Digital Commons Network^™

Communicating Colorectal Cancer Risk To Average Risk Adults: Examining The Impact On Risk Perceptions And Health Behavior Intentions, Carrie A. Miller

Theses and Dissertations

Background. CRC risk can be reduced though lifestyle modification and regular screenings. Providing CRC risk feedback that promotes preventive behaviors to those at average risk has the potential to significantly reduce CRC morbidity and mortality.

Purpose. The purpose of this dissertation was to examine the impact of CRC risk assessment feedback among adults aged 50-75 with no personal or family history of the disease. The specific aims were to: (1a) test personalized (vs. generic) risk assessment feedback on individuals’ risk perceptions and intentions to engage in three risk-reducing behaviors (e.g., physical activity, diet, and screening); (1b) determine if the provision …

Validation Of Virginia's Juvenile Risk Assessment Instrument, Jessica P. Schneider

Theses and Dissertations

Utilizing a validated risk assessment tool to predict future offending is recommended as best practices in corrections by a number of professional organizations (Latessa & Lovins, 2010). Guided by the risk-needs-responsivity model, risk assessment tools have evolved to help inform criminal justice practitioners by identifying offenders most in need of intervention or supervision, guiding the case plan to optimize outcomes (Bonta & Andrews, 2007). The Virginia Department of Juvenile Justice (DJJ) utilizes the Youth Assessment and Screening Instrument (YASI) at all stages of contact with youthful offenders, including intake, probation, commitment, and parole (DJJ, 2016). However, risk assessment instruments do …

Impact Of Aerobic Exercise On Monocyte Subset Receptor Expression And Macrophage Polarization, Anson M. Blanks

Theses and Dissertations

Atherosclerotic cardiovascular disease (CVD) is hallmarked by inflammatory immune activation, particularly by the induction of a response by monocytes. Classical (CD14⁺⁺CD16^-) are anti-inflammatory mediators under homeostatic conditions, while intermediate (CD14⁺⁺CD16⁺) and non-classical (CD14^LowCD16⁺⁺) monocytes promote inflammation following activation. Monocyte activation and functionality is dependent upon receptor expression and ligand production by a variety of cells, including monocytes. Alterations in the expression of surface receptors often have a direct impact upon monocyte function, such as the increased pro-inflammatory cytokine production in response to activation that accompanies elevated CD14 expression …

Discovering Driver Mutations In Biological Data, Yahya Bokhari

Theses and Dissertations

Background

Somatic mutations accumulate in human cells throughout life. Some may have no adverse consequences, but some of them may lead to cancer. A cancer genome is typically unstable, and thus more mutations can accumulate in the DNA of cancer cells. An ongoing problem is to figure out which mutations are drivers - play a role in oncogenesis, and which are passengers - do not play a role. One way of addressing this question is through inspection of somatic mutations in DNA of cancer samples from a cohort of patients and detection of patterns that differentiate driver from passenger mutations. …

Trna Profiling Of Mesenchymal Stem Cell Exosome, Khin Mimi San

Theses and Dissertations

Background: Exosomes have great potential in regenerative medicine through the

transfer of their bioactive cargos, such as RNA. tRF RNA and tiRNA are tRNAderived

non-coding RNA. Here, we sought to identify the tRF/tiRNA profile in human

mesenchymal stem cell (hMSC) exosomes. Methods: Bone marrow hMSCs were

cultured with/without osteogenic differentiation medium and exosomes were

harvested. RNA was extracted from: 1) control cells (Cell-NT); 2) control exosomes

(EXO-NT); 3) differentiated cells (Cell-OM); 4) exosomes produced by differentiated

cells (EXO-OM). RNA was sequenced to profile the small RNA with a focus on

tRF/tiRNA. Results: tRF/tiRNA was highly enriched in hMSC exosomes. Less …

Genomic Instability In Severe Congenital Neutropenia, A Leukemia Predisposition Syndrome, Adya Sapra

