Digital Commons Network^™

Discriminating Between Technical And Global Competence In Cbt Programs For Youth Anxiety, Jennifer Cecilione

Theses and Dissertations

Therapist competence refers to the skillfulness and responsiveness demonstrated when delivering an intervention and is an important factor to consider in the training and evaluation of therapists. However, competence research is sparse, especially in the youth psychosocial treatment field. A primary discrepancy is whether technical (related to interventions associated with a specific treatment program) and global (general clinical expertise) competence can be measured as distinct dimensions of competence. The goal of the current study was to determine whether instruments of technical (Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale; CBAY-C; McLeod et al., 2018) and global (Global Therapist Competence Scale …

Understanding Structure-Activity Relationship Of Synthetic Cathinones (Bath Salts) Utilizing Methylphenidate, Barkha J. Yadav

Theses and Dissertations

Synthetic cathinones are stimulant drugs of abuse that act at monoamine transporters e.g. the dopamine transporter (DAT) as releasing agents or as reuptake inhibitors. More than >150 new synthetic cathinones have emerged on the clandestine market and have attracted considerable attention from the medical and law enforcement communities.

threo-Methylphenidate (tMP) is an FDA approved drug for the treatment of ADHD and narcolepsy, which also acts as a DAT reuptake inhibitor and is widely abused. tMP and synthetic cathinones share some structural similarities and extensive structure-activity relationship (SAR) studies on tMP have been conducted. However, much less is known about the …

Trauma Related Drinking To Cope: A Phenotypic And Molecular Genetic Investigation Of The Self-Medication Model, Sage E. Hawn

Theses and Dissertations

Posttraumatic stress disorder (PTSD) and alcohol use problems (AUP) commonly co-occur, have shared latent genetic risk, and are associated with many negative public health outcomes. Via a self-medication framework, trauma-related drinking to cope (TRD), an unexplored construct to date, may help explain why these two disorders co-occur, thus serving as an essential target for treatment and prevention efforts. The present study aimed to create a novel measure of TRD and examine its psychometric properties, investigate its indirect influences on the association between PTSD and AUP, as well as explore its potential shared molecular genetic risk with PTSD in a genetically-informative …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

The Anaplasma Phagocytophilum Adhesin Asp14 Directs Pdi-Mediated Disulfide Reduction To Promote Infection, Ryan S. Green

Theses and Dissertations

Obligate intracellular pathogens must invade host cells to survive and pose a global health risk. As such, internalization is a critical life stage and represents an excellent therapeutic target. Oxidoreductase exploitation is a thematic invasion strategy among obligate intracellular pathogens. Delineating the mechanisms and proteins mediating this exploitation could identify novel therapeutic targets for many important pathogens. Anaplasma phagocytophilum infects neutrophils by an incompletely defined mechanism, resulting in the emerging potentially fatal disease, human granulocytic anaplasmosis. The bacterial adhesin, Asp14, contributes to invasion by virtue of its C-terminus engaging an unknown receptor. Yeast two-hybrid analysis identified protein disulfide isomerase (PDI) …

Regorafenib Enhances Lethality Of Sildenafil And Curcumin In Colorectal Cancer Cells, Kervin Benjamin Owusu

Theses and Dissertations

In the United States, more than 130,000 people will be diagnosed with colorectal cancer (CRC) each year and an estimated 50,000 people will die from the disease. Standard of care (SOC) therapies for CRC combine multiple cytotoxic chemotherapeutic drugs. These combinations have varying degrees of effectiveness and can often result in significant patient morbidity. For second recurrence patients, the multi-kinase inhibitor, regorafenib, is an approved agent, but is often poorly tolerated at current doses. In the current study, we propose to develop therapeutic regime of combining agents with modest toxicity profiles: curcumin and sildenafil with regorafenib. Using clinically achievable enterohepatic …

Pharmacologic Profiling Of Novel Compounds Via Fluorometric Analyses Of Monoamine Transporter Responses, Ashkhan Hojati

Theses and Dissertations

In humans and other organisms, monoaminergic systems are crucial in neuronal function and behavior. The monoamine transporters (MATs), which can be found on the presynaptic plasma membrane of neurons in the central nervous system (CNS), are crucial in the regulation of neurotransmitter concentration in the synaptic cleft. As the duration and concentration of neurotransmitters in the cleft affect further downstream signaling responses, these proteins are important targets for both understanding neuronal physiology and compounds of interest. Multiple theories exist proponing the contribution of MATs to a variety of mental and neurological disorders, including depression. This theory establishes that depression is …

Examining Biobehavioral Variables And Predictors Associated With Type 2 Diabetes Self- Management, Karin A. Emery

Theses and Dissertations

Type 2 diabetes mellitus self-management is a challenging process that brings forward a variety of emotional responses. The purpose of this work was to explore relationships between diabetes distress, self-efficacy and resilience and outcomes of glycosylated hemoglobin, quality of life and health status. A cross sectional descriptive design was used for this pilot study of 78 individuals enrolled from an Endocrine clinic in the Midwest United States and a Primary Care clinic in the southeast United States.

