Digital Commons Network^™

Engaging Hmong Americans Long-Term Use Of Healthcare Technology Using Culturally Revised Social Cognitive Theory Model, Peggy Xiong

Theses and Dissertations

Purpose: Information technology benefits the world, and it’s required for health care system, such as electronic medical records (EMR). User acceptance model is to systematically study how users come to accept and use a technology. For example, the cultural values of a society restrict use of technology in which an individual can be less incline to accept it. There is a significant amount of Hmong population in great Milwaukee area. Spirits are a central part of Hmong religious beliefs where the spirit is tied to health. Chronic disease is believed to be caused by bad actions done by the individual’s …

Kujdesi I Infermieror Ne Te Semuret Me Hemofili, Çëndrim Jetishi

Theses and Dissertations

Hyrje: Hemofilia është një sëmundje hemorragjike recesive e lidhur me kromozomin X i karakterizuar nga mungesa apo deficienca e faktorit VIII (hemofilia A ose hemofilia klasike) ose e faktorit IX (hemofilia B ose sëmundja Christmas). Subjektet mashkullore preken klinikisht; femrat që mbartin një gjen të vetëm me mutacion përgjithësisht janë asimptomatike. Cilësia e kujdesit infermieror është shkalla e kujdesit shëndetësor për pacientin rrit mundësinë e rezultatit të dëshiruar dhe në përputhje me njohuritë aktuale profesionale (Anrlab, 2006). Shkalla e përsosmërisë me respektimin e shërbimeve mjekësore dhe infermierore të perceptuara në aspektin teknik, të kompetencës përshtatshmërinë, pranueshmërinë, njerëzimin dhe strukturën (Wikipedia, …

Engaging Hmong Americans Long-Term Use Of Healthcare Technology Using Culturally Revised Social Cognitive Theory Model, Peggy Xiong

Theses and Dissertations

Purpose: Information technology benefits the world, and it’s required for health care system, such as electronic medical records (EMR). User acceptance model is to systematically study how users come to accept and use a technology. For example, the cultural values of a society restrict use of technology in which an individual can be less incline to accept it. There is a significant amount of Hmong population in great Milwaukee area. Spirits are a central part of Hmong religious beliefs where the spirit is tied to health. Chronic disease is believed to be caused by bad actions done by the individual’s …

Ndikimi I Ndërrimit Të Natës Në Gjendjen Emocionale Të Infermierëve Në Qkmf-Në E Rahovecit, Sumera Kabashi

Theses and Dissertations

Ky studim adreson çështje të gjendjes emocionale në punë të infermierëve në Qendrën Kryesore të Mjekësisë Familjare të Rahovecit. Një model linear që lidh rolin në punë dhe faktorët shoqërorë, ankthin depresionin, dhe vetvlersimin.

Ky hulumtim është realizuar me 24 infermierë, ku 12 infermierë janë intervistuar gjatë ndërrimit të natës dhe 12 infermierë gjatë ndërrimit të ditës. Nga këta, 6 janë të gjinisë mashkullore apo 25%, dhe 18 të gjinisë femërore apo 75%. Mosha më e ulët e infermierëve ishte 32 vjeç, ndërsa më e larta 54 vjeç.

Ky studim synon të identifikojë provat shkencore mbi shfaqjen e ndryshimeve të …

Assessing Egyptians' Knowledge, Perceptions, And Attitudes Towards Generic Medicines, Radwa Ahmed Elmoneer

Theses and Dissertations

Medicines are vital component of any health system worldwide, and ensuring accessibility of affordable, effective and safe medications is a critical public policy goal considered by every country. Egypt has, recently, faced aggravated challenges in ensuring the availability of medications countrywide. In response, the Egyptian government has adopted a number of pharmaceutical policies and interventions, mainly, targeting the supply side of the market. Promoting the use of generic medicines is an effective policy intervention that addresses the demand side, a highly recommended intervention given other countries’ experiences. As the main users of medications, patients are a crucial source of knowledge …

