Digital Commons Network^™

The Clinical Inquiry Process Diagram (Version 4), Roy E. Brown

VCU Libraries Faculty and Staff Publications

The purpose of the diagram is to provide a clear understanding of the clinical inquiry process and to highlight the similarities and differences between research, performance improvement, and evidence-based practice. While it is not meant to be comprehensive, it serves as a tool to facilitate a shared understanding of when a particular question may lead to one of these three areas of clinical inquiry.

The author would like to acknowledge the following for their ideas and willingness to provide feedback to improve this latest version of the diagram.

• Kady Martini, DNP, RN, EBP-CH, NEA-BC (The Ohio State University School of …

The Cultural Diplomacy Of U.S. Peace Corps: Understanding The Role Of Peace Corps Volunteers As Strategic Geopolitical Assets, Corey B. Miles

Theses and Dissertations

Beginning in the Summer of 1961, the United States government has deployed volunteer humanitarians around the world to serve the mission of U.S. Peace Corps and has since contributed to communities in 143 partner countries while enjoying widespread popularity. Its mission of promoting world peace and friendship is pursued through three operational goals: technical training, cultural exportation, and cultural importation. Since 2016, with the election of U.S. President Donald Trump, and continuing through the Covid-19 pandemic, which produced the first global service interruption in agency history, the value of the Peace Corps service model has been fundamentally challenged. As a …

Risk And Resilience: An Exploration Of Adverse Childhood Experiences, Protective Factors, And Internalizing Symptoms In Black Youth, Irene A. Jacobs

Theses and Dissertations

The study examines mechanisms of risk and resilience that influence the psychological well-being of Black youth. Previous literature has established a link between adverse childhood experiences (ACEs) and mental health outcomes in youth (Kerker et al., 2015; Thakur et al., 2020). A substantial amount of the ACEs literature solely focuses on risk factors (e.g., mental impairment, low SES, health risk behaviors) for poor outcomes associated with ACEs. Despite Black youth experiencing high rates of ACEs (Liu et al., 2019), the ACEs literature examining mechanisms of their resilience is sparse (Meeker et al., 2021). Given the state of the ACEs literature, …

Probing The Porphyromonas Gingivalis Nitrosative Stress Response Network, Alexandra Galina

Theses and Dissertations

Objective: To persist in the oral cavity, the perio-pathogen Porphyromonas gingivalis must have an efficient nitrosative stress response mechanism. To better understand how P. gingivalis responds to nitrite (NO₂^-) we must determine what genes are involved in the nitrosative stress response network.

Methods: Through genomic screening, a list of genes was generated that were hypothesized to be part of the nitrosative stress response network and believed to be involved in nitrate/nitrite metabolism or redox state of the cells. Protein coding regions were replaced with the ermF sequence by allelic exchange mutagenesis. 15 mutants were created …

Crafting Community: A Ceramics Center, Nadia Mechboukh

Theses and Dissertations

For artisans, being part of a community can facilitate engaging with the public. Networking and collaborating with peers are vital for building meaningful relationships that can lead to mutual inspiration and learning opportunities. By strengthening the connection between society and various forms of craft, we can weave invisible threads that link the stories that craft tells with the time and place in which they were created. Pottery is a craft that has existed for thousands of years. Ceramics and clay have carried the history of communities and their ways of living through centuries and have been used as identifiers of …

A Theory Of General Relativity, Madeleine Mae Morris

Theses and Dissertations

"A Theory of General Relativity" is a quiet exploration into the poetic and scientific ways we inhabit space and time. This work is a manifestation of the time I spent being my grandmother's caretaker and exists now in the form of an artist book, an exhibition of framed photographs with glass objects, and this written thesis. Throughout those five years, I became consumed by the relationships between Mothers and Daughters, which brought into excruciatingly sharp focus seemingly simple questions like: who are we, what have we done to each other, what do we owe to each other, do I reap …

Sustaining Breaths For Restorative Rest: A Preliminary Evaluation Of Sleep, Mental Health, And Cognitive Function Following Hypoglossal Nerve Stimulation For Obstructive Sleep Apnea, Elliottnell Perez

Theses and Dissertations

Introduction: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that produces repetitive obstruction or collapse of the upper airway. Positive airway pressure (PAP) therapy is the gold standard treatment for OSA. Hypoglossal nerve stimulation (HNS) is considered an alternative treatment for patients who are unable to tolerate PAP therapy. The purpose of the study was to examine sleep, mental health, and cognitive health outcomes before and after HNS to determine its viability as an alternative treatment.