Data were analyzed using descriptive statistics to characterize the sample and model variables. Spearman’s correlation was completed to identify relationships among variables. A …

Inhibition Of Cancer Stem Cells By Glycosaminoglycan Mimetics, Connor P. O'Hara

Theses and Dissertations

Connor O’Hara July 29, 2019

Inhibition of Cancer Stem Cells by Glycosaminoglycan Mimetics

In the United States cancer is the second leading cause of death, with colorectal cancer (CRC) being the third deadliest cancer and expected to cause over 51,000 fatalities in 2019 alone.¹ The current standard of care for CRC depends largely on the staging, location, and presence of metastasis.² As the tumor grows and invades nearby lymph tissue and blood vessels, CRC has the opportunity to invade not only nearby tissue but also metastasize into the liver and lung (most commonly).³ The 5-year survival rate …

Role Of Glial Ccr5 In Mediating Hiv-1 Tat And Opiate Neurotoxicity And Behavioral Phenotype, Sarah Kim

Theses and Dissertations

Human immunodeficiency virus type 1 (HIV-1) persists in certain CNS cell populations, despite peripheral control of the infection with modern antiretroviral therapy. Infected and/or activated cells release viral proteins, such as trans-activator of transcription (Tat) and various pro-inflammatory factors such as CCL5, creating a positive loop of neuro-inflammation. This serves as the basis for the resulting sublethal and lethal neuropathology that manifests as a spectrum of HIV-mediated CNS impairments, known as HIV-associated neurocognitive disorders (HAND). Opiates, which exist as an interlinked epidemic with HIV-1 infections, exacerbate these neurological effects through direct and indirect mechanisms that disrupt both glial and neuronal …

Structural Determinants Of High Potency Mdpv Inhibition Of The Dopamine Transporter, Tyler Steele

Theses and Dissertations

Monoamine transporters (MATs) are a unique group of neurotransmitter transporters that include the dopamine, serotonin, and norepinephrine transporters (DAT, SERT, and NET, respectively). MATs are a target for a number of licit and illicit compounds. The significance of this work lies in the fact that these transporters share affinity for certain ligands to varying degrees, but the structural features within the transporters that govern the observed selectivity for these ligands has not been completely determined. One such ligand is methylenedioxypyrovalerone (MDPV), which was frequently found in “bath salts” preparations that were available in convenience stores and were sold with “not …

University President Compensation: A Complex Examination Of Its Determinants And Consequences, Sheila Keener

Theses and Dissertations

This dissertation examined the controversy surrounding the high levels of compensation paid to university presidents. To do this, the first half of this dissertation includes a systematic review of the existing literature regarding the relation between university performance and university president compensation in nonprofit universities. The second half of this dissertation attempts to replicate the findings from the systematic review with more current data. Several gaps identified in the literature, including the effects of analyzing specific compensation components, the effect of university president compensation on subsequent university performance, potential nonlinear relations, and how relations between university performance and university president …

The Role Of Psychosocial And Health Behavioral Factors In Pregnancy Induced Hypertension, Sylvia Sreeparna Rozario

Theses and Dissertations

Background: Pregnancy induced hypertension (PIH) is the leading cause of maternal mortality and a major contributor to preterm birth and neonatal mortality. Literature suggests that several modifiable psychosocial and health behavioral factors may play significant roles in the development of PIH. However, interrelationships among these factors and their collective impact on PIH are not well understood.

Objectives: This study aims to: 1) Examine the relationship between pre-pregnancy physical activity and risk of PIH, 2) Determine the association between prepregnancy depression and PIH and the role of race/ethnicity in this association, 3) Evaluate the association between intimate partner violence (IPV) in …

Predictors Of Employment In A Treatment Sample Of Individuals With Substance Use Disorders, Enkelejda Ngjelina

Theses and Dissertations

Efforts to increase employment rates through vocational skills training and job interview skills development have yielded mixed results. While initial studies of Job Seekers Workshop (JSW) found greater employment success for participants randomized to JSW as compared to a control condition (Hall, Loeb & Norton, 1977), a more recent Clinical Trials Network (CTN) study found no differences in employment outcomes between the JSW and control groups and the rate of employment overall was substantively lower than those reported in the early studies (Svikis et al., 2012). To better understand these discrepant findings, the present study conducted secondary analyses using the …

The Effects Of Long-Term Deafness On Density And Diameter Of Dendritic Spines On Pyramidal Neurons In The Dorsal Zone Of The Feline Auditory Cortex, Rachel J. Bauer