Did Medicaid Expansion Under The Affordable Care Act Reduce The Likelihood That People Report Employment Status Changes Due To Health, U.S., 2009-2017, Songyuan Deng

Theses and Dissertations

Medicaid expansion of Affordable Care Act (ACA) extended coverage to low-income working adults. While Medicaid expansion led to increased healthcare use and national healthcare expenditures, current studies do not examine the effects of Medicaid expansion on health status from the perspective of social roles, for example, changes in employment status. This study use data from the Current Population Survey to examine the association between Medicaid expansion and the probability to attribute part-time work or not-in-labor- force to health issues among people with family annual income no more than 138 of Federal Poverty Level, with a difference-in-differences study design. We found …

Modification And Characterization Of Chloro-Sugar Derivatives As Anti-Bacterial Agents, Mansi Jani

Theses and Dissertations

Sucralose is an artificial sugar substitute which is most commonly used sweetener among other artificial sweeteners. It is derived from sucrose through a complex chemical process that selectively substitutes three atoms of chlorine for three hydroxyl groups on sucrose molecule, which have shown some inhibition of bacterial growth in gut. The goal of the project was to substitute halide in sucralose in a way that it sustains potential anti-bacterial activity along with sweetening effect, which can be then incorporated into mouthwash formulation. Sucralose is very stable molecule and it also has other physico-chemical advantages which are suitable for our anticipated …

Kinematic And Acoustic Vowel Changes In Adult Bite Block Speech, Tanner Keith Low

Theses and Dissertations

The current study examined the lingual kinematic and acoustic effects of bite blocks on vowels in a sentence context. Twenty adult native English speakers (10 male, 10 female) with no speech, language, or hearing deficits participated in the study. The corner vowels found in the sentence, The blue spot is on the black key again (i.e., /u/, /É‘/, /æ/, /i/), were measured kinematically and acoustically immediately before and after bite block insertion. The participants' speech was audio-recorded and their lingual articulatory movements were measured with a Northern Digital Instruments Wave electromagnetic articulograph. The sensor coils were attached to three different …

The Distinction Between Lingua-Palatal Contact Patterns Of English Light And Dark [Ɫ]: A Precursor To Using Electropalatography In Second Language Instruction, Kallie Lynne Chaves

Theses and Dissertations

Electropalatography (EPG) is a system designed to provide visual feedback of lingua-palatal contact via electrodes and computer software in real-time. Traditionally, EPG technology has been effective in the treatment of both developmental and acquired speech disorders. Little research, however, has been done to show the effectiveness of EPG feedback in second language instruction and foreign accent reduction. The present thesis is part of a larger project examining the utility of EPG technology as a potential tool for teaching English speakers learning German as a second language (L2). A common error that English speakers make in German pronunciation is the incorrect …

Articulatory Kinematic Compensation For A Bite Block During Diphthong Production, Michelle Olson Richins

Theses and Dissertations

The current study examined the effects of bite blocks on articulatory kinematics when producing diphthongs /ɑɪ/ and /É‘ÊŠ/ within a phrase. Participants consisted of 20 young adults (10 males, 10 females) with no speech, language or hearing disorders. Participants produced the diphthongs in the carrier phrase Im an owl that hoots. A Northern Digital Instruments Wave electromagnetic articulograph measured the articulatory movements while the speaker produced the stimuli in two conditions (pre bite block insertion and post bite block insertion). Bilateral bite blocks were made using Express dental putty, which is a silicone impression material, in order to create a …

Impact Of A Single Injury Prevention Instructional Session On The Incidence Of Injury Among U.S. Army Rotc Cadets, Joshua Wooldridge

Theses and Dissertations

Background: Musculoskeletal injuries are the leading health concern for the United States Army. These injuries are the third leading cause of hospitalizations for Army service members and the primary cause for the majority of service-connect disability discharges. Over 80% of musculoskeletal injuries are overuse injuries caused by physical training. The Joint Services Physical Training Injury Prevention Work Group considers education to be a mandatory component of all injury prevention efforts; however, little military research has investigated the impact of education as a primary intervention. Objective: To examine the effect of an injury prevention education class on the incidence of injuries …