Methods: The study utilized a single-group, pretest-posttest design. Objective and subjective sleep was measured using actigraphy, sleep diary, and questionnaires. Objective and subjective …

Machine Learning Models To Automate Radiotherapy Structure Name Standardization, Priyankar Bose

Theses and Dissertations

Structure name standardization is a critical problem in Radiotherapy planning systems to correctly identify the various Organs-at-Risk, Planning Target Volumes and `Other' organs for monitoring present and future medications. Physicians often label anatomical structure sets in Digital Imaging and Communications in Medicine (DICOM) images with nonstandard random names. Hence, the standardization of these names for the Organs at Risk (OARs), Planning Target Volumes (PTVs), and `Other' organs is a vital problem. Prior works considered traditional machine learning approaches on structure sets with moderate success. We compare both traditional methods and deep neural network-based approaches on the multimodal vision-language prostate cancer …

Community On Campus: Examining The Impact Of Campus Climate, Belonging, And Flourishing On Bystander Behavior Among Diverse University Students, Amelia Liadis

Theses and Dissertations

This exploratory, nonexperimental study aimed to investigate the relationships among diverse undergraduate and graduate students’ perceived campus climate, flourishing, and university belonging on bystander intentions and bystander behaviors during the COVID-19 pandemic. The study’s theoretical framework combined the Theory of Planned Behavior and feminist theory, and examined intersectionality through an Identity Risk Index. Data used in the current study were originally collected as part of an institutional Healthy Minds Survey, on health behaviors of college students; responses from n = 171 of the randomly selected participants were used in the current study’s analyses. The majority of participants indicated at least …

Supporting Students Who Are Deafblind To Increase Their Access To The General Education Curriculum Through Trained Interveners: A Mixed Methods Study, Ira Padhye

Theses and Dissertations

The purpose of this mixed-methods research study was to identify the educational trends of children and young adults who are deafblind and identify strategies to improve the outcomes through interviews of nationally qualified interveners who have received training in deafblind specific strategies. Secondary data from the 2017-2021 National Center on Deafblindness and interview transcripts were used for data analysis and then integrated to identify the supports students who are deafblind should access. Trends in age of identification, primary eligibility category, school settings and access to state standardized assessments showed a plateau and displayed no significant improvement in educational outcomes. Nationally …

The Promis Women Education Program: Promoting Cervical Cancer Prevention Methods Among Muslim Women In Virginia, Asmaa M. Namoos

Theses and Dissertations

Abstract

Purpose: US Muslim women have suboptimal participation in cervical cancer screening and prevention services. This is due in part to a lack of access to culturally relevant education programs. To address this issue three aims were identified: Aim 1. Adapt existing evidence- based educational materials for a religious and culturally appropriate intervention; Aim 2. Test the preliminary efficacy of the intervention and Aim 3. Assess the feasibility and acceptability of the intervention and materials.

Methods: The ORBIT model for developing behavioral interventions guided intervention design, refinement (Phase I), and preliminary testing (Phase II). Focus groups and interviews were conducted …

Dermatoses Of The Breast During Lactation, Divya Shan, Sindhuja Koppu, Valerie Coleman, Gauri Gulati, Kimberly Salkey

Open and Affordable Course Content at VCU

No abstract provided.

Dermatologic Manifestations Of Rheumatic Disease: Malignant Cutaneous Tumors, Divya Shan, Julianna S. Kang, Allison Cinats, Julia R. Nunley, Beth Rubinstein

Open and Affordable Course Content at VCU

No abstract provided.

