Theses and Dissertations at Montana State University (MSU)
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Item The social consequences of blood quantum in Native American communities(Montana State University - Bozeman, College of Letters & Science, 2024) Young, Lyndsey Alexis; Chairperson, Graduate Committee: Matthew HermanIn the United States, many federally recognized tribes use a minimum blood quantum to determine membership. The concept of blood quantum was introduced to Native American tribes by several U.S. federal Indian policies. In recent years, several studies have detailed the impact of blood quantum policies on tribes and offer alternative membership criteria. No studies have analyzed the impact of blood quantum on individual Native Americans. Social decisions like dating, marriage, and family creation are all influenced by minimum blood quantum membership criteria. In this study, survey and interview data from enrolled and non-enrolled descendant Native Americans were used to assess the level of influence blood quantum has on these social decisions. The results of the surveys were statistically analyzed based on gender identity and enrollment status using an independent sample t-test. The study observed no significant difference in how male and female participants felt about the enrollment status of their partners and children. A significant difference in how enrolled and non-enrolled descendant participants felt about their partner being enrolled in the same tribe as themselves was found. The interviews revealed five themes that participants thought were important when considering blood quantum in social decisions. Those themes were: cultural knowledge/inheritance, benefits of enrollment, family involvement in dating, cultural compatibility, and cultural identity. For many tribes, traditional kinship systems and marriage practices require tribal members to marry outside of their kinship groups, sometimes resulting in inter-tribal marriages. One of the biggest issues posed by minimum blood quantum membership criteria is that individuals must look within their own tribe or reservation for a partner to ensure their children will be enrolled. Native American individuals are faced with the decision of either dating within the confines of blood quantum and potentially breaking traditional kinship practices or dating outside the confines of blood quantum and potentially having children who do not meet blood quantum enrollment requirements.Item Characterization of osteoarthritis metabolism: a mass spectrometry based-approach(Montana State University - Bozeman, College of Letters & Science, 2024) Welhaven, Hope Diane Aloha; Co-chairs, Graduate Committee: Brian Bothner and Ronald K. June II; This is a manuscript style paper that includes co-authored chapters.Osteoarthritis (OA) effects 7% of the global population, equating to more than 500 million people worldwide, and is the leading cause of disability. Its multifaceted etiology includes risk factors ranging from genetics, to aging, obesity, sex, race, and joint injury. OA manifests differently across the patient population where symptom severity, rate of progression, response to treatment, pain perception, as well as others vary person to person posing significant challenges for effective management and prevention. At the cellular level, imbalanced matrix catabolism and anabolism contribute to the breakdown of cartilage, underlying bone, and other tissues affected by OA. Leveraging mass spectrometry-based techniques, particularly metabolomics, offers a promising avenue to dissect OA metabolism across musculoskeletal tissues, while considering individual patient-specific risk factors. Therefore, the goals of this research were to: (1) comprehensively characterize OA phenotypes and endotypes and (2) explore OA pathogenesis within the context of disease-associated risk factors. The first area of research focuses on profiling OA phenotypes and endotypes across disease development. These results provide clear evidence of OA-induced metabolic perturbations in OA cartilage and bone and elucidate mechanisms that shift as disease progresses. Several metabolites and pathways associated with lipid, amino acid, matrix, and vitamin metabolism were differentially regulated between healthy and OA tissues and within OA endotypes. The second area of research focuses on the impact of OA risk factors -- sex, injury, obesity, loading -- on the metabolism of circulatory fluids (i.e., serum, synovial fluid) and chondrocytes. Identification of metabolic indicators of disease, such as cervonyl carnitine, and metabolic pathways associated with these risk factors holds potential for improving screening, monitoring disease progression, and guiding preventative strategies. Overall, this work contributes to our current understanding of OA, its diverse metabolic landscape, risk factors and their interactions. Moreover, it lays the groundwork for