Digital Commons Network^™

The Role Of Sleep And Social-Ecological Supports In The Association Between Racial Discrimination And Cardiometabolic Risk In Black Youth, Jelaina R. Shipman-Lacewell

Theses and Dissertations

Black youth are at an increased risk for poor short and long-term cardiometabolic health, including obesity, hypertension, and type 2 diabetes. Racial discrimination and poor sleep are theorized as key factors contributing to cardiometabolic health. While adult studies support sleep as a pathway through which discrimination is associated with health, there is a critical gap in our knowledge of this pathway in youth. Socio-ecological supports may protect Black youth against stressors, including racism. However, studies of the protective nature of these factors in Black youth have primarily focused on psychological and behavioral outcomes. Thus, the current study built upon previous …

From Suicidal Ideation To Suicide Attempt: Clarifying The Role Of Painful And Provocative Events, Mallory Stephenson

Theses and Dissertations

The Interpersonal-Psychological Theory of Suicide hypothesizes that capability for suicide is acquired in part through exposure to physically painful and/or fear-inducing experiences, referred to as painful and provocative events (PPEs). Studies of PPE exposure offer an opportunity to characterize potential targets for suicide prevention and inform efforts to identify individuals at elevated suicide risk. However, the literature on PPE exposure and risk for suicidality has been limited by a reliance on cross-sectional designs, lack of genetically informed research, inclusion of risk-taking behaviors as potential PPEs, and focus on risk over resilience. In this dissertation, we aimed to address these knowledge …

The Influence Of Flavor On The Abuse Liability Of A Heated Tobacco Product And Its Feasibility As A Menthol Cigarette Substitute, Augustus White

Theses and Dissertations

Heated Tobacco Products (HTPs) purport to expose people that use cigarettes to fewer of the harmful or potentially harmful constituents of tobacco while still delivering reinforcing amounts of nicotine (Auer, Concha-Lozano et al., 2017). An exemplar of the HTP class, IQOS, and its three varieties of “HeatSticks” have been authorized by the Food and Drug Administration (FDA) as “Modified Risk Tobacco Products” (MRTP). However, as the FDA is planning to ban menthol as a characterizing flavor in cigarettes, questions remain regarding whether characterizing flavors should be permitted in HTPs (FDA, 2022e). New evidence regarding HTP abuse liability (i.e., the likelihood …

“I Know What Nothing Means”: Nostalgia, Hope, And The Postmodern Search For The Sublime, Kathryn L. Donati

Theses and Dissertations

Amid simultaneous crises of self, nation, digital citizenship, global health, climate change, and socio-political polarization, to name but a few of the catastrophes that seem to define life in the global West in the twenty-first century, where do we find hope? Do we find it at all? Is there any hope to be found? These are the questions that serve as the genesis for this undertaking in which I locate the origin of these crises far before the events of the 2016 and 2020 elections, far before even the panic of Y2K. I begin my examination of hope in contemporary …

Living The American Dream? College Experiences Of Undocumented Students In An Era Of Rising Xenophobia And Political Turmoil, Sandra Y. Ting Ph.D.

Theses and Dissertations

This research study sought to deepen the understanding of the journeys of undocumented and DACAmented college students in an era of escalated xenophobia and political unrest. Three noteworthy themes emerged from the sentiments expressed by participants. The experiences they described included: 1) the turmoil of undocumented status eliciting unique and empowering demonstrations of resourcefulness, creativity, and self-advocacy, 2) motivation and stress from their respective citizenship statuses existing as two mutually dependent facets of a unified whole, 3) a community of support from other undocumented and/or DACAmented peers as a necessity for wellbeing. These critical outcomes culminate in the conditioning to …

Shinners, Alexis E. Mabry

Theses and Dissertations

Shinners is a project that aims to examine the position of women in subcultures and capture conversations of women in subcultural sports. Within feminism, sociological constructs, campy horror, and personal experience I am manifesting the physical and mental obstacles faced in the subcultural sport of Bicycle Motocross (BMX) through photography, painting, collage, video, and sculpture. I interpret images posted to social media of injuries obtained while riding BMX as forms of empowerment, bodily gore as extreme evidence of participation, performative violence, valorizing the understanding of both the physical and psychological pain of failure, and the use of failure as a …

Validation Of A Screening Tool For Sleep Apnea In Children, Brandon Khor

Theses and Dissertations

Objective: The aims of this study were to (1) determine the ability of a pediatric obstructive sleep apnea (POSA) questionnaire to identify high-risk patients through confirmation with an at-home sleep apnea test (HSAT) and (2) to evaluate the correlation between high-risk patients as identified by the questionnaire (PM-STOP-Bang) and an already validated POSA screening tool.

