Medicine and Health Sciences Commons^™

Cerebrovascular Dysfunction And Degeneration In Alzheimer’S Disease Pathophysiology, Dominic Dimitri Quintana

Graduate Theses, Dissertations, and Problem Reports

Alzheimer’s disease (AD) is a terminal illness and the most common form of dementia, which disproportionately affects the aged population. The pathophysiology of AD is characterized by neurodegeneration that slowly progresses, affecting regions of the brain that are involved in learning, memory, language, and executive function. In patients with the disease, early symptoms include non-disruptive forgetfulness that evolves into the inability to form new memories and ultimately the loss of autonomy at late stages. Histopathological hallmarks in the brain from patients with AD is the presence of amyloid-β (Aβ)-plaques and neurofibrillary tangles (NFT) deposited in the parenchyma. Since the discovery …

Evaluation Of The Impact Of An Educational Intervention Focused On Adolescent Vaping Among Rural Middle School Students, Holly F. Fitzwater

Graduate Theses, Dissertations, and Problem Reports

According to the Centers for Disease Control (CDC), sixty deaths due to the use of electronic cigarettes or other vaping products have been reported to date. Vaping has become viewed as a safe alternative to traditional cigarette smoking, particularly in the adolescent population. The U.S. Preventive Services Task Force (USPSTF) recommends education by primary care clinicians to prevent initiation of tobacco products among adolescents. In order to combat this health disparity in America’s youth, intervention by the nursing profession is necessary. An educational session and interactive game were implemented by a school-based family nurse practitioner in order to change the …

A Phenomenological Photovoice Exploration Of Female Exercisers’ Experiences Of Their Body In Fitness Center Environments, Katherine E. Fairhurst

Graduate Theses, Dissertations, and Problem Reports

For many women, the relationship with their body and exercise is complex. Exercise can have positive effects on body image, however, not all women appear to benefit positively from all types of exercise. To date, body image research has focused on exercise as an activity and less so on the context in which exercise is performed. Women frequently exercise in fitness centers as young adults which, unfortunately, is associated with body dissatisfaction. Using an Interpretative Phenomenological Analysis (IPA) approach with Photovoice methodology, we explored young adult women’s lived body experiences while exercising in fitness centers. A purposive sample of 11 …

The Effects Of Intrinsic Foot Muscle Strengthening On Foot Posture, Balance, And Agility In Ice Hockey Players, Rebecca Eve Veltrie

Graduate Theses, Dissertations, and Problem Reports

Context: Research has shown that intrinsic foot muscle strengthening over a 4-week period is beneficial for improvements in dynamic postural control, function, stability and foot posture. Ice hockey is a sport that requires immense levels of balance, stability and performance on the lateral aspect of the skate. With research lacking on the impact of intrinsic foot muscle strengthening on ice hockey athletes’ balance, foot posture and performance, implementation of such a program may be beneficial for ice hockey players. Objective: The purpose of this study was to explore the effects of foot intrinsic muscle strengthening versus a traditional …

The Effects Of Acute Photobiomodulation On Anaerobic Exercise Performance, Jillian Danielle Forsey

Graduate Theses, Dissertations, and Problem Reports

Optimal performance in sport requires a balance between training stress and recovery. Therapeutic modalities that allow athletes to maintain this balance while training hard are in high demand, but many lack research. Photobiomodulation is a red and near-infrared light therapy that is proposed to enhance exercise performance and hasten recovery. The purpose of this study was to examine the effects of acute whole body photobiomodulation, applied pre-exercise, on anaerobic exercise performance.

Forty-eight healthy, active subjects participated in this single-blind, crossover study. Subjects visited the lab three times to complete a repeat Wingate test, with one week between each visit. All …

Tobacco Cessation In A Dental School Setting, Kerri T. Simpson

Graduate Theses, Dissertations, and Problem Reports

Introduction

Tobacco use remains the single largest preventable cause of death in the United States. Currently, the prevalence of tobacco use is 20.7% in adults (≥18 years old) and 31.2% among high school students. According to various studies, over 60% of Americans want to quit tobacco, but it takes a person several attempts to quit before they are successful. There is limited data in the literature that discusses the effectiveness of tobacco cessation programs in US dental schools. Therefore, information on the effectiveness of a tobacco cessation program in a dental school setting could benefit this state and the problem …