personalized medicine by providing detailed insights into individualized phenotypic profiles, thereby advancing the prospect of tailored treatment strategies for OA individuals.Item Consider the roots: examining barley belowground in the search for adaptation(Montana State University - Bozeman, College of Agriculture, 2024) Williams, Jessica Lynn; Chairperson, Graduate Committee: Jamie Sherman; This is a manuscript style paper that includes co-authored chapters.Barley is important for global food security and sustaining the economically valuable malt industry. Montana is a top barley producer in the United States, but terminal drought stress poses a significant threat to this production by negatively impacting yield and quality. New crop varieties with enhanced environmental adaptation and soil resource extraction would help address this and other issues facing modern agriculture. Stay-green is a trait that extends grain fill in cereals and can stabilize yield and quality under drought. However, this trait and its benefits can be inconsistent across environments and its successful incorporation into breeding strategies would benefit from expanded understanding of stay-green. Roots may play a role in stay-green physiology. Roots provide plants with the water and nutrients needed for growth and are important for crop performance in their own right. Different root system architectures provide adaptation to different environmental stressors, but studying these belowground structures is challenging. Adaptation is also impacted by soil properties and microbial communities. For this dissertation, roots were examined in greenhouse seedling assays and field trials in Montana. Agronomic performance was also assessed for malt barley and spring wheat cultivars varying for stay-green, a biparental barley population segregating for stay-green, and a diverse mapping population of barley lines from different breeding programs. Stay-green cultivars had a greater percentage of deep roots, more prolonged root growth during grain fill, and greater yield. Analysis of the biparental population identified genetic co-segregations of stay-green, root phenotypes, grain quality, and quality stability between environments, further supporting the benefit of stay-green in dry environments and its connection to roots. The diverse mapping population was used to find associations between the relative abundances of bacteria in the rhizosphere and barley genetic loci, that were mostly environment specific. Rhizospheric bacteria may be involved in local adaptation of plants. Finding plant genetic signal for these microbial characteristics supports the idea that it may be possible to breed crops with enhanced ability to recruit beneficial microbiomes if environmental influence and agronomic impact can be understood. Root examination remains a challenging but worthwhile avenue to pursue in crop adaptation research.Item Improving new patient cancer treatment education: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2024) Wilcox, Jamie Michelle; Chairperson, Graduate Committee: Elizabeth A. JohnsonBackground: A cancer diagnosis invokes high levels of uncertainty and anxiety. Healthcare professionals task themselves with providing appropriate education to help patients traverse their cancer treatment experience. Effective communication and educational interventions help patients acquire appropriate coping strategies to manage the disease process and reduce uncertainty. Purpose: This project aimed to improve patient satisfaction and decrease anxiety and uncertainty through an enhanced patient education process. The project took place in a rural outpatient oncology center. Participants included newly diagnosed oncology patients receiving intravenous (IV) chemotherapy/immunotherapy and clinic staff. Method: This project used the Demming Cycle quality improvement method. The education components drew on the guidance of literature reviewed for best practices and national guidelines for patient education and teaching techniques. Data obtained through surveys from patients and RNs, observations from the project lead, and additional feedback from staff informed the development of the education visit components. Intervention: A nurse education visit was scheduled the week before IV treatment started and included a learning needs assessment, clinic tour, education on port-a-cath care, regimen-specific side effects and self-management, and how and when to contact the healthcare team. Nurses provided content using the teach-back method. Results: Patient and staff completed surveys over six weeks of implementation. Sixteen patients completed surveys. 100% (n=16) were confident they could manage their symptoms at home after the education visit. Thematic findings from survey responses regarding the most valuable education piece included Theme 1, logistics of treatment; Theme 2, anticipated side effects and management; Theme 3, other value of knowledge and education regarding managing the disease process. Nine nurses were surveyed 17 times during the project, with each nurse completing 1 to 2 education sessions. 