Theses and Dissertations

Neuroplasticity has been researched in many different ways, from the growing neonatal brain to neural responses to trauma and injury. According to recent research, neuroplasticity is also prevalent in the ability of the brain to repurpose areas that are not of use, like in the case of a loss of a sense. Specifically, behavioral studies have shown that deaf humans (Bavalier and Neville, 2002) and cats have increased visual ability, and that different areas of the auditory cortex enhance specific kinds of sight. One such behavioral test demonstrated that the dorsal zone (DZ) of the auditory cortex enhances sensitivity to …

Engineering High Reaction Economy Or, An Intensification/Scoring Program For The Preparation Of Simple And Complex Molecules, Caleb J. Kong

Theses and Dissertations

Success of newly discovered chemistry in academia is often scored in terms of its novelty and level of scholarship. In industrial settings, cost, safety and quality are often times the ruler by which new processes are measured. Our group has identified that there is a gap between these two measures of success and has sought to develop principles in order formalize an approach to synthetic strategy and developing ready-to-implement manufacturing processes for molecules, simple and complex.

Some of these principles include (1) the development and application of new chemical methods and reactor technologies (2) recognition of globally amenable chemical environments …

Incidence And Predictor Variables Of Pressure Injuries In Patients Undergoing Ventricular Assist Device And Total Artificial Heart Surgeries: An Eight-Year Retrospective Review, Christopher T. Brindle

Theses and Dissertations

BACKGROUND

Cardiac surgery patients have some of the highest reported incidence and prevalence of pressure injuries (PI). A growing subset of cardiac surgery include patients with end-stage heart failure who undergo ventricular assist device (VAD) or total artificial heart (TAH) surgery. The risk of PI and their natural history of development in this population are unknown and the specific risk factors for PI development remain unexplored.

OBJECTIVES

To perform a systematic review of the literature to identify the incidence and risk factors of PI development in patients undergoing VAD-TAH surgery and thereby inform study design and variables in an eight-year …

Conceptualization Of Body Image And Eating Disorders Among South Asian American Women: A Qualitative Investigation, Neha J. Goel

Theses and Dissertations

Though it is known that eating disorders (EDs) affect individuals of all racial/ethnic backgrounds (Cheng, Perko, Fuller-Marashi, Gau, & Stice, 2019), people of color tend to be overlooked in the ED literature. South Asian Americans, a specific subset of individuals traditionally categorized within the larger umbrella group of “Asians,” have been notoriously neglected in both the broader mental health literature, and in the ED literature (Inman, Devdas, Spektor, & Pendse, 2014; Iyer & Haslam, 2003, 2006). Currently, very little information exists on the etiology and presentation of EDs amongst South Asian communities. Even less is known about culturally-specific barriers to …

Chemical Characterization Of Pseudognaphalium Obtusifolium By Gas Chromatography - Mass Spectrometry (Gc-Ms) To Assess Potential Therapeutic Phytochemicals And Toxicological Concerns Using Simulated Use Conditions, Regina Ballentine

Theses and Dissertations

Chemical Characterization of Pseudognaphalium obtusifolium by Gas Chromatography – Mass Spectrometry (GC-MS) to Assess Potential Therapeutic Phytochemicals and Toxicological Concerns Using Simulated Use Conditions

By Regina Ballentine

Virginia Commonwealth University, 2019

Director: Sarah C. Rutan, Professor, Department of Chemistry

Currently, there is an increasing demand for natural therapies and herbal products to treat various ailments. It is generally believed that natural therapies have fewer side-effects than traditional western medicine; however, they are often used in different strengths and formulations without consistency of the levels of target compounds or knowledge about toxicity. Due to this growing trend, a comprehensive chemical evaluation …

Using Lipidomics To Characterize The Inflammatory Mechanisms In Sepsis And Pre-Eclampsia, Daniel Stephenson

Theses and Dissertations

Lipidomics, a rapidly developing field of study, focuses on the classification and quantitation of lipid species. Lipidomics has emerged in the forefront of scientific research due to the key roles that lipids play in metabolism, cancer, and disease. Using mass spectrometry as a tool for analysis, understanding the role eicosanoids and sphingolipids play has advanced rapidly. Being able to observe these small molecules in vivo has led to better understanding of several lipid-driven mechanisms and identification of eicosanoid and sphingolipid biomarkers in neurodegenerative disease, cancer, sepsis, wound healing, and pre-eclampsia. In the studies herein, we developed targeted mass spectrometric methods …

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 …

Bayesian Nonparametric Analysis Of Longitudinal Data With Non-Ignorable Non-Monotone Missingness, Yu Cao

