Digital Commons Network^™

Promoting The Use Of Smoke Evacuation Systems In The Operating Room: A Quality Improvement Initiative, Andrea Leigh Drayer

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Surgical smoke produced during procedures poses serious health risks to operating

room (OR) staff and patients, yet many hospitals, including an academic medical center in

northern West Virginia, have underutilized smoke evacuation systems. The imminent

enforcement of West Virginia House Bill 4376, mandating smoke evacuation use, provided both

urgency and opportunity for an intervention.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project

was to increase timely compliance with the use of smoke evacuation systems during all smoke-

producing procedures, ensuring alignment with safety standards and legislative requirements.

Methods: A systematic evidence review of academic …

Preliminary Analysis Of Soil Volatile Organic Compounds As Soil Health Indicators, Thorne Taul

Graduate Theses, Dissertations, and Problem Reports (ETD)

Over the past decade, soil health (SH) has gained popularity due to the novelty of sustainable soil use related to human wellbeing. Soil health describes the overall quality of soil and its capacity to function over time. As interest in SH grows, researchers continue to explore new soil health indicators that can improve knowledge on how soil health is assessed and managed. Some indicators directly reflect soil health status, and some indirectly relate to processes and functions occurring within the soil. Volatile organic compounds (VOCs) are naturally occurring compounds that play a role in multiple soil processes. They are associated …

“This, To Me, Was My Town”: How Segregation Shaped Huntington, West Virginia’S Black Community, Jillian Alexis Kendall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Using Huntington, West Virginia as a case study to examine Black urban-Appalachian communities, this thesis analyzes Huntington’s Black “city within a city” from 1934–1961, exploring how city-sanctioned segregationist practices shaped the community. In 1929, The Herald Dispatch asserted that Black Huntingtonians were able to thrive due to racial harmony facilitated by the “tolerant” attitudes of white Huntingtonians. However, closer inspection reveals that the city’s Black population survived in spite of persistent racial intolerance from white citizens, as well as city, state, and federal authorities. Though Huntington was not technically segregated by de jure means, it is apparent that the city …

Ornithine Metabolism In Retinal Pigment Epithelium And Retina And Implications In Gyrate Atrophy, Artjola Puja

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ornithine aminotransferase (OAT) is a mitochondrial enzyme that regulates ornithine metabolism by converting ornithine to pyrroline-5-carboxylate, a precursor for proline and glutamate synthesis. Deficiency of OAT causes systemic ornithine accumulation and leads to gyrate atrophy (GA) of the choroid and retina, a hereditary disorder characterized by progressive chorioretinal degeneration and irreversible vision loss. Chorioretinal atrophy typically starts at the mid-peripheral retina and progresses toward the macula. Although elevated ornithine is considered toxic to the eye, how ornithine is metabolized in ocular tissues and why OAT deficiency causes selective, region-specific vulnerability remain unclear. We combined ex vivo and in vivo stable …

Graft: Graph-Augmented Framework With Vision Transformers For Multi-Label Classification, Ghazaleh Mirzaee

Graduate Theses, Dissertations, and Problem Reports (ETD)

Multi-label classification of thoracic diseases from chest X-ray images poses a distinctive challenge: patients rarely present with a single isolated pathology, and automated systems must identify multiple co-occurring conditions simultaneously from a single radiograph. Standard classification architectures treat each disease label as an independent binary decision, failing to capture the statistical co-occurrence patterns, spatial anatomical relationships, and visual feature similarities that characterize multi-disease presentations in clinical data. Class imbalance and incomplete labels compound these problems. In NIH ChestX-ray14, the rarest pathological class has only 227 training instances, and many co-occurring conditions go unlabeled because radiologists focus their reports on the …

Revival Through Resilience In The Post-Mined Landscape: Demonstrating The Socio-Economic Context Of Appalachia And Exploring How Community Infrastructure And Cultural Tourism Can Be Catalysts For Economic Regeneration In Appalachian Communities, Azita Tasnim Ritu

Graduate Theses, Dissertations, and Problem Reports (ETD)

Post-industrial communities across Appalachia continue to experience economic and environmental challenges following the decline of coal mining and related industries. Towns such as Smithers and Montgomery, West Virginia, reflect these conditions through economic stagnation, population loss, aging infrastructure, and degraded landscapes, creating an urgent need for sustainable redevelopment strategies.

