Digital Commons Network^™

Let's Talk Tobacco: African American Parent-Adolescent Communication About Tobacco Use Within The Context Of Parental Smoking, Michell Pope

Theses and Dissertations

Tobacco use and the associated health risks are a major public health concern. Research suggests that parents’ own tobacco use, caregiver-adolescent antismoking communication, and parenting practices (e.g., prompting, parental monitoring) may work to influence adolescents’ tobacco-related attitudes and behavioral outcomes (e.g., refusal efficacy, intentions to use and actual use). Although historically African American adolescents have exhibited lower rates of tobacco use than their racial/ethnic counterparts, there is growing evidence to suggest that this may be changing because of increased use of tobacco products and/or underreporting of the use of alternative tobacco products or ATPs (e.g., cigars, cigarillos), among this population. …

High School Teacher And Administrator Perceptions Of Student Health Promotion: An Exploratory Study, Sarah B. Conklin

Theses and Dissertations

The current study explored the high school health promotion environment with regards to physical activity, nutrition, and sedentary behaviors from the perspective of high school health and physical education teachers and administrators. Specifically, potential strategies for a prevention program to promote student physical activity participation and healthy eating, and decrease student sedentary time were explored.

Individual semi-structured interviews were conducted with physical education teachers to explore potential strategies to promote student health behaviors. Next, interviews were conducted with high school administrators to determine the feasibility of recommended strategies. Teachers and administrators in the current study expressed a need for strategies …

Role Of Extracytoplasmic Rna Polymerase Sigma 70 Factor, Pg0214, In The Survival Of Porphyromonas Gingivalis And In Adaptation To Environmental Stress., David M. Smith

Theses and Dissertations

Porphyromonas gingivalis, a gram-negative anaerobic, pathogenic bacterium is a major etiological agent in the initiation and progression of periodontal disease. Due to the ever-changing environment of the oral cavity, inhabitants like Porphyromonas gingivalis must possess the ability to adapt to changes in environmental conditions like pH, temperature, oxygen tension, and metal concentration. P. gingivalis should therefore have an efficient regulatory system in order to adapt and survive in the oral cavity. This response adaptation occurs at the transcriptional level, which involves alternative sigma factors. Extracytoplasmic function sigma (ECF-s) factors are the largest group of alternative sigma factors that play …

Relieving Post-Stroke Fatigue Using A Group-Based Educational Training Approach, Catherine E. Emery

Theses and Dissertations

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale …

Kensington Center For Health: An Exploration Of Health, Wellness And The Built Environment., Rose Peck

Theses and Dissertations

This is a project that explores how design can integrate medical treatment and community support. The high prevalence of chronic disease is creating a national healthcare crisis. Chronic disease is the leading cause of death and disability in the United States. Consideration of a holistic sense of well-being that focuses on disease resistance, resilience, and self-management is necessary to realize and sustain health outcomes. Community engagement is imperative to improve adherence rates for lifestyle changes. This project aims to design a community wellness space that is focused on prevention, resilience and self-management. A new typology of a community-anchored wellness clinic …

An Association Study Between Adult Blood Pressure And Time To First Cardiovascular Disease, Yongjia Pu

Theses and Dissertations

BACKGROUND: Several studies have demonstrated the association between the time to hypertension event and multiple baseline measurements for adults, yet other survival cardiovascular disease (CVD) outcomes such as high cholesterol and heart attack have been somewhat less considered. The Fels Longitudinal Study (FLS) provides us an opportunity to connect adult blood pressure (BP) at certain ages to the time to first CVD outcomes. The availability of long-term serial BP measurements from FLS also potentially allows us to evaluate if the trend of the measured BP biomarkers over time predicts survival outcomes in adulthood through statistical modeling.