88% (n=17) of nurses surveyed felt the education visit improved from the previous system, and 71% (n=17) of nurses found the teach-back method was supportive of patient outcomes surrounding patient education. Conclusion: Providing a structured education visit for new oncology patients receiving chemotherapy/immunotherapy improved patient confidence in identifying and managing symptoms and side effects of therapy at home. The teach-back method reinforced the education content and demonstrated an understanding of the material.Item The use of asthma action plans in improving asthma control: a quality improvement project(Montana State University - Bozeman, College of Nursing, 2024) Wenger, Mary Catherine; Chairperson, Graduate Committee: Alice Running; This is a manuscript style paper that includes co-authored chapters.Background: In the United States, approximately 1 in 13 adults and children suffer from the chronic condition asthma. Asthma is a disease in which the airways of the lungs become inflamed, narrowed, or blocked due to bronchoconstriction and increased secretions, reducing airflow and gas exchange. Without proper treatment, asthma exacerbations may lead to death in worst-case scenarios. An Asthma Action Plan (AAP) is a written, individualized template that lists actions patients can take to keep asthma symptoms from worsening. An AAP also provides guidelines that indicate when patients should call a provider or go to the emergency room. Methods: Current workflows, previously created when Asthma Control Tests (ACT) were implemented, were expanded upon to include implementation of AAPs. AAPs are created using the National Asthma Education and Prevention Program (NAEPP) guidelines. Implementation consisted of three two-week Plan-Do-Study-Act cycles with debriefing sessions after quantitative and qualitative data collection. Results: 70% of patients received AAPs in the final implementation phase compared to 25% in the first and 56% in the second implementation phases. The provider felt increased confidence in managing the patient's asthma through evidence-based guidelines. Nursing felt an increased strain on workload and moderate resistance from patients. Front desk staff noted minimal changes in daily work and believes patients appreciate receiving AAPs to take home. ACT rates were 85% in the first cycle, improving to 89% in the second and 100% in the final cycle. The provider and nursing believe the ACT is a useful tool for understanding patient asthma control. Conclusion: Implementing AAPs was monumental in the standardization of managing asthma in a small one-provider private practice clinic. Further research can now be completed to assess whether implementing AAPs actually improves patient asthma symptoms through ACT score evaluation. More work could be done on assessing the severity of asthma in patients and evaluating patient inhaler techniques.Item Characterization of multi-physics aging effects on the thermomechanical viscoelastic response of ultra high molecular weight polyethylene fiber reinforced composites(Montana State University - Bozeman, College of Engineering, 2024) Weaver, Jonmichael Andrew; Chairperson, Graduate Committee: David A. MillerUltra High Molecular Weight Polyethylene (UHMWPE) fiber reinforced composites have a high strength-to-weight ratio and are gaining attention as a material of choice for specialized applications subjected to extreme environmental conditions. Users value the water-repellent, lightweight, and flexible nature of the material for applications where weight is crucial. Marine, aerospace, and alternative energy sectors are exploring UHMWPE fiber reinforced composites for specialized applications in demanding environments where strength, flexibility, and weight efficiency are important design criteria. The viscoelastic and hydrophobic nature of UHMWPE makes it an attractive replacement for Kevlar® in ballistics protection shields and other industrial applications, providing similar performance while achieving upwards of 40% reduction in weight. However, the durability of UHMWPE composites under real-world aging conditions remains insufficiently examined. This research investigates how the viscoelastic properties of UHMWPE fiber reinforced composites, created through various manufacturing techniques, are altered after exposure to harsh conditions including immersion in water, temperature variations, humidity, and UV exposure. Additionally, the composites were irradiated with: X-rays, gamma-rays, and neutrons. After exposure to adverse environments, the thermomechanical viscoelastic response was characterized through Dynamic Mechanical Analysis (DMA). Surface morphology was evaluated using a field emission scanning electron microscope. DMA revealed an increase in