarction and improved cognitive function in hACE2 mice. SARS-CoV-2 spike protein caused RAAS system imbalances in hACE2 mice by increasing AT1R and downstream inflammatory signal. Moreover, spike protein decreased the protective RAAS arm by decreasing AT2R and Mas receptors in hACE2 brains. Conclusion: In hACE2 mice, SARS-CoV-2 spike protein exacerbates hypercoagulation and inflammation, leading to increased cerebrovascular damage and cognitive dysfunction. However, the AT1R blocker, Losartan, restored the RAAS balance and reduced COVID-19-induced thromboembolic cerebrovascular complications.
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Characterization of Herpes Simplex Virus Type 1 Portal MutantsThe Herpesviridae family is comprised of nine ubiquitous viruses capable of causing primary and latent infection in humans. Herpes Simplex Virus Type 1 (HSV-1) is an alpha-herpesvirus that can manifest as herpes labialis, ocular infection, and encephalitis. The HSV-1 capsid contains a dodecameric assembly of pUL6 monomers at one vertex forming a portal for DNA to be translocated into the capsid. The portal contains several potential functional domains (stem, clip, b-hairpin, wing, crown, and wall) that coordinate the DNA encapsidation process during viral replication. In this study, we aimed to examine the contribution(s) of these domains to DNA packaging. A library of mutant UL6 genes containing in-frame insertions of 15 base-pairs throughout the gene as well as specific mutations to the region encoding the pUL6 -hairpin was generated. In addition, specific mutations to amino acid 541- 558 B-Hairpin domain included a full knockout, a scramble of residues and a substitution of charged residues (KRNQ) to alanine. Thirty-seven random insertions throughout UL6 gene were identified and the location of each insertion confirmed by DNA sequencing. Each mutant gene was cloned into the HSV-1 Strain-17 bacterial artificial chromosome (BAC) using a heat-shock controlled, homologous recombination event in SW102 E. coli. Mutant BACs were transfected into African green monkey kidney (Vero) and 31 (HSV-1 UL6 complementing) cell lines to generate mutant virus stocks. Western blot analysis of virus infected cell lysates was performed to confirm expression of mutant pUL6 proteins. In addition, viral replication kinetics were assessed in a replication assay.
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THE POTENTIAL POWER OF PEER FEEDBACK: A QUASI-EXPERIMENTAL EXPLORATION OF GIFTED MIDDLE SCHOOL STUDENTS’ PERCEPTIONS OF PEER FEEDBACK AS AN INSTRUCTIONAL TOOL TO IMPROVE SCIENCE LEARNINGThis study investigated how peer feedback as an instructional tool might increase the engagement of gifted middle school science students, potentially impacting their academic performance in science. It specifically addressed gifted students’ perceptions of peer feedback in science. Furthermore, it explored how peer feedback could be considered a potentially effective learning strategy to increase student’s engagement and learning from their peers in the science classroom. In this quantitative study, the researcher examined the independent variable, which was comprised of three peer feedback conditions: learning condition, rubric condition, and line condition, to see how students’ perceptions of the usefulness of peer feedback were in science. A one-way repeated measures ANOVA was used to understand if there were any changes in student perceptions during peer feedback conditions through a STEM prosthetic hand project. All students participated in each stage of the study design by learning about the peer feedback conditions (learning, rubric, and line-by-line condition) and completed each survey at the conclusion of each condition. Within each peer feedback condition, students were learning how to give, receive, and apply peer feedback (the peer feedback cycle). However, the results of statistical analyses revealed no significant differences among the three peer feedback conditions. These findings challenge much of the available literature on peer feedback and suggest that these different conditions may be influenced by factors not accounted for in this study. There is evidence to suggest that there is enough promise in utilizing peer feedback, specifically using peer feedback in science and STEM courses. Future research should explore the potential impact on study results if the peer feedback cycle is applied after engaging in extensive community-building, in non-gifted learning environments, and with a control condition over a longer implementation period.
