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An Educational Program for Medical-Surgical Bedside Registered Nurses Effect on Nursing Knowledge of Self-Care Behaviors and the Nurses' Comfort of Utilization of the Teach-Back Method in Hospitalized Heart Failure Patients
No full textUB SON, DNP Research ProjectApproximately one-third to one-half of heart failure readmissions are considered
preventable through health promotion and treatment plan compliance. The primary bedside educators are Registered Nurses (RNs); however, sometimes they are not versed in self-care behaviors. Additionally, many RNs are uncomfortable with the teach-back method, a research-supported technique. The purpose of the project was to evaluate whether an educational program for medical-surgical RNs increased the nurses’ knowledge of heart failure self-care behaviors and comfort in the utilization of the teach-back method. The theoretical framework used was Malcolm Knowles’ Theory of Adult Learning. This study was a pre-test post-test quasi-experimental study. Thirteen bedside RNs were recruited from a medical-surgical unit. The survey tools used were a demographic survey, Dr. Nancy Albert’s Nurses’ Knowledge of Heart Failure Educational Principles Survey (NKHFEPS), and the Conviction and Confidence Scale (CCS). The participants watched a 25-minute voiceover PowerPoint presentation and retook the NKHFEPS and CCS 30 days later; seven participants completed both post-test surveys. Chi-square analysis was run on all demographic variables, and the pre-test scores of the NKHFEPS and CCS; there was no significance found. Paired t-test was run to analyze the means of the scores pre and post-intervention; there was no significance found. Because of the small sample size, finding significance was difficult; however, there was an increase in the mean NKHFEPS scores as well as the mean confidence score of using the teach-back method. More research is needed on the effectiveness of heart failure education programs on nursing knowledge
Recommendations for Mental Health Screening and Monitoring in Hemophilia Patients
No full textUB SON, DNP Research ProjectBackground and Significance: Hemophilia is a life-long hemorrhagic disease characterized by
a deficiency in coagulation factor VIII or IX. The recent development of novel therapeutic agents
has helped to prolong the lifespan of patients. However, the unique challenges to mental health
associated with this disease remain poorly understood and managed, especially in light of the
increasing chronicity of disease.
Purpose and Aim: The purpose of this Doctor of Nursing Practice (DNP) project was to provide
the staff of a hemophilia center in Buffalo, New York with evidence-based recommendations for
the screening and monitoring of depression and anxiety of hemophilia patients as well as mental
health via an educational PowerPoint video presentation. The aim of this project was to increase
knowledge and understanding among staff working in a hemophilia clinic regarding how to
screen patients for depression and anxiety and how to refer patients for mental health counseling
when warranted.
Theoretical Framework: Parse’s Human Becoming Theory acted as the project theoretical
framework.
Methods and Design: An extensive review of evidence-based literature regarding screening
tools used to assess mental health and quality of life in hemophilia patients was performed.
Information collected from this systematic review was synthesized and guided the development
of the educational PowerPoint video presentation. The presentation was content expert reviewed
by the DNP Project Faculty Advisor and content experts at the project site prior to distribution.
