Digital Commons Network^™

The Decision-Making Process For Individuals At Risk For Hereditary Diffuse Gastric Cancer, Alexa Prose

Theses and Dissertations

Hereditary diffuse gastric cancer (HDGC) is caused by mutations in the CDH1 gene. Individuals who carry mutations in the CDH1 gene have as high as an 80% lifetime risk for gastric cancer. To reduce the high lifetime risk of gastric cancer, CDH1 mutation carriers are recommended to undergo a prophylactic total gastrectomy (TG). Individuals within this at-risk population face a difficult task of deciding whether to have genetic testing for the CDH1 mutation and to have a prophylactic TG. Currently, there is little research that examines the factors influencing decision-making for this population and their specific informational and support needs. …

Efficacy Of Collaborative Consulting Training Module, Brenda Stone

Theses and Dissertations

Code for America Fellowships pair technologists with local city governments to develop digital tools that support how governments provide service to their communities. The lack of project sustainability following these Fellowships has been a source of dissatisfaction for both Fellows and clients. Code for America supports each Fellow with technical training, but provides no training on consulting techniques that help clients sustain the changes or new technology being introduced. The purpose of this action research study was to determine the efficacy of a collaborative consultation module for the Fellows at Code for America. To gather data, surveys, interviews and analysis …

The Lived Experiences Of Academic Advisors With Counseling Degrees In Addressing Wellness With College Student-Athletes, Jennifer M. Gerlach

Theses and Dissertations

The purpose of this qualitative phenomenological study was to investigate the lived experiences of academic advisors who have master’s degrees in counseling in addressing wellness with college student-athletes. Of particular note was to explore if they addressed wellness and, if so, how they addressed wellness. Extant literature is replete with evidence documenting the numerous challenges and stressors student-athletes experience due to their athlete status. Prior to this study, the role of the academic advisor in addressing wellness has not been represented in the literature. This study examined the lived experiences of 10 academic advisors with counseling degrees, or currently enrolled …

Socially Assigned Race, Reactions To Perceived Racial Discrimination And Type Ii Diabetes Mellitus, Jourdyn A. Lawrence

Theses and Dissertations

Background: Numerous studies have utilized race to document health inequities. As race is considered a social classification of persons based upon physical traits, studies have begun to consider socially assigned race defined as the race/ethnicity perceived by others. Socially assigned race may serve as the basis for differential or unfair treatment of persons ascribed to historically oppressed groups. Socially assigned race may also provide additional insight into racial health disparities, particularly among Latino populations who are commonly defined by their ethnicity. This study assesses the relationship between self-identified and socially assigned race/ethnicity and tests the moderating effects of emotional and …

Association Between Diabetes And Cancer In Indian And Us Populations Using Longitudinal Study Design, Shraddha S. Vyas

Theses and Dissertations

Background: There is growing evidence of association between diabetes and cancer. No studies have been conducted in India evaluating this association. With the current epidemiologic, nutritional and economic transition in India, it becomes extremely important to examine this association in an Indian population. Additionally, difference in association exists based on different cancer subtypes. Research has shown that diabetes is associated with an increased risk of colorectal cancer. However most of these studies suggest detection bias to be one of the probable reasons for this association. Additionally, the common risk factors shared by both these conditions are considered to one of …

Paleodemographic And Biochemical Analysis Of Urbanization, Famine, And Mortality, Brittany S. Walter

Theses and Dissertations

Urbanization is a transitional period often associated with deteriorating population health and increased mortality, as the rapid increase of population density in urban centers facilitates the transmission of infectious diseases, unsanitary living conditions, and precarious food supplies. Research on the transition to an urban environment in the past offers a temporal depth to our understanding of the consequences of urbanization that cannot be accomplished through examination of contemporary populations. This project integrates paleodemographic (hazard analysis) and biochemical (stable isotope analysis) approaches to examine the health and diet of inhabitants in late medieval England (c. 1120-1539 CE), specifically the relationship between …

Maternal Physical Activity And Cardiorespiratory Fitness During Pregnancy And Its Relation To Infant Size, Samantha M. Mcdonald