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FITNESS AND IMMUNOREGULATORY FUNCTIONS OF HUMAN MESENCHYMAL STROMAL CELLS FROM IMMUNOLOGICALLY PRIVILEGED VERSUS IMMUNOLOGICALLY ACTIVE TISSUESMesenchymal Stem/Stromal Cells (MSCs) are non-hematopoietic, immunomodulatory cells with therapeutic potential. MSCs have been extensively researched; however, many mysteries hinder their progression to clinical application. This project investigated the immunoregulatory characteristics of MSCs from immunologically active tissue, bone marrow, and immunologically privileged tissue, cornea. An assay matrix consisting of flow cytometry, metabolic assays, secretory analysis, immunosuppressive assays, and qPCR was implemented to conduct this research. Aim one characterizes the immunosuppressive functionality of Human-Cornea derived Mesenchymal Stromal Cells (cMSCs). cMSCs demonstrate the capability to suppress the proliferation of T-cells in stimulated peripheral blood mononuclear cells (PBMCs) when cocultured or separated by a transwell membrane, which allows for the exchange of soluble factors. Further mechanistic analysis shows that activated PBMCs induce expression of the immunomodulatory enzymes of the tryptophan catabolizing pathway, specifically, indoleamine 2,3-dioxygenase (IDO). Knocking down of IDO abolishes cMSCs’ immunosuppression on the proliferation of T-cells. These results suggest that immunosuppression via cMSCs occurs in a paracrine manner using IDO as the principal mechanism. Therapeutic utilization of MSCs in the treatment of inflammatory bowel disease (IBD) patients is currently being tested and has been approved in Europe. As such, aim two elucidates the impact of confounding factors on the potency mechanisms of Human Bone Marrow-derived MSCs (BM-MSCs) in the large intestine. The secretory analysis determined that BM-MSCs secrete copious amounts of the angiogenic factor Vascular Endothelial Growth Factor-A (VEGF-A). Dose-dependent inhibition of VEGF-A is observed when BM-MSCs are cocultured with Human Large-intestinal Microvascular Endothelial Cells (HLMVECs). BM-MSCs’ immunosuppressive functionality is not compromised regardless of the presence of HLMVECs. Further analysis confirmed the expression of endothelial Nitric Oxide Synthase (eNOS) in HLMVECs. Blocking of eNOS by a pharmacological inhibitor restores BM-MSCs’ VEGF-A secretion and does not modulate MSCs’ immunosuppressive capabilities. These findings suggest wound healing and immunosuppression are two separable MSC potency mechanisms. Overall, this research has illustrated that regardless of anatomical tissue site, MSCs display non-overlapping immunosuppressive and wound-healing mechanisms.
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THE UTILIZATION OF NOISE MASKING INTERVENTIONS ON PATIENT-REPORTED SLEEP QUALITY: A SYSTEMATIC REVIEW AND META-ANALYSISANGIE C. KING THE UTILIZATION OF NOISE MASKING INTERVENTIONS ON PATIENT-REPORTED SLEEP QUALITY: A SYSTEMATIC REVIEW AND META-ANALYSIS Under the direction of JUSTUS RANDOLPH, Ph.D. Hospital noise can disrupt patients' sleep cycles at night, which is linked to negative physiological outcomes. Considering the potential adverse effects of pharmacological treatment, such as cardiovascular and respiratory depression, it is crucial to assess the effect of nonpharmacological interventions on sleep quality. The use of noise masking devices as a nonpharmacological intervention has been shown to statistically improve the sleep quality of patients; however, the magnitude of the treatment effect remains unclear. The objective of this study was to examine the magnitude of the treatment effect of utilizing noise masking interventions and the effects of different types of interventions, white or pink noise, on sleep quality among hospitalized patients using meta-analysis. The selection criteria included randomized controlled trials (RCTs) and quasi-experimental study designs evaluating the utilization of noise masking interventions in hospitalized patients that measured the effects on sleep quality. Following Cochrane’s guidelines, risk of bias was assessed using the Risk of Bias 2 tool and the ROBINS-I tool. Data synthesis was performed using the SPSS package random-effects model, and the DerSimonian and Laird random-effects model with the Knapp Hartung adjustment was used. Among 3,583 titles, the full text of 140 articles was carefully reviewed. Five studies met the inclusion criteria, and all studies were judged as having a high risk of bias. Noise masking interventions were effective in improving sleep quality among hospitalized patients with (g = 1.60, 95% CI [0.47, 2.75, p = .02]) and without an outlier (g = 1.23, 95% CI [0.44, 2.03, p = .01]). When the types of noise were examined, white noise was more effective in improving sleep quality among hospitalized patients with, g = 2.17, and without an outlier, g = 1.50, than pink noise, g = 1.07. The findings from this study support the use of noise masking to improve sleep quality among hospitalized patients. However, it is important to note the quality of evidence was low according to the GRADE approach. Although there is a concern about the quality of evidence, the large effect sizes were robust and favored using noise making to improve sleep quality.