The Appalachian Regional Commission emphasizes economic diversification, infrastructure investment, and community revitalization as critical components for improving regional quality of life. However, many former mining communities continue to struggle with underutilized heritage assets, degraded landscapes, and limited economic alternatives. Cultural landscapes and local identity remain significant but often overlooked resources that …

Process Optimization And Quality Control In Manufacturing Of Frp Composites By Vartm, Mohamed Emadeldin Omar Abdelhadi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Railroad tank cars, being one of the most used means of transportation of hazardous material across the country, have not been structurally upgraded for a long time. Thus, the Pipeline and Hazardous Materials Safety Administration (PHMSA), a United States Department of Transportation (USDOT) agency, released a rule for safer transportation of highly hazardous and flammable liquids by railroad to enhance the design specifications of both the new and existing tank cars in May 2015. A multifunctional composite jacket is proposed as a new material to structurally enhance the railroad tank cars to withstand any accidents that could happen en route. …

Addressing Algorithmic Bias In Ai Journalism: A Toolkit For More Equitable Coverage Of Marginalized Communitie, Sierra Monet Worden

Graduate Theses, Dissertations, and Problem Reports (ETD)

This project addresses a critical gap in journalism reporting concerning the use of artificial intelligence (AI) when covering stories on marginalized communities. Partially as it relates to the bias that exists in artificial intelligence algorithms, and the lack of training that exists for the implementation of these tools. Journalists play a crucial role in providing accurate and fair information on marginalized communities, yet the implementation of AI presents a set of all new challenges and allows opportunities for more bias to make its way into news coverage. Existing resources for reporting focus more on ethics and less on how to …

Machine Learning-Based Prediction Of Heavy-Duty Diesel Engine Emissions And Comparative Analysis Against Statistical Models, Abdullah Ahmad Khan

Graduate Theses, Dissertations, and Problem Reports (ETD)

The increasing stringency of emissions regulations for heavy-duty (HD) diesel engines necessitates the development of accurate, efficient, and general predictive models for engine-out emissions under steady-state operating conditions. Traditional statistical approaches, while computationally efficient, often fail to capture the inherent nonlinear relationships between the engine operating parameters and emissions formation. In contrast, machine learning (ML) techniques offer a promising alternative by learning the complex patterns directly from experimental data. The present thesis summarizes a comprehensive study on the prediction of steady-state, HD diesel engine emissions using ML models, along with a comparative analysis against conventional statistical modeling approaches.

A high-quality …

Public Perception Of Using Public Lands For Climate Change Mitigation, Casey Marie Zaitzew

Graduate Theses, Dissertations, and Problem Reports (ETD)

Biological carbon sequestration provides a way to integrate carbon initiatives while meeting sustainable forestry management needs. In the United States, woody plants capture about 13% of annual carbon emissions, highlighting the importance of forests and other ecosystems in national climate strategies.With over 640 million acres of public land, management strategies that incorporate carbon sequestration could significantly influence national carbon storage. Because public lands are taxpayer-funded, public acceptance is critical in carbon-focused policies. While prior studies have examined public attitudes toward carbon capture and storage techniques, fewer studies have focused on biological sequestration within federally managed lands.

This study analyzes public …

Exploring The Role Of Occupational Therapy In A Pediatric Specialty Care Office, Sierra Leigh Hays

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The role of OT in primary and specialty care clinics is a rising area of interest in the field. There are also many multidisciplinary clinics that OTs can be or are apart of. This study aims to evaluate the consulting role of OT in primary and specialty care clinics, as well as to evaluate data collected by an OT in a pediatric brachial plexus and peripheral nerve clinic. Methods: The first objective was focused on analyzing functional outcomes, using the Active Movement Scale (AMS), of children following neurosurgery or onabotulinum toxin A injections. This was a retrospective study with …

Data-Driven Methodologies For Mapping Cultural Heritage: The Case Of The National Coal Heritage Area, West Virginia, Usa, Hossain Mohammad Nahyan

Graduate Theses, Dissertations, and Problem Reports (ETD)

The objective of this dissertation was to develop a comprehensive, data-driven spatial framework for characterizing the complex cultural landscape of the National Coal Heritage Area (NCHA) in West Virginia. By transitioning away from traditional, heuristic spatial mapping, this research integrates advanced spatial statistics, machine learning, and GIS-based methodologies to objectively quantify the physical, visual, and cultural dimensions of the post-mining environment. The research is structured around three interconnected empirical studies, each addressing a specific scale of the Landscape Character Assessment (LCA) framework to support heritage conservation and sustainable spatial planning. The first paper focused on landform classification, developing an automated …