the storage modulus with aging; however, elevated temperature creep tests showed that UV and hygrothermal aging had a higher creep compliance and decreased the ability of the composite to recover strain after unloading. Both single layer and pressed UHMWPE panels showed an increase in weight after submersion in water. Distilled water resulted in a faster rate of hydrolysis in the matrix than did salt water. The UV, gamma-ray, and neutron environments caused the composites to become brittle and yellow through chain scission and crosslinking, whereas the X-ray radiation exposure did not cause a measurable effect. Analysis on the surface of these composites after aging suggested the matrix protects these fibers from damage in harsh environments. Synthetic rubber matrix materials aged at a faster rate than the polyurethane rubber matrix materials. Increasing the strain rate showed an increase in moduli response during tensile DMA. These results quantify the limitations and strengths of this material for future models to accurately predict the lifespan and expand the application of this performance material in extreme environments to ensure safety for applications ranging from extreme sports to aerospace.Item Efficacy of an educational tool implementation to decrease relapse utilization by asthma patients(Montana State University - Bozeman, College of Nursing, 2024) Webb, Cicily Gretchan; Chairperson, Graduate Committee: Alice Running; This is a manuscript style paper that includes co-authored chapters.Asthma exacerbation patients often rely on emergency departments (ED) and urgent care or acute care clinic settings to regain control of their symptoms with almost 10% of asthmatic adults having an asthma related ED visit between 2011 and 2016 (Centers for Disease Control and Prevention [CDC], 2023). The Global Initiative for Asthma (GINA), encourages the utilization of self-management plans, such as an Asthma Action Plan (AAP), by patients as the first step of care in an asthma exacerbation (GINA, 2022). 10% of Montanans carry an asthma diagnosis and in 2018 with 2,000 ED visits related to asthma exacerbation treatment. The purpose of this project was to decrease relapse utilization of urgent care facilities by asthma exacerbation patients by implementing an educational tool to help increase utilization of AAPs and foster the patient-primary care provider relationship. This project aimed to provide patients presenting to the urgent care a discharge packet containing an AAP and primary care resources upon visit completion to decrease relapse utilization of the urgent care setting by asthma patients. Additionally, the number asthma exacerbation patients presenting to the urgent care was to be monitored and with a focus on those presenting on more than one occasion. Additionally, barriers to implementation were evaluated. The project aims of decreasing relapse urgent care utilization by asthma patients was inconclusive due to absence of data points available during the study timeline of relapse asthma exacerbation patients in comparison to the same 6-week timeframe from the prior year. However, this project illuminated significant gaps in what is recommended for asthma exacerbation patients and what this practice implements. Additionally, the lack of data also encouraged discussion regarding triggers to asthma exacerbation and encouraged comparing trackable triggers from the 2022-2023 season to the 2023-2024 season. Interestingly, this project highlighted a need for further education and guideline-based training for system providers to align actual treatment of asthma patients more closely to guideline-suggested management of asthma patients. More data needs to be collected regarding the implementation of self-management tool impact on decreasing relapse utilization of urgent care facilities.Item Removal of PFAS from synthetic wastewater using aerobic granular sludge(Montana State University - Bozeman, College of Engineering, 2023) Ritu, Tasnim Sultana; Co-chairs, Graduate Committee: Catherine KirklandThe project assesses the performance of the aerobic granular sludge (AGS) to remove poly- and per-fluoroalkyl substances (PFAS) and conventional nutrients like carbon, nitrogen, and phosphorus from synthetic wastewater in a sequencing batch reactor (SBR). AGS is an emerging wastewater treatment biofilm that may be effective in reducing the PFAS concentration in wastewater via sorption. PFAS are a class of man-made chemicals used as surfactants, fire retardants, and coating materials. PFAS compounds are very persistent in the environment and can lead to adverse health outcomes in humans. PFAS can migrate from consumer products and enter the influent of wastewater treatment plant (WWTP). PFAS compounds are poorly removed by conventional wastewater treatment methods making effluent from WWTP a significant source of PFAS in the environment. The project uses two specific PFAS which are perfluorooctanoic