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A Compassionate Approach to Pain: A Qualitative Journey Through Women's Experiences of Self-Compassion and Gratitude Interventions for Chronic Pain ManagementThe purpose of this qualitative descriptive phenomenological study was to explore the lived experiences of women with chronic pain who are currently using self-compassion and gratitude interventions. The theoretical framework for this study was based on self-compassion theory and Buddhist psychology. The research question guiding this study was: What are the lived experiences of women with chronic pain who are currently using self-compassion and gratitude interventions? Fifteen women with chronic pain participated in semi-structured interviews. The data collected were analyzed using Moustakas's (1994) Modification of the Stevick-Colaizzi-Keen Method of Phenomenological data analysis. This involved a thorough process of obtaining and analyzing verbatim transcripts, identifying invariant meaning units, clustering these into themes, and developing comprehensive descriptions of the participants' experiences. Five major themes emerged from the data: (1) Way of Life, highlighting the transformational impact of self-compassion and gratitude practices on participants' daily lives and self-perception; (2) Spiritual Perspectives, showing how faith and spiritual practices were intertwined with gratitude and self-compassion; (3) Acceptance, demonstrating how these practices helped participants accept their pain without judgment; (4) Self-Compassion and Gratitude Techniques, detailing the various emotional, spiritual, and physical practices used by participants; and (5) Self-Compassion and Gratitude Characteristics, discussing the strengths and challenges of these practices as perceived by the participants. The findings revealed that self-compassion and gratitude practices led to significant improvements in how participants managed their chronic pain. Participants reported changes in their internal dialogue, greater emotional resilience, and a more positive outlook on life.
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The Experiences of Counselors Working with Mixed-Orientation CouplesMixed-orientation couples are relationships where one or both partners have a mixed sexual orientation. These couples face distinctive challenges that result in high relational distress and low relationship satisfaction. There is a significant lack of understanding of how counselors work with mixed-orientation couples, and little research on their experiences in couple therapy. Understanding their experiences is necessary to advance effective clinical practices due to the unique challenges these couples face. This qualitative study utilized Interpretive Phenomenological Analysis (IPA) to interview 6 independently licensed mental health providers who have worked with at least one mixed-orientation couple in couple therapy. The purpose of this study is to understand the experiences of counselors working with couples who present with issues of mixed sexual orientation in therapy.
