Digital Commons Network^™

Ageism Among Healthcare Professionals: The Influence Of Personal Aging Anxiety, Job Role, And Work Setting On Attitudes Toward Older Patients, Jennifer L. K. Inker

Theses and Dissertations

Older adults make up a significant and increasing proportion of the U.S. population and are frequent users of healthcare services. Ageism in healthcare, driven by an incomplete and narrowly biomedical perspective on aging, has been linked to various problematic outcomes for older patients, including under- and over-treatment. The purpose of this study was to use the theory of relational ageism to explore the relationship between personal aging anxiety among healthcare professionals and their attitudes to older patients, considering the potentially moderating factors of job role and work setting. Using convenience sampling, clinical healthcare professionals working for a mid-sized, regional healthcare …

The Relationship Between Central Venous Catheter And Post-Operative Complications In Patients Undergoing Hepatic Resection, David C. O'Connor

Theses and Dissertations

The Relationship Between Central Venous Catheter and Post-operative Complications in Patients Undergoing Hepatic Resection

David C. O’Connor, Ph.D., DNAP, CRNA

A dissertation submitted in partial fulfillment of the requirements for the degree of

Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2018

Dissertation Chair: Clarence J. Biddle, Ph.D., CRNA

Hepatic resection is indicated for primary and secondary malignancies. Use of a low central venous pressure technique is associated with decreased blood loss in these cases. This technique has evolved; central venous catheters and high dose morphine are no longer used, and patients are extubated earlier. The purpose of …

Inpatient Utilization Of Computed Tomography: The Influence Of Market, Hospital, And Patient Characteristics, Michael Hanshew

Theses and Dissertations

The use of computed tomography (CT) in the care of patients has grown dramatically since its introduction over 30 years ago. The vast majority of the utilization research has focused on factors associated with the variable use in the outpatient and emergency department settings. This has left much of the inpatient use and variation understudied. This study has multiple aims. The first is to characterize the inpatient variation across multiple states and markets. The second is to evaluate the relationship between inpatient CT use and commercial payers across these areas. The third is to develop a model to evaluate the …

Impact Of Sensory Adapted Dental Environment On Children With Developmental Disabilities, Gail Kim

Theses and Dissertations

Purpose: This was a pilot study assessing the impact of a sensory adapted dental environment (SADE) on children with developmental disabilities (DD) receiving routine dental care.

Methods: A crossover study of 22 children with DD, aged 6 through 21, was conducted at Virginia Commonwealth University Pediatric Dental clinic. Each participant was randomized to a sequence of two dental cleanings, one regular dental environment (RDE) and one SADE with a 3-4-month recall. Outcomes included physiological measures (heart rate and oxygen saturation) and cooperation (Frankl scores).

Results: Study subjects completed a total of 36 visits. None of the physiological measures differed at …

A Survey Of Cannabis Consumption And Implications Of An Experimental Policy Manipulation Among Young Adults, Alyssa K. Rudy

Theses and Dissertations

The purpose of this online cross-sectional study was to identify cannabis user profiles by administration method and examine how differential cannabis policies influence intentions among young adults. Participants were assigned randomly to one of three hypothetical cannabis policy conditions (recreationally legal; medically legal; illegal). Within conditions, participants completed measures regarding cannabis use, including administration methods, cannabis attitudes, norms, perceived behavioral control, self-efficacy, and intentions. Latent class analysis (LCA) was used to determine sub-groups of past 30-day cannabis users by administration method followed by sub-group comparisons. Condition effects on intentions and associated variables were examined using ANCOVA. Four classes (Low-Blunt, Low-Bong, …

The Experiences Of School Counseling Directors In Relation To Job Satisfaction And Leadership, Robyn Walsh

Theses and Dissertations

The current literature on school counselor job satisfaction does not address the experiences of school counseling directors. This is a unique set of counselors due to their role as leaders and supervisors in the building. Therefore, this study sought to better understand the experiences of school counseling directors in relation to job satisfaction and leadership. The researcher collected data through 10 interviews with participants having met the criteria of serving as a school counseling director of a middle or high school, supervising a department of at least two counselors, and working in the role for at least two years. Data …

Directing Mesenchymal Stem Cells For Periodontal Regeneration, Charles Stoianovici