Methods: Orthodontic patients aged 12-17 who met the inclusion criteria were consecutively enrolled in the study (n=16). At the initial orthodontic appointment, the clinician filled out the PM-STOP-Bang questionnaire. Subsequently, participants were invited to complete a one-night HSAT (WatchPat, WP-Itamar-Medical, Caesarea, Israel), which recorded diagnostic …

Factors Important To Underrepresented Minority Applicants In Ranking Orthodontic Programs, Alyssa Patterson

Theses and Dissertations

Purpose: To determine if there was a difference in desirability of various factors used by applicants ranking orthodontic programs depending on their racial or ethnic background.

Method: A survey was distributed to orthodontic residents to assess overall preferences, and differences in desirability of various factors between underrepresented minority (URM) and non-URM applicants.

Results: For applicants overall, “clear aligner therapy training”, “good quality of clinical faculty” and “high number of cases started” had the highest mean desirability. “Racial and ethnic diversity among current and former residents”, “racial and ethnic diversity among faculty” and “participation in care of Medicaid patients” were significantly …

A Radiographic Analysis Of Teeth With Carrier-Based Obturation Requiring Retreatment, Robert W. Rudnicki

Theses and Dissertations

Objective: The purpose of this study was to determine observer accuracy and agreement in detecting carriers using preoperative radiographs, as well as to identify potential radiographic indicators for the presence of carriers.

Methods: A chart review was conducted for patients seen at the VCU graduate endodontic clinic. Eligible cases included previously treated teeth that were nonsurgically retreated, with and without identified carriers. 100 cases were identified, including 61 carrier and 39 non-carrier cases. Preoperative radiographs were randomized, and evaluators assessed each case for the presence of carrier-based obturation. Evaluators included three endodontists, one general dentist, and four endodontic residents. Statistical …

Using Natural Language Processing To Understand The Lived Experiences Of People Identifying With Adhd: What Themes Emerge In Social Media Posts?, Gabby C. Scalzo

Theses and Dissertations

Compared to the amount of research conducted on how to identify and understand children with Attention-Deficit Hyperactivity Disorder (ADHD), there has been relatively little work done to understand the lived experiences of adults with ADHD. Increased understanding of how adults with ADHD conceptualize themselves in the context of their diagnosis would help clinical experts tailor research and treatments to better serve these communities. However, there are several barriers towards conducting high-quality qualitative research, including time- and labor-intensity. This study, informed by qualitative research traditions, used innovative data sources (i.e., social media) and analytic techniques (i.e., machine learning) to reduce these …

Characteristics Of Permanent Teeth Diagnosed With Pulpal Necrosis: A Retrospective Study, William Lee

Theses and Dissertations

Objective: To determine associations of pulpally necrotic teeth with demographics, clinical findings, radiographic presentation, and periapical status.

Methods: Virginia Commonwealth University uses AxiUm software to record dental treatment and treatment notes. The current study involves a keyword search using the term “pulpal necrosis”. Factors compiled and evaluated included but not limited to patient demographics, location in the dental arch, clinical findings, radiographic presentation, and periapical status.

Results: Data has revealed that teeth with pulpal necrosis can present with a variety of different clinical findings. All of the following were observations of teeth with pulpal necrosis. A total of 325 teeth …

Relations Between Adverse Childhood Experiences And Substance Use In Adolescents And Emerging Adults: The Moderating Role Of Exposure To Community Violence And Community Support And Community Recognition, Kiara Brown

Theses and Dissertations

Due to historical and current systemic racial inequities, African American adolescents and emerging adults living in low-income urban communities bear the burden of higher rates of adverse childhood experiences (ACEs) and exposure to community violence. Both exposure to ACEs and community violence are linked to higher levels of substance use. However, limited research exists on how exposure to community violence exacerbates the association between ACEs and higher frequencies of substance use in adolescence and emerging adulthood. There is also a need to understand how community-level protective factors may weaken the relations between ACEs and higher rates of substance use. The …

