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Articles 6901 - 6930 of 14292
Full-Text Articles in Entire DC Network
Medication-Related Problems In Older Adults: A Focus On Underuse Of Warfarin And Warfarin-Antibiotic Interactions, Parinaz K. Ghaswalla
Medication-Related Problems In Older Adults: A Focus On Underuse Of Warfarin And Warfarin-Antibiotic Interactions, Parinaz K. Ghaswalla
Theses and Dissertations
The work presented in this dissertation focuses on two important medication-related problems in older adults, that is, untreated indication and drug-drug interactions, specifically with respect to a high-risk medication such as warfarin. Warfarin is a challenge to use in clinical practice due to its narrow therapeutic index, variability in dose-response and its interactions with numerous foods and drugs. This dissertation presents the research from two projects. In the first project the prevalence and predictors of warfarin use in nursing home (NH) residents with atrial fibrillation (AF), and use of secondary stroke prevention strategies was determined, in order to understand the …
Development Of A Novel Approach To Assess Qualitative And Quantitative Dynamics Associated With The Subcutaneous Or Intramuscular Administration Of Pharmaceuticals And Associated Parenteral Delivery Systems, Eric Edwards
Theses and Dissertations
There has been a significant increase in the number of injectable pharmaceutical products over the last decade that have been incorporated into unique delivery systems such as pen injectors, auto-injectors, or pre-filled syringes. The advancement of these delivery systems and the paradigm shift towards administration of injectables in the out-of-hospital or home setting have introduced variables that can affect the bioavailability of injectable drugs and potential pharmacologic outcomes. An approach that allows for the qualitative and quantitative dispersion assessment of an injectable at the moment of tissue deposition coupled with an assessment of systemic exposure parameters could provide substantial information …
The Determinants Of A Nurse's Discretionary Decision To Respond To Situations That Place Patients At Risk For Safety Events But Requires A Response That Is Beyond The Scope Of Nursing Practice, Kathy Baker
Theses and Dissertations
A nurse’s contribution to patient safety in regards to early detection of issues in the clinical setting is undisputed (Redman, 2008). If these patient situations require a response that is beyond the scope of nursing practice, in most instances nurses are not sanctioned to intervene without physician consultation (Gaba, 2000). The evidence in the nursing literature does suggest that some nurses exercise professional discretion and are, at times, making the decision to initiate interventions independently (Benner, Hooper-Kyriakidis, & Stannard, 1999; Hutchinson, 1990; Tiffany, Cruise, & Cruise, 1988). The focus of this inquiry was to examine the determinants of a nurse’s …
A Hierarchical Image Processing Approach For Diagnostic Analysis Of Microcirculation Videos, Nazanin Mirshahi
A Hierarchical Image Processing Approach For Diagnostic Analysis Of Microcirculation Videos, Nazanin Mirshahi
Theses and Dissertations
Knowledge of the microcirculatory system has added significant value to the analysis of tissue oxygenation and perfusion. While developments in videomicroscopy technology have enabled medical researchers and physicians to observe the microvascular system, the available software tools are limited in their capabilities to determine quantitative features of microcirculation, either automatically or accurately. In particular, microvessel density has been a critical diagnostic measure in evaluating disease progression and a prognostic indicator in various clinical conditions. As a result, automated analysis of the microcirculatory system can be substantially beneficial in various real-time and off-line therapeutic medical applications, such as optimization of resuscitation. …
Response To And Recovery From Endotracheal Suctioning In Preterm Infants Using Routine Versus Four-Handed Care, Sharon Cone
Response To And Recovery From Endotracheal Suctioning In Preterm Infants Using Routine Versus Four-Handed Care, Sharon Cone
Theses and Dissertations
Neonatal Intensive Care Units have experienced profound advances in technology and treatment modalities over the last two decades. Infants born at the edge of viability are now surviving despite prolonged hospitalizations. These infants born preterm are prone to a high degree of stress from life sustaining and routine interventions. Much focus has been directed toward addressing noxious environmental factors such as noise, light, and infectious disease; however, little has been done to examine the stress experienced by the professional caregiver who work in these environments. Environmental press theory, which focuses on the interplay between human beings and their surroundings, is …
