Digital Commons Network^™

Cohort Membership, Dental Insurance And Utilization Of Dental Services In Adults Age 47 And Over Receiving Dental Care At Virginia Commonwealth University’S School Of Dentistry, Patricia Brown Bonwell

Theses and Dissertations

This cross-sectional, non-experimental study evaluates associations between cohort membership, type of dental coverage, and utilization of dental services in all patients age 47 and over who received dental care at Virginia Commonwealth University’s (VCU) School of Dentistry in 2011. Structural Lag Theory poses that society’s institutions lag behind the actuality of a healthy and capable older adult population. The two dynamisms of the Structural Lag Theory were used for this study. The Dynamism of Changing Lives is represented by Cohort differences. Cohort differences include cohort size, people living longer and retaining more of their natural teeth along with different attitudes …

Investigation Of A Possible Association Between Pon1 Polymorphisms L55m And Q192r With Coronary Artery Disease And Type 2 Diabetes Patients Within A Southern Population, Chiquita Yvette Mcdaniel

Theses and Dissertations

Mississippi has a very high prevalence of coronary artery disease (CAD) and type 2 diabetes (T2D), especially among African Americans compared to Caucasians. This project determined the L55M genotypes of paraoxonase 1 (PON1) in 187 people and evaluated associations of PON1 single nucleotide polymorphisms (SNPs), Q192R and L55M, with CAD and T2D in a Mississippian (southern) population. Significant associations were found with PON1 SNPs and race: genotypes LL, LM, QR, and RR showed significant associations with race (p values 0.0000955, 0.0024, 0.00001244, and 0.00001676, respectively), and combined genotypes LMQQ and LMRR were significantly associated with race (p values = 0.0001013 …

Use Of Evidence To Assess Decreased Agitation In Alzheimer's Patients With Music Therapy, Rebecca Kreis

Theses and Dissertations

The purpose of this paper is to provide evidence-based research of the literature on music therapy as an intervention for agitation in Alzheimer's dementia patients. An agitated behavior state continues to be one of the most challenging behavior states in caring for individuals with Alzheimer's disease. An extensive review of the literature showed that music therapy is a successful, easy to apply, low cost intervention for agitated behavior in Alzheimer's disease patients

Home-Based Primary Care: A Return Of The House Call, Nicole M. Windjue

Theses and Dissertations

Retention and recruitment of providers is an ongoing stmggle in small and rural communities and poses a significant public health concern in meeting the needs of our aging population. This unfortunate situation will force many of our aging adults and home bound elders out of their homes and into skilled nursing facilities or assisted living environments long before they would have otherwise required skilled care. Providing primary care visits in the home is one way of addressing this issue. The medical and nursing communities have an obligation and a difficult challenge in providing our aging elders with a continuity of …

Early Implementation Of Palliative Care Services In The Elderly Population, Jenifer Wynne

Theses and Dissertations

No abstract provided.

Pain Assessment And Management In Clients With Alzheimer's, Kristen Jaster

Theses and Dissertations

No abstract provided.

Approaching A Sociology Of Aesthetics: Searching For Method In Georg Simmel's Rembrandt, Michelle Marie Nixon

Theses and Dissertations

Art leaves the viewer with an aesthetic experience. Through art, "a truth is experienced that we cannot attain in any other way" (Gadamer 1975: xxii-xxiii). Traditional sociological methods of studying art negate both this experience and the concept of aesthetics altogether. This thesis attempts to find a method to approach the sociological study of aesthetics that acknowledges its existence and the aesthetic experience by studying the work of sociological founder, George Simmel, in his recently translated monograph Rembrandt: An Essay in the Philosophy of Art. Even though it has recently been translated into English, among German-speakers, it was the …

Factors Associated With Access To Palliative Care In A Large Urban Public Teaching Hospital With A Formal Hospital-Based Palliative Care Program, Leland Waters