The Compass, Summer 2023

The Compass, 2018-

The Compass is an annual orientation guide for VCU students produced by the Student Media Collective in the VCU Student Media Centered. The guide is distributed physically during summer orientation sessions for new and transfer students. The publication includes short articles, illustrations, letters of welcome from students and administrators, comics, and advertisements from VCU and Richmond organizations.

Underrepresentation Of Black Participants In Drug Court: Reasons Reported For Non-Admission In Six Jurisdictions, Kathryn J. Genthon

Theses and Dissertations

Despite the beneficial impacts of drug court participation, access to these programs may not be equitable across racial groups. The reasons behind racial disparities in access to these programs are not well-documented in the current literature. This study investigates disparities in access to drug court and the possible reasons they occur. Chi-square tests are used to assess for disparities in admissions between Black and White individuals referred to drug court. Additional statistical analyses addressed the association of sex and age with admission to provide a broader picture of the impact of a variety of demographic characteristics on admission to drug …

Sense Of Belonging As Behaviorist Construct: “Doing Belonging” And Its Application For College Students With Disabilities, Chris Parthemos Phd

Theses and Dissertations

Sense of Belonging has been widely linked to academic performance, retention and persistence for college students. Students with disabilities are less likely to enroll than peers, and are more likely to drop out. Similar to other historically-marginalized groups, these students report lower sense of belonging than peers. Research with this population suggests that they may be seeking ways of building community and belonging at their universities which are self-driven. This notion of “doing belonging”, as it is described in the sociological literature, appears at first glance to be compatible with behaviorist approaches to student support. Although not without controversy, behavior …

Activity Levels Of Different Cell Types In An Epileptogenic Model Of Cortical Microgyria: A Cfos Investigation, Peter F. Lamothe

Theses and Dissertations

A large percentage of individuals with intractable epilepsies have an accompanying cortical malformation, the underlying cellular mechanisms of which are not fully understood. In an animal model for one such malformation, polymicrogyria, epileptogenesis occurs most easily in a region of tissue just adjacent to the microgyria termed the paramicrogyral region (PMR). Previous studies implicate somatostatin containing interneurons (SOM) as a potential contributor to this pathology, and show increased excitation of SOM in the PMR. We hypothesis that SOM are more active in the PMR when compared to SOM within the homologous region of the control cortex. In addition to this …

Formation Of Vasculogenic Mimicry: Role Of Melanoma Differentiation Associated Gene-9 In Human Melanoma, Jinkal Shah

Theses and Dissertations

Malignant melanoma (MM) is the most aggressive skin cancer and the most frequent skin disorder in Caucasians. MM is associated with aggressive and progressive disease states, leading to major cancer-related morbidity and mortality. Recent investigations identify an alternative pathway -vasculogenic mimicry (VM), which is considered a cancer hallmark that can independently facilitate tumor neovascularization by the formation of fluid-conducting and vascular endothelial cells. MM cells undergoing VM can dedifferentiate into numerous cellular phenotypes and acquire endothelial-like features, resulting in the formation of the de novo matrix-rich vascular-like networks, such as plasma and red blood cells. The co-generation of endothelial cells, …

Incorporating A Developmental Perspective Into Gene Identification Models For Alcohol Use Behaviors, Nathaniel S. Thomas

Theses and Dissertations

Frequent alcohol use can lead to alcohol use disorder, which accounts for three million deaths and over 133 million life years lost to disability and death worldwide per year. Alcohol use behaviors unfold across development, beginning with initiation of drinking and progressing through various escalating stages of use. Alcohol use behaviors are also under genetic influence. Genome-wide association represents the state-of-the-science statistical methodology for identifying genes associated with alcohol use outcomes. However, contemporary genome-wide association study (GWAS) methods typically do not account for variability in genetic effects throughout development. In this project, I applied novel multivariate genomic methods to combine …