Teachers' Perception Of Computer Use And Technical Support In A Rural Virginia School Division: A Case Study, Rodney Berry
Teachers' Perception Of Computer Use And Technical Support In A Rural Virginia School Division: A Case Study, Rodney Berry
Theses and Dissertations
The purpose of this study was to investigate teacher perceptions of computer-based technology and technology support provided by a rural school division; the extent of teachers’ self reported computer skills, comfort levels, perception of obstacles; and the amount of support, time, and training available to them to accomplish the integration during the course of instruction. This research was conducted during the 2010-2011 school term as a case study of a small rural K-12 school division in southern Virginia, consisting of teachers from each core curriculum from each of the three schools, selected deliberately. The study was divided into three phases: …
Caring For A Preterm Infant During The First Six Months Post Nicu Discharge: A Mother’S Perspective, Lois Phillips-Pula
Caring For A Preterm Infant During The First Six Months Post Nicu Discharge: A Mother’S Perspective, Lois Phillips-Pula
Theses and Dissertations
Overview There are numerous studies in the current literature focusing on the intense emotions experienced by parents, following the birth of a preterm infant, (i.e., born prior to 37 weeks gestational age [GA]). Research findings have helped us understand the fear and anxiety they feel while attempting to navigate the neonatal intensive care unit (NICU) environment. What happens in those early weeks and months at home after discharge, however, is surprisingly absent from the literature. It is well known that preterm infants are readmitted to the hospital during the first few months after discharge at a rate of 10% - …
Fluctuations And Instantons In Complex Landscapes: From Ligand Unbinding To Proton Transfer, Justin Elenewski
Fluctuations And Instantons In Complex Landscapes: From Ligand Unbinding To Proton Transfer, Justin Elenewski
Theses and Dissertations
Biophysical entities are complex systems systems with strong environmental coupling, dominated by fluctuations on a hierarchy of timescales. These properties confound simulation of ligand binding and catalysis, inflating the scale of the problem to one tractable only with a considerable outlay of resources. In an attempt to ameliorate this restriction, several techniques are developed to accelerate biomolecular simulations while collaterally lending physical insight. The first segment of this dissertation is concerned with directed simulations of ligand binding in a model system. Using the serum retinol binding protein as a prototype, the potential of mean force associated with ligand binding is …
Identifying Modulators Of The Development Of Acute Functional Tolerance To Ethanol In Caenorhabditis Elegans., Ka-Po Leung
Identifying Modulators Of The Development Of Acute Functional Tolerance To Ethanol In Caenorhabditis Elegans., Ka-Po Leung
Theses and Dissertations
Alcohol abuse is a problem in our society. There are few treatments available, in part due to the unclear molecular mechanisms of ethanol’s effects. Human studies indicate that there is a genetic component influencing disease susceptibility, and that an individual’s initial response to alcohol can predict their development of addiction. We have taken a forward genetics approach to study one component of initial response, acute functional tolerance (AFT), in Caenorhabditis elegans. We identified bet11, a mutation that causes animals to be defective in the development of AFT. Genetic analysis suggested that the gene that bet11 disrupts participates in a synthetic …
Living With Hiv: Views Through The Blog, Linda Eastham
Living With Hiv: Views Through The Blog, Linda Eastham
Theses and Dissertations
The purpose of this qualitative descriptive study was to develop a greater clarity of how HIV infected individuals live and work within the sphere of HIV infection as represented through unsolicited, personal narratives posted on blogs. Existing, single author, personal blogs were identified via a search engine. Blogs were defined as the blog author's postings and all responses, whether written by the blog author or a reader respondent. Inclusion and exclusion criteria were developed to respect indicators of bloggers' intentions for privacy, e.g., blogs which required a password were excluded. A total of 14 blogs met inclusion criteria. Actions to …
Organizational Capacity To Absorb External Knowledge: An Exploratory Study Of Public And Nonprofit Decision Makers' Perceptions Of Impediments And Facilitators, Linda S. Birtley