Theses and Dissertations

Background: Directing autogenous Mesenchymal Stem Cell (MSC) to defect sites has a great promise in bone regeneration. We designed a MSC specific, bone affinity peptide (E7HA7) by conjugating E7 with a polyglutamate hydroxyapatite (HA) binding motif. We sought to characterize the in-vivo releasing pattern and bioactivity of E7HA7. Methods: HA discs were coated with fluorescent labeled peptides E7HA7, E7HA2 or E7 were subcutaneously implanted in Sprague Dawley rats. In an ectopic bone formation model was used to test the in-vivo bioactivity of E7HA7 conjugated to DBM. Results: E7HA7 showed slower peptide release from scaffolds in comparison to other groups, being …

Usefulness Of The Captia Syphilis Igg Eia Test Method And Reverse Algorithm For Detection Of Syphilis Infection In A Public Health Setting, Patricia Armour

Theses and Dissertations

Syphilis, a systemic sexually transmitted disease, is on the rise in the US, with infection rates the highest recorded since 1994 according to the CDC. Useful laboratory testing is an important diagnostic tool for determining individual syphilis infection and preventing community-wide disease spread.

The purpose of this study was to determine the usefulness of a specific automated treponemal test method, the Captia^TM Syphilis IgG EIA, and the syphilis reverse algorithm interpretation for detecting syphilis infection among patients seeking care in a public health clinic. The study employed a retrospective, nonexperimental descriptive correlational design with data collected between 2012-2013 from …

The Effect Of Instrumentation Taper On Dentin Conservation, Megan E. Green

Theses and Dissertations

Introduction: The aim of this in vitro study was two part. The first being to assess and compare the amount of dentin removed by an instrument with a taper of 0.04 versus an instrument with a taper of 0.06 using the Edge Evolve® file system at different increments within the canal system. Secondly, this study evaluated whether instrumentation with either taper resulted in a remaining dentin thickness (RDT) of less than 0.3mm. If this RDT was imposed upon, fracture resistance was compromised. Both pre and post instrumentation measurements were taken of samples instrumented with the 0.04 and 0.06 tapered files. …

The Cognitive And Functional Impact Of Open Heart Surgery: A Pilot Study Including Three Common Procedures (Coronary Artery Bypass Graft, Heart Valve Replacement, And Left Ventricular Assist Device), Robert Fix

Theses and Dissertations

This study investigated the impact of open heart surgery (Coronary Artery Bypass Graft, Heart Valve Replacement, or Left Ventricular Assist Device placement) on cognition, functional performance, and mood in the three months following surgery. The Montreal Cognitive Assessment (MoCA), Kettle Test (KT), Physical Self Maintenance Scale (PSMS), and Hospital Anxiety and Depression Scale (HD) measured global cognition, functional cognition, functional performance, and mood states, respectively.

Thirteen male participants (ages 38 – 75) completed assessments at four time points -- when they were scheduled for surgery, within one week prior to surgery, before hospital discharge after surgery, and three months after …

The Feldenkrais Method In The Voice And Speech Classroom: Intertwining Linklater Voice And The Feldenkrais Method, Janel Miley Knipple

Theses and Dissertations

Abstract

INTEGRATING THE FELDENKRAIS METHOD INTO THE VOICE AND SPEECH CLASSROOM: INTERTWINING LINKLATER VOICE AND THE FELDENKRAIS METHOD

By Janel R. Miley Knipple, MFA

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Fine Arts at Virginia Commonwealth University.

Virginia Commonwealth University, 2018.

Major Director: Karen Kopryanski, Head of Voice and Speech, Assistant Professor

Department of Theatre

Proprioception and kinesthetic awareness are important factors in actor training as performers strive to increase their physical and vocal prowess in order to respond to the demands of roles. The Feldenkrais Method, a somatic approach to …

Association Between Polypharmacy And Functional Status In Community-Dwelling Older Adults, Duaa M. Bakhshwin

Theses and Dissertations

Background: Polypharmacy has no consensus definition in the literature. Previously used definitions include those based on the number of medications and those based on unnecessary or inappropriate medication use. Polypharmacy has been associated with increased risk of disability and functional limitations that impair a person's ability to live independently. Older adults are a population of interest as they are at increased risk for both polypharmacy and functional impairments. Understanding the relationship between polypharmacy and functional impairment in older adults could help health care providers and policy makers to target an at-risk population for interventions.

