Digital Commons Network^™

Factors That Influence Breast Cancer Diagnoses In Virginia Women 40-64 Years Old Who Utlized The Every Woman’S Life Program 1998-2012, Melanie C. Dempsey

Theses and Dissertations

This dissertation examines sociodemographic determinants and preventive health behaviors among women 40-64 years of age who participated in the Virginia Department of Health’s Every Woman’s Life breast cancer screening program. Utilizing secondary data, this research sought to explore patterns of breast cancer incidence, mammography screening utilization and sources of health information among low-income women.

The Virginia Department of Health provided a large sample size (N=34,942) on which to perform binary logistic regression analyses. Sociodemographic determinants and preventive health behaviors were analyzed as potential influencing factors in the diagnosis of breast cancer, the stage at the time of diagnosis and source …

The Effects Of Fatigue On Lower Extremity Kinetics And Kinematics In Subjects With Known Ankle Instability, Lindsay E. Clayton

Theses and Dissertations

The goal of this study was to evaluate biomechanical differences between healthy subjects and those with ankle instability during the gradual onset of lower extremity fatigue from a landing activity. An understanding of these differences is needed in order to prevent future injury to or further debilitation in individuals with ankle instability. A functional fatiguing activity was designed to focus fatigue on the quadriceps muscles, as those are the muscles most frequently fatigued during sport. Measures were taken throughout the progression of fatigue with a force plate and a motion tracking system and included vertical ground reaction force and lower …

Light Controlled Drug Activation And Release, Jonathon Sheldon

Theses and Dissertations

Cancer constitutes a terrible burden on modern society. In the United States there are an estimated 1,658,370 new cancer diagnoses resulting in 589,430 deaths in 2015 alone.^[1] An estimated 41,170 of these cases will be diagnosed right here in Virginia. With new cancer patients comes the expanding demand for new treatments. As we all know, many modern chemotherapeutics cause adverse reactions to patients. This is because the toxic nature of these therapies often affects normal tissue alongside the tumors that are infesting the body. Therefore, researching novel ways to make chemotherapeutics selective for cancer, while leaving healthy tissue unscathed, …

Normalizing Tumor Vasculature Using Sepiapterin To Increase Radiosensitivity, Ninu Bruno

Theses and Dissertations

Our studies examine the role of nitric oxide synthase (NOS) in tumor vasculature. NOS is “uncoupled” in tumor cells, resulting in peroxynitrite (ONOO^-) formation in lieu of nitric oxide (NO). NO signaling is critical for vascular function, thus uncoupling of eNOS in endothelial cells may partly explain the poor vasculature found within tumors. NOS can be “recoupled” through Sepiapterin (SP) treatment of tumor cells. We examined whether SP could normalize tumor vasculature, promoting radiosensitivity. Optoacoustic tomography of flank xenografts and spontaneous tumor models demonstrate that SP significantly enhances percent oxyhemoglobin in tumors. Immunohistochemical analysis of SP-treated tumors showed …

Dispersant Effects On Zinc Dialkyldithiophosphate (Zddp) Tribofilm Structure And Composition, Makaye Tabibi

Theses and Dissertations

For decades, global regulations and government mandates have driven technological developments to improve vehicle fuel economy. Tribological components found in all automotive engines contain metal-on-metal contact zones that may result in increased friction and wear, reducing overall engine efficiency. Lubricant additives such as antiwear and friction modifying components are added to motor oils to prevent some of the damages that may occur at contact zones and improve friction. The effects of other additive components, such as dispersants, that are prevalent in a lubricant additive package on the anti-wear layer remain relatively unknown. Polyisobutenyl Succinimide (PIBSI) dispersants were evaluated for their …

The Role Of Psychology In Integrated Primary Care For Complex Patients: Effects On Mental Health, Utilization Of Medical Services, And Physiological Markers Of Health, Danielle C. Worthington

Theses and Dissertations

This study served as an initial evaluation of integrated psychology services within a clinic designed to serve uninsured patients with complex medical concerns and high utilization histories at the Medical College of Virginia in Richmond, Virginia. The current study evaluates patient outcomes, and more specifically, it further quantifies and describes the role that psychologists play in the primary care setting and their impact on utilization of medical care and in improved health outcomes. Additionally, the study evaluates psychologists’ success at treating mental and behavioral health conditions within the primary care model. The present study demonstrates that patients with complex medical …

Heteroatom-Doped Nanoporous Carbons: Synthesis, Characterization And Application To Gas Storage And Separation, Babak Ashourirad

Theses and Dissertations

Activated carbons as emerging classes of porous materials have gained tremendous attention because of their versatile applications such as gas storage/separations sorbents, oxygen reduction reaction (ORR) catalysts and supercapacitor electrodes. This diversity originates from fascinating features such as low-cost, lightweight, thermal, chemical and physical stability as well as adjustable textural properties. More interestingly, sole heteroatom or combinations of various elements can be doped into their framework to modify the surface chemistry. Among all dopants, nitrogen as the most frequently used element, induces basicity and charge delocalization into the carbon network and enhances selective adsorption of CO₂. Transformation of …

Nitric Oxide Synthase Activity And Its Modulation In The Treatment Of Colorectal Cancer, Asim Alam