Theses and Dissertations

In longitudinal studies, outcomes are measured repeatedly over time, but in reality clinical studies are full of missing data points of monotone and non-monotone nature. Often this missingness is related to the unobserved data so that it is non-ignorable. In such context, pattern-mixture model (PMM) is one popular tool to analyze the joint distribution of outcome and missingness patterns. Then the unobserved outcomes are imputed using the distribution of observed outcomes, conditioned on missing patterns. However, the existing methods suffer from model identification issues if data is sparse in specific missing patterns, which is very likely to happen with a …

Development Of Bivalent Ligands Targeting The Putative Mu Opioid Receptor And Chemokine Receptor Cxcr4 Heterodimer, Bethany A. Reinecke

Theses and Dissertations

Human immunodeficiency virus (HIV) and opioid abuse have been described as synergistic epidemics. Pharmacologically, it has been found that opioids have the capacity to enhance HIV infection and replication. Research has shown that activation of the mu-opioid receptor (MOR) elevates the expression of the HIV-1 entry co-receptor CXCR4 on T-lymphocytes in the peripheral nervous system, thus allowing for enhanced viral entry and invasion. Although the exact mechanism for opioid modulation of CXCR4 expression and subsequent exacerbation of HIV is unknown, several hypotheses exist. One hypothesis is that MOR and CXCR4 are functionally interacting through the formation of a heterodimer. This …

Social Influences On Racial Identity, Perceived Social Support, And Mental Health Among Black College Students, Sultan A. Hubbard

Theses and Dissertations

The first goal for the study was to estimate trait effects and social influences for racial centrality, racial private regard, and racial public regard. The second was to estimate correlational relationships between racial identity, depression, and anxiety symptoms. The study used 110 Black university students (M_age=19.5,SD=4.13) from a southeastern American university. Restricted maximum likelihood estimation was conducted to estimate variance components for all constructs. Racial centrality, racial private regard, and racial public regard consisted of mostly trait effects, although reflecting substantial social influences. Correlational findings indicated that providers who evoked high racial centrality also evoked …

Glial Cell Mechanisms Regulate Alcohol Sedation In Drosophila Melanogaster, Kristen M. Lee

Theses and Dissertations

Approximately 16 million people in America are diagnosed with Alcohol Use Disorder (AUD) but no efficacious medical treatments exist. Alcohol-related behaviors can be studied in model organisms, and changes in these behaviors can be correlated with either (i) a risk for alcohol dependence or (ii) a symptom/feature of AUD itself. Although AUD is a disease of the central nervous system, a majority of research has focused on the neuronal underpinnings, leaving glial contributions largely undescribed. We used Drosophila melanogaster (fruit fly) to identify genes whose expression in glia regulates alcohol sedation. Mammals and Drosophila have conserved behavioral responses to alcohol …

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. …

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 …

Evaluating Predixcan’S Ability To Predict Differential Expression Between Alcoholics And Non-Alcoholics, John E. Drake Jr

Theses and Dissertations

PrediXcan is a recent software for the imputation of gene expression from genotype data alone. Using an overlapping set of transcriptome datasets from postmortem brain tissues of donors with alcohol use disorder and neurotypical controls, which were generated by two different platforms (e.g., Arraystar and Affymetrix), and an additional unrelated transcriptome dataset from lung tissue, we sought to evaluate PrediXcan’s ability to impute gene expression and identify differentially expressed genes. From the Arraystar platform, 1.3% of matched genes between the measured and imputed expression had a Pearson correlation ≥ 0.5. Our attempt to replicate this finding using the expression data …

Work-Life Factors That Impact Job Burnout And Turnover Intention Among Athletic Academic Support Professionals, Jennifer Gellock

Theses and Dissertations

The purpose of the current study was to investigate factors in the work environment that impact job burnout among academic support professionals who work with college student-athletes. Specifically, the factors of job control match, fairness march, rewards match, and workload match were explored. Additionally, the extent to which emotional exhaustion and depersonalization had an effect on turnover intention was explored. Job burnout has been found to have negative impacts on professionals in human services professions. The sample consisted of academic advisors and learning specialists affiliated with National Collegiate Athletic Association (NCAA) Division I programs. Results suggest academic support professionals experience …

Antinociceptive Tolerance To Morphine Is Driven By Colonic Inflammation And Mediated By Peripheral Opioid Receptors, Essie S. Komla

Theses and Dissertations

Opioids are powerful analgesics. Despite their high efficacy for the management of moderate to severe pain, their clinical utility is limited due to the occurrence of adverse effects. The main problem associated with opioid use is the differential rate of tolerance development to the various pharmacological effects of opioids, with tolerance to respiratory depression occurring at a slower rate than analgesic and euphoric effects. The development of analgesic tolerance, where the efficacy of the drug progressively diminishes with repeated administration, requires higher doses of the drug to achieve a maximum effect. Reports have implicated inflammation as a major driver of …