Objectives:

1. To assess the relationship between …

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Mechanisms Regulating Axon Initial Segment Stability, Savannah D. Benusa

Theses and Dissertations

Axon initial segment (AIS) disruption has been described in a number of pathological environments where neuroinflammation is a contributing factor; however, whether this disruption is reversible in unknown. To address the principle of AIS structural recovery, we employed an acute neuroinflammatory model. Acute neuroinflammation induced disruption of AIS structural and functional domains and, importantly, upon resolution of neuroinflammatory conditions, was reversed.

Consistent with other studies, we observed a close interaction of microglia with AISs, and utilized this acute neuroinflammatory model to investigate the relationship between reactive microglia and AIS integrity. Gene expression analysis of microglial transcription profiles identified reactive oxygen …

Investigating The Role Of Nicotinic Acetylcholine Receptors (Nachrs) In The Development And Maintenance Of Chemotherpy-Induced Peripheral Neuropathy In Mice, Wisam B. Toma

Theses and Dissertations

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a major dose-limiting side effect of several anticancer drugs. The prevalence of CIPN ranges from one-third to two-thirds of cancer patients. CIPN can persist for months to years after completion of chemotherapy. Despite the efficacious use of paclitaxel in the treatment of tumors, it can induce many sensory symptoms, such as paresthesia, numbness, tingling and burning pain, and mechanical and cold allodynia, which typically are present in the hands and feet. Similar to other types of chronic pain, paclitaxel-induced CIPN is comorbid with depression and anxiety in cancer survivors, and paclitaxel induces changes in affect-like …

An Innovative Use Of Technology And Associative Learning To Assess Prone Motor Learning And Design Interventions To Enhance Motor Development In Infants, Tanya Tripathi

Theses and Dissertations

Since the introduction of the American Academy of Pediatrics Back to Sleep Campaign infants have not met the recommendation to “incorporate supervised, awake “prone play” in their infant’s daily routine to support motor development and minimize the risk of plagiocephaly”. Interventions are needed to increase infants’ tolerance for prone position and prone playtime to reduce the risk of plagiocephaly and motor delays. Associative learning is the ability to understand causal relationship between events. Operant conditioning is a form of associative learning that occurs by associating a behavior with positive or negative consequences. Operant conditions has been utilized to encourage behaviors …

Assessment Of A Predicted Diguanylate Cyclase In Treponema Denticola, Dhara T. Patel

Theses and Dissertations

Periodontal disease is a progressive inflammatory condition that is characterized by the reabsorption of alveolar bone, the destruction of connective tissue, and edentulism. It is caused by a dysbiosis in the oral microbiome as a result of a shift from a Gram-positive aerobic bacterial population, to one that becomes more Gram-negative and anaerobic. Treponema denticola is thought to drive this diseased state based on its role as a keystone periopathogen. A major component of T.denticola’s invasiveness is its motility, which allows the spirochete to penetrate and disseminate through tissues. This motility, which has been seen to be crucial to …

Understanding The Role Of Sport For Development In Addressing Health Disparities In Low-Ses Communities, Tiesha R. Martin

Theses and Dissertations

The purpose of this study was to understand the role of Sport for Development (SFD) in addressing health disparities in low-SES communities. This was done using a multiple case study design, in which administrators, staff, and youth participants from five SFD programs were interviewed. A theoretical model, consisting of the theory of fundamental causes (Link & Phelan, 1995), the classification of SFD programs (Coalter, 2007), and the ecological model of health promotion (McLeroy, 1988), was developed to guide this study.