METHODS: When the reference …

A Comparison Of Vitamin D Levels In Children With Early Childhood Caries, Vanessa O. Hofilena

Theses and Dissertations

Purpose: To determine if there is an association between early childhood caries (ECC) and vitamin D deficiency, as measured via a serum sample. An exploratory goal was to investigate the possibility of measuring vitamin D with a salivary assay. Methods: Serum samples of patients who were scheduled for a dental or otolaryngology procedure under general anesthesia were assessed for 25-hydroxyvitamin D (25(OH)D), parathyroid hormone and calcium. Results: Our analysis indicates that the vitamin D levels of the controls and ECC group were significantly different. There were significant inverse correlations between: 1) PTH levels and vitamin D and 2) decayed, missing, …

Motivational Factors For Treating Patients With Special Health Care Needs, Arpi Patel

Theses and Dissertations

Purpose: The purpose of this study is to assess what training and motivational factors dental providers report in providing dental care to PSHCN (patients with special healthcare needs. Materials and Methods: An electronic questionnaire was sent to n=104 fourth year dental students, n=147 general dentists with a specific continuing education course pertaining to PSCHN, and n=140 pediatric dentists in Virginia. The questionnaire consisted of four sections including Demographics, Professional Attitudes, Special Needs Patients and Motivational Factors, and PSCHN Cases. Results: The overall response rate for our study was 21%. The response rates of dental students, general dentists, …

The Effects Of Income Inequality On Society, Jessica Lee Clark

Theses and Dissertations

This study is an examination of the relationship between income inequality and numerous indicators that capture the physical health of the citizens, additionally controlling for numerous other confounding factors. The analysis contributes to the literature by examining this relationship at a more disaggregated level within the Unites States than previous studies. This approach may help us to explore any impacts of income inequality on health that are lost in aggregation. The analysis also includes the most recent recession and adds to the literature the impact of inequality on health during a period of economic crisis. Results suggest that there is …

Disaggregating Tree And Grass Phenology In Tropical Savannas, Qiang Zhou

Theses and Dissertations

Savannas are mixed tree-grass systems and as one of the world’s largest biomes represent an important component of the Earth system affecting water and energy balances, carbon sequestration and biodiversity as well as supporting large human populations. Savanna vegetation structure and its distribution, however, may change because of major anthropogenic disturbances from climate change, wildfire, agriculture, and livestock production. The overstory and understory may have different water use strategies, different nutrient requirements and have different responses to fire and climate variation. The accurate measurement of the spatial distribution and structure of the overstory and understory are essential for understanding the …

The Relationship Between A Series Of Vitamin D Levels And A Blood Glucose Level In Pregnant Women In The Upper Midwest, Jeanine Louise Senti

Theses and Dissertations

Hyperglycemia during pregnancy is associated with adverse outcomes for both mother and offspring. In order to facilitate glucose delivery to the fetus, insulin resistance increases as gestation progresses which results in hyperglycemia if the mother’s body is unable to compensate by producing adequate insulin in response to these changes in glucose metabolism. Evidence suggests that calcidiol (vitamin D) influences insulin sensitivity and glucose metabolism in the non-pregnant population yet there are inconsistent findings on the effects of calcidiol on maternal glucose levels during pregnancy. A secondary analysis was completed on a de-identified data set. The original prospective study included a …

Patterns Of Sedentary Behavior And Association With Health Risks Among African American Adults, Tatiana Y. Warren-Jones

Theses and Dissertations

Introduction: There is growing and compelling evidence suggesting time spent in sedentary behaviors (SB) is a unique contributor to health risk that appears to be independent of time spent in moderate- and/or vigorous-intensity physical activity (PA). However, few studies have examined these associations in women and even fewer studies have included ethnic minority populations.

Purpose: The major objectives of this study were to: (1) describe patterns of objectively measured sedentary and PA behaviors and variation in these behaviors in African American (AA) adults; (2) assess the association between bouts of and breaks in SB and waist circumference risk, body mass …

Food Security Status And Life Events Among Households With Children In The Midlands Of South Carolina, Erin Rebekah Drucker

Theses and Dissertations

Purpose: Food insecurity is a major public health problem in the United States (US) with 14.5% of US households having experienced some level of food insecurity in 2012. Among households with children, 20% experienced low food security in 2012, and in half of these households, both the children and adults were affected. Food insecurity among children can have lifelong negative health and mental effects. Life events are defined as self-­‐reported life changes, which create a strain on resources and an opportunity for food insecurity, Methods: The Midlands Family Study (MFS) was a cross-­‐ sectional study that surveyed households …