Theses and Dissertations

Hospital-based specialist palliative care services are designed to address the needs of critically ill patients by psychosocial and spiritual support, improving symptoms management, and offering discussions on goals of care. Integrating palliative care upstream in the care continuum for patients who eventually die in the hospital will help to address the many individualistic needs of the critically ill patient. The diffusion of specialist hospital-based palliative care services requires an understanding of patterns of utilization by patients. The purpose of this study was to examine the population characteristics of decedents who may or may not have utilized specialist palliative care services …

Addressing Functional Decline And Psychosocial Needs In Hospitalized Elderly, Rebecca A. Porier

Theses and Dissertations

Do hospitalized geriatric patients have better outcomes such as increased patient satisfaction, decreased length of stay, and decreased readmission rates with specialized interdisciplinary care, as on Acute Care of Elders (ACE) units, versus usual care? This is one question that this paper will address. The goal in this type of care is to achieve medical stability while preserving maximum functioning. Collaboration with all health care specialties is crucial to geriatric care . Secondarily, the gap in nursing knowledge of the elderly patient's care needs has to be addressed. Thirdly, patient's psychosocial needs should be addressed in order to promote their …

Intonation Perception In Elderly And Young Adult Subjects, Afua Mmra Blay

Theses and Dissertations

Various studies have reported that elderly individuals have difficulty perceiving intonation, especially in emotional context. However, the nature and the extent to which this problem affects the communication ability of these individuals are poorly understood. Most studies use isolated sentences which unlike natural discourse indicate no contextual information. Consequently, it is unclear whether the intonation processing problems for the elderly are manifested across the board regardless of availability of contextual information. To understand this issue, the present study sought to compare the performance of elderly adults on perception of intonation in stimuli presented with and without contextual information. Participants were …

A Re-Examination Of The Meyers And Volbrecht Motor Equation For The Identification Of Suspect Effort, Ashley R. Curiel

Theses and Dissertations

Neuropsychologists are frequently called upon to evaluate cognitive functioning and to participate in determining disability status, particularly in the wake of traumatic brain injuries, strokes, and other health events that compromise central nervous system functioning. A critical component of each evaluation is effort assessment. Ideally, the methods for assessing the credibility of effort are neither obvious to test-takers nor vulnerable to coaching. One of the promising ways to evaluate effort is to use a combination of test scores that assess a common domain, such as motor functioning. The purpose of the present study was to cross validate a linear regression …

C-Met Initiates Epithelial Scattering Through Transient Calcium Influxes And Nfat-Dependent Gene Transcription, Peter R. Langford

Theses and Dissertations

Hepatocyte growth factor (HGF) signaling drives epithelial cells to scatter by breaking cell-cell adhesions and migrating as solitary cells, a process that parallels epithelial-mesenchymal transition. HGF binds and activates the c-Met receptor tyrosine kinase, but downstream signaling required for scattering remains poorly defined. This study addresses this shortcoming in a number of ways.A high-throughput in vitro drug screen was employed to identify proteins necessary in this HGF-induced signaling. Cells were tested for reactivity to HGF stimulation in a Boyden chamber assay. This tactic yielded several small molecules that block HGF-induced scattering, including a calcium channel blocker. Patch clamping was used …

Effect Of Experimentally-Induced Anterior Knee Pain On Postural Control, Emily Elizabeth Falk

Theses and Dissertations

Context: Knee pain is experienced by many people. Because of this, authors have started researching the effects of pain on lower extremity mechanics and also on static and dynamic postural control. However, the effects of pain are difficult to study due to associated confounding variables. Objective: We asked: (1) Will experimentally-induced anterior knee pain alter perceived pain using the visual analogue scale? ; (2) will perceived pain affect postural control as measured by center-of-pressure during static and dynamic movement? Design: Crossover. Setting: Biomechanics laboratory. Participants: Fifteen healthy subjects. Intervention: Each subject participated in single leg quiet stance, landing, and walking …