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AROMATASE INTERACTING PARTNER IN BREAST (AIPB), LOCALIZED TO THE MITOCHONDRIA ASSOCIATED-ER MEMBRANE (MAM) SYNTHESIZES ESTRADIOL IN TRIPLE-NEGATIVE BREAST CANCER (ER-/PR-/ HER2- OR TNBC)Estradiol (E2), synthesized by Endoplasmic Reticulum (ER) resident enzyme, aromatase, is essential for the development of sex characteristics and fertility in females. Produced in the ovaries and adipose tissue, Estradiol levels often become unregulated, supporting breast tumorigenesis. Therapeutics aim to reduce these levels via the inhibition of Aromatase or the modulation of the estrogen receptor (Er+). Aromatase Inhibitors and Estradiol agonists are effective for treating most breast cancers, but treatment challenges present for Triple-negative breast cancer (Er-/Pr-/Her2-). Receptors for Triple-negative breast cancer (Er-/Pr-/Her2-), and the rate-limiting enzyme, Aromatase, are absent. From human breast tissue, we cloned a 207 amino acid cDNA encoding for a 21.7-kDa protein, entitled Aromatase Interacting Partner in Breast (AIPB), that directly interacts with Aromatase. AIPB is present in affected and unaffected breast tissue. A stable selection was developed (Puromycin) for MDA-MB-231 (Er-/Pr-/Her2-), after AIPB was subcloned into a vector with a TET-ON promoter. Overexpression of AIPB in Er+/Pr+/Her2- and Er-/Pr-/Her2+ resulted in the decreased levels of Estradiol (E2). In the tumor microenvironment, serine proteases are overexpressed, aiding in cancer metastasis and invasion. I hypothesized that serine proteases may be proteolyzing AIPB, resulting in elevated Estradiol levels, in MDA-MB-231 (Er-/Pr-/Her2-) cells. A time course study (12-96h) was performed, with serine protease inhibitor, Epigallocatechin gallate (EG), in the presence and absence of Doxycycline (250 μg/mL). Data suggests that AIPB expression is stabilized between the concentrations of 5-50 μM in the presence of Epigallocatechin gallate (EG) and plays a central role in Estradiol (E2) synthesis (Er-/Pr-/Her2-), either directly or indirectly. In conclusion, AIPB may permit early detection of Triple-negative breast tumors, acting as a biomarker at the Mitochondria Associated-ER Membrane (MAM).
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IMPACT OF GENDER AND GIFTEDNESS ON CHEMISTRY STUDENTS’ SELF-EFFICACY AND SCIENTIFIC IDENTITYHigh school students’ chemistry self-efficacy (CSE) and scientific identity (SI) are not well understood in the high school chemistry classroom. The purpose of this research was to quantitatively investigate the interaction between gender and giftedness on students’ CSE and SI in a suburban high school chemistry classroom, with and without consideration of laboratory modalities as an intervention. The participants were high school students in a suburban chemistry classroom in a Southeastern state. Data was collected through pre- and post-test surveys with Likert style questions. Data was evaluated using quantitative analysis. The results revealed that neither laboratory modalities, nor gender or giftedness, significantly impacted students’ CSE and SI. Implications suggest that district stakeholders and teachers have a duty to help students grow and understand students’ CSE and SI. Students can strengthen their CSE and SI by having mastery and vicarious experiences as well as opportunities for discussion and verbal persuasion in the chemistry classroom. Future research could explore enlarging the sample size through expansion to more high schools within the same district, changing the methodology to a mixed methods study, or increasing the length of time for the study to see how students perform over the whole course compared to a small segment of it. Key words: chemistry self-efficacy, scientific identity, gender, giftedness, laboratory modality
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THE EFFECTS OF STRESS-INDUCED VIRAL REACTIVATION ON THE SR-BI PATHWAY AND ATHEROSCLEROSIS PATHOPHYSIOLOGYChronic stress has become an issue that plagues modern day humanity. In short bursts, stress can be beneficial; however, in the longer term, stress can become harmful to the human body. Chronic stress leads to the overstimulation of the Hypothalamic-Pituitary-Adrenal Axis (HPA), resulting in an overproduction of cortisol. Initially this can aid in several anti-inflammatory responses, such as tissue repair; however, prolonged elevated cortisol levels may suppress the immune system and impair its ability to control opportunistic pathogens in the human body (Gu, et al., 2012). Previous studies