Maternal Obesity, Gestational Weight Gain And Offspring’S Asthma, Kristen Polinski

Theses and Dissertations

Introduction: Obesity is common among women of childbearing age and intrauterine exposures may influence the development of early childhood asthma. A handful of studies have investigated pre-pregnancy obesity, but even fewer have thoroughly explored gestational weight gain as possible childhood asthma risk factors. Gaps remain in the literature and to our knowledge, none have longitudinally explored these relationships in a nationally representative sample of U.S. children.

Methods: We used data from the Early Childhood Longitudinal Study – Birth Cohort, in which children were followed through age four (n≈5,200). Asthma was based on parent report of a physician’s diagnosis. …

Engineered 3d Microenvironments To Direct Osteogenic Differentiation And Modulate Inflammation, Katherine Elizabeth Rutledge

Theses and Dissertations

Current methods of treating critical size bone defects (CSDs) include autografts and allografts, however both present major limitations including donor-site morbidity, risk of disease transmission, and immune-rejection. Tissue engineering provides a promising alternative to circumvent these shortcomings through the use of stem cells, three dimensional (3D) scaffolds, and growth factors. Cells receive signals from their microenvironment that determine cell phenotype, and a combination of physical cues and chemical factors is thought to have the most profound influence on stem cell behavior. A major focus of tissue engineering strategies is scaffold design to recapitulate in vivo microenvironmental architecture to direct stem …

Anarchic Wills: De Factoism And Its Discontents In Shakespeare And Milton, William Dean Clement

Theses and Dissertations

My dissertation explores the literary origins of de factoism – the political philosophy which considers any “right” to rule inconsequential to political legitimacy. My work introduces the concept of the “anarchic will,” my term for a literary character that recognizes the growing distance between an authority’s claim to power and the material fact of that power. I locate these figures in early modern drama and epic to demonstrate how their existence threatens the traditional power structures, both on the stage and in the streets of London. I argue that anarchic wills jeopardize political order at the most basic level, in …

The Relationship Of The Mediterranean Diet And The Dietary Approaches To Stop Hypertension (Dash) Style Diet With Cardiometabolic Health, Yong-Moon Park

Theses and Dissertations

Introduction: Much evidence shows that the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) style diet are associated with risk reduction of cardiometabolic disease as well as lower risk of all-cause, cardiovascular disease (CVD), and cancer mortality. A subgroup of obese individuals (metabolically healthy obese (MHO) phenotype) and normal weight individuals (metabolically obese normal weight (MONW) phenotype) have been identified to have different cardiometabolic risks compared with their counterparts in the same category of body mass index (BMI). Scarce evidence exists demonstrating a relationship between adherence to Mediterranean diet or DASH style diets with MHO and MONW …

Low-Dose Stimulant Treatment During Periadolescence In A Fasd Model: Interactions Among The Catecholamines, Victoria Macht

Theses and Dissertations

One of the most common of deficits observed in Fetal Alcohol Spectrum Disorders (FASD) is difficulties with attention. Because attention deficits are commonly treated with stimulants, the impact of d-amphetamine (AMPH) treatment during the juvenile period in an animal model of FASD was examined. A dose-response study first assessed the appropriate dose of AMPH to use. In the dose-response study, therapeutic doses of 0.5, 1.0, and 2.0 mg/kg/day of AMPH were chronically administered to female rats between postnatal days (PD) 26-40. Rats were subjected to an open field test on the first and last day of treatment. The dose of …

Longitudinal Association Between Television Watching, Computer Use And Meal Frequency And Risk Markers In Diabetes Among Youth With Diabetes, Chao Li