Results: The educational PowerPoint video presentation was distributed with project site
permission via email to the staff working at the hemophilia clinic
Reconstructing Arctic precipitation seasonality using aquatic leaf wax δ2H in lakes with contrasting residence times
No full textAn edited version of this paper was published by AGU. Copyright (2020) American Geophysical Union.Arctic precipitation is predicted to increase this century. Records of past precipitation seasonality provide baselines for a mechanistic understanding of the dynamics controlling Arctic precipitation. We present an approach to reconstruct Arctic precipitation seasonality using stable hydrogen isotopes (δ2H) of aquatic plant waxes in neighboring lakes with contrasting water residence times and present a case study of this approach in two lakes on western Greenland. Residence time calculations suggest that growing season lake water δ2H in one lake reflects summer precipitation δ2H, while the other reflects amount-weighted annual precipitation δ2H and evaporative enrichment. Aquatic plant wax δ2H in the “summer lake” is relatively constant throughout the Holocene, perhaps reflecting competing effects of local summer warmth and increased distal moisture transport due to a strengthened latitudinal temperature gradient. In contrast, aquatic plant wax δ2H in the “mean annual lake” is 100‰ 2H depleted from 6 to 4 ka relative to the beginning and end of the record. Because there are relatively minor changes in summer precipitation δ2H, we interpret the 100‰ 2H depletion in mean annual precipitation to reflect an increase in winter precipitation amount, likely accompanied by changes in winter precipitation δ2H and decreased evaporative enrichment. Thus, unlike the “summer lake,” the “mean annual lake” records changes in winter precipitation. This dual-lake approach may be applied to reconstruct past changes in precipitation seasonality at sites with strong precipitation isotope seasonality and minimal lake water evaporative enrichment.Funding for this research was provided by National Science Foundation (NSF) ARCSS-1504267 and NSF EAR IF-1652274 to EKT, an NSF Graduate Research Fellowship to AAC, and a UB Center for Undergraduate Research and Creative Activities grant to KVH
Up in Smoke: Exploring the Relationship Between Bullying Victimization and E-Cigarette Use in LGBTQ+ Youths
No full textM.A.The full text PDF of this thesis is embargoed at author's request until 2022-02-19.This study explored the relationship between bullying in school and cyberbullying (i.e., bullying through social media or instant messaging) victimization with past 30-day e-cigarette use. The Youth Risk Behavioral Survey was utilized to study a nationally representative sample of lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ+) high school students (N = 2,302; 69.4% female). Three models were utilized to examine whether bullying in school or cyberbullying victimization were related to e-cigarette use after controlling only for demographics in the demographics model, and then the use of other substances in the substance use model. Finally, cigarette use was combined with e-cigarettes as the dependent variable in the third comparative model. After controlling for age, race, gender, sexual identity, and substance use, neither bullying victimization in school or online were significantly related to current e-cigarette use alone. However, cyberbullying victimization was significantly related to the combined cigarette and e-cigarette use variable. These findings suggest that LGBTQ+ students who report cyberbullying victimization may use cigarette products more than their non-cyberbullied peers. Thus, cyberbullying prevention and interventions should continue to be targeted in schools, especially for LGBTQ+ youths
Studies on the Structure, Function, and Selective Inhibition of the Hsp90 Family of Molecular Chaperones
No full textPh.D.The full text PDF of this dissertation is embargoed at author's request until 2022-02-19.Hsp90s are a conserved family of ATP-driven molecular chaperones required for the conformational maturation of a widely diverse set of essential client proteins. This same chaperone function, however, is co-opted in cancer and other diseases to protect a dysregulated proteome, stabilize mutant proteins that would otherwise be degraded, and promote disease progression, making hsp90s attractive therapeutic targets. Humans possess four hsp90 paralogs: Hsp90α and Hsp90β in the cytosol, Grp94 in the endoplasmic reticulum (ER), and Trap1 in the mitochondria. Grp94, which is the main focus of this dissertation, is required for the proper localization of many cell surface receptors, such as toll-like receptors (TLRs) and integrins, along with growth factor receptors such as HER2. The mechanism by which Grp94 engages and matures its client proteins in the ER to ensure their proper localization is almost completely unknown. Overexpression of Grp94 is a hallmark of many cancers and is associated with aggressive behavior and poor prognosis. The oncogenic roles of Grp94 as a cancer chaperone, however, have only recently been established. The overarching goal of this work is to characterize the mechanism of Grp94 action and, in the long-term, to exploit these understandings for therapeutic benefit. Hsp90s form constitutive homodimers via their C-terminal domains and cycle through a series of large conformational shifts between open and closed dimer