The Anthropology And Sociology Of Proponent And Opponent Worldviews In Central Arkansas Regarding Same-Sex Issues And Constitutionally Protected Rights: An Interdisciplinary Perspective, Rohn Muse

Theses and Dissertations

This thesis autoethnographically examines divergent worldviews, specifically with respect to the contentious issues of same-sex marriage and adoption/foster-parenting of children by unmarried cohabitating couples in Arkansas. Moral panics and moral politics are central to current debates about each. This thesis integrates and synthesizes interdisciplinary perspectives and insights while deconstructing and unpacking dissimilar beliefs and behaviors found in this Bible-belt state. Selected GLBTQQ/SGL narratives, interwoven with my story, compare left-leaning liberalism with ultraconservative cognitive framing utilized to oppose gay rights. Vicious targeting of gays prevails in absolute opposition to gay issues when strictly based in faith and resolute religious dogma. Humanism …

The Effects Of Gender And Elicitation Method On The Prosodic Cues Used By 7- To 11-Year-Old Children To Signal Sentence Type, Lacey Ann Powell

Theses and Dissertations

The purpose of this study was to examine the prosodic cues used by 7 to 11 year-old children to signal questions and declarative statements in terms of changes in fundamental frequency (F0), duration, and intensity. Additional aims were to evaluate how children's use of prosody changes as a function of gender and method of elicitation. A group of 16 children participated in three different types of elicitation tasks (imitative, reading, and naturalistic). An acoustic analysis revealed that the participants produced the different sentence types using a variety of acoustic cues. Not only do children vary the mean of F0 and …

Natural Disasters And Older Adults: The Social Construction Of Disaster Planning, Elizabeth Fugate-Whitlock

Theses and Dissertations

Examining older adults’ experiences with and response toward hurricanes within the context of the community of residence is key to both understanding their experiences and planning for future hurricanes. Specific to this research, the objective was to understand the current social network of older adults, or who provides care for whom under what circumstances, using the social constructionist perspective. Grounded theory combined with action research was the theoretical orientation guiding the study. Sources of data included the collection of household disaster plans, semi-structured interviews with older adult residents of housing authority neighborhoods, semi-structured interviews with community planners, and observation of …

Changes In Life History Within An Individual's Lifetime, Eric J. Billman

Theses and Dissertations

A central goal of life history theory is to understand the selective factors that generate the diversity of reproductive patterns observed in nature. Within lifetime changes in reproductive investment will determine an organism's fitness; however, this area of life history theory has received less attention than comparisons among population that characterize life history traits as a single population mean. Reproductive allocation can be affected by multiple cues; the integration of these cues across an organism's lifetime generates the diversity in life history strategies observed in nature. Life history studies should examine the interacting effects of multiple cues on life history …

Mechanical Characterization Of The Interspinous Ligament Using Anisotropic Small Punch Testing, Rachel Jane Bradshaw

Theses and Dissertations

Objective: The objective of this work was to characterize the nonlinear anisotropic material constitutive response of the interspinous ligament (ISL).

Methods: Cadaveric test samples of the interspinous ligament were tested using the anisotropic small punch test. The measured force-displacement response served as experimental input into a system identification optimization routine to determine the constitutive material parameters that replicated the measured material response.

Results: The constitutive behavior of the ISL is notably different from that reported for knee, shoulder, and hip ligaments. Specifically, the high collagen fiber content and unique collagen architecture provided a stiffer material response. The results from the …

The Professional Identity Development Of Gerontologists: An Experiential Learning Approach, Tracey Gendron

Theses and Dissertations

Professional identity is a complex construct that describes how an individual develops a sense of self-concept within a chosen profession. Professional identity refers to a self definition within a professional role based on attributes, beliefs, values, motives, and experiences (Ibarra, 1999). This study explored the relationships between the professional identity of gerontology graduates and age, career stage, student typology, occupation, and value of experiential learning both quantitatively and qualitatively. Survey results indicate that experiential learning opportunities provide a framework for all gerontology students to gain and apply the skills and knowledge necessary for professional identity development in the field of …