Theses and Dissertations

Recent evidence indicates that U.S.-born infants are larger today compared to 20 years ago. A strong determinant of neonatal size is maternal body mass, where larger mothers deliver larger infants. Consistent evidence indicates that higher levels of maternal physical activity (PA) during pregnancy reduce the risk of delivering a larger infant. However, this protective effect has only been demonstrated in normal weight pregnant women. Little is known about the relationship between maternal PA and neonatal size in overweight or obese pregnant women. Moreover, no studies have examined the association between maternal cardiorespiratory fitness (CRF), an indicator of habitual PA, on …

The Impact Of A Reflective Practice Series On The Awareness Level Of Six Teacher Candidates At A Public University In The Southeast, Lindsay M. Sturkie

Theses and Dissertations

This study examined the impact of a Reflective Practice Series (RPS) on the awareness level of preservice teachers enrolled in a field experience course in a teacher education program at a university in the southeast United States. This study took place during the Fall 2016 semester with six participants, two early childhood majors, two elementary majors, and two middle level majors. Data were collected through pre- and post-questionnaires, course assignments, and field observations. The results revealed that the teacher candidates were able to make connections between theory and reflective teaching, had varying viewpoints about the process of reflection, and most …

Children’S Obesogenic Behaviors During Summer Versus School, Keith Brazendale

Theses and Dissertations

Emerging evidence shows children gain 3-5 times the amount of weight and lose cardiorespiratory fitness (CRF) during summer compared to the 9-months of the school year. Notably, this trend is more pronounced in children who are already overweight or obese going into summer and/or from low-income ethnic minority households. There is little evidence to investigating the underlying mechanisms driving the pronounced occurrence of these negative health outcomes during summer.

The purpose of this dissertation as a whole was to investigate children’s obesogenic behaviors (physical activity, sedentary/ screen time, sleep, and diet) during summer versus school, and compare any differences in …

Identifying Associations Between Religious Commitment And Preventive Health Behaviors In A Southeastern Rural County, Nathan A. Peters

Theses and Dissertations

Health disparities within the United States (US) are continuing to impact ethnic minorities living in rural areas nationwide. In response, there is growing interest in using faith-based settings as vehicles to deliver much needed disease prevention interventions. However, few studies have identified the relationship between private and public religious commitment, individually, and the behaviors or risk factors associated with chronic disease. The purpose of this study was to observe the association between religious commitment, both private (i.e., time spent trying to grow in one’s religious understanding) and public (i.e., frequency of attendance, time spent in fellowship with others) individually, and …

Effects Of A Mindfulness Based Intervention On Diurnal Cortisol In Cancer Survivors, Susannah Small

Theses and Dissertations

Background. There are approximately 15.5 million individuals alive today in the U.S. with a personal history of cancer. For this large and growing population, ill effects associated with cancer diagnosis and treatment include both physical and psychosocial symptoms adversely affecting quality of life. One low-risk alternative to conventional pharmaceutical use in treating these symptoms is mindfulness practice. Research on self-reported measures provides strong evidence that this type of intervention improves quality of life for cancer survivors, but evidence of impact on objective measures is limited. Cortisol, the body’s primary stress hormone, is one relatively easy to measure indicator that …

Mercury Bioaccumulation In Three Popular Subsistence And Recreational Estuarine Fishes From Southeastern U.S.A., Taylor Cannon

Theses and Dissertations

A rising concern in recent years has occurred over the presence of methylmercury in seafood, particularly fishes, and its impact on human health. However, fish also provide many health benefits, including improved cardiovascular health and neurodevelopment. Because fishes are the main source of methylmercury exposure to humans, and are such an integral part of the human diet, understanding the risks versus the benefits of fish consumption is imperative in allowing the public to make healthy, educated choices. One way that state and federal governments attempt to do this is through issuing fish consumption advisories. Unfortunately, these advisories do not always …

Analysis Of Food Exposures In Foodborne Disease Outbreaks, Alecia T. Alianell

Theses and Dissertations

Foodborne illness remains a serious public health problem in the United States in general as well as South Carolina in particular. Obtaining good food ingestion histories as well as possible risky environmental exposures is one of the earliest, most important tasks to complete in any foodborne outbreak investigations. Because time is of the essence in investigations, we have evaluated a rarely used biostatistical method, Random Forests, to data obtained from DHEC. Random Forests has the potential to facilitate more rapid identification of foods or environmental exposures that may be associated with outbreaks. We also examined previous cases of salmonellosis using …