Exploring The Effect Of Early Motor Delay And Physical Therapy Interventions On The Parent-Child Relationship, Rebecca Molinini

Theses and Dissertations

Emotional availability (EA) or the ability of the parent-child dyad to engage emotionally and partake in congruent and mutually enjoyable interactions, is essential for familial health and well-being. EA is considered the “connective tissue” of healthy parent-child relationships and is associated with secure attachment, maternal mental health, and children’s adaptive development. Most evidence supporting the integral role of EA on healthy outcomes is supported by typically developing populations in which adults present with a social or biological risk factor such as experiencing past traumas of adversities with mental health. In line with the transactional model of development, children are equal …

Examining Psychosocial Factors Of Chronic Disease Control To Improve Outcomes For Patients With Multiple Chronic Conditions, Kristen O'Loughlin

Theses and Dissertations

Psychosocial needs are associated with worse health outcomes for patients with multiple chronic conditions (MCC). The Biopsychosocial Model provides a framework for conceptualizing the influence that psychosocial factors have on the management of disease. To date, research has primarily focused on examining the relation between psychosocial factors and chronic disease onset. Therefore, the temporal relation between psychosocial factors and disease management remains poorly understood. The current study aimed to 1) describe patients’ psychosocial needs and their prioritization, 2) examine reciprocal relations between anxious symptoms, depressive symptoms, social needs, and MCC management, and 3) qualitatively explore patient definitions of health in …

Age-Associated Collagen Crosslinking And Its Role In Skeletal Muscle Regeneration, Lucas C. Olson

Theses and Dissertations

Advanced glycation end-products (AGEs) non-enzymatically accumulate on skeletal muscle collagen in old age via the Maillard reaction, causing an increase in intramuscular collagen and a stiffening of the muscle’s microenvironment. AGEs abrogate muscle regeneration through stiffening the muscle stem cell (MuSC) microenvironment and by binding to the receptor for advanced glycation end products (RAGE). Stiffer substrates promote MuSC proliferation at the expense of differentiation, and soluble AGEs are known to abrogate myogenic differentiation. Previously our group has demonstrated that decellularized muscle matrix (DMM), a type of extracellular matrix (ECM) scaffold extracted from skeletal muscle, encourages regeneration in a challenging rat …

Evaluation Of Cytokeratin-Specific Antibody And Autofluorescent Signals As Predictors Of Time Since Deposition For Saliva Samples, Dillon Ryder

Master of Science in Forensic Science Directed Research Projects

In a forensic investigation, STR profiles generated from biological evidence can frequently be informative to identify an individual or provide an investigative lead. However, STR typing does not provide information to answer activity-level questions which can be highly important to a criminal case, such as the Time Since Deposition (TSD) of biological evidence. Determining the relative time in which a biological sample was left at a crime scene would provide additional information regarding the timeline of a crime and a person of interest’s relationship to the scene. One proposed method of estimating TSD is to use flow cytometry to analyze …

Bones As An Alternative Matrix For The Detection Of New Synthetic Opioids In Cold Cases: Introducing New Animal Models For Bone:Blood Correlation Studies, Kala N. Babb

Master of Science in Forensic Science Directed Research Projects

Introduction: The growing opioid epidemic in North America presents a call to action to develop new techniques for the identification and quantitation of novel synthetic opioids in uncommon matrices. In instances of extreme decomposition and/or significant scavenging, bone may be the only matrix available. In order to develop an extraction method for synthetic opioids in bone, bone samples were obtained from animal models. The animal model of choice is the rabbit due to their exhibition of spontaneous cortical bone remodeling, a process that is exhibited in humans but not in rats and mice.