Role Of Ciliary Proteins Adp Ribosylation Factor Like Gtpase 13b (Arl13b) And Bardet-Biedl Syndrome-8 (Bbs8) In Photoreceptor Outer Segment Morphogenesis, Maintenance, And Viability, Tanya L. Dilan

Graduate Theses, Dissertations, and Problem Reports

Photoreceptor neurons are modified primary cilia with an extended ciliary compartment known as the outer segment (OS). The mechanisms behind the elaboration of photoreceptor cilia, OS morphogenesis, and maintenance remain poorly understood. In this work, we focused on dissecting the role of two ciliary proteins, the small GTPase ADP-ribosylation factor-like GTPase 13B (ARL13B) and Bardet-Biedl Syndrome-8 (BBS8) in the context of photoreceptor biology. Both BBS8 and ARL13B are linked to defects in ciliogenesis (cilia development) and Retinitis Pigmentosa (vision loss). ARL13B is implicated in regulating ciliary length, and BBS8 is part of the Bardet-Biedl Syndrome complex (BBSome); the BBSome is …

Root Coverage Predictability In The Treatment Of Gingival Recessions On Mandibular And Anterior Teeth, Michele Agusto

Graduate Theses, Dissertations, and Problem Reports

Introduction. Mandibular anterior teeth are most frequently affected by gingival recessions. However, data regarding mucogingival treatment aimed at root coverage in this specific location is limited.

Aim. To systematically review the literature addressing the focused question: “What is the effectiveness, efficacy and efficiency of different surgical approaches on clinical and patient-related outcomes in the treatment of buccal gingival recessions on mandibular anterior teeth?”

Material methods. Electronic (Medline, Scopus, and Cochrane databases) and hand literature searches were performed for studies including at least one arm involving the use of pedicle flaps and/or free soft tissue grafts in the …

Mental Health Service Use In The Kingdom Of Saudi Arabia, Abdulaziz S. Alangari

Graduate Theses, Dissertations, and Problem Reports

Objectives: The goal of this project was to increase knowledge concerning the current prevalence, needs and barriers to mental health service use in the Kingdom of Saudi Arabia (KSA). It’s purpose was to gather data that would help to inform future policy decisions aimed at optimizing the use and availability of these services in the KSA. There were three specific aims: 1) Examine the barriers to initiation and continuation of mental health treatment in people with a disorder diagnosed during the previous 12-months. 2) Explore the prevalence and predictors of mental health treatment dropout. 3) Examine the prevalence and patterns …

Comparison Of Skeletal And Dentoalveolar Changes Between Two Bone-Borne Maxillary Expanders, Mohamad Sarraj

Graduate Theses, Dissertations, and Problem Reports

Introduction: Bone-borne maxillary expander (BBME) are designed to provide additional anchorage to widen the maxillary arch for patients who exhibit maxillary transverse deficiency. One form of BBME is the hybrid BBME which uses mini-implants (bone-borne) and posterior teeth (tooth-borne) as anchorage for maxillary expansion. The other form of BBME is absolute BBME which only uses mini-implants as anchorage. It is not clear in the literature if there is a difference in skeletal and dental changes with these two types of expanders. The objective of this study was to compare the skeletal, dentoalveolar, and periodontal changes between the hybrid and the …

Predictors Of Cardiovascular And Gastrointestinal Disorders, Inappropriate Nonsteroidal Anti-Inflammatory Drug Use, And Alzheimer’S Disease And Related Dementia In Older Adults With Osteoarthritis, Jayeshkumar Patel

Graduate Theses, Dissertations, and Problem Reports

Osteoarthritis (OA) is a degenerative arthritis affecting over 30 million Americans most of whom are over 65 years or older. Its clinical management is complicated by several disease- and treatment-specific factors. These include the co-occurrence of cardiovascular and gastrointestinal disorders (CV-GID), the inappropriate use of non-steroidal anti-inflammatory drugs (NSAID) to manage pain, and the risk of certain age-related chronic conditions like Alzheimer’s disease and related dementia (ADRD). Moreover, older adults with OA are at a higher risk of CV-GID, inappropriate NSAID use, and ADRD. Additionally, these factors can also affect one another in both a positive and a negative way. …

Respiratory Flow Characteristics Of Intensive Care Healthcare Workers Performing Patient Care Activities, Shawn R. Williamson

Graduate Theses, Dissertations, and Problem Reports

In the United States, under OSHA regulations, all respirators used in the workplace must be certified by the National Institute of Occupational Safety and Health (NIOSH). Under current NIOSH standards, loose-fitting powered air-purifying respirators (PAPR) must provide a minimum operational flow of 170 liters per minute. The objective of this study was to characterize the breathing flow rates of nine health care workers during patient care activities typically performed in a hospital's intensive care unit. This characterization will be used to determine the feasibility of lowering the minimum operational flow rate of PAPRS used in health care settings.