in our lab have identified significant changes in the brain and heart of mice subjected to stressful environments and infection with murid herpes virus type 4. These findings suggest that there is a common factor causing this, which we believed could be vascular changes triggered by the stress response and the re-activation of latent viruses. The main objective of this study was to evaluate the impact of chronic stress-induced viral re-activation on the development of atherosclerosis through the suppression of the SR-BI/HDL pathway. SR-BI is a multi-functional scavenger receptor with high affinity for HDL that plays a role in lipid transport out of cells for loading onto HDL and delivery back to the liver for secretion (Linton, et al., 2017). It is expressed on macrophage and endothelial cells, which are key players in the pathogenesis of Atherosclerosis. In literature, it has been observed that in the absence of SR-BI, plaque formation occurs at a higher rate within arterial walls (van Eck, et al., 2003). According to the CDC, there currently exists a high prevalence of heart disease and stroke within underserved communities. These communities face increased levels of poverty that can directly translate into chronic stress within individuals. If this is paired with the re-activation of dormant viruses within individuals in these communities, then it may play a role in atherosclerosis induced vascular dysfunction that could explain the increased prevalence of heart disease and strokes. This study consisted of an in-vivo and in-vitro model in which mice and cells were studied to assess changes in gene and protein expression of atherogenic markers in response to chronic stress and viral infection. The in-vivo portion consisted of mice subjected to stress and infected with murid herpes virus 4 as a model of Epstein Barr virus infection in humans. The in-vitro portion of this study dealt with creating a model that could mimic stress and viral infection within cultured macrophage and endothelial cells with the use of Cortisol and Polyinosinic:polycytidylic acid (Poly I:C). The in-vivo and in-vitro studies were performed in tandem to reinforce the validity of the in-vivo results as well as to further isolate whether macrophages or endothelial cells within the brain and heart could contribute more to atherosclerosis development. Our results suggest that stress-induced viral re-activation may indeed play a significant role in the development of plaque within arteries and contribute to an increased risk of cardiovascular/neurovascular diseases.
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Gender and Sexual Minority Student Perceptions of Safety in University SettingsThis phenomenological study explored current perceptions of the personal safety of gender and sexual minority (GSM) college students in college campus settings through the application of queer theory. By collecting the personal experiences, perspectives, and feelings of GSM college students, the study identified coherent themes and suggested actions to promote successful on-campus GSM interactions, raise awareness of GSM perceptions of what are safe and unsafe conditions, and improve diversity and inclusion efforts accordingly. The study attempted to show GSM college students perceive safety on campus by interpreting the experiences and perspectives that shaped the participants' sense of safety awareness and determining the feelings evoked by different campus and near-campus locations and attributes. Based on data collected through face-to-face semi-structured interviews, digital image submissions, and elicitation interviews, this study concluded that the participants started their understanding of GSM safety by recognizing that being a GSM individual was an inherently negative and undesirable condition. Still these understandings developed as the participants gained positive safety experiences with many of them coming out because of the perceived safety of the college setting. Three themes emerged from the data analysis. First, GSM college students grow their respective understandings of GSM safety and adjust their proximity to GSM safety. Second, GSM college students are aware of many unsafe sources, ranging from expected prejudices and microaggressions to new contentions, arising from the expansion of the gender and sexuality spectrum. Third, GSM college students’ safety perceptions and experiences influence one another. An additional point of interest appeared regarding the perceived onus of GSM safety based on traditional and non-traditional student types.