Theses and Dissertations

Severe congenital neutropenia (SCN) is a rare blood disorder characterized by abnormally low levels of circulating neutrophils. Mutations in multiple genes like neutrophil elastase gene (ELANE) and granulocyte colony stimulating factor receptor (CSF3R) may cause SCN. The treatment of choice for SCN is the administration of granulocyte-colony stimulating factor (G-CSF) which elevates the neutrophil count and hence improves the survival and quality of life. Long term survivorship on G-CSF is however linked to development of MDS (myelodysplastic syndrome)/AML (acute myeloid leukemia). About 70% of MDS/AML patients acquire nonsense mutations affecting the cytoplasmic domain of CSF3R. …

Integrating Obesity And Eating Disorder Prevention: A Pilot And Feasibility Trial Of Inspire, Courtney C. Simpson

Theses and Dissertations

Obesity and eating disorders are pervasive concerns among young adult women, and profoundly impact physical and psychological functioning. Weight-related disorders are typically chronic conditions; their treatment is often complex and frequently ineffective. Moreover, Black and Latina women have disproportionately high rates of obesity, and experience rates of eating disorders comparable to those of their White peers; yet, they are less likely to be referred to appropriate treatment. Given the intractability of weight-related concerns and their detrimental consequences, attempts to prevent unhealthy eating attitudes and behaviors are essential. To date, few prevention programs have significantly reduced both obesity risk and eating …

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …

The Experiences That Promote Success For Students With Intellectual Disability In Postsecondary Education, Kimberly S. Handsome

Theses and Dissertations

This in-depth qualitative, phenomenological (Smith & Fowler, 2009) research study attempted to understand the experiences of young adults with intellectual disability who had completed a 2-year, inclusive postsecondary education program. 13 participants (4 former students with ID, 5 parents, and 4 Postsecondary Education staff members) participated in semi-structured interviews. Interviews were coded to provide themes amongst each individual group of participants. A document review was also conducted to better understand the program components and add validity to self-reports from interviews. Results were analyzed and used to provide implications for future research and program development.

An Exploration Of Identity Negotiation In Adult English Learners’ Communities Of Practice, Kathleen D. Rolander

Theses and Dissertations

This study utilizes Lave and Wenger’s (1991) communities of practice (COP) model to explore how ELLs navigate their positions within and between their many language learning communities. Drawing on Norton’s (1995, 2013) work on ELLs’ identity negotiation and Wenger’s 1998 work on the reinforcing impacts of identities between multiple COPs, this study explores what adults consider to be their COPs, how they perceive themselves within and between them, and how past, current, and imagined or possible COPs impact each other.

A constructivist, multiple case study design was used to focus on participants’ perceptions of their identity negotiation processes through their …

A Practice Elements-Based Approach To Adherence Measurement, Stephanie Violante

Theses and Dissertations

The measurement of treatment adherence (i.e., the frequency and thoroughness with which a therapist delivers a treatment as designed) is critical to the field of implementation science, as adherence is often considered an indicator of successful implementation. Most existing instruments of treatment adherence are treatment protocol specific; however, this approach is costly, inefficient, and disallows cross-treatment and cross-study comparisons. Thus, there is a need for adherence instruments that can be used across treatment protocols. It has been suggested that an instrument that captures adherence at the practice element level would meet this need, as it would have utility across protocols …

Alternative Splicing Of Cytoplasmic Polyadenylation Element Binding Protein 2 Is Modulated Via Serine Arginine Splicing Factor 3 In Cancer Metastasis, James T. Deligio, James Thomas Deligio

Theses and Dissertations

Our laboratory delineated a role for alternative pre-mRNA splicing (AS) in triple negative breast cancer (TNBC). We found the translational regulator cytosolic polyadenylation element binding protein 2 (CPEB2) which has two isoforms, CPEB2A and CPEB2B, is alternatively spliced during acquisition of anoikis resistance (AnR) and metastasis. The splicing event which determines the CPEB2 isoform is via inclusion/ exclusion of exon four in the mature mRNA transcript. The loss of CPEB2A with a concomitant increase in CPEB2B is required for TNBC cells to metastasize in vivo. We examined RNAseq profiles of TNBC cells which had CPEB2 isoforms specifically downregulated to …