Interviews were transcribed and then analyzed using a deductive coding process (Gilgun, 2005). The findings revealed that the SFD programs …

“We’Re All In This Together:” Exploring The Effectiveness And Responsiveness Of Nonprofits In Promoting The Socioeconomic Integration Of Refugees, Brittany Keegan

Theses and Dissertations

When a person is forced to flee their home due to violence or the fear of persecution, they must seek refuge elsewhere – either within the borders of their home country or in a new country. Those who travel to another country in search of safety and protection are known as refugees, and as world conflicts continue, the number of refugees around the world is steadily increasing. As refugees integrate into their new communities, they often receive support from nonprofit organizations once government assistance has ceased. This mixed method study uses 60 open-ended, first-person interviews with refugees and nonprofit service …

A Qualitative Study Toward Understanding Educators’ Perceptions Of A Talent Development Program Designed To Address The Underrepresentation Of Historically Marginalized Students In Advanced Programming In A Large Virginia School Division, Christopher Mark Sumner

Theses and Dissertations

This study extends the limited, existing research on Sunnydale Public School’s (SPS’s) SOAR program. For clarity, SOAR is a talent development (TD) program that aims to not only enhance students’ reasoning and problem-solving abilities but also to remedy the racial/ethnic disproportionality of SPS's gifted and talented program. More specifically, I used interpretive, qualitative methods for this investigation to understand participants’ perceptions of SOAR, in hopes of adding to the talent development knowledge base and informing SOAR policy and practice. Ultimately, participant views converged on several topics (i.e. racial and ethnic disproportionality, brain malleability, multiple intelligences, etc.) and diverged on others …

Examination Of The Role Of Dehumanization As A Potential Mechanism Underlying The Racial Disparities In School Disciplinary Measures., Ebony A. Lambert

Theses and Dissertations

Schools should be safe and supportive spaces for all students, yet Black students tend to face biased treatment in the education system, which often results in harsh disciplinary measures. This research examined the role of animalistic dehumanization (i.e., perceiving others as animal-like and uncultured and denying uniquely human characteristics), in predicting choice of harsher disciplinary measures for Black students as opposed to White students. It was hypothesized that individuals who dehumanize Black students to a greater degree would be more likely to believe that Black students need to be disciplined through harsher measures. Additionally, it was hypothesized that the link …

Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers

Theses and Dissertations

Anxiety disorders (ADs) and stress-related disorders are some of the most common psychiatric disorders in the United States. Like other c0mplex psychiatric illness, genetics and neuroimaging research has focused on understanding their underlying neurobiology. Areas within the fear-network play important roles in threat perception, fear conditioning/learning, cognitive processing, and modulation of fear responses including contextual modulation and extinction and have been implicated in ADs as well as stress disorders such as posttraumatic stress disorder (PTSD). The primary gap in the current search for underlying biological mechanisms is in whether biomarkers associated with disorders share genetic influences with the disorders they …

Ethnic-Racial Identity And Academic Achievement: Examining Mental Health And Racial Discrimination As Moderators Among Black College Students, Eryn Delaney

Theses and Dissertations

This study tested the role that dimensions of ethnic- racial identity play on academic achievement, and examined mental health, racial discrimination, and gender as moderators of this association among Black college students. A total of 321 college students who identified as a Black/African American female or male (M age= 18.4; SD = .34) completed measures of ethnic-racial identity, perceived racial discrimination, and mental health. Hypotheses were tested using path analyses to assess the associations between ethnic-racial identity (i.e., affirmation, exploration, and resolution) and GPA, and whether anxiety, depression, and racial discrimination moderated these relations similarly or differently for males …

Social And Emotional Adjustment Across Aggressor/Victim Subgroups: Do Aggressive-Victims Possess Unique Risk?, Kelly E. Oconnor

Theses and Dissertations

Both theory and empirical evidence support the existence of “aggressive-victims,” a subgroup of youth who have been found to experience the negative outcomes associated with being an aggressor and being a victim. It remains unclear, however, if aggressive-victims possess risk factors that are unique from youth who are either aggressive or victimized. The present study sought to: (a) identify subgroups of seventh grade adolescents who differ in their patterns of aggression and victimization, (b) determine the number and structure of subgroups differ by school or sex, and (c) investigate whether aggressive-victims differ from all other subgroups in their social and …

Cross-Ideological Solar Power Coalitions In The American South: An Advocacy Coalition Approach, Brian T. Toibin

Theses and Dissertations

Abstract

CROSS-IDEOLOGICAL SOLAR POWER COALITIONS IN THE AMERICAN SOUTH: AN ADVOCACY COALITION APPROACH

By Brian T. Toibin, Ph.D.