Chronobiology Of Meal Timing In Early-Stage Hypertension: Effects On Renal And Vascular Function, Natalie J. Bohmke

Theses and Dissertations

Introduction: Previous research determined that a Western-style meal acts as a stressor to the kidney and contributed to impaired blood pressure and vascular function. Despite an understanding of acute postprandial physiology in humans, studies have not investigated the impact of the time of day of meal consumption on physiology. Methods: Ten participants with elevated or stage-one hypertension underwent a randomized crossover trial with a controlled feeding intervention of a Western-style meal in the morning or the evening. Participants completed a run-in day to standardize diet followed by the experimental day. On day 2, participants completed ambulatory blood pressure, core temperature, …

On The Rebound: Resilience And Subjective Cognitive Symptoms In Cancer, Giuliana V. Zarrella

Theses and Dissertations

Recent studies have shown a strong connection between resilience and subjective cognitive symptoms in clinical populations. However, there is limited understanding of this relationship in cancer survivors, and no studies examine whether resilience training could alleviate subjective cognitive symptoms in these patients. This study examined the relationship between subjective cognitive function and resilience in non-CNS cancer survivors who participated in a resiliency training intervention, at baseline and from pre- to post-intervention, as well as investigated potential influences of change in subjective cognition. Adult cancer survivors (N=275) participated in the Stress Management and Resilience Training-Relaxation Response Resilience Program (SMART-3RP) …

Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Biodistribution Comparison Of Fentanyl And Morphine Following Acute And Repeated Expsoure, Rosamond M. Goodson

Theses and Dissertations

The ongoing opioid crisis constitutes a dire public health threat that has resulted in staggering loss of life. In 2021, opioids were implicated in over 75% of the approximately 107,000 deaths attributed to drug overdose (CDC), and synthetic opioids such as fentanyl and its analogues are key drivers of the surge in opioid fatalities in recent years. Although fentanyl is a μ opioid receptor agonist, it has several distinct attributes compared to other drugs in this category, such as morphine. These include enhanced lipophilicity, heightened potency to induce respiratory depression, more rapid entry into the central nervous system, reduced sensitivity …

Disparities Between Native Americans And White Individuals In Trajectories Of Community Participation Over The 5 Years After Traumatic Brain Injury, Jack Watson

Theses and Dissertations

Traumatic brain injury (TBI) disproportionately affects minoritized populations within the U.S., especially Native Americans who are more likely to experience a more severe or fatal TBI than White individuals. The current study used a subsample of 63 Native Americans with TBI from the TBI Model Systems (TBIMS) database matched by age, sex, and injury severity to 63 White individuals to examine disparities in community participation, as measured by the Participation Assessment with Recombined Tools—Objective (PART-O), over the five years following TBI. Analysis of variance (ANOVA) and chi-square tests revealed Native Americans were less likely to be employed prior to injury, …

The Sexually Dimorphic Role Of Connexin 43 In Bone Remodeling And Disuse-Induced Bone Loss, Gabriel A. Hoppock

Theses and Dissertations

Bone loss is frequently experienced by individuals undergoing long-term disuse, such as prolonged bedrest, immobilization due to paralysis or injury, and conditions such as spaceflight. Under normal physiological conditions, bone remodeling is balanced by bone-forming osteoblasts and bone-resorbing osteoclasts, and the activity of osteoblasts and osteoclasts is orchestrated by osteocytes. Osteocytes are the most abundant cell type found in bone and ample evidence suggests they are bone’s main mechanosensory cell type. Therefore, understanding osteocyte biology and responses to mechanical signals, or lack thereof during unloading, may lead to new therapeutic targets to combat bone loss during disuse. Previous data has …

Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado

Theses and Dissertations

Tobacco dependence has posed a significant public health challenge in the United States and disproportionately affects Latine adults' risk of developing a variety of adverse health conditions. Childhood trauma is a recognized risk factor for dependence, overall health, and mental health concerns. Still, the influence of compassion for self or compassion for others in this context remains unclear. This cross-sectional study investigated the moderating effects of self-compassion and compassion for others on the relationship between childhood trauma and cigarette dependence among Latine adults. Data was collected through questionnaires assessing childhood trauma, self-compassion, cultural values and factors, compassion for others, and …