Spatial Learning And Memory In Brain-Injured And Non-Injured Mice: Investigating The Roles Of Diacylglycerol Lipase-Α And -Β., Lesley D. Schurman

Theses and Dissertations

A growing body of evidence implicates the importance of the endogenous cannabinoid 2-arachidonyl glycerol (2-AG) in memory regulation. The biosynthesis of 2-AG occurs primarily through the diacylglycerol lipases (DAGL-α and -β), with 2-AG serving as a bioactive lipid to both activate cannabinoid receptors and as a rate limiting precursor for the production of arachidonic acid and subsequent pro-inflammatory mediators. Gene deletion of DAGL-α shows decrements in synaptic plasticity and hippocampal neurogenesis suggesting this biosynthetic enzyme may be important for processes of normal spatial memory. Additionally, 2-AG is elevated in response to pathogenic events such as traumatic brain injury (TBI), suggesting …

Influence Of Muscle Strength On Mobility In Critically Ill Adult Patients On Mechanical Ventilation, Audrey R. Roberson

Theses and Dissertations

Patients in the intensive care unit (ICU) setting are prone to develop muscle weakness and the causes are multi-factorial. Muscle strength in adult, critically ill patients on mechanical ventilation decreases with immobility. The influence of muscle strength on different muscle groups and its influence on progressive mobility in the adult, critically ill patient on mechanical ventilation has not been examined. Identifying muscle strength in this patient population can benefit overall muscle health and minimize muscle deconditioning through a progressive mobility plan. The objective of this dissertation was to describe muscle strength in different muscle groups and to describe the influence …

Age-Dependent Changes In Oxygen Supply And Demand Of Rat Spinotrapezius Muscle, Sami C. Dodhy

Theses and Dissertations

Because of the aerobic nature of cellular metabolism in mammalian organisms, a continuous supply of oxygen is necessary to maintain normal physiological function. As organisms age, their metabolic rates generally decline and there are accompanying alterations in the structure and function of the microcirculation, as this part of the cardiovascular system is especially important for oxygen exchange. The overall Oxygen Transport System can be considered as being composed of two complementary components: one for Oxygen Demand and one for Oxygen Supply. The purpose of the current work is to describe the age-dependent changes in both oxygen demand and oxygen supply …

Snd1-Targeted Gene Therapy For Hepatocellular Carcinoma, Bryan D. Mckiver

Theses and Dissertations

Staphylococcal nuclease and tudor-domain containing 1 (SND1) is an oncogene for a wide variety of cancers, including hepatocellular carcinoma (HCC). SND1 is a multifunctional protein regulating gene expression of proto-oncogenes and tumor suppressor genes, making SND1 a prime target for developing cancer therapeutics. This notion is especially attributed to HCC as most patients are diagnosed in advanced stages and the therapeutic options available for these patients are severely limited. In this study, we evaluated the therapeutic potential of a replication-defective adenovirus vector delivering SND1 shRNA (Ad.SND1sh) to human HCC cell lines, HepG3, HuH-7, and Hep3B. Adenovirus infection in HCC cells …

Structured Poetic Expressions For Emerging Adults Experiencing Bereavement, Kelcie D. Willis

Theses and Dissertations

Previous research has produced heterogeneous findings regarding the effectiveness of expressive writing in reducing grief symptomatology among the bereaved (e.g., Collison, 2016; Lichtenthal & Cruess, 2010; Stroebe et al., 2006). The purpose of this study was to address these mixed results by exploring the effects and linguistic characteristics of a novel writing task (i.e., the acrostic poem) among bereaved undergraduates, using an innovative data analysis technique (i.e., Linguistic Inquiry and Word Count). The current study recruited 68 undergraduates who had lost a loved one. Participants were randomly assigned to write over multiple days using the acrostic poem, emotional disclosure prompt, …

Evaluating And Reducing The Effects Of Misclassification In A Sequential Multiple Assignment Randomized Trial (Smart), Jun He