Examining The Mediating Factors Between Religiosity And Pornography Use In Adolescents, Michael A. Steelman

Theses and Dissertations

The purpose of this study was to examine relations between adolescent religiosity and pornography use, and the roles of self-regulation, attitudes towards pornography, and social control as mediators of these relations. It was hypothesized that religiosity would protect adolescents from exposure to pornography by increasing their self-regulation capacity, their conservative attitudes about pornography, and their perceived social norms regarding pornography. The sample consisted of 419 adolescents (ages 15 - 18 years; M age = 15.68, SD = .98; 56% male) recruited online from across the U.S. Participants completed an online survey. All variables were bivariately associated as expected. Path models …

Communal And Exchange Relationships In Marriage And Their Effects On Ambulatory Blood Pressure In Caucasians And Foreign-Born Mexican Americans, Bryan J. Jensen

Theses and Dissertations

Research shows Mexican Americans typically have better cardiovascular health than European Americans, despite being relatively economically disadvantaged. Given research indicating the importance of relationship quality on one's health, the present study examined whether certain relationship orientations (e.g. communal or exchange) were more prevalent in different ethnic groups and if these orientations could help explain this Hispanic Paradox. 582 adults were recruited from the community. Participants were primarily European American (40%) and foreign-born Mexican Americans (55%). A cross-sectional designed was used where participants wore 24-hour ambulatory blood pressure (ABP) monitors and completed self-report measures of relationship satisfaction and relationship orientation. Results …

Theory-Derived Approaches To Behavioral And Psychological Symptoms Of Dementia, Bethany Speecy

Theses and Dissertations

As the world's population ages, the prevalence of Alzheimer's disease and other conditions that cause dementia is expected to increase. Although there is some awareness of the dangers of psychotropic drugs used to address behavioral and psychological symptoms of dementia, all too often these agents continue to be used as first-line treatment. Nurses need to be cognizant of safer, efficacious, holistic nonpharmacological approaches and utilize these in an individualized, systematic manner. Two mid-range nursing theories, the Need-Driven Dementia-Compromised Behavior model and the Progressively Lowered Stress Threshold model, provide conceptual frameworks for nonpharmacological interventions. This paper examines these models and describes …

Assessment Of Pain In The Older Adult With Dementia, Helen Laferriere

Theses and Dissertations

Pain is common in the older adult as they continue to age regardless of their cognitive ability. Whether the older adult resides in the community, in a nursing facility or is hospitalized, pain is prevalent in this population. The assessment and management of pain in the older adult with cognitive impairment is a challenge for those in healthcare. Based on the severity of the dementia, the older adult may not be able to verbalize or describe their pain. Therefore, it is vital that healthcare providers are able to identify pain in this population. Observational assessment scales, such as the Abbey …

The Effectiveness Of Using Non-Pharmacological Interventions In Managing Behavioral And Psychological Symptoms Of Dementia (Bpsd) In Long Term Care Facilities, Sandra J. Holmgren

Theses and Dissertations

Neuropsychiatric symptoms such as aggression, agitation, anxiety, mood disorders, and psychosis are frequently associated with the diagnosis of dementia (Schneder, Dagennan, & lnsel, 2005; Wand et al., 2005; Zee & Burkett, 2008). These tenns have been grouped together under the term 'behavioral and psychological symptoms of dementia' (BPSD) by the International Psychogeriatiic Association (Douglas, James, & Ballard, 2004). Neuropsychiatric symptoms are often reasons for institutionalization in nursing homes due to increased burden and stress on the caregiver (Douglas, James & Clive, 2004; Murman et al, 2002). As the elderly population continues to grow, dementia and its related symptoms will remain …

Metamemory And Eyewitness Memory: Will The Accessibility Heuristic Be Used To Predict Memory For Details Of A Complex Event?, Kathryn Meredith Webster