Organizational Capacity To Absorb External Knowledge: An Exploratory Study Of Public And Nonprofit Decision Makers' Perceptions Of Impediments And Facilitators, Linda S. Birtley
Theses and Dissertations
Research indicates that many youth-serving agencies do not adopt evidence-based innovations in the field of youth violence prevention. This qualitative study was designed to explore a sample of community-based decision makers’ perceptions of why innovative, evidence-based programs and practices for the prevention of violence by youth are, or are not, adopted at the local level. The rationale for this study was that knowledge of evidence-based innovations in youth violence prevention originates primarily from research scientists who are external to the organizations that are the intended recipients of the innovations. Prior research has not viewed the failure to adopt evidence-based innovations …
"Visual Vessels", Theresa Ornoff
"Visual Vessels", Theresa Ornoff
Theses and Dissertations
In 1989 while our severely ill son lay in our arms my husband and I asked the surgeon what he would do if he were in our shoes. “Play the hand you’re dealt.” he replied. It was not this doctor’s only reference to the gamble life holds for each of us. Based on his advice to us I began to investigate the role that fate and predetermination play in our lives and consequently how much control we have on the outcome of life’s events. A cathartic family portrait piece laid the groundwork for a series of metaphorical portraits as I …
Understanding Mothers Of Late Preterm Infants, Brenda Baker
Understanding Mothers Of Late Preterm Infants, Brenda Baker
Theses and Dissertations
The experience of becoming a mother is a personal and social experience influenced by individual characteristics, friends and family, and the infant. The journey to become a mother encompasses concepts of maternal competence and responsiveness. The purpose of this study was to examine maternal competence and responsiveness to the infant in mothers of late preterm infants compared to mothers of full term infants. The conceptual model for this work was based on the work of Reva Rubin describing maternal identity and role development. Maternal competence and responsiveness are components of maternal role and are influenced by social support, maternal self-esteem, …
Healthcare Acquired Infection Risk And Toothbrush Contamination In The Icu., Michelle Frazelle
Healthcare Acquired Infection Risk And Toothbrush Contamination In The Icu., Michelle Frazelle
Theses and Dissertations
Healthcare acquired infections (HAIs) are a complex and multi-factorial problem associated with high morbidity, mortality, and cost. Toothbrushes (TBs) may be at risk for contamination with potential pathogenic microorganisms (PPMs) from the patient care environment or autoinnoculation from the patient. We focused on three PPMs: multiply resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), and Acinetobacter. Specific aims were to (1) describe environmental factors associated with TB contamination in the ICU; (2) describe the relationship between TB contamination and oral colonization in critically ill adults.
Examining Criminal Justice Professionals’ Attitudes And Responsiveness Towards Intimidated Witnesses On The Local Level: An Exploratory Analysis, Moon Michon
Theses and Dissertations
Abstract EXAMINING CRIMINAL JUSTICE PROFESSIONALS’ ATTITUDES AND RESPONSIVENESS TOWARDS INTIMIDATED WITNESSES ON THE LOCAL LEVEL: AN EXPLORATORY ANALYSIS By Michon J. Moon, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2011 Major Director: Laura J. Moriarty, Ph. D, Professor and Vice Provost of Academic and Faculty Affairs L. Douglas Wilder School of Government and Public Affairs The study explored criminal justice professionals’ attitudes and responsiveness toward witness intimidation on the local level based on their occupation and region of employment. Intimidated witnesses are vulnerable …
Sensory Modulation Disorder In Puerto Rican Preschoolers: Associated Risk Factors, Rosa L. Roman-Oyola
Sensory Modulation Disorder In Puerto Rican Preschoolers: Associated Risk Factors, Rosa L. Roman-Oyola
Theses and Dissertations
Sensory Modulation Disorder (SMD) reduces a child’s ability to respond to sensory stimuli in the environment in a manner that corresponds to the nature or intensity of the stimulus; this disorder therefore significantly can impact participation in developmentally appropriate play and functional activities. More studies are needed to enhance research in the field of SMD and aid the general community in understanding the disorder and its causes. The purpose of this study was to characterize the prevalence of SMD among Puerto Rican preschoolers and examine the relationship between specific risk factors (socioeconomic status, pre-natal alcohol exposure, low birth weight, preterm …