Contesting The Generic Refugee: Siv Identity, Community, And Agency During Resettlement, Benjamin J. Sylvester

Theses and Dissertations

This thesis examines the complexity of identity and community formation by Special Immigrant Visa (SIV) holders during resettlement in Columbia, South Carolina. It explores the ways in which identities coalesce around various themes, such as religion, gender, and military service, how these identities serve to create, expand, and claim membership in communities, and how SIVs exercise agency throughout these processes. Through semi-structured interviews with 9 SIVs in Columbia, SC, this qualitative study highlights the unique, highly individualized ways in which a select group of refugees experience resettlement, how they negotiate their placement within socio-economic hierarchies, and exercise agency to obtain …

The Nutrition Assistance Landscape In Afterschool Programs: Understanding The Gap Between Research, Policy, And Practice, Falon Elizabet Tilley

Theses and Dissertations

The Child and Adult Care Food Program (CACFP) aims to increase children’s access to healthful foods in out-of-home care. Approximately half of the 10.2 million children enrolled in afterschool programs (ASPs) are eligible for nutrition assistance through programs like CACFP. Despite awareness of its potential impact on the nutritional status of millions of children, CACFP is underutilized among ASPs and notably understudied in comparison to other federal nutrition assistance programs.

This dissertation addresses key gaps in CACFP research and provides a deeper understanding of the nutrition assistance landscape in afterschool programs by (1) assessing the type of afterschool snacks served …

Muscle Inflammatory Signaling Regulates Eccentric Contraction-Induced Protein Synthesis During Cancer Cachexia, Justin Perry Hardee

Theses and Dissertations

Cancer-related cachexia is a complex metabolic syndrome that involves the unintentional loss of skeletal muscle mass that cannot be reversed by standard nutritional intervention. Skeletal muscle mass depletion directly impacts patient survival and life quality, and therefore treatments that preserve muscle mass and function may have significant implications for cancer patient treatment and survival. Systemic and muscle inflammation has been implicated in the regulation of skeletal muscle homeostasis, and the cytokine interleukin-6 (IL-6) and muscle gp130 receptor signaling have established roles in cancer-induced muscle wasting. Resistance exercise is a nonpharmacological treatment that can improve physical function and metabolic health in …

Validation Study Of The Science Literacy Assessment: A Measure To Assess Middle School Students' Attitudes Toward Science And Ability To Think Scientifically, Tammy Mckeown

Theses and Dissertations

This study investigated validity evidence for the Science Literacy Assessment, an instrument designed to assess middle school students’ ability to think scientifically as well as their motivation and beliefs about science (Fives, Huebner, Birnbaum, & Nicolich, 2014). Specifically, three sources of evidence were considered; internal structure, concurrent criterion-related, and predictive criterion-related. Exploratory factor analysis was utilized to examine the underlying factor structure of each of the instrument’s two components, motivation and beliefs related to science and demonstrated scientific literacy. Pearson product-moment correlations were calculated to determine the relationship between scores on the motivation and belief component of the Science Literacy …

Understanding Over-The-Counter Medication Use And Decision-Making Among Community-Dwelling Us Older Adults: A Mixed-Methods Approach, Yoshita Paliwal

Theses and Dissertations

Introduction

Older adults are regular consumers of over-the-counter (OTC) medications. OTC medications are generally considered safe, and convenient to use without requiring a prescription. However, the safety of an OTC medication and the final health outcome depends in part upon consumers’ perceptions, beliefs, and their decision-making about OTC medication use. The main objectives of this study were: 1) to examine the prevalence and characteristics of OTC medication use among community-dwelling US older adults (65 years and older), 2) to explore older adults’ knowledge, attitudes, beliefs and experiences about OTC medications, and 3) to elicit the OTC medication decision-making process in …

Influence Of Contextual Factors And Self Efficacy On Self- Management In Parents Of Children With Cystic Fibrosis, Erin B. Booth