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CAN IT TEACH STUDENTS WITH SPECIAL NEEDS TO READ? A MULTI-METHODS CASE STUDY ANALYSIS OF COMPUTER-AIDED INSTRUCTIONJENEEN L. SUTTON CAN IT TEACH STUDENTS WITH SPECIAL NEEDS TO READ? A MULTI-METHODS CASE STUDY ANALYSIS OF COMPUTER-AIDED INSTRUCTION This research aims to explore the impact of Computer-Aided Instruction (CAI) on the reading achievement of students with special needs, framed within Zhu’s Theory of Smart Learning Environments and insights from Snyder et al. (2019) on technology in special needs education. The study addresses whether CAI can significantly enhance reading outcomes for these students, navigating through the perceptions of teachers, students, and parents. The research employs a mixed-methods approach, combining qualitative and quantitative methodologies. Data collection involved pre- and post-intervention assessments of students' reading levels using the Lexile framework, interviews with teachers, students, and parents, and classroom observations. Categorization and coding of qualitative data ensured a coherent analysis despite inherent biases related to the researcher's dual role as investigator and educator. Results indicate an overall positive trend in reading achievement among students post-CAI intervention, aligning with Zhu’s emphasis on personalized, adaptive learning environments. However, not all students showed significant improvement, highlighting the variability in CAI effectiveness. Teachers generally held positive perceptions of CAI but faced challenges integrating it seamlessly into existing instructional practices. Parents and students also provided mixed feedback, emphasizing the need for tailored approaches to meet individual needs. The study concludes that while CAI presents substantial benefits for special needs education, its effectiveness is not universal. The positive outcomes observed underscore the potential of CAI to enhance reading skills among special needs students, confirming the researcher’s perception of its value. However, challenges related to integration and varied student responses call for ongoing support and customization of CAI interventions. Recommendations for future research include longitudinal studies to assess the sustained impact of CAI, exploring its effects across diverse populations with different disabilities, and investigating the role of targeted professional development for teachers. Additionally, further exploration into parental involvement and collaborative strategies is suggested to optimize the benefits of CAI in special education. As technology evolves, particularly with advancements in AI, there is a promising horizon for the enhanced application of CAI, potentially transforming special education practices and outcomes.
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INVESTIGATING THE SOCIAL PERCEPTIONS ON THE STIGMA AND HEALTH CONSEQUENCES OF ONLINE GAMBLINGStigmatization is a known barrier to treatment seeking among those with substance abuse. As gambling disorder is now considered a non-substance, substance abuse disorder, previous research in substance abuse can drive the development of research and evidence based recommendations for treatment and prevention of gambling disorder. In 2018, the Supreme Court overturned the 1992 Professional and Amateur Sports Protection Act, allowing states to individually legalize sports betting. As of 2024, 38 of 50 states have legalized sports betting, drastically increasing the number of citizens exposed and able to place wagers. The Total Consumption Model and the Theory of Deviance suggests that the higher the exposure to gambling, the lower the estimation of the risks and the proportional rise in addiction to exposure. Gambling disorder is not an equitable addiction, with a disproportionate number of self-identifying Black men as well as Hispanic or Latino men suffering a disordered relationship and gambling, and women disproportionately spending more money per wager. An adapted Bogardus scale was deployed on Survey Monkey to understand the stigmatization of gambling activities and the impacts of acceptance and lifetime frequency on stigmatization. This study did not produce meaningful results. This sample will tolerate a disordered gambler as a close friend as the closest degree of social distance. Lifetime frequency and personal acceptance of gambling activities did not impact stigmatization. Age, education, income and sex were not factors in meaningful relationships
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A RETROSPECTIVE EPIDEMIOLOGICAL ANALYSIS USING SECONDARY DATA: INVESTIGATING THE INFLUENCE OF ADVERSE CHILDHOOD EXPERIENCE ON BREASTFEEDING AMONG AFRICAN AMERICAN MOTHERSBreastfeeding offers significant health benefits for both infants and mothers, yet disparities in breastfeeding initiation persist, particularly among African American mothers. These disparities are not merely the result of individual choices but are deeply rooted in factors including Adverse Childhood Experiences (ACEs), which have been shown to impact health behaviors and outcomes across lifespans. Nonprofits and community-based programs, such as Reaching Our Sisters Everywhere, Inc. (ROSE), work to increase breastfeeding rates by providing healthcare provider training on breastfeeding support but lack awareness of ACEs' influence on breastfeeding behaviors. This study investigates the influence ACEs has on breastfeeding behaviors among African American mothers in Georgia from an epidemiological perspective. The objective of this research is to analyze ACEs and breastfeeding data of African American mothers to contribute to the understanding of the correlation between ACEs and breastfeeding behaviors. Other objectives are to determine if significant differences exist in ACEs based on region and to determine if the region is associated with breastfeeding behaviors. This study analyzes BRFSS self-reported ACEs data and demographics of African American women ages 18 and older with the CDC WONDER breastfeeding data about infants breastfeeding or not breastfeeding at the time of discharge. Data collected from this query system is specific to African American mothers in Georgia. Binary logistic regression and ANCOVA are the statistical analyses conducted using SPSS for Windows. The study revealed that even when demographic variables are controlled for, there are no significant regional variations in breastfeeding behavior among African American women in Georgia, nor in the overall ACEs scores. This study also provides evidence-based recommendations for including the findings in the curriculum used during the Healthcare Provider Training initiative at ROSE, Inc. The results of this study add to the literature through the investigation of breastfeeding behaviors and ACEs in African American mothers in Georgia. Overall, the study contributes towards closing gaps in maternal and child health disparities in the U.S., adding value to the body of knowledge needed to address the critical public health issue of low breastfeeding rates in African American women in Georgia.