Theses and Dissertations

Metamemory is a person’s knowledge about their own memory. Metamemory judgments are sometimes accurate and sometimes not. Eakin (2005) found a dissociation between metamemory predictions and memory performance under conditions of retroactive interference and attributed this dissociation to the accessibility heuristic. This study investigated whether the accessibility heuristic would be used to make metamemory predictions in the more complex context of the eyewitness memory paradigm. The results indicate that the accessibility heuristic was used to make metamamory predictions. Memory performance was better for control than misled critical items, but people predicted they would perform equally well in both conditions. It …

Organizational Culture And Partnership Process: A Grounded Theory Study Of Community-Campus Partnerships, Kready Sharon Foreman

Theses and Dissertations

Community engagement initiatives have experienced an increase in attention, appreciation, and participation among those in academic, nonprofit, and other community-based organizations over the past two decades. The purpose of this study is to explore the meanings of community-campus partnerships among stakeholders in the community and in academia towards the goal of generating a theory grounded in these data that will concomitantly contribute to the social work profession and the community engagement movement. Using as its foundation the shared interest among the social work profession and the community engagement movement on values and ethics, this study utilizes a traditional grounded theory …

Metabolic Control, Marital Conflict, Caregiver Burden And Psychological Control In Parents Of Children With Type 1 Diabetes, Ann P. Jubber

Theses and Dissertations

Using data from a purposive sample of 78 parents of children with type 1 diabetes, relationships were examined between the level of metabolic control of the child with diabetes (as measured by the HbA1c percentage), parents' marital conflict, caregiver burden, and use of psychological control. Also explored were family income and the education levels of mothers and fathers. Differences between mothers and fathers were also considered. Better metabolic control (lower HbA1c) was related to lower levels of fathers' caregiver burden. Marital conflict was also associated with mothers' and fathers' caregiver burden. Finally, mothers' caregiver burden predicted mothers' use of psychological …

Challenges Of Neuropsychological Testing With Asian American Adults: A Critical Review Of The Literature, Heejin Kim

Theses and Dissertations

The present study is a critical analysis of literature surrounding the challenges faced during neuropsychological testing with Asian American adults. This dissertation will provide a comprehensive overview and critically analyze what is known with regards to neuropsychological assessment of Asian individuals, challenges that psychologists face in conducting culturally competent neuropsychological assessment of this population, and recommendations for conducting such assessments. Current literature reveals how confounds such as culture, acculturation, language, and the inappropriate use of tests and normative data can impact scores and subsequent treatment recommendations. Given these confounds, recommendations will be made regarding the neuropsychological test selection, test administration, …

The Cultural Context Of Alzheimer’S Disease: The Impact Of Perception And Knowledge On Willingness To Seek Medcial [I.E., Medical] Help Among Ghanaian Immigrants In The United States., Olivia Owusu-Boakyewaah

Theses and Dissertations

This correlational study explored the knowledge, perceived seriousness, and willingness to seek medical help for Alzheimer’s Disease (AD) among Ghanaian Immigrants currently residing in the Unites States. Study participants were 163 Ghanaian Immigrants between the ages of 45 and 90, attending Ghanaian community churches in Virginia and Maryland. Significant results include a positive correlation between knowledge and perceived seriousness of the disease, perceived seriousness of the disease was negatively correlated with caregiving experience. These results as well as several seemingly counterintuitive findings are discussed in terms of the Health Disparities and Psychometric challenges. Specifically, these results points to the necessity …

Muslim Female Leadership, Maliha Marri

Theses and Dissertations

Leadership by women is by no means a new concept in the Islamic world. In fact, Islamic history is replete with female Muslim leaders. Researcher Badawi (1995) has extrapolated that the obstacles in the path of Muslim female leadership are “cultural practices”, not Islam. Even though it may be hard to do so in an Islamic way, there is actually no proof in the Quran that prohibits Muslim women from assuming leadership roles. Remnant androcentrism continues to be an impediment in the way of Muslim female leadership. Abugideriri has explained that traditionally, Islamic leadership has been gendered, with the males …