Theses and Dissertations

The American Cancer Society estimates more than 141,000 new cases of and about 50,000 deaths from colorectal cancer every year. Treatment options include surgery, radiation therapy and targeted therapies such as anti-angiogenics. However, no therapies address the key driving factor of colorectal cancer: inflammation. It is well known that chronic inflammatory conditions such as Crohn’s Disease, ulcerative colitis, diabetes, obesity and cigarette smoking all elevate the risk of developing colorectal cancer. One of the hallmarks of chronic inflammation is the elevated levels of reactive oxygen/nitrogen species (ROS/RNS). A primary source of these ROS/RNS is uncoupled Nitric Oxide Synthase (NOS). Under …

Censoring And Fusion In Non-Linear Distributed Tracking Systems With Application To 2d Radar, Armond S. Conte Ii

Theses and Dissertations

The objective of this research is to study various methods for censoring state estimate updates generated from radar measurements. The generated 2-D radar data are sent to a fusion center using the J-Divergence metric as the means to assess the quality of the data. Three different distributed sensor network architectures are considered which include different levels of feedback. The Extended Kalman Filter (EKF) and the Gaussian Particle Filter (GPF) were used in order to test the censoring methods in scenarios which vary in their degrees of non-linearity. A derivation for the direct calculation of the J-Divergence using a particle filter …

Integrated Nanoscale Imaging And Spatial Recognition Of Biomolecules On Surfaces, Congzhou Wang

Theses and Dissertations

Biomolecules on cell surfaces play critical roles in diverse biological and physiological processes. However, conventional bulk scale techniques are unable to clarify the density and distribution of specific biomolecules in situ on single, living cell surfaces at the micro or nanoscale. In this work, a single cell analysis technique based on Atomic Force Microscopy (AFM) is developed to spatially identify biomolecules and characterize nanomechanical properties on single cell surfaces. The unique advantage of these AFM-based techniques lies in the ability to operate in situ (in a non-destructive fashion) and in real time, under physiological conditions or controlled micro-environments.

First, AFM-based …

Physicochemical And Structural Analysis Of Polymers As Putative Drugs, Meghan L. Thompson

Theses and Dissertations

Sulfated low molecular weight lignins (LMWLs) have shown good activity as anticoagulants by allosterically inhibiting thrombin, as well as promising agents for treating emphysema through inhibition of elastolysis, oxidation, and inflammation. Sulfated LMWLs are chemo-enzymatically synthesized from starting monomers caffeic, ferulic, and sinapic acid into sulfated dehydropolymers known as CDS, FDS, and SDS. To further the LMWLs’ development as drugs, their structural composition and physicochemical characteristics were defined in this work. The molecular weight distribution profile of the sulfated LMWLs from size exclusion chromatography performed on a high pressure liquid chromatography system (SEC-HPLC) changed from bimodal when no surfactant is …

Conjoined Lucuma Fruit Vessels: Evolution & Context In Nasca Art, Carley Elder

Theses and Dissertations

The function of a ceramic vessel is often evaluated in relation to its form. Vessels with complex forms can be challenging to analyze from this perspective and require a different approach. One such example is an overlooked yet long-lived specialized vessel type in the form of conjoined lúcuma fruits found throughout the ancient Andes. The main object of this study is a Nasca version of this vessel type in the Virginia Museum of Fine Art. This study explores the relationship between form and iconography, rather than function. It examines how Nasca potters adopted the conjoined lúcuma form vessel and adapted …

Measuring The Impact Of Recognized Patient-Centered Medical Homes (Pcmh), Rick Moore

Theses and Dissertations

This dissertation proposal seeks to understand if the increasingnumbers (density) of recognized PCMH practices incommunities affect avoidable hospitalizations related toambulatory care sensitive conditions (ACSC), as measured bythe AHRQ Composite Prevention Quality Indicators (PQI). Theresearch has two purposes: 1. Establish constructs and hypotheses to measurethe effect of the increasing numbers of NCQA-Recognized PCMH practices in communities(counties). 2. Using an outcomes-based measurement approach,investigate the relationship between growingdensities of NCQA-Recognized PCMH practicedoctors among all primary care doctors (PCD) ina community and the associated impact on theutilization of inpatient care, specifically related toACSCs, as measured by the AHRQ CompositePQIs.

The research is quasi-experimental in …

Efficiency Of Unified Vs. Non-Unified State Judiciaries: An Examination Of Court Organizational Performance, William Raftery

Theses and Dissertations

State court systems function in much the same manner as any other government agency in terms of organization and management to utilize public resources in order to provide a public service. The question posed in the late 19th century was whether the courts should be organized and managed as they had been for centuries as local entities locally controlled and operated or transferred to the state level. The desired end was a more efficient use of public resources to achieve faster disposition of cases. This reorganization, called unification, was made up of three individual components: 1) consolidation required the reduction …

Individuals With Fetal Alcohol Spectrum Disorder: Predictive Factors For Successful Occupational Performance, Mary Culshaw

Theses and Dissertations

As awareness and diagnoses of FASD grow in Canada, there is increased need to support these individuals across their lifespan. One study suggested the prevalence of FASD may be as high as 10 per 1000 births (May & Gossage, 2001). The impact to society is growing as well, since this population requires support across their lifespan due to cognitive and sometimes physical impairments. It was estimated that the annual cost to Canadians was $53 billion (in 2007 dollar value) to support individuals aged 0-53 years (Stade et al., 2009). There is mounting evidence identifying the cognitive and physical impairments that …

The Integration History Of Kuwaiti Television From 1957-1990: An Audience