Each participant …

Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler

Graduate Theses, Dissertations, and Problem Reports

Many individuals receiving care at a predominantly free primary health care clinic in the northern part of West Virginia are experiencing depression, and medication therapy is the most common form of management with limited resources for psychosocial treatment. Brief psychosocial therapy interventions provided by the primary care provider should be explored as an adjunct treatment for this population in the primary care setting.

A pilot study was conducted to explore the integration of behavioral activation, a brief psychosocial intervention focused on decreasing depressed behavior by increasing nondepressed behavior to reinforce corresponding improvements in mood. Eligible patients were invited to attend …

Health Outcomes Associated With Gulf War Illness, Shannon K. Barth

Graduate Theses, Dissertations, and Problem Reports

Background:

Nearlythirty years after the 1990-1991 Persian Gulf War a definitive case definition for Gulf War Illness (GWI) is lacking. The objective is to explore health outcomes associated with GWI using currently accepted classifications in order to better understand GWI by examining pre-war medical conditions as predictors of probable GWI, mortality outcomes of veterans with probable GWI, and female-specific medical conditions among women with probable GWI. Additionally, we utilize an alternative GWI case definition.

Methods:

Data come from theDepartment of Veterans Affairs (VA)1995-1997 National Health Survey of Persian Gulf War Era Veterans, a population-based survey of deployed …

Effect Of Western Diet And Caloric Substitution With Apple Pomace On Fatty Acid Composition And Gene Expression In The Hypothalamus Of Growing Female Sprague-Dawley Rats, Ayad Abdulhamid Alawadi

Graduate Theses, Dissertations, and Problem Reports

The hypothalamus plays a major role in regulating food-intake and energy-expenditure. Hypothalamic dysfunction implicated in neurodegenerative diseases is characterized by diet-induced neuroinflammation and energy dysregulation. Apple pomace, a waste byproduct of processing, is rich in polyphenols and soluble fibers, has the potential to ameliorate diet-inducing inflammation. The objective of this study was to determine the effects of Western diet and caloric substitution of Western diet with 10% apple pomace on brain fatty acid composition and gene expression related to hypothalamic function and health in growing female rats. Growing female Sprague-Dawley rats (age 22-29 days) were randomly assigned (n=8 rats/group) to …

Obese Zucker Rats As A Reverse Translational Model Of Human Left Ventricular Hypertrophy, Mackenzie Shelby Newman

Graduate Theses, Dissertations, and Problem Reports

Heart failure is a lifelong disability that for over half of those affected leads to mortality within five years after initial diagnosis. Left ventricular hypertrophy (LVH) is one of the most reliable independent predictors of heart failure. Pathological LVH is irreversible, but early diagnosis is often missed due to its asymptomatic nature. Obese Zucker rats (OZR), which develop obesity due to dysfunctional leptin signaling, naturally exhibit a LVH that mimics the obese human condition. Animal models are necessary because human donor tissue is scarce. The central hypothesis is that genes and proteins that are differentially expressed during development of LVH, …

Integrating Care: Evaluation Of A Hepatitis C Clinic Co-Located With Harm Reduction And Addiction Treatment Programs In A Rural Clinic, Susan Ruth Mckenrick

Graduate Theses, Dissertations, and Problem Reports

Background: West Virginia (WV) is second in the nation for cases of Hepatitis C Virus (HCV) per capita – meaning more than 24,000 residents are living with HCV. Most new cases are in young persons who inject drugs (PWID). However, the no-call, no-show rate for HCV patients coming to clinics in Morgantown is about 50%, indicating the need to do a better job engaging them in care. Literature suggests that integrating HCV clinics with harm reduction and addiction treatment programs increases uptake of HCV treatment.