Caring For The Caregiver: Implementing An Occupational Therapy-Tailored Educational Program To Alleviate Caregiver Burden, Lura Elizabeth Simons

Graduate Theses, Dissertations, and Problem Reports (ETD)

Caregivers of traumatic brain injury (TBI) survivors experience caregiver burden, which is a prevalent issue. The most significant concern is for symptoms of burden affecting mental health and sleep quality. This doctoral capstone project addressed the knowledge gap regarding programs that alleviate these signs and symptoms through evidence-based interventions. The objective was to create an educational program with modules that demonstrated improvement in satisfaction and content understanding through in-person sessions and individualized interviews with staff members. This project aimed to reduce perceived burden by conducting in-person sessions to implement interventions through an occupational therapy (OT) lens and by using educational …

Three Essays In Cpi Bias And Health Economics, Auderta Amoako-Nuamah

Graduate Theses, Dissertations, and Problem Reports (ETD)

The first essay estimates bias in the Consumer Price Index (CPI) for elderly individuals in the United States using Engel curve methodology and household-level data from the Panel Study of Income Dynamics (1999–2023). The analysis focuses on how well the CPI reflects changes in the cost of living for older Americans, with particular attention to differences by gender and marital status. Results show that from 1999–2011, the CPI overstated the increase in the cost of living for both elderly and non-elderly households. In contrast, from 1999–2023, the CPI understated cost increases, with the bias generally larger for non-elderly households. Within …

Back To The Office Or Out The Door: The Impact Of Return-To-Office Mandates On Employee Well-Being And Turnover Intention, Charlotte Renee Nelson

Graduate Theses, Dissertations, and Problem Reports (ETD)

The widespread adoption of remote work during the COVID-19 pandemic significantly altered traditional workplace arrangements. As organizations increasingly implement RTO mandates, questions have emerged about how these changes affect employee well-being and turnover intentions. Guided by the Job Demands–Resources framework, this study examined the relationship between RTO mandates and two employee outcomes: employee well-being and turnover intention. The study also tested whether work engagement mediated these relationships and whether perceived organizational support and work stressors moderated the relationship between RTO mandates and work engagement.

A quantitative, non-experimental, cross-sectional survey design was employed. Data were collected from 229 U.S. employees working …

Enhancing Occupational Engagement And Wellness In Middle-Aged And Retired Adults Through Movement And Mindfulness Program Development, Erin J. Harvey

Graduate Theses, Dissertations, and Problem Reports (ETD)

Occupational imbalance and a diminished sense of purpose are common challenges faced during middle age and the transition into retirement. These issues can contribute to increased burnout, decreased participation in meaningful activities, and an overall decline in health and well-being. Occupational therapy is well-equipped to address these concerns through comprehensive and holistic, occupation-based wellness programs that promote healthy routines and engagement in meaningful roles. This doctoral capstone project involved developing and implementing two community-based wellness programs tailored to different populations. The first program included self-paced wellness modules for middle-aged adults, aiming to encourage healthy lifestyle habits, enhance coping skills, and …

A Quality Improvement Initiative To Decrease The Length Of Stay In The Post-Anesthesia Care Unit For Children Undergoing Iv Anesthetic Inductions For Gastrointestinal Procedures, Kaylee Bahret Bangs

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Pediatric patients at WVU Medicine Children’s (WVU-CH) are emerging slowly from anesthetics during diagnostic gastrointestinal procedures which delays discharge from the post-anesthesia care unit. The cumulative effect is an increased length of hospital stay and the associated increases in costs. This project explores a novel method to reduce the amount of medication pediatric patients receive by using virtual reality goggles as a nonpharmacologic intervention to reduce preprocedural anxiety.