Theses and Dissertations

SMART designs tailor individual treatment by re-randomizing patients to subsequent therapies based on their response to initial treatment. However, the classification of patients being responders/non-responders could be inaccurate and thus lead to inappropriate treatment assignment. In a two-step SMART design, by assuming equal randomization, and equal variances of misclassified patients and correctly classified patients, we evaluated misclassification effects on mean, variance, and type I error/ power of single sequential treatment outcome (SST), dynamic treatment outcome (DTRs), and overall outcome. The results showed that misclassification could introduce bias to estimates of treatment effect in all types of outcome. Though the magnitude …

The Role Of Adam10 And Adam17 In Humoral And Type 2 Immunity, Joseph C. Lownik

Theses and Dissertations

The proper regulation of inducible costimulator (ICOS) and its ligand (ICOSL) have been shown to be essential for maintaining immune homeostasis. Loss of either protein results in defective humoral immunity, and overexpression of ICOS results in aberrant antibody production resembling lupus. How ICOSL is regulated in response to ICOS interaction is still unclear. We demonstrate that ADAM10 is the primary physiological sheddase of ICOSL in both mouse and human. Using an in vivo system in which ADAM10 is deleted only on B cells (ADAM10^B-/-), elevated levels of ICOSL were seen. This increase is also seen when ADAM10 is …

Signaling Through Homomeric And Heteromeric Cannabinoid Cb1 Receptors, Guoqing Xiang

Theses and Dissertations

Cannabis (Marijuana) has multiple effects on the human body, such as analgesia, euphoria and memory impairment. Delta-9 tetrahydrocannabinol (D9-THC), the active ingredient in cannabis, binds to cannabinoid receptors, seven-transmembrane G protein-coupled receptors (GPCRs) that mediate a variety of physiological functions. GPCRs were believed to function only in homomeric forms, however, recent findings show that different GPCRs can also form heteromeric complexes that may expand their signaling properties. In this study, we focused on Cannabinoid CB1 receptor (CB1R) heteromers with the mu-opioid receptor (MOR) and the Dopamine type 2 receptor (D2R), respectively. We utilized a variety of techniques, such as the …

Effects Of Hiv-1 Tat And Drugs Of Abuse On Antiretroviral Penetration Inside Different Cns Cell Types, Sulay H. Patel

Theses and Dissertations

Human immunodeficiency (HIV) infection can result in neurocognitive deficits in about one-half of infected individuals. Despite excellent systemic effectiveness, restricted antiretroviral penetration across the blood-brain barrier (BBB) is a major limitation in fighting HIV infection within the central nervous system (CNS). Drug abuse exacerbates cognitive impairment and pathologic CNS changes in HIV-infected individuals. This work investigates the effects of the HIV-1 protein, Tat, and drugs of abuse on factors affecting drug penetration into the brain.

Firstly, an in vitro model of the blood-brain barrier was built to study effects of HIV-1 Tat and methamphetamine (Meth) on integrity and function of …

Relationship Between Patient-Health Coach Interactions And Changes In Markers Of Glucose Homeostasis, Jason P. Nagy

Theses and Dissertations

Diabetes and insulin resistance are on the rise in the United States. Early detection and deployment of therapies has allowed for the reversal of pancreatic beta cell damage. Unfortunately, not all providers can offer the support to facilitating the required life style modifications. The introduction of clinical health consultants (CHC) as supplemental care has improved patient health for a variety of chronic diseases. Missing in the literature are studies investigating the correlation between the number of CHC interactions and improvement in biomarkers.

The study utilized a non-experimental, retrospective study design to evaluate the relationship between the use between the use …

Critical Consciousness, Racial Identity, And Appropriated Racial Oppression In Black Emerging Adults, Keyona Allen

Theses and Dissertations

The present study explored private regard and public regard, two subcomponents of racial identity, as mediators of the association between critical consciousness and appropriated racial oppression. In a sample of 75 Black emerging adults, ages 18-25, the current study examined (1) the relationships between critical consciousness, racial identity, and appropriated racial oppression and (2) whether racial identity mediates the relationship between critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between private regard and both critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between public regard and critical consciousness. Further, mediation …

Family Planning And Hiv Interventions Among Women In Low-Income Settings, Steven P. Masiano

Theses and Dissertations

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.