Objective: The overall objective was to establish an integrated HCV clinic where harm reduction …

Frontal Brain Injury: Effects On Flexibility, Impulse Control, And Attention, Christopher Matthew O'Hearn

Graduate Theses, Dissertations, and Problem Reports

Traumatic Brain Injury (TBI) is defined as an impact to the head, penetration of the skull, or rapid deceleration of the skull, resulting in an alteration of brain function or neurological deficit. Cognitive deficits are common following TBI and often go unresolved due to a lack of effective treatments. These deficits often perseverate into the chronic post injury phase, so the development of rehabilitative strategies is imperative. Behavioral flexibility, impulse control, and attention are a few cognitive processes that are commonly affected by TBI. The current research compares these processes between rats with and without a severe frontal brain injury …

Retrospective Evaluation Of The Changes In The Nasal And Pharyngeal Airway Volume After Miniscrew Assisted Rapid Palatal Expansion (Marpe) Appliance, Joanna Song

Graduate Theses, Dissertations, and Problem Reports

Background and Objectives: A transverse deficiency of the maxilla is a pervasive skeletal problem that can affect almost a quarter of the primary dentition population. The interesting relationship between rapid maxillary expansion (RME) and its effects on the surrounding airway is not well described in the literature. For today’s contemporary orthodontist, there are a variety of rapid palatal expanders (RPE) and expansion protocols to prescribe for patient treatment. Of late, the miniscrew-assisted RPE (MARPE) has been receiving attention by clinicians because of its increased orthopedic effects when compared to conventional RPE while avoiding the surgical procedure needed with SARPE. …

Knowledge Of Content For Clinical Nursing Educators: An Ethnographic Investigation Of Clinical Experts Who Transition To The Role Of Novice Clinical Nursing Educator, Stacy Wheat Huber

Graduate Theses, Dissertations, and Problem Reports

The purpose of this research study was to identify and describe the teaching practices and the grounding experiences of the teaching practices novice educators use when teaching undergraduate students in the clinical patient care area. The following research questions guided this investigation: What teaching practices and teacher knowledge do novice clinical nursing educators demonstrate or draw from when teaching undergraduate nursing students in the clinical patient-care area? In what ways do novice clinical nursing educators change or adapt their teaching behaviors as a response to the context of the teaching/learning environment? What grounding educational or professional experiences do novice clinical …

Changing Dynamics Of Opioid Overdoses In West Virginia And Impact Of Medication For Opioid Use Disorder And Recurrence Of Overdose On Reducing Mortality Among West Virginia Medicaid Beneficiaries, Zheng Dai

Graduate Theses, Dissertations, and Problem Reports

Background

With increasing number of opioid overdoses in West Virginia (WV) in recent years and limited number of people receiving treatment, the dissertation study aims to better understand fatal overdose problems in WV and the impact of medication for opioid use disorder (MOUD) in preventing overdose deaths.

Method

WV drug-related deaths from 2005 to 2018 was used to describe the involvement of fentanyl and FAs. WV Medicaid claim data was analyzed to describe the recurrent opioid overdose and the changes in receipt of MOUD. Further, a Medicaid opioid overdose cohort was created to evaluate the effect of occurrence of recurrent …

Asthma-Copd Overlap: Economic Burden And Medication Adherence, Mona Nili

Graduate Theses, Dissertations, and Problem Reports

In many older adults, asthma and chronic obstructive pulmonary disease (COPD) coexist as “Asthma-COPD overlap” (ACO). This dissertation pursued three Aims: 1) estimate the economic burden of ACO and its contributory factors; 2) evaluate the association of ACO to “cost-related medication nonadherence” (CRN); and 3) identify adherence trajectory patterns and examine the impact of initial maintenance therapies (IMT) type (inhaled corticosteroids monotherapy (ICS) vs. fixed-dose combination of ICS and long-acting beta agonist (ICS/LABA)) on adherence trajectory patterns among older adults Medicare Beneficiaries. The first and second Aims were cross-sectional studies by using Medicare Current Beneficiary Survey data. For the third …

Evaluation Of Control Strategies For Overhead Work Using Electromyography Of Rotator Cuff Muscles, Hossein Motabar

Graduate Theses, Dissertations, and Problem Reports

Work-related musculoskeletal disorders (MSDs) of shoulder have a significant impact on overall health and economics in the industrialized nations. Rotator cuff is the most frequently injured region in the shoulder complex. Overhead work is considered as one of the most predominant causes of rotator cuff injuries. The workers in construction, automotive, and aerospace industries are routinely exposed to overhead exertions. Elimination of overhead work is nearly impossible due to various task and technology constraints. Therefore, appropriate intervention strategies based on the engineering and administrative controls opt to be used to prevent the hazardous impact of overhead exertions. The objective of …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Multimorbidity, Immune Checkpoint Inhibitor Use, And Healthcare Expenditures Among Older Patients With Late-Stage Melanoma, Pragya Rai