Purpose: This quality improvement project seeks to reduce time spent in PACU for children undergoing IV induction GI procedures by using preoperative virtual reality (VR) headsets during IV placement …

Intersectionality In Discrimination, Posttraumatic Stress Symptoms, And Suicide Ideation: Black Americans In Appalachian Contexts, Jailyn May Wilson

Graduate Theses, Dissertations, and Problem Reports (ETD)

Racial discrimination is recognized as a race-based traumatic stressor that has been associated with posttraumatic stress symptoms (PTSS) and suicide ideation (SI). However, there remains a paucity of research investigating the impact of racial and other forms of discrimination on understudied populations, including Black Americans residing in Appalachian regions. The current study used an online self-report survey to examine PTSS as a mediator in the association between perceived discrimination and SI and to examine the moderating effect of the number of identity factors with which one experienced discrimination (i.e., race, gender, region) on the relationship between perceived discrimination and PTSS. …

Cross-Cue Reactivity Of Nicotine And Cannabis Vaping Products, Madeline Smith

Graduate Theses, Dissertations, and Problem Reports (ETD)

SIGNIFICANCE. The rewarding properties of nicotine increase when administration is paired with external stimuli, or “cues”, including those related to vaping products. Given the visual similarity between nicotine vaping products (NVPs) and THC vaping products (TVPs), exposure to one product may elicit reactivity (e.g., craving, urge to use) to the other. The present study aimed to develop a set of cues capable of differentiating NVPs from TVPs to inform investigations of cross-cue reactivity. METHODS. Images (n=61 NVPs; n=64 TVPs; 7=unspecified) were obtained via an online search using both generic (“vape”, “vape pen”) and product-specific (e.g., “nicotine vape”, “dab pen”) keywords …

Exploring Youth Soccer Coach Recruitment Practices, Han-Earl Lim

Graduate Theses, Dissertations, and Problem Reports (ETD)

This qualitative single-case study examined how a private-interest, nonprofit youth soccer club in the Midwestern United States recruits coaches, what coach qualities are prioritized in hiring, and how organizational and sociocultural conditions shape those practices. The study was guided by three research questions focused on (a) recruitment and early support processes, (b) hiring criteria and decision rationales, and (c) the organizational and sociocultural contexts influencing recruitment. Data were generated through five semi-structured interviews with four participants who were involved in recruitment practices (the Executive Director, the Assistant Director, and two full-time head coaches). Additional sources included an organizational mapping survey …

Comparison Of Push-Pull Air Curtain To Overhead Downdraft Systems On Aerosol Containment And Distribution In Controlled Environments, Manal Mutairi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparison of Push-Pull Air Curtain to Overhead Downdraft Systems on Aerosol Containment and Distribution in Controlled Environments.

This dissertation looks at the ongoing issue of tiny airborne particles created during medical and dental procedures and evaluates ways to reduce the risk of exposure for healthcare workers and patients to these particles. The first study focuses on the size, how long particles stay in the air, and how far they travel from common medical procedures that create aerosols, showing that tiny particles (less than 5 µm) can stay in the air long enough to escape basic droplet controls. As a …

An Evidence-Based Practice Initiative To Promote Debriefing Within The Obstetrics Surgical Team, Rachel Lynn Runatz

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Operating room debriefing is an evidence-based strategy shown to improve communication, efficiency, patient safety, and safety culture; however, debriefing is inconsistently performed in obstetric operating rooms due to workflow, cultural, and time-related barriers.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to increase the frequency of debriefings in the Birthing Center operating rooms at WVU Medicine Children’s Hospital through implementation of a nurse-driven, evidence-based debriefing initiative.

Intervention: A nurse-driven debriefing protocol was implemented using the Iowa Implementation for Sustainability Framework. Interventions included staff education, accessible laminated debriefing documents, identification of nurse champions, leadership support, and …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

The Effects Of Music Therapy On Anxiety And Sedation Requirements For Total Knee Arthroplasty Patients Undergoing Regional Anesthesia: An Evidence-Based Practice Pilot Initiative, Kyra Marie Savrese

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Excessive noise in the operating room negatively impacts patient comfort and outcomes, particularly in patients undergoing spinal anesthesia who have the potential for awareness.

Background: Research demonstrates that music therapy is a low-cost, low-risk intervention that reduces perioperative anxiety and sedative requirements. Literature supports the use of music as an adjunct to anesthesia care, especially in orthopedic populations.

Purpose: At J.W. Ruby Memorial Hospital, orthopedic procedures with regional anesthesia expose patients to high noise levels, often leading to increased anxiety, sedation use, and longer recovery times. Addressing this problem aligns with institution goals for safe, patient-centered care.