Theses and Dissertations

BACKGROUND AND OBJECTIVES: Television watching and computer use are considered to be the main sedentary behaviors in children and youth. However, their longitudinal impact on HbA1c and serum lipids among youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) are under-studied. Sedentary behavior is normally assessed by questionnaire in large epidemiological studies, however, its measurement by questionnaire has not been evaluated among youth with diabetes. Also, no recent studies have evaluated the optimal meal frequency for glycemic control in youth with T1D and T2D; for this reason nutritional guidelines on meal frequency for youth with diabetes are vague. …

The Effects Of An Active Study Break Intervention In College Students: An Observational Study, Kathryn Joann Southard

Theses and Dissertations

Background: Sedentary lifestyles are a major public health concern. Research has shown that frequent active breaks are beneficial to productivity, mental and physical health, and may prevent obesity.

Purpose: This study examined the effectiveness of a signage intervention in a university library to promote the use of physically active (AB) compared to inactive (IB) study breaks.

Methods: College students were observed over three weeks: pre-intervention (PRE); signage intervention (SIGN); and post-intervention (POST). Each week of observation consisted of 12 hours, (6, 2-hour segments) on Sunday, Monday, and Tuesday (36 hours total). SIGN consisted of table tents and signs posted in …

Experiences Of Clinicians Using Mindfulness-Based Therapy With Adult Survivors Of Childhood Sexual Abuse: A Qualitative Analysis, Nathan Edwards

Theses and Dissertations

The long-term devastation caused by childhood sexual abuse among adult survivors has been well documented within the literature. Similarly, numerous studies have addressed efficacy of various treatment modalities targeting psychological sequelae associated with such abuse. However, despite the recent rise in popularity of mindfulness within the field of psychology, as well as indication of tremendous psychological benefits associated with such practice, few studies have sought to understand the connection between mindfulness and healing among abuse survivors. The current study attempts to bridge the gap in the literature by examining the experiences of clinicians using mindfulness as a framework for their …

Women In Nonprofit Leadership: Strategies For Work-Life Balance, Amanda Colleen Green

Theses and Dissertations

The nonprofit sector is the third largest employing industry in the United States and impacts almost 10% of the economy (Roeger, Blackwood, & Pettijohn, 2012; Salamon, Sokolowski, & Geller, 2012). Women comprise over 75% of the nonprofit workforce, yet men hold over 80% of leadership positions (Bronznick & Goldenhar, 2009; McInnes, 2008). The purpose of this qualitative, phenomenological study was to examine the work-life balance practices of women leaders in nonprofit organizations and determine experiences impacting their life course. The ultimate goal was to gain insight from women leaders in nonprofit organizations to identify strategies for more women to advance …

Building Capacity For Advocacy For Local Food Systems Change: An Ethnographic Study Documenting The Process Of Change In South Carolina Communities, Casey Denise Childers

Theses and Dissertations

The Guide to Community Preventive Services currently does not have sufficient evidence to recommend any nutrition strategies for obesity prevention. Nonetheless, food systems changes are recommended for childhood obesity prevention by the C.D.C., U.S.D.A., and many thought-leading organizations. Creating healthy food communities will require physical and social environmental changes. Community-based groups need to build their capacity to frame community health issues as physical and social environmental issues. This research partnered with community-based groups to build their capacity for advocacy by using media framing research and strategic communications training. Specifically we: 1) conducted a media content about food systems, childhood obesity …

Patient And Provider Perceptions Of Weight Gain, Physical Activity, And Nutrition In Pregnancy, Kara M. Whitaker

Theses and Dissertations

Background: The high percentage of women who enter pregnancy overweight or obese and gain excessive weight during pregnancy is a growing public health problem. Health care providers are recommended to counsel women on weight gain, physical activity (PA), and nutrition during pregnancy. However, little is known about patient or provider perceptions of these topics. Purpose: Guided by the Theory of Planned Behavior (TPB), this study examined women’s and health care providers’ perceptions of weight gain, PA, and nutrition in pregnancy. This study also examined the role of the health care provider in optimizing pregnancy weight gain. Methods: Pregnant women between …

The Social Determinants Of Success: The Effect Of Status, Framing, And Group Membership On Test Scores, Jennifer L. Mcleer