Graduate Theses, Dissertations, and Problem Reports

With decades of unchanged cancer care with no added survival benefit, immune checkpoint inhibitors (ICI) changed the treatment landscape of late-stage melanoma in 2011. A key factor in determining the use of ICIs is the presence of pre-existing chronic conditions, which can influence the outcome. However, the prevalence of multimorbidity (defined as presence of two or more chronic conditions) among older patients with late-stage melanoma remains unknown. It also remains unknown if the presence of multimorbidity factors into the use of ICIs. Hospital-related factors associated with ICI use have been studied. Yet, patient-level factors, such as age, sex, marital status, …

Quality Improvement Of Substance Misuse Screening Of Older Adults In Primary Care Using Evidence-Based Training, Kelly Lopez

Graduate Theses, Dissertations, and Problem Reports

Background

The largest increase in preventable overdose deaths from 1999-2017 occurred among adults 50 and older, yet substance misuse among older adults is often not screened for or recognized in primary care settings. This oversight has been attributed to many factors, including age-related biases, unrecognized psychosocial and physiological differences, stigmatization, and a rapidly growing geriatric population.

Objectives

A quality improvement program using evidence-based educational training was implemented in a primary care setting with the intention to expand care knowledge and ultimately improve screening practices of older adults, especially those suffering from substance misuse.

Design

This quality improvement (QI) project used …

Integrating The Natural Healing Process For Post-Traumatic Stress Disorder Treatment In Veterans Through A Healing Garden., Taiwo A. Ajibade

Graduate Theses, Dissertations, and Problem Reports

In 2002, several ex-service personnel brought a court case against the Ministry of Defense for the inability to identify PTSD issues at an early stage and to provide support and effective treatment (Langston et al. 2007). Also in recent times, reports have suggested that US marine and army infantry units returning from duty in Iraq and Afghanistan have a higher level of expected proportions of mental disorders and that about 10% of personnel are returning home are with symptoms of post-traumatic stress disorder (Smith et al., 2008). This discovery made it pertinent to look for natural ways to assist veterans …

Association Of Common Chronic Pain Conditions To Incident Alzheimer’S Disease And Related Dementias In Two Cohorts Of Older Medicare Beneficiaries, Sumaira Khalid

Graduate Theses, Dissertations, and Problem Reports

Objective: The purpose of this research was to study the collective and incremental association of common non-cancer chronic pain conditions (NCPC) to risk for Alzheimer’s disease and related dementias (ADRD); to explore the potential mediating influence of mood and sleep disorders; and to assess the potential synergistic effects of NCPC’s and multimorbidity on ADRD risk. This research also aimed to study the contribution of NCPC to ADRD risk in poor, rural, underserved United States populations who suffer a disproportionate burden of ADRD risk factors. To achieve these goals, this dissertation pursued three specific aims: 1) assess the association of …

Fracture Resistance Of Simulated External Cervical Resorption In Anterior Teeth Restored With And Without A Fiber Post., Michelle M. Romeo

Graduate Theses, Dissertations, and Problem Reports

Introduction: External cervical resorption (ECR) is a destructive type of external resorption that can be difficult to treat. ECR usually begins subgingival at the cementoenamel junction of teeth and continues apically and circumferentially. This substantial loss of tooth structure may make these teeth more prone to fracture and should be addressed when treatment planning teeth with ECR. The aim of this in vitro study was to evaluate the fracture resistance of treated and non-treated teeth with simulated ECR using two different treatment modalities.

Materials and Methods: Forty-eight extracted human permanent mandibular central incisors were selected. Teeth were randomly divided into …

Applications Of Machine Learning Methods In Health Outcomes Research: Heart Failure In Women, Khalid Abdullah Alhussain

Graduate Theses, Dissertations, and Problem Reports

There is robust evidence that heart failure (HF) is associated with substantial mortality, morbidity, poor health-related quality of life, healthcare utilization, and economic burden. Previous research has revealed that there are sex differences in the epidemiology, etiology, and disease burden of HF. However, research on HF among women, especially postmenopausal women, is limited. To fill the knowledge gap, the three related aims of this dissertation were to: (1) identify knowledge gaps in HF research among women, especially postmenopausal women, using unsupervised machine learning methods and big data (i.e., articles published in PubMed); (2) identify emerging predictors (i.e., polypharmacy and some …