Theses and Dissertations

Cystic Fibrosis, a life threatening autosomal recessive genetic disease, is characterized by a defective gene resulting in the production of thick mucus that obstructs the lungs and pancreas. CF requires intensive management performed at the home. An initial pilot study was performed to describe knowledge of CF related diabetes (CFRD) in adults with CF. The findings of this study, which demonstrated that adults with CF lacked sufficient knowledge about CFRD confirmed the need to explore additional factors of self-management guided by a theoretical framework. The second study presented in this dissertation used the Individual and Family Self-Management Theory (IFSMT) to …

Managing Sociality Of A Captive Female Bornean Orangutan From Breeding To Post-Partum At The Smithsonian's National Zoo, Marie Vergamini

Theses and Dissertations

The Association of Zoos and Aquariums’ Orangutan Species Survival Plan® aims to maintain 100 Bornean orangutans (Pongo pygmaeus) in captivity. Because investment in breeding these lineages is high, properly managing sociality of potential mothers is essential. This study assessed how behaviors of a captive breeding female at the Smithsonian’s National Zoo changed from pre-gestation through the offspring’s sixth month of age to improve breeding recommendations.

The infant Bornean orangutan was born September 2016. Results indicate that during breeding, the mother socialized most with two adult females. During pregnancy, the pregnant female socialized in less energy-consuming ways, i.e. grooming. …

"C-Terminal Binding Protein 2" An Emerging Oncogene In Colon And Pancreatic Cancers, Ayesha Chawla

Theses and Dissertations

The C terminal binding proteins (CtBP) 1 and 2 are a family of transcriptional co-repressors overexpressed in a variety of cancers, and are frequently associated with poor prognosis and chemoresistance. CtBP has also been characterized in cell culture models as drivers of migration/invasion and epithelial-mesenchymal transition. CtBP mediates its transcriptional corepressor activity via its dehydrogenase domain, and inhibition of this domain interferes with CtBP oncogenic functions. The role of CtBP in APC mutant neoplasia remains obscure even though APC is responsible for degradation of both β-catenin and CtBP in suppressing colorectal tumorigenesis. Our prior work demonstrated that CtBP proteins can …

The Role Of Social Networks In Breastfeeding Duration, Jordyn T. Wallenborn

Theses and Dissertations

Background: The United States has one of the lowest rates of breastfeeding in the world. Studies hypothesize that inadequate social support from healthcare providers, family members, and employers may have contributed to the low breastfeeding rate. This study aims to: 1) examine the importance of each individual (father, maternal grandmother, paternal grandmother, obstetrician, and pediatrician) within the social support network on breastfeeding initiation and duration, 2) determine the relationship between type of prenatal care provider and time to breastfeeding cessation, and 3) examine the role of breastfeeding intention and confidence as mediators in the association between workplace support and breastfeeding …

A Computational Study Of The Kinematics Of Femoroacetabular Morphology During A Sit-To-Stand Transfer, Brandon K. Marine

Theses and Dissertations

Computational modeling in the field of biomechanics is becoming increasingly popular and successful in practice for its ability to predict function and provide information that would otherwise be unobtainable. Through the application of these new and constantly improving methods, kinematics and joint contact characteristics in pathological conditions of femoroacetabular impingement (FAI) and total hip arthroplasty (THA) were studied using a lower extremity computational model. Patients presenting with FAI exhibit abnormal contact between the femoral neck and acetabular rim leading to surrounding tissue damage in daily use. THA is the replacement of both the proximal femur and acetabular region of the …

The Experiences And Perceptions Of Behavioral Factors That Contribute To Successful Weight Loss In Male Bariatric Patients, Stephen P. Sowulewski

Theses and Dissertations

The purpose of this study was to examine the experiences and perceptions of behavioral factors that contribute to successful weight loss in male bariatric patients. By analyzing participant experiences and perceptions, this study contributes to a better understanding of which factors are most important in the postoperative phase of gastric bypass in males owing to successful weight loss. Although there is a tremendous amount of quantitative research within the bariatric population, there is a significant gap within the qualitative literature as it relates to male outcomes. As such, by conducting interviews with 10 postoperative male gastric bypass patients, this study …