The Effectiveness Of Religion-Affiliated Nonprofit Organizations In Social Services: A Survey Study Of Nursing Homes In Virginia, Bulent Ucar
Theses and Dissertations
The primary purpose of this study is to determine whether being a church affiliated nursing home influences performance. Performance is measured based on criterion put in place by the Center for Medicare and Medicaid Services (CMS). The secondary purpose is, regardless of ownership type - religiously affiliated or secular- to investigate if more religiously involved nursing homes perform better than their less religiously involved counterparts. These two purposes are hypothesized with six different hypotheses each of which are tested by utilizing OLS regression analysis. This study extensively discusses the arguments surrounding the Charitable Choice Initiative, which allowed faith-based organizations (FBOs) …
The Decision-Making Process Of Finding Students With Significant Intellectual Disabilities Eligible For Participation In The Virginia Alternate Assessment Program, Karren Streagle
Theses and Dissertations
The purpose of this study was to understand the decision-making process used by IEP teams and case managers for students with significant intellectual disabilities who participate in alternate assessments based on aligned academic achievement standards (AA-AAS). Semi-structured in-depth interviews were conducted with case managers for students participating in the Virginia Alternate Assessment Program (VAAP) from school divisions in central Virginia. Traditional inductive data analysis techniques were used to analyze data collected from the in-depth interviews, the researcher’s reflexive field notes and observations, and a review of VAAP training and guidance documents provided by study participants. Findings illuminated the decision-making process …
Comparing The Efficacy Of Two Cognitive Dissonance Interventions For Eating Pathology: Are Online And Face-To-Face Interventions Equally Effective?, Kasey Serdar
Theses and Dissertations
Clinical and subclinical eating pathology are common, especially among female undergraduates. Such problems are often chronic and associated with a range of negative medical and psychological outcomes. Thus, it is important to develop effective prevention programs to reduce eating disorder risk. Numerous studies suggest that dissonance-based prevention programs are the most successful in reducing eating disorder risk factors, however, such programs might not be convenient for students limited by scheduling restraints or geographic proximity. Further, some students may be reluctant to attend such groups due to lack of anonymity. One way to address these potential barriers is to adapt dissonance-based …
Use Of Historic Tax Credits For School Construction In Virginia: Costs, Benefits, Administrative Implications, And Public Policy Issues, Paola Brooks
Theses and Dissertations
A number of studies show that school facilities in the United States are deteriorating and that a substantial outlay of financial capital is required to bring school facilities to good overall condition. The current economic environment, marked by slow growth, high unemployment, and low tax revenues has highlighted widespread issues with the financial condition and fiscal sustainability of local governments. While studies show that the success of the educational process is related to the condition of school facilities, providing a safe and effective educational environment for students and teachers is a great challenge for local governments. Alternative sources of funding …
Utilization Of Structural And Biochemical Cues To Enhance Peripheral Nerve Regeneration, Balendu Shekhar Jha
Utilization Of Structural And Biochemical Cues To Enhance Peripheral Nerve Regeneration, Balendu Shekhar Jha
Theses and Dissertations
This study examines the prospects of using the electrospinning process to fabricate tissue engineering scaffolds targeting a variety of regenerative applications, with a primary focus on the production of nerve guides for the treatment of long-defect nerve injuries in the peripheral nervous system. A basic overview of the conventional electrospinning process is provided, and the utility of this fabrication scheme in the production of collagen-based tissue engineering scaffolds is demonstrated. Next, a novel modification of the basic electrospinning process is presented. This process, called two pole air gap electrospinning, was developed to produce nerve guides that exhibit an anisotropic structure …
Evaluating The Incremental Validity Of The Mmpi-2-Rc Scales For Custody Litigants, Elizabeth Wheeler
Evaluating The Incremental Validity Of The Mmpi-2-Rc Scales For Custody Litigants, Elizabeth Wheeler