A dissertation submitted in partial fulfillment of the requirements for the degree of

Doctor of Philosophy in Public Policy and Administration at Virginia Commonwealth University.

Virginia Commonwealth University, 2018.

Major Director: Dr. Damian Pitt

Associate Professor of Urban and Regional Studies and Planning

L. Douglas Wilder School of Government and Public Affairs

The purpose of this study was to explore two particular cross-ideological coalitions that have formed in order to promote pro-solar power policies in Georgia and Florida through the lens of …

5-Ht2b Receptor-Mediated Cardiac Valvulopathy, Pallavi Nistala

Theses and Dissertations

5-HT_2B receptor agonism causes cardiac valvulopathy, a condition characterized by thickening of the heart valves and as a result, regurgitation of blood within the heart. The anti-obesity drug fenfluramine, which was originally prescribed as an anorectic, was withdrawn from the market due to causing cardiac valvulopathy. Fenfluramine, after metabolism by N-dealkylation, produces the metabolite norfenfluramine, which acts as a more potent valvulopathogen. The same was seen with MDMA (ecstasy), a popular drug of abuse, which is metabolized by N-dealkylation to produce MDA, a more potent valvulopathogen. Glennon and co-workers. studied a series of 2,5-dimethoxy-4- substituted phenylisopropylamines (DOX type) hallucinogens …

Decellularized Matrices Effect On The Adaptive Immune Response, Kegan Sowers

Theses and Dissertations

Decellularized extracellular matrices have been a growing area of interest in the biomedical engineering fields of tissue engineering and regenerative medicine.As these materials move toward clinical applications, the immune response to these materials will be a driving force toward their success in clinical approaches. Fully digested decellularized matrix constructs derived from porcine liver, muscle and lung were created to test the adaptive immune response. Hydrogel characterization ensured that the materials had relatively similar stiffness levels to reduce variability, and in vitro studies were conducted. Each individual construct as well as a gelatin control were plated with a co-culture of macrophages …

Packers, Beth Liechti

Mighty Pen Project Anthology & Archive

An army officer reminisces about her past love, her military career, and a great pair of cowboy boots.

Articles, stories, and other compositions in this archive were written by participants in the Mighty Pen Project. The program, developed by author David L. Robbins, and in partnership with Virginia Commonwealth University and the Virginia War Memorial in Richmond, Virginia, offers veterans and their family members a customized twelve-week writing class, free of charge. The program encourages, supports, and assists participants in sharing their stories and experiences of military experience so both writer and audience may benefit.

Pwatem: An Anthology Of Literature And Art (2018)

Pwatem (Poictesme), 2006-

Pwatem is an anthology of literature and art from undergraduate students at Virginia Commonwealth University. Pwatem publishes poetry, prose and art of all kinds from talented undergraduate students of all majors.

Speech Recognition Technology: Improving Speed And Accuracy Of Emergency Medical Services Documentation To Protect Patients, Tan Tran

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Because hospital errors, such as mistakes in documentation, cause one in six deaths each year in the United States, the accuracy of health records in the emergency medical services (EMS) must be improved. One possible solution is to incorporate speech recognition (SR) software into current tools used by EMS first responders. The purpose of this research was to determine if SR software could increase the efficiency and accuracy of EMS documentation to improve the safety of patients of EMS. An initial review of the literature on the performance of current SR software demonstrated that this software was not 99% accurate, …

Cataract Blindness: Socioeconomic Factors Associated With Treatment Barriers And High Blindness Rates For Women In Rural Regions Of Andhra Pradesh, Kiranpreet Kaur

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Despite efforts of Vision 2020 in India, the 2001 Andhra Pradesh Eye Disease Study (APEDS) extrapolated that approximately 18.7 million blind people resided in India and projected an increase to 31.6 million blind people by 2020. Within the Andhra Pradesh state itself, the preventable blindness population had increased from approximately 1,143,150 people in 1990 to 1,402,264 people in 2001, against reformation attempts by the National Program for Control of Blindness. Of this, cataracts were consistently the leading cause of avoidable blindness. Numerous public health studies have been conducted to outline factors that preclude treatment of avoidable cataract blindness in the …