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The objective of this dissertation is to inform clinicians, researchers and policy makers of the potential value of prosthesis intervention for individuals who experience a lower limb amputation. In addition, this dissertation supports the call for more studies of high methodological quality to provide evidence of the functional and economic value associated with prostheses intervention post lower limb amputation.
The first chapter (study 1) measured the time to prosthesis receipt for based on different demographic (e.g. amputation level and sex) and personal health factors (e.g. diabetes or vascular disease and age) using administrative claims data. Kaplan-Meir method and log-rank tests were used to examine overall survival based on covariates. Multivariable cox proportional hazard models were fit to assess the overall risk of prosthesis receipt after amputation.
The second chapter (study 2 and 3) investigated the cost and utilization of prosthesis receipt stratified by time from surgery up to 12 months post-amputation using administrative claims data. The adjusted analysis was performed using general linear modeling with log transformed cost and logistic regression models assessed healthcare utilization.
The third chapter (study 4) assessed the relationship between injurious falls and self-perceived functional mobility. Multivariable logistic regression was applied to a cross-sectional sample using clinical outcomes data.
As demonstrated in this dissertation, earlier provision of prosthetic devices is associated with lower direct costs and reduced healthcare utilization. For those who are currently using a prosthesis, maintaining and improving mobility may help to reduce the burden and risk of injurious falls.
This study examined the influence of drama participation on foundational, digital, and Black Girls’ literacies of Black girls in an urban middle school. This case study used the Culturally Relevant Arts Education framework with Black Feminist Thought epistemology to address the following research questions: What are the experiences of middle school Black girls who participate in drama classes in relation to language, identity, and social media engagement? What perceptions do drama teachers have of urban middle school Black girls who participate in drama classes as they address language, identity, and social media engagement? Purposive criterion sampling was used to recruit participants for this study. Semi-structured interviews and a focus group were conducted with five Black females; four participants were middle school students who attended Stonybrook School (pseudonym), and one participant was a teacher who taught at the school. The findings of the study suggest that Black girls who participated in drama 1) Experienced enhanced foundational language, 2) Acquired a more positive racial identity, and 3) Demonstrated effective management of social media engagement. Additional findings suggest that the Black female drama teacher perceives Black middle school girls as mature enough to successfully navigate academics, identity, and social media engagement through practicing drama activities, despite the race and gender challenges they face. The findings from this study help inform educational practices, policies, and research aimed at improving outcomes for Black girls in urban middle schools.
Avena sativa, or common oat, is a staple crop and member of the Poaceae or Grasses family. Following behind wheat, maize and rice, oats account for 10.5 million hectares of the world’s produced crops as of 2017. Phytocompounds such as β-glucan and other phytochemicals such as avenanthramides, vanillic, syringic, ferric, and caffeic acids are noted to benefit cardiovascular health or represent prospective benefactors to human health, however further investigation into these potential benefiting factors requires research that surpasses past works in breadth and scope. Much has been done to bridge the gap in resources for oats, such as the development of high throughput markers, consensus linkage maps and most recently genome sequencing efforts, however the relative complexity of cultivated oat, an allohexaploid with high similarity subgenomes, provides additional challenges to the development of these resources. A final layer of complexity is the genome size of hexaploid oats, believed to be approximately 12.8 gigabases, of which a significant portion is composed of complex repetitive elements. Characterization of these highly complex repetitive regions is difficult as repetitive regions contained within reads are characteristically difficult to map, thereby complicating assembly efforts and resulting in misassembly and gaps. Through investigation of repetitive elements by utilization of a novel pipeline capable of offering enhanced resolution and detection of repetitive elements, use of this novel information of all repetitive elements in a given genome were further examined within well-characterized Avena genomes, concluding with phylogenetic analyses examine evolutionary relationships between elements in efforts to gain insight into the of the role transposable elements across Avena, and bolster overall knowledge of the Avena family.