Theses and Dissertations
The use of psychological testing in child custody assessments has become more common and important as psychologists are increasingly used as expert witnesses in contested child custody and visitation cases. Currently, the MMPI-2 is the most commonly used psychological test in child custody cases, but there is no research indicating which version of the measure (K-corrected, non-K-corrected, or the RC scales) provides the most accurate picture of the custody litigant in terms of substantial correlations with external variables. This study represents the first examination of the convergent, discriminant, and incremental validity of the MMPI-2 K-corrected Basic Clinical Scales, the MMPI-2 …
Disclosure And Health: Enhancing The Benefits Of Trauma Writing Through Response Training, Andrea Konig
Disclosure And Health: Enhancing The Benefits Of Trauma Writing Through Response Training, Andrea Konig
Theses and Dissertations
Writing about a personal traumatic event has been found to have psychological and physical health benefits. Focusing on traumatic memories in writing may be a form of exposure. In imagery exposure and trauma writing, greater physiological reactivity was predictive of better outcomes. Given the importance of physiological output in emotional processing, response training was developed and found to be effective in increasing appropriate physiological reactivity in imagery exposure. If response training amplifies physiological reactivity and the benefits of writing, the hypothesis that writing is a form of exposure would be strengthened, and training may be a valuable tool to improve …
Shrubs As Sentinels Of Ordnance Contamination: Using Plant Physiology And Remote Sensing To Detect Tnt In Soils, Kathryn Rubis
Shrubs As Sentinels Of Ordnance Contamination: Using Plant Physiology And Remote Sensing To Detect Tnt In Soils, Kathryn Rubis
Theses and Dissertations
Methods for rapid, safe and effective detection of unmapped buried ordnance are vital to the protection of humans and environmental quality throughout the world. This study aimed to investigate the use of phytosensing and to understand the physiological response of woody plants to 2,4,6-trinitrotoluene (TNT) contamination. Baccharis halimifolia were potted in soils containing various concentrations of TNT and physiological responses were observed over a 9-week experimental period. Measurements included the collection of remotely sensed data, such as hyperspectral reflectance and chlorophyll fluorescence, and traditional plant-level physiological data. In accordance with the hypothesis, low levels of TNT improved physiological response in …
Efficacy Of A Cognitive-Behavioral Treatment For Insomnia Among Afghanistan And Iraq (Oef/Oif) Veterans With Ptsd, Margolies Skye Ochsner
Efficacy Of A Cognitive-Behavioral Treatment For Insomnia Among Afghanistan And Iraq (Oef/Oif) Veterans With Ptsd, Margolies Skye Ochsner
Theses and Dissertations
Sleep disturbances are a core and salient feature of PTSD and can maintain or exacerbate associated symptoms. Recent research demonstrates that cognitive-behavioral sleep-focused interventions improve sleep disturbances as well as PTSD symptoms. The present study is a randomized controlled trial comparing Cognitive Behavioral Therapy for Insomnia (CBT-I) to a waitlist control group. Conducted at a Veterans Affairs Medical Center, the study: 1) compared subjective outcome measures of sleep amongst veterans assigned to either a treatment group (CBT-I) or a waitlist control group; (2) examined the influence of the intervention on measures of PTSD, general mood and daytime functioning, comparing veterans …
Characterization Of The Effect Of Serum And Chelating Agents On Staphylococcus Aureus Biofilm Formation; Chelating Agents Augment Biofilm Formation Through Clumping Factor B, Nabil Mathew Abraham
Characterization Of The Effect Of Serum And Chelating Agents On Staphylococcus Aureus Biofilm Formation; Chelating Agents Augment Biofilm Formation Through Clumping Factor B, Nabil Mathew Abraham
Theses and Dissertations
Staphylococcus aureus is the causative agent of a diverse array of acute and chronic infections, and some these infections, including infective endocarditis, joint infections, and medical device-associated bloodstream infections, depend upon its capacity to form tenacious biofilms on surfaces. Inserted medical devices such as intravenous catheters, pacemakers, and artificial heart valves save lives, but unfortunately, they can also serve as a substrate on which S. aureus can form a biofilm, attributing S. aureus as a leading cause of medical device-related infections. The major aim of this work was take compounds to which S. aureus would be exposed during infection and …