acid (PFOA) and perfluoro octane sulfonate acid (PFOS). Other objectives of this project are to monitor how PFAS influences the treatment of conventional wastewater constituents and the granules' structure and morphology. Two SBRs were started with floccular sludge from seed granules and continued for 402 days. Some standard laboratory analytical methods for nitrogen, phosphorus, and organic carbon were used to monitor the removal efficiencies of the granules. Solid phase extraction (SPE) and liquid chromatography with mass spectrometry (UPLC with ESI Q-TOF-MS) were used to assess the removal of PFOA and PFOS both from liquid and sludge phases. Maximum removal of 33% for PFOS and 28% for PFOA was achieved by AGS in the test SBR. PFOS/PFOA exposure affected the granule's physical properties, and the properties recovered within approximately 34 days of dosing. PFOS/PFOA contamination produced no significant effect on conventional nutrient removal except nitrification. Thus, the treatment of PFAS by AGS is economical, since AGS can treat several pollutants simultaneously in a single reactor. More research should be done on the disposal of PFAS-contaminated sludge and to increase the treatment efficiency.Item The effects of working memory capacity on collaborative inhibition across categorized and unrelated lists(Montana State University - Bozeman, College of Letters & Science, 2024) De Silva, Siyambalapitige Ninoo Nethmalie; Chairperson, Graduate Committee: Michelle L. MeadeThe current study examined if working memory capacity (WMC) predicts collaborative inhibition and if this influence can be generalized across categorized and uncategorized lists. Across two experiments, participants' WMC was measured using the operation span, reading span, and symmetry span. They were then presented with the unrelated lists only (Experiment 1), or unrelated words lists and categorized word lists (Experiment 2). Participants were asked to recall the lists on their own or in collaboration with another participant (recall test 1). In addition, they were given a subsequent individual recall test (recall test 2), and an individual source monitoring recognition test. Results from both experiments showed collaborative inhibition in recall test 1 and post collaborative benefits in recall test 2. Importantly, the pattern of collaboration results did not vary across WMC. Higher WMC individuals and lower WMC individuals showed similar effects of collaboration across unrelated and categorized lists. These findings identify important parameters of if and when WMC influences collaborative memory. Moreover, future research can investigate if mechanisms such as attentional control, retrieval inhibition, and collaborative process variables related to collaborative inhibition play a role when WMC is at work.Item A quality improvement project to bolster psychiatric advance directive utilization in community mental health(Montana State University - Bozeman, College of Nursing, 2024) Fonner, Laira Lee; Chairperson, Graduate Committee: Lindsay Benes; This is a manuscript style paper that includes co-authored chapters.Background: This quality improvement (QI) project aimed to increase Psychiatric Advance Directive (PAD) use in a community mental health organization serving clients with severe mental illness (SMI). PAD utilization has been shown to decrease involuntary hospitalization rates and associated coercive treatments, such as forced medication and seclusion and restraint for this vulnerable patient population. Local Problem: In Montana, busy clinicians rarely offer PAD education and assistance to clients with SMI. However, studies have demonstrated increased PAD utilization followed by reduced involuntary hospitalization rates for clients receiving these services from Peer Support Specialists (PSSs). PSSs are trusted employees with SMI working in outpatient mental health facilities. Methods: This quality improvement project established a repeatable PAD implementation workflow in an outpatient mental health care organization where PSSs were trained to facilitate PAD support events. Interventions: Interventions included hosting three online training workshops for PSSs followed by peer- facilitated events to offer client education and assistance in PAD completion. Event attendees were asked to complete event feedback surveys. Results: All invited PSSs attended one of the three online training workshops (n=X). X clients attended peer-facilitated events of X invited. Only two clients completed documents during the peer- facilitated events. Five clients started documents and wished to complete them later. None of the attendees completed event feedback surveys. Conclusions: The project successfully increased PAD awareness and utilization for PSSs and clients with SMI. The project team successfully established a repeatable workflow to bolster PAD use and generated organizational enthusiasm to continue utilization efforts.