Theses and Dissertations

Previous findings have shown that intelligence test scores of members of disadvantaged groups are negatively affected by their relative status in test situations. We explain this by assuming that lower-status actors forego benefits that normally follow from successful performance of a task if they anticipate that there are also costs associated with success. We use an integration of Status Characteristics Theory, Rational Choice Theory, Prospect Theory, and Self-Categorization Theory to argue that compared to high status individuals, those of lower status should be particularly affected by costs associated with high performance. We ran an experiment that manipulated factors such as …

Low-Flow Domiciliary Oxygen As A Mechanism Of Ongoing Oxidative Stress In Copd Patients, Jill Stulce

Theses and Dissertations

Healthcare costs are escalating in the U.S., with a projected 48 trillion dollars by 2021. More than ever medical researches are obligated to ensure that costly treatment modalities are safe and effective. Chronic obstructive pulmonary disease (COPD) is a costly and debilitating disease, ranked as the third leading cause of death in America. Currently, treatment for COPD consists of anti-inflammatory agents, bronchodilators, antibiotics and supplemental oxygen when hypoxemia or clinical manifestations ensue. Oxidative stress is central to the pathology of COPD. Supplemental oxygen has been substantiated as an instigator of oxidative stress; however, LFDO has not been evaluated as a …

An Observational Study Of Parent Practices And Children's Physical Activity, Analee Hokkala

Theses and Dissertations

Background: Childhood obesity affects approximately 17% of U.S. children and teens. Children who are overweight or obese are at risk of developing psychosocial problems and cardiovascular risk factors. It is recommended that children engage in at least 60 minutes of physical activity at least 5 days per week, however, children are not meeting these recommendations.

Purpose: To our knowledge, there has not been an observed controlled study examining parent practices and children’s physical activity. Thus, the primary purpose of this study was to observe parenting practices and to examine the relationship with children’s physical activity. The secondary purpose of this …

The Use Of Experiential Acceptance In Psychotherapy With Emerging Adults, Lauren Ford

Theses and Dissertations

Emerging adulthood is recognized as a growing developmental stage that varies within and across cultures. Existing research generally characterizes this period as one of identity exploration, instability, self-reflection, and optimism. For many in this cohort, life events that were once organized into a stable sequence such as entering the workforce, marriage, and having children are increasingly a highly individualized and somewhat unstructured trajectory. This lack of structure provides opportunities and potential challenges to those transitioning from adolescence to adulthood. To this end, experiential acceptance may be an important target skill for intervention in guiding emerging adults through this tumultuous period. …

Site Administrators' Perceptions Of Barriers And Enablers To Parent Involvement In Urban Title I Charter Schools, Jessica T. Boro

Theses and Dissertations

The purpose of this qualitative study was to explore site administrators perspectives of barriers and enablers to parent involvement in urban Title I charter middle schools, specifically related to communication, volunteering, and decision making. The study design allowed for in depth analysis of participants interview responses. A total of ten charter school site administrators participated in the semi-structured interviews that informed this study. The semi-structured interviews consisted of six interview questions and nine probing questions. The participant interview responses to the interview protocol were coded to highlight key words and statements to extract themes that informed the study findings. The …

Neuropsychological Rehabilitation Specific To Anorexia Nervosa: A Critical Review Of The Literature On Executive Functioning Symptomatology And Cognitive Remediation Treatment Applications Tailored To This Patient Population, Kayleigh Elizabeth Hale

Theses and Dissertations

Engaging, maintaining, and treating patients with anorexia nervosa (AN) remains a significant challenge for clinicians, hypothesized explanations for which are thought to involve specific executive functioning impairments. The neuropsychological treatment paradigm Cognitive Remediation Therapy (CRT) represents the translation of neurocognitive research into practice, and is thought to remediate neuropsychological symptoms and associated maladaptive cognitive processes. Additionally, the etiological model of AN related to executive functioning provides a conceptual framework for this novel approach to treatment. This study identifies and examines such a model, in addition to CRT protocols. Methodology involved a comprehensive synthesis and critical analysis of the literature pertaining …