Educational Predictors For Postsecondary Living Status, Irina Cain

Theses and Dissertations

This study was performed as the result of gaps in the literature in the area of transition to independent living (IL) using secondary data from the National Longitudinal Transition Study 2 (NLTS-2). Its findings identify individual, skills, family, and school factors that predict postsecondary living status and moderators of the relationships between predictors and the outcome. Specifically, results indicated the following factors as predicting postsecondary living status: individual factors (ethnicity and disability label), skills (self-care, functional mental, personal autonomy, self-realization, and social), family factors (parental expectations and parental involvement in school), and school factors (student’s role in transition planning and …

Person-Centered Treatment To Optimize Psychiatric Medication Adherence, Natalie Bareis

Theses and Dissertations

Objectives: Adherence to psychotropic medication is poor among individuals with bipolar disorder (BD). To understand treatment experiences and associated adherence among these individuals, we developed a novel construct of Clinical Net Benefit (CNB) using psychiatric symptoms, adverse effects and overall functioning assessments. We tested whether adherence differed across classes of CNB, whether individuals transitioned between classes over time, and whether these transitions were differentially associated with adherence.

Methods: Data come from individuals aged 18+ during five years of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Latent class analysis identified groups of CNB. Latent transition analysis determined probabilities of …

Weighted Quantile Sum Regression For Analyzing Correlated Predictors Acting Through A Mediation Pathway On A Biological Outcome, Bhanu M. Evani

Theses and Dissertations

Abstract

Weighted Quantile Sum Regression for Analyzing Correlated Predictors Acting Through a Mediation Pathway on a Biological Outcome

By

Bhanu M. Evani, Ph.D.

A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2017.

Major Director: Robert A. Perera, Asst. Professor, Department of Biostatistics

This work examines mediated effects of a set of correlated predictors using the recently developed Weighted Quantile Sum (WQS) regression method. Traditionally, mediation analysis has been conducted using the multiple regression method, first proposed by Baron and Kenny (1986), which has since …

Diabetes-Induced Expression And Regulation Of Glp-1 Levels By Bile Acid Receptors (Tgr5 & Fxr), Joseph R. Spengler

Theses and Dissertations

Diabetes Mellitus has continued to drastically affect the health of the world and many complications can prove fatal. As long as this metabolic disease persist, research discoveries will need to continue to be made so that patient outcomes and healthcare are dramatically enhanced. In recent years, GLP-1 has been the topic of conversation for diabetes research, due to its promising effects in promoting insulin sensitivity. Furthermore, bile acids and their receptors (TGR5 & FXR) have shown promise in their actions in the regulation of GLP-1, and thus glucose homeostasis. Here we have shown the detection and increased expression of TGR5 …

Community Gardens: Exploring Race, Racial Diversity And Social Capital In Urban Food Deserts, Jennifer F. Jettner

Theses and Dissertations

Study purpose. The study examined race and racial diversity in community gardens located in Southern urban food deserts, as well as the capacity of community gardens to generate social capital and promote social justice. Methods. A mixed-methods approach was used to describe characteristics of gardeners and community gardens located in urban food deserts, and test Social Capital Theory hypotheses. A convenience sample of 60 gardeners from 10 community gardens was obtained. Data was collected using surveys and semi-structured interviews. Analyses. Univariate and bivariate statistics were used to describe gardeners and gardens. Leader rationales for garden characteristics were analyzed using thematic …

Short And Long Chain Free Fatty Acids Differentially Regulate Glucagon-Like Peptide-1 And Peptide Yy Transcript Levels In Enteroendocrine Cells (Stc-1), Colin M. Catherman

Theses and Dissertations

The regulation of glucagon-like peptide-1 and peptide YY hormone levels are regulated based on different influential factors, but primarily levels are dependent upon ingested food content. As meals today become more fat-enriched, there is greater requirement for evaluation of these hormones that regulate insulin and satiety levels within the body. We have shown that the gene expression transcript production of glucagon-like peptide-1 and peptide YY are modulated by different concentrations, and times of short-chain fatty acids and long-chain fatty acids. Although the peptide hormone levels have the influential physiological role on effector tissue, the regulation of these hormones begins at …