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Quantifying Cancer Equity: A Novel Index for Measurement, Planning, and ActionWithin the United States a wide variety of deep and entrenched health inequities persist. These inequities are deeply rooted and have been documented extensively in the literature with notable disparities based on race, ethnicity, income, education, gender, and geography among others. These same disparities are apparent when looking at cancer care and outcomes. While efforts to affect change in these areas are ongoing, significant work remains to improve equity while addressing the second leading cause of death in the United States. Progress is dependent on reliable measurement strategies sensitive to the unique constellation of factors influencing cancer equity. The solution is the development of a Cancer Equity Index. Consisting of four unique domains addressing the constructs of risk factors, estimates of disparity, structural factors, and access factors, the Index provides a measure that sufficiently captures the broad factors contributing to equity. Using exploratory factor analysis and structural equation modeling, we developed an Index for measuring cancer equity. Following a stringent design, testing, and revision process, the resulting Index demonstrated good performance. The Index represents a new tool to inform planning and decision making at a time where cancer inequities have garnered extensive attention. As such, the Cancer Equity Index represents a compelling step forward in the field of social epidemiology, applying a rigorous approach to better characterize the influence of equity in cancer, and outline paths toward a more equitable future.
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LIVED EXPERIENCES OF ABORTION STIGMA: A QUALITATIVE ANALYSISReproductive healthcare remains an incredibly difficult system to navigate, riddled with burdens and obstacles. Reproductive healthcare is also plagued with elements of stigma, especially regarding abortion care, that influence how people navigate their reproductive healthcare needs and decisions. Limited qualitative research has investigated the impact of reproductive health and abortion stigma on reproductive health-related decision-making. This research sought out to gain insights on the influence of stigma across reproductive health and medical decision-making from the lived experiences of women with roots in the Southern region of the United States. Fifteen in-depth, semi-structured interviews were conducted with self-identified women, recruited through purposive and snowball sampling, who have previously had an abortion or have experience working in abortion healthcare delivery. Inductive analysis of the interview data revealed reproductive healthcare access barriers and resources, various sources of reproductive health stigma, stigma’s influence on health-related decision-making, and the multi-level implications of stigma in reproductive healthcare. Five themes emerged from the lived experiences of the women in this study and provided insights into how women navigate reproductive health access, abortion, associated stigma, decision-making, while also enduring the world around them. This research unveiled ingrained stigma associated with the entire field of reproductive healthcare and the role stigma plays in peoples’ complex lives, but investigation into more diverse populations is recommended. The research also uncovered the need to invest more deeply in collaborative, public health comprehensive sexuality education rooted empowerment, storytelling, and narrative creation, while addressing the multi-leveled nature of the world we live, play, and work in. The study also highlights that despite the burdens, shame, judgment, stigma, cultural influences, religious ideologies, and political attacks against reproductive health and abortion access, people can still envision a world where people can make autonomous decisions related to their reproductive health - but more work must be done.