Methods: An extraction method was developed to …

Investigation Into The Relationship Between Dna Content And Dna Yield Prediction And Presence Of A Multiple Contributor Cell Population In Trace Dna, Sarah Holton Roisch

Master of Science in Forensic Science Directed Research Projects

Due to advancements in DNA analysis technology and an increased ability to detect trace quantities of low template DNA, ‘touch’ or trace DNA has become a prevalent form of evidence for forensic investigations. Trace DNA is biological material left on a surface from skin cells after being touched or handled. The success rate of casework could be improved with new methods to non-destructively screen trace DNA to predict DNA yield and whether multiple cell populations are present in the evidence prior to STR analysis. Current methods of trace DNA analysis require quantifying the sample with qPCR followed by STR analysis, …

Comparison Of Cell Counts To Dna Yield In Mock Biological Evidence Samples, Jacob Sewell

Master of Science in Forensic Science Directed Research Projects

The implementation of rapid DNA analysis systems is of interest to forensic DNA casework, as this technology exhibits a sample-to-profile time of approximately two hours with limited handling of samples. This decreases the likelihood of contamination, and can potentially reduce DNA backlogs; however, current rapid DNA analysis systems do not execute one crucial step of the forensic DNA analysis workflow: human DNA quantitation. This step is necessary for DNA profiles to be compliant with the FBI’s Quality Assurance Standard 9.4, allowing DNA profiles to be uploaded and searched within the CODIS database. Coupling traditional qPCR methods with rapid DNA analysis …

Morphological And Autofluorescence Signatures For The Identification Of Vaginal Cells In Mixture Samples Containing Saliva And/Or Epidermal Cells, Hannah L. Burden

Master of Science in Forensic Science Directed Research Projects

In forensic casework the identification of body fluids at a crime scene can frequently play an important role in reconstructing the events that occurred. There are several bodily fluid identification methods to characterize unknown stains recovered as evidence. However, there has not been a reliable method for detecting the presence vaginal cells and/or differentiate it from other forensically relevant tissue types that may be recovered from a crime scene. The detection of vaginal fluid is important for forensic casework due to the abundance of sexual assault kits that are not only backlogged but continue to be submitted to the lab …

Amtrak Staples Mill Station: Strategic Vision Plan 2023, Daniel S. Longest

Master of Urban and Regional Planning Capstone Projects

This plan proposes the replacement of the current Amtrak Staples Mill Station with a new facility designed to incorporate civic art, multi-use development, and fast and easy train boarding. Drawing on successful examples like Union Station in D.C. and Main Street Station in Richmond, this plan encourages stakeholders to adopt a strategic vision for the station and its vicinity as an asset to the region. An independent commission with equal representation from state agency representatives and residents would enact these improvements through a public-private partnership, including a transit-oriented development scheme for adjacent land.

Putting The “U” In Shore U: Expanding Postsecondary Education On Virginia’S Eastern Shore, Katelyn D. Jones, Karen Belanger, Katharine Wise, Takeya Mclaurin

Doctor of Education Capstones

The University of the Eastern Shore of Virginia Foundation (Shore U) submitted a Request for Assistance to examine opportunities to expand postsecondary education on Virginia’s Eastern Shore. In response to this request, a doctoral research team conducted a mixed-methods study that explored potential pathways for a four-year degree option on the Eastern Shore. Eastern Shore Community College (ESCC) students, ESCC employees, and Eastern Shore community members were surveyed during the quantitative phase of the study. Secondary data was used to understand the postsecondary positionality of Eastern Shore high school students. The President of ESCC, Eastern Shore community members, and Virginia …

Assessing Graduate Student Needs And Structures Of Support At Virginia Commonwealth University, Trisha Saunders, Kiama Anthony Bishop, Herbert Hill Iii, Tameka Fitzgerald Burroughs

Doctor of Education Capstones

The purpose of this multi-case study was to explore how the institutional landscape is designed to support graduate student success at Virginia Commonwealth University (VCU), a large, public, urban, R1 research university. The study included review of existing literature on the various factors that contribute to or limit graduate student success at institutions across the country. A major aim of this study was to collect qualitative data from participants with a key stake in this issue, including enrolled graduate students, and faculty/staff supporting graduate (master’s and doctoral) programs at VCU. Participants included 39 graduate students and 23 institutional stakeholders. All …