states. These shifts are driven by the binding of ATP to the N-terminal domain (NTD), which in the ATP-bound state forms the second, closed dimer interface. Cytosolic Hsp90 utilizes a cohort of co-chaperones to regulate this dimer closure, modulate the rate of ATP hydrolysis, and recruit client proteins and other chaperone systems. Interestingly, the ER does not contain homologous co-chaperones. A structure of Grp94 in a closed state has not been described, and the determinants that regulate closure have not been intensively studied. In chapter 2, we present the crystal structure of AMPPNP-bound Grp94 in the closed dimer conformation, capturing Grp94 in its catalytically active state. The structure includes the Pre-N domain, a region that is poorly conserved between hsp90 paralogs that is upstream of the NTD. We show that the Grp94 Pre-N domain is essential for client maturation, and identify this region as an important intrinsic regulatory element of the Grp94 ATPase cycle. In chapter 3, we found that the Pre-N domain is a required for chaperone function due to its protective role in regulating the total levels of N-linked glycosylation. We found that truncations and mutations of the Pre-N domain fundamentally disrupt normal glycosylation, leading to hyper-glycosylation that inactivates the chaperone. Lastly, in chapter 4, we explored the binding of an Hsp90α selective inhibitor to the cytosolic paralogs, revealing the mechanistic basis behind the reported binding preference and identifying an exploitable residue that may aid future efforts to improve selectivity. Together, these studies illuminate key mechanistic questions about Grp94 chaperone function, which will help guide the development of new and improved therapeutics
Boon of Hybrid Approaches over the Bane of Model Based and Machine Learning Approaches in Modelling Cyber-Physical Systems
No full textM.S.The full text PDF of this thesis is embargoed at author's request until 2021-02-19.Physics-based models (MB) and machine learning models (ML) have emerged as two paradigms for modeling any system. They represent the two opposite ends of the spectrum of system knowledge/data. Interpretability, tractability, and composability provided the thrust for MB. Genericity and accuracy drove ML. Interestingly, the drivers of physics models are the deterrents of machine learning models and vice versa. Even with their inherent boons and banes, they have evolved and practiced independently of each other for computing. Recently, several works attempted to merge MB and ML models for the complete exploitation of their combined potential. However, the research is scattered and unorganized. So, we make a meticulous attempt at organizing and standardizing the methods of combining ML and MB models. In addition to that, we prepared a five-faceted generic framework for the comprehensive evaluation of hybrid learning models (MB + ML). Finally, we conclude by shedding some light on the challenges of hybrid models, which we as a research community should focus for expediting the research and harnessing the full potential of hybrid learning models. All of these have been discussed with a clear focus on modeling cyber-physical systems (CPS) and overcoming the limitations of the existing models of CPS
Antifouling Membranes by Surface Modification using Hydrophilic Polymers
No full textPh.D.The full text PDF of this dissertation is embargoed at author's request until 2021-02-19.Today water purification and wastewater treatment are important in many of industries. Polymeric membranes are being used in this area because of their promising features such as low cost and high energy efficiency. The contaminants in the water may adhere to the surface of membranes, resulting in the water flux reduction, a phenomenon named fouling. Membrane surface modification is a promising approach to mitigate fouling. Herein we study surface modification of ultrafiltration (UF) and nanofiltration (NF) membranes using different zwitterionic materials, as superhydrophilic agents, to increase the antifouling properties of membranes. In the first chapter, an introduction to the membrane technology and membrane fouling, as well as different categories of membrane surface modification are presented. In the second chapter, we present the synthesis and characterization of novel betaine-based zwitterionic materials containing thiol functional group. We grafted these zwitterions with bio-inspired dopamine as a two-step approach onto the polyethersulfone (PES) UF membranes, and evaluated the modified membranes antifouling properties with a model biofoulant. Due to the high solubility of super hydrophilic zwitterions, forming a robust zwitterionic layer on the membrane surface for under water operation is still challenging. Employing this approach, there would be covalent interactions between the zwitterionic polymers and polydopamine layer, making stable layers of zwitterions on the surface. In the third chapter, we present a facile technique to fabricate antifouling membranes via dopamine and hydrophilic zwitterionic monomers containing methacrylate functional group. The existing approaches in the literature to enhance the membrane surface hydrophilicity, aiming to decrease the rate of fouling, suffer from complexity. The technique we propose in the third chapter is doable under room temperature and in one-step, which can easily be scaled up for water purification/wastewater reuse. In the fourth chapter, we