Optimizing Deep Inspiration Breath Hold Technique For Personalized Breast Cancer Radiotherapy, Srinidhi Rajagopalan

Theses and Dissertations

The purpose of this research is entrenched in advancing the practice of 3D Conformal Radiation Therapy (3D CRT) for breast cancer patients by meticulously evaluating the impact of different Deep Inspiration Breath Hold (DIBH) techniques on dosimetric parameters. This study aims to ascertain the quantitative benefits of varied breathing techniques, primarily focusing on the 'Ultimate DIBH' method's efficacy in sparing critical organs such as the heart and lungs.

The comprehensive analysis of different DIBH techniques in this research is not merely an academic exercise but is geared towards substantiating the hypothesized advantages of these techniques with empirical data. By generating …

From Temporary Nurse Aide To Certified Nurse Aide: Examining Temporary Nurse Aides’ Perceptions Of Situated Learning As Preparation For The National Nurse Aide Assessment Program Examination, Amy Taloma

Theses and Dissertations

The Covid-19 pandemic exacerbated Certified Nurse Aide (CNA) staffing shortages in Long Term Care (LTC) facilities. To address these shortages, the Centers for Medicare and Medicaid Services (CMS) authorized LTC facilities to employ Temporary Nurse Aides (TNA). The American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) developed free online training for individuals which is much shorter than traditional nurse aide training and does not require hands-on skill training or a clinical practicum. The Federal Public Health Emergency (PHE) ended in October 2022. As a result, TNAs are no longer authorized to work in LTC Facilities …

Evaluation Of Cervical Dentin Removal After Orifice Shaping In Maxillary Premolars: A Micro Ct Study, Abdulaziz Mallik

Theses and Dissertations

Objective: The research aims to compare the volume and percentage of pericervical dentin removed by Gates Glidden Drills, ProTaper SX, and a 20-06 Rotary File.

Methods: A total of 24 extracted two-rooted maxillary first premolars were divided into three groups (n=8) and were coronally flared using either Gates-Glidden Drills, ProTaper Gold SX, or a 20-06 Brasseler Endosequence CM Rotary File. Pre- and post-flaring micro-CT scans were obtained. The dentin volume of the buccal canals was measured from the chamber floor and 2 mm apically in the buccal canal only. Data were analyzed using the ANCOVA test to compare dentin removal …

“Black Wom(B)Anhood”: An Explorative Analysis Of Black Women's Narratives Of Healthcare Encounters During And After Pregnancy, Janae A. Baker

Theses and Dissertations

This qualitative study explores the intricate dynamics of patient-provider relationships within the context of prenatal care among Black women and how these experiences may affect their perinatal mental health. The study was conducted using a methodology consisting of structured interviews with 12 participants, snowball sampling facilitated recruitment. Thematic analysis revealed six prominent themes encapsulating the multifaceted interactions between Black women and their healthcare providers during the perinatal period. The findings illuminate nuanced aspects of the patient-provider relationship, shedding light on issues such as: (a) Anticipation of Low Quality Care, (b) Lack of Communication, (c) Listening, (d) Stereotype Threat, (e) Colorism, …

Exploring The Experiences Of Refugee Youth In Public Schools: An Ethical Phenomenological Inquiry, Hilary T. Stim

Theses and Dissertations

The study outlined in this dissertation focuses on the intersection between refugee youth between the ages of 13-18 and the United States public school, specifically the manner in which refugee youth experience institutionalized education. It utilizes ethical phenomenology as a means to amplify the voices of refugee students and to centralize the students' experiences, thoughts, and ideas related to education The study was framed by one research question that is addressed to the participants: “What is it like being a student in a public school?” Seven students took part in the study. Collaborative dialogues took place with the participants across …

Online Racism And Mental Health Symptomatology Among Black Adolescents: A Longitudinal Examination, Stephen M. Gibson