This …

Drug Delivery With Light, Patrick S. Dupart

Theses and Dissertations

Cancer is responsible for about 25% of deaths in developed countries and for 15% of all deaths worldwide. Cancer is a devastating disease and while there have been great advances in the development of anticancer drugs, off-target toxicity is a major limitation with conventional cancer chemotherapy. The consequence of this form of treatment results in the killing of healthy and rapidly-growing non-cancerous cells including cells in the bone marrow; hair follicles; and cells in the mouth, digestive tract, and reproductive system. In addition to these general effects, certain anticancer drugs can have other associated toxicities. For instance, the anticancer drug …

Relationships Among Parenting Stress, Parenting Practices, And Conduct Problems In African American Mothers Of Children With And Without Adhd, Amanda Parks

Theses and Dissertations

Parents of children with attention-deficit/hyperactivity disorder (ADHD) endorse increased levels of parenting stress and subsequently employ ineffective parenting practices. For children with comorbid conduct problems, mothers report more parenting stress than mothers of children with ADHD alone. I investigated the relationships among child ADHD diagnostic status, parenting stress, parenting behaviors (i.e., involvement and positive parenting) and child conduct problems in 78 African American mothers of children with and without ADHD. Mothers completed a demographic questionnaire, a semi-structured clinical interview, the ADHD Rating scale (also completed by teachers), the Impairment Rating Scale, the Parenting Stress Index – Short Form, and the …

"To Conceive With Child Is The Earnest Desire If Not Of All, Yet Of Most Women": The Advancement Of Prenatal Care And Childbirth In Early Modern England: 1500-1770, Victoria E.C. Glover

Theses and Dissertations

This thesis analyzes medical manuals published in England between 1500 and 1770 to trace developing medical understandings and prescriptive approaches to conception, pregnancy, and childbirth. While there have been plenty of books written regarding social and religious changes in the reproductive process during the early modern era, there is a dearth of scholarly work focusing on the medical changes which took place in obstetrics over this period. Early modern England was a time of great change in the field of obstetrics as physicians incorporated newly-discovered knowledge about the male and female body, new fields and tools, and new or revived …

Reducing Sepsis Mortality: A Cloud-Based Alert Approach, Janet A. Zink

Theses and Dissertations

The aim of this study is to examine the impact of a cloud-based CDS alerting system for SIRS, a precursor to sepsis, and sepsis itself, on adult patient and process outcomes at VCU Health System. The two main hypotheses are: 1) the implementation of cloud-based SIRS and sepsis alerts will lead to lower sepsis-related mortality and lower average length of stay, and 2) the implementation of cloud-based SIRS and sepsis alerts will lead to more frequent ordering of the Sepsis PowerPlan and more recording of sepsis diagnoses. To measure these outcomes, a pre-post study was conducted. A pre-implementation group diagnosed …

Decoding The Signaling Of The D2r-2ar Heteromer: Relevance To Schizophrenia, Miao Huang

Theses and Dissertations

Schizophrenia is a severe mental disorder affecting ~1% of world population. Two G protein coupled receptors (GPCRs): Gi-coupled dopamine D2 receptor (D₂R), and Gq-coupled serotonin 2A receptor (2AR), are targeted by the typical and atypical antipsychotic drugs to treat schizophrenia. These two receptors have been shown to co-localize in brain regions relevant to schizophrenia, including the ventral tegmental area (VTA), striatum, and prefrontal cortex (PFC). Studies in our lab characterized the integrated signaling of the D₂R-2AR heteromer and found that both the Gi activity of D₂R and the Gq activity of 2AR were potentiated …

The Impact Of Mother–Father Relationship, Social Support And Neighborhood Context On Preterm Birth, Timothy O. Ihongbe

Theses and Dissertations

Background: Preterm birth is a major public health concern in the US. Previous studies have suggested that quality of the mother-father relationship, social support, and neighborhood violence may be associated with preterm birth; however, findings are equivocal.

Objectives: The main objectives of this dissertation were: 1) to determine the modifying effect of perceived residential environment on the association between quality of mother–father relationship and preterm birth in a sample of African-American women, 2) to examine whether the receipt of social support modifies the association between neighborhood violence exposure and preterm birth in a nationally representative sample of US women, and …