Designing Biomimetic Implant Surfaces To Promote Osseointegration Under Osteoporotic Conditions By Revitalizing Mechanisms Coupling Bone Resorption To Formation, Ethan M. Lotz

Theses and Dissertations

In cases of compromised bone remodeling like osteoporosis, insufficient osseointegration occurs and results in implant failure. Implant retention relies on proper secondary fixation, which is developed during bone remodeling. This process is disrupted in metastatic bone diseases like osteoporosis. Osteoporosis is characterized low bone mass and bone strength resulting from either accelerated osteoclast-mediated bone resorption or impaired osteoblast-mediated bone formation. These two processes are not independent phenomena. In fact, osteoporosis can be viewed as a breakdown of the cellular communication connecting bone resorption to bone formation. Because bone remodeling occurs at temporally generated specific anatomical sites and at different times, …

Understanding The Impact The Hospital Readmission Rate Program And Value Based Purchasing Has Had On The Financial Viability Of Academic Health Centers, 2011 To 2015., David Allen

Theses and Dissertations

Academic Health Centers (AHCs) hold a unique place in today’s health care environment. They service their communities through a tripartite mission of education, research, and provision of complex care to disadvantaged populations. To achieve this mission, AHCs face challenges in funding and cost containment compared to non-AHCs. Additionally, the implementation of government programs like the Hospital Readmission Rate Program (HRRP) and Value Based Purchasing (VBP) have the potential to affect AHCs differently from non-AHCs. While AHC’s unique features are known and there has been research to date on HRRP and VBP, literature has yet to statistically explore the financial differences …

Management Of The Open Apex Using A Bioceramic Apical Barrier: Success And Survival Rates At Virginia Commonwealth University, Adam Sarnowski

Theses and Dissertations

Purpose: The aim of this study was to assess the outcome of treatment of teeth with open apices managed by the orthograde placement of a bioceramic apical barrier as well as to identify potential outcome factors for this type of treatment. Methods: Patient records were pooled from graduate resident cases completed at Virginia Commonwealth University between January 1, 2010 and May 31, 2018. A total of 515 patients were identified using relevant ADA codes and a key word search within the patient record database. A total of 104 patients (119 teeth) had an open apex that had NSRCT utilizing a …

Antibiotics And Antimicrobial Resistance: An Evaluation Of The Knowledge, Attitude And Perception Among Dental Students And Academic Deans And Department Chairs Within U.S. Dental Schools, Magdalena S. Holz

Theses and Dissertations

Purpose: This study aimed to survey current 3^rd and 4^th year dental students, academic deans, and department chairs within U.S. dental schools to analyze the level of understanding; education; guidelines; and overall awareness regarding antibiotic use within dentistry and antimicrobial resistance.

Methods: A 25-question survey intended for 3^rd and 4^th year dental students and a 20-question survey intended for academic deans and various department chairs of U.S dental schools were each developed utilizing REDCap. The survey invitations were sent via e-mail to the current academic dean of each U.S. dental school for distribution.

Results: There were …

Evaluation And Comparison Of Periapical Healing Using Periapical Films And Cone Beam Computed Tomography: Post-Treatment Follow Up, Adam S. Polinsky

Theses and Dissertations

Purpose: The purpose of this study was to assess the radiographic changes in periapical status and analysis of healing determined using periapical radiographs (PA) versus cone beam computed tomography (CBCT) pre-operatively and at 3-64 months following endodontic treatment.

Methods: Pre/post treatment radiograph and CBCT scans of patients who had NSRCT, NSReTx, or SRCT from July 2011-December 2018 at VCU Graduate Endodontic clinic were included in this study. Volumetric and linear measurements of periapical lesions on initial and recall PA and CBCT images were performed using three calibrated examiners. Changes and differences in the estimated area from PA to CBCT were …

Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon

Theses and Dissertations

USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS

Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …

The Efficacy Of A Fluoride-Containing Orthodontic Primer In Preventing Demineralization, Alyssa G. Ricci

Theses and Dissertations

Purpose: To evaluate the efficacy of a fluoride-containing orthodontic primer in preventing demineralization adjacent to brackets and compare the quality of enamel on tooth surfaces that received interproximal reduction (IPR).