Methods: Using …

Resilience And Reactivity: The Relation Between John Henryism And Cardiovascular Responses To Laboratory Stressors In An Appalachian Sample, Emma Raycher Thompson

Graduate Theses, Dissertations, and Problem Reports (ETD)

John Henryism active coping (JHAC), named for folk hero John Henry, is defined as the perception that one can overcome stressors through hard work (James et al., 1983). This construct has been tied to numerous health outcomes, showing a negative influence on cardiovascular health (Bennett et al., 2004). Many researchers have examined the relation between JHAC and cardiovascular reactivity to stress, though findings are mixed. Further, despite the legend of John Henry occurring in Appalachia, and traits associated with John Henryism, such as resilience, being prominent within this region, no study has examined the relation between JHAC and reactivity in …

Do Transdiagnostic Factors Predict Emotion Recognition?, Grace L. Wheeler

Graduate Theses, Dissertations, and Problem Reports (ETD)

While emotion recognition deficits have been found in several anxiety and related disorders (e.g., social anxiety, obsessive-compulsive), consistent results have not been established. To clarify the relationship between emotion recognition abilities and anxiety, the current study tested if transdiagnostic factors related to anxiety are predictors of emotion recognition abilities. Data was analyzed from participants (N = 188) recruited via CloudResearch; they completed measures of three transdiagnostic factors related to anxiety (e.g., anxiety sensitivity, intolerance of uncertainty, and rumination), followed by an emotion recognition task. Multiple regression analyses revealed higher levels of anxiety sensitivity predicted worse recognition for anger, disgust, …

Feasibility Of Parent-Child Interaction Therapy-Toddler In Community Clinics In The United States And Japan, Sharon T. Phillips

Graduate Theses, Dissertations, and Problem Reports (ETD)

The toddler age (12-36 months) is characterized by a toddler’s increasing desire for autonomy, which can result in caregiver-child conflict and toddler externalizing problems (Kohlhoff & Morgan, 2014). Clinical levels of disruptive behavior in toddlerhood can be predictive of a host of negative outcomes, including problems with academic achievement and delinquency (Copeland et al., 2007; Milledge et al., 2019). High levels of toddler behavior problems also are associated with poor caregiver-child relationships and poor toddler emotion regulation skills (Beijers et al., 2013; Umemura et al., 2022). Thus, interventions targeting toddler behavior problems need to focus on strengthening the caregiver-child relationship …

An Evidence-Based Practice Initiative To Expedite Pediatric Recovery And Discharge Following Myringotomy Tube Placement, Nicole Marie Rillera

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The use of multiple sedatives, anxiolytics, and analgesics to prevent emergence agitation (EA)in pediatric patients undergoing myringotomy (MT) placement at West Virginia University Medicine Children's is leading to prolonged lengths of stay in the post-anesthesia care unit (PACU). These extended stays are causing delays in subsequent procedures and raising concerns for staff, patients, and their families.

Evidence Review: The combination of intranasal dexmedetomidine given preoperatively and intramuscular ketorolac given intraoperatively for pediatric patients reduces the incidence of EA more effectively than oral midazolam and acetaminophen.

Purpose: This evidence-based practice project aims to establish a standardized, evidence-based anesthesia plan to …

Mechanisms Of Glyphosate Toxicity: Uptake, Mitochondrial Function, And Metabolism, Dionysios Patriarcheas

Graduate Theses, Dissertations, and Problem Reports (ETD)

Glyphosate, the most widely used herbicide in the world, is an inhibitor of chorismate biosynthesis, the precursor of aromatic amino acids. The target of glyphosate is absent in animals, but findings reporting toxicity in model organisms without a known mechanism or target are increasing. Saccharomyces cerevisiae is a useful and versatile model for understanding molecular mechanisms of toxicity. In yeast, previous work has shown that the aspartate/glutamate permease Dip5 is the proposed transporter for glyphosate and that mitochondrial metabolism has been implicated in response to glyphosate toxicity. This dissertation aimed to identify the effects of glyphosate on mitochondrial function through …

Multi-Omic Characterization Of Immune And Metabolic Responses To Inflammatory Challenges In Sheep, Samanthia Raceine Johnson

Graduate Theses, Dissertations, and Problem Reports (ETD)

To meet the demands of the growing population, it is imperative to develop sustainable and applicable ways to improve animal health and productivity. The first step in doing so is understanding the mechanisms that govern health and immune response and find ways to appropriately modulate them to improve animal health and productivity. The objective of this study is to use multi-omic techniques to understand breed-specific immune responses in sheep that may contribute to their resistance and susceptibility to parasites and to a greater extent, immunocompetence. Known parasite-resistant breed, St. Croix (STC) were compared to parasite susceptible Suffolk (SUF) sheep for …