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ADDRESSING MALIGNANT NEOPLASMS AND HEART DISEASES IN GEORGIA RURAL AND URBAN COUNTIES THROUGH POLICY INTERVENTIONSABSTRACT WAYNE A. HAIRSTON II, MPH, MBA ADDRESSING MALIGNANT NEOPLASMS AND HEART DISEASES IN GEORGIA RURAL AND URBAN COUNTIES THROUGH POLICY INTERVENTIONS Under the Direction of DAWOOD H. SULTAN, PhD, MA Malignant neoplasms and heart diseases are the leading causes of premature death in all counties in the state of Georgia, USA. Data show that in Georgia, heart diseases and cancer have age-adjusted death rates of 195.2 and 151.5, respectively. In 2022, heart diseases caused 21,931 and cancer caused 18,136 deaths in Georgia. Chronic diseases cost Georgia over $40 billion dollars per year. According to the Georgia Department of Health, Georgia is ranked 39th in the nation for health outcomes. This study asks two questions: how do chronic diseases affect Years of Potential Life Lost (YPLL) in rural and urban counties in Georgia, and how can policies and interventions be designed to address these variables and promote health equity? Variable measures for this study were obtained from the County Health Rankings and Roadmaps website. Regression was used to determine the effects of the independent variables on YPLL, and t-tests were used to obtain nonparametric coefficients. County status was used as a control and grouping variable. Correlation analysis was used to detect potential collinearity. T-tests were conducted to determine if variable means differ among rural and urban counties. Malignant neoplasms, heart diseases, rural and urban status, percent Black people, percent obese, percent physical inactivity, percent smoking, percent unemployed, and percent injury-related deaths were strong predictors of YPLL in Georgia. However, Heart disease has the strongest effect on YPLL. Reducing the prevalence of cancer and heart diseases will prevent premature death in Georgia, particularly in rural counties.
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EVALUATING CROSS-SECTOR COMMUNITY COLLABORATION FOR PARKINSON’S: THE HEALTHY PARKINSON’S COMMUNITIESTM (HPC) NETWORKSUSANA MARLYN CARLOS EVALUATING CROSS-SECTOR COMMUNITY COLLABORATION FOR PARKINSON’S: THE HEALTHY PARKINSON’S COMMUNITIES (HPC) NETWORK Under the direction of SUZIE MADDEN, DrPH, MPH Parkinson’s Disease (PD) is a significantly increasing public health concern, and the neurodegenerative disease requires a holistic, collaborative approach to addressing all aspects of the disease as well as working toward prevention. Many national, statewide, regional, and local Parkinson’s-oriented organizations exist, and there is little effort to coordinate these players toward improving the local community. The objective of the study was to evaluate individual local-level coalition-building efforts, utilizing a survey and interview process to measure success factors and areas for improvement. The research question was, “How to measure existing collective action effectively?” The two main tools utilized for the study included the Community Coalition Action Theory (CCAT) and the Wilder Collaborative Factors Inventory (WCFI). The survey expanded upon the WCFI to assess the outlined factors, and the interviews helped define these factors qualitatively for future community development. A total of 14 community leaders participated in the survey, of which 5 were also interviewed. Statistical Rho correlations were conducted to test the association between success factors within a category, against the category, and against outcome data. The first series of correlations for success factors within each category resulted in one significant pairing between mutual respect and the ability to compromise (under membership characteristics). The second series of correlations for each category with its relative success factors yielded significant correlations for at least one success factor for each category. The third correlation for categories and outcome variables highlighted membership characteristics, and resources stood out as substantial categories highly associated with the outcomes tested using linear regressions. The linear regressions resulted in one significant outcome where the category of resources predicted access to resources and programs (F(1,10) = 8.10, p < 0.01, R2 = 39%). In addition, the two tools utilized (WCFI and CCAT) have not been employed together to define coalitions and pose a significant research pathway that maps information visually and with data.