Methods: Patients at the VCU Orthodontic clinic who consented to orthodontic treatment involving extraction of at least 2 premolars were recruited to this pilot clinical study. Brackets were bonded to premolars using one of two primers, fluoride-containing experimental or control. IPR was also performed, and the experimental primer was applied to randomly selected teeth. Extracted teeth were analyzed visually for the presence of white spot lesions (WSLs). Micro-CT analyses were …

The Effects Of Notch Signaling On Functional Recovery Following Traumatic Brain Injury, Jyoti Lodha

Theses and Dissertations

2.5 million people sustain a traumatic brain injury (TBI) annually in the United States. Although there is potential for functional recovery following TBI, there is no definitive treatment to improve recovery after TBI. Our lab has shown that TBI enhances an endogenous neurogenic response in the subventricular zone and hippocampus. TBI-induced neural stem cells (NSCs) can integrate into regions such as the hippocampus and olfactory bulb. Although the mechanism behind TBI-enhanced neurogenesis remains unknown, the Notch signaling pathway has been implicated as a regulator in the maintenance and survival of NSCs.

This thesis explores the effects of Notch pathway manipulation …

An Evaluation Of Differences In Motivations To Receive Cervical Cancer Screening And Follow-Up Care Between Black And White Women, Ashlee Sawyer

Theses and Dissertations

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black …

Perception Of Patient Cooperation Among Dentist, Guardian, And Child, Cole A. Staines Dds

Theses and Dissertations

Purpose: Evaluate behavior assessment and agreement among dentist, guardian, and child. Evaluate child behavior by appointment type.

Methods: Patients recruited from the pediatric dental department at Virginia Commonwealth University for this convenience sample. Inclusion criteria: patients presenting for clinical exams and/or restorative treatment without the use of advanced behavior guidance between August 29, 2018, and March 7, 2019; ages 4-12-years-old; and scheduled with a single clinician. Appointments were stratified by difficulty. Behavior was assessed by dentist and caregiver using the Frankl Scale. Patient self-assessed cooperation using an age-appropriate modified Frankl Scale, developed for this study. Agreement assessed among the 3 …

Comparison Of Triple Combination Oral Sedation Regimens For Pediatric Dental Treatment, Brett H. Henderson

Theses and Dissertations

Purpose: Compare the efficacy of two benzodiazepines (diazepam or midazolam) in combination with meperidine and hydroxyzine for pediatric dental sedation. Methods: A randomized, double blind observation study of behaviors and outcomes related to two sedation groups. Frankl and Houpt behavior scores were recorded at three time points: injection time, initiation of treatment and at the end of treatment. Postoperative phone call surveys were conducted within eight hours of discharge to assess sleep, activity, and behavior. Results: A total of 40 sedation subjects were included in the study, of which 20 were treated with diazepam triple Combination (Di+M+H) and 20 with …

Frictional Properties Of Novel Bracket Systems: An In-Vitro Study, Stephen M. Haverkos

Theses and Dissertations

Orthodontic brackets undergo resistance during sliding that includes classical friction, binding, and notching. Current bracket systems are hampered by these challenging forces. As a result, the clinician usually needs to apply additional forces to overcome the resistance which increases the risk of root resorption and discomfort for the patient. This study evaluated frictional properties of a novel bracket that had polytetrafluoroethylene (Teflon™) coated rollers in its design. Five types of brackets (n = 10, each), including a passive self-ligating bracket, a traditional ligated bracket, a three-dimensionally printed direct metal laser sintering (DMLS) bracket with and without Teflon™ rollers, and computer …

Comparison Of Patient Factors Influencing The Selection Of An Orthodontist, General Dentist, Or Direct-To-Consumer Aligners For Orthodontic Treatment, Jeffrey C. Olson

Theses and Dissertations

Purpose: To evaluate the factors that influence potential orthodontic patients choosing between an orthodontist, general dentist, and direct-to-consumer (DTC) aligners for their treatment, and to determine the demand for each provider type.