study a new class of zwitterionic monomers containing amine functional group and their co-deposition with dopamine to improve the grafting density of zwitterions on the membrane surface. During the project described in the third chapter, we successfully demonstrated improved antifouling properties of both flat sheet membranes and membrane modules using methacrylate functionalized zwitterions. However, the loading of zwitterions on the surface was only ~11 wt%. In the last project, we demonstrated that zwitterions with amine groups can deposit more easily on the surface, through co-deposition with dopamine (upto ~31 wt%), compared with those containing methacrylate functional group. Polysulfone (PSf) UF membranes grafted with amine-containing zwitterions exhibited lower transport resistance, compared with pristine and methacrylate-functionalized counterparts, during a filtration experiment via a constant flux crossflow filtration apparatus and sodium alginate as the foulant.**To request an accessible version of the file(s) associated with this item, contact [email protected]. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.*
Ostinatic Doxography: Parallel Inquiries to Metaphysical Content-Structures of Modernist-Adjacent American Poetry
No full textPh.D.The full text PDF of this dissertation is embargoed at author's request until 2022-02-19.This project reads Gertrude Stein, Robert Duncan, and Lyn Hejinian in parallel with philosophical works by Plato, Edmund Husserl, and Jacques Derrida in order to expand on these poets’ claims that content that follows lines of inquiry in the discourse of metaphysics is the basic structural unit of their poetic achievements.**To request an accessible version of the file(s) associated with this item, contact [email protected]. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.*
Degrees of Freedom: The Consideration of Embodiment in the Process of Constituting a Virtual Reality Experience
No full textM.F.A.The growing accessibility of virtual reality (VR) has extended its boundaries and opened a new understanding of VR as an artistic medium. Constituting a software-embedded, interactable, virtual environment, it is attributed great aesthetic potential. Its most distinctive characteristic is the feeling of immersion, primarily achieved through the active mental and physical engagement of the participant. While immersion helps to generate sensations that replicate a sense of embodiment towards a virtual body, it remains unknown how deviations of such are reflected in the experience of one's embodiment – not or only partly feeling to be inside, have, and control a body. This thesis presents an overview of the investigations on the constitution of embodiment by bringing together works from the fields of computer science, philosophy and cognitive sciences. Within this framework, I apply qualitative exploratory research methods to identify which modes of embodiment experiences representing a meaningful self-experience can be perceived by participants. To do so, I explore the most salient characteristics of VR, the role of cognition and interaction in regard to experiencing our surroundings and, in particular, our body's role in a virtual environment. With the suggested understanding of embodiment as a dynamic experience of one's body which depends highly on the particular interplay of endogenous sensations, I reveal its potential to be shaped by the deployment of varying feedback and interaction modalities. For the following propositions on how such experiential factors are reflected in the overall experience of embodiment, I suggest the term modes of embodiment and exemplify three cases: terrestrial detachment, puppet-master and scatter presence. The thesis is intended to serve as a practically applicable resource to system designers who embrace a more reflective approach to VR.**To request an accessible version of the file(s) associated with this item, contact [email protected]. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.*
Resident Space Object Characterization Using Polarized and Multispectral Light Curves
No full textPh.D.As the number of objects in space grows, and the space environment becomes more contested, Space Situational Awareness (SSA) becomes an increasingly important task. Increasing the accuracy in orbit propagation, which is necessary to increase the accuracy of collision probability estimates, requires modeling the impact of non-conservative perturbations, such as drag and solar radiation pressure, on complex shapes. Knowledge of a resident space object's attitude and surface material can allow for more accurate orbit propagation. However, this attitude and surface information is often difficult to determine remotely. Light curves have previously been demonstrated to allow for estimation of an object's attitude, shape, and surface parameters. However, these methods are subject to many limitations, including the need for accurate initial attitude estimates to initialize filters, and the inability to regularly estimate attitude and surface parameters simultaneously due to information dilution. Monochromatic, unpolarized light curves also can only allow for surface reflectance parameter determination, and not determination of surface materials themselves.**To request an accessible version of the file(s) associated with this item, contact [email protected]. Please include the item's persistent URL [http://hdl.handle.net/. . .] in your request.*