Theses and Dissertations

Online racism (i.e., racism perpetrated and embedded within media and platforms on the Internet) is increasingly becoming a public health concern. Recent empirical evidence demonstrates that over a three year period, Black adolescents reported experiencing at least one online racial discriminatory incident, including exposure to racist images or videos within digital spaces (Tynes et al., 2020). One way in which Black adolescents are exposed to online racism is through the consumption of digital news media on the coverage of racially traumatic events (e.g., murders of Black men and women by police officers, racial hate crimes committed against Black people) and …

Exploring The Relationship Of Intact Limb Knee Joint Loading With Step Lengths And Step Length Symmetry In Individuals With Lower Limb Amputation, Edward D. Syrett

Theses and Dissertations

Individuals with unilateral lower limb amputation (LLA) frequently experience intact limb knee pain, dysfunction, and osteoarthritis. These problems can worsen pre-existing reductions in mobility and quality of life that this population regularly experiences. It is widely accepted that knee joint loading is implicated in the development of knee joint issues, and intact limb knee joint load alterations are thought to be widespread in individuals with LLA. Prior work suggests that gait deviations frequently present in this population may be a contributory cause of these altered forces. These deviations can take many forms, but individuals with LLA commonly demonstrate alterations in …

Fitbit Engagement In An Health Physical Activity Intervention For Young Adult Cancer Survivors: A Secondary Analysis Of The Impact Randomized Controlled Trial, Jessica Gomez Smith

Theses and Dissertations

Wearable devices allow for objective remote and real-time data collection and have been increasingly popular among the general public and in mHealth activity (PA) interventions. Despite this, our knowledge of feasibility and efficacy for using wearable devices to increase PA among a particularly vulnerable population—young adult cancer survivors age 18-39 (YACS)—is limited. Engaging in physical activity while undergoing cancer treatment contributes to reduced risk for recurrence and secondary cancers, and can also help to manage treatment side effects. However, there are a multitude of barriers to PA engagement among cancer survivors, with YACS in particular demonstrating low rates of PA. …

Spatial Transcriptomics Unravels Palmitoylation And Zonation- Dependent Gene Regulation Of Aeg-1 In Mouse Liver, Alissa Saverino

Theses and Dissertations

Obesity-induced metabolic dysfunction-associated steatohepatitis (MASH) leads to hepatocellular carcinoma (HCC). Astrocyte-elevated gene-1/Metadherin (AEG-1/MTDH) plays a key role in promoting MASH and HCC. AEG-1 is palmitoylated at residue cysteine 75 (Cys75) and a knock-in mouse representing mutated Cys75 to serine (AEG-1-C75S) showed activation of MASH- and HCC-promoting gene signature when compared to wild-type littermates (AEG-1-WT). The liver consists of 3 zones, periportal, midlobular, and pericentral, and zone-specific dysregulated gene expression impairs metabolic homeostasis in the liver, contributing to MASH and HCC. Here, to elucidate how palmitoylation influences AEG-1-mediated gene regulation in regards to hepatic zonation, we performed spatial transcriptomics (ST) in …

Development Of A Validity Scale For The Icd-11 Personality Disorder Measure (Psi-11), Rae Lutz

Theses and Dissertations

Invalid responding is a significant issue in the utilization of self-report information. Invalid responding can be assessed by stand-alone validity measures or embedded validity scales. The International Classification of Diseases (ICD) is one of two major diagnostic systems which provide guidance on diagnosing personality disorder, with the most recent version (ICD-11) providing a fully dimensional model for personality disorders. No existing measures aimed at assessing dimensional personality pathology have addressed the combination of PD severity and trait qualifiers that were based upon ICD-11 guidelines. To address this gap, Clark et al. (2021) developed the ICD-11 Personality Disorder Measure (PSI-11). However, …

Community Informant And Mental Health Provider Perspectives On Access To Mental Healthcare For Lgbtqia+ Communities In Virginia, Chariz Seijo

Theses and Dissertations

The existing literature on mental health disparities for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) populations suggests members of LGBTQIA+ populations are at greater risk of mental health disorders than cisgender and heterosexual individuals. The COVID-19 pandemic has also exacerbated mental health disparities for many, including LGBTQIA+ populations. Combined with mental health provider shortages and anti- LGBTQIA+ bills across the country, inequities in mental healthcare are a significant concern. This qualitative study was designed to gather unique perspectives of key community informants and mental health providers on their experiences with mental healthcare provision to LGBTQIA+ communities in Virginia. …