Methods: An electronic survey was administered to 250 individuals among the general population of adults in the United States. Questions were designed to determine the respondent’s level of interest in pursuing orthodontic treatment with each provider type, evaluate their current level of knowledge concerning provider options, and identify factors influencing their selection. Pearson’s chi-squared test and ANOVA were used to evaluate the factors influencing patients in …

Long-Term Effects Of Notch1 Signaling On Neural Stem Cells Following Traumatic Brain Injury, Cruz Sevilla Jr

Theses and Dissertations

Traumatic brain injury (TBI) is a devastating problem which stands as a leading cause of death and disability. The elderly is significantly affected by TBI, typically as the result of falls, and recovery is especially limited. This, in part, is associated with decreased tissue-specific stem cell regeneration and replacement of damaged cells in the aged brain. The diminished ability of the aged brain to recover is especially devastating after TBI, likely leading to permanent loss of sensory, motor, and cognitive functions. Studies have shown that the mature mammalian brain contains Neural Stem Cells (NSCs), found in specific regions of the …

Axon Initial Segment Integrity In Aging And Traumatic Brain Injury, Mazen M. Gouda

Theses and Dissertations

According to the Center for Disease Control’s (CDC) report to the Congress, there are 2.2 million emergency department visits; 80,000 hospitalizations; and 50,000 deaths each year due to traumatic brain injury. Adults 65 years and older account substantially for the majority of the hospitalization and deaths. Over 70% of the traumatic brain injuries of the older adults are classified as mild to moderate; however, even with these milder injuries, older adults present with a significantly higher morbidity and mortality compared to all other age groups (LeBlanc et al., 2006). With that in mind, it seems essential to develop a deeper …

Examination Of Strain-Dependent Differences In S. Sanguinis Virulence And Growth, Shannon Baker

Theses and Dissertations

Streptococcus sanguinis, an abundant and benign inhabitant of the oral cavity, is an important etiologic agent of infective endocarditis, particularly in people with pre-disposing cardiac valvular damage. Although commonly isolated from patients with IE, little is known about the factors that make any particular S. sanguinis isolate more virulent than another or, indeed, whether significant differences in virulence exist among isolates. To investigate the virulence of multiple isolates, a variation of the Bar-seq (barcode sequencing) method was employed. A conserved chromosomal site was identified for subsequent insertion of a barcode identifier, unique for each strain. Barcode insertion did not …

The Effect Of Change In Medi-Cal Dental Coverage On Dental Care Utilization Among Medi-Cal Beneficiaries, Min H. Zhang

Theses and Dissertations

One of the most important factors in accessing dental care is having dental insurance. For people with low incomes, Medicaid is the main source of health insurance. Medi-Cal is California’s Medicaid program. Adult dental services were mostly eliminated in Medi-Cal in 2009 due to the economic downturn and partially restored in 2014. The objective of this study is to evaluate the effect of change in Medi-Cal dental coverage, specifically the partial restoration of adult dental coverage in 2014, on dental care utilization among Medi-Cal beneficiaries. The partial restoration significantly increased the utilization rates in dental clinics from 2014 to 2017 …

Adaptation And Validation Of The Situation Awareness Global Assessment Technique For Student Registered Nurse Anesthetists, Deniz Dishman

Theses and Dissertations

Anesthesia is a health care specialty fraught with high workload demands, stressful work environments, increased production pressure, work areas with many distractions, an increasing use of advanced technology, and the constant need to prioritize work actions. Effective clinical judgment in this dynamic environment necessitates that the provider demonstrate the ability to project what may occur secondary to actual or potential condition changes. These key elements operationalize situation awareness (SA).

High level SA is an important characteristic for the successful development of student registered nurse anesthetists (SRNAs). With Endsley’s “Theory of Situation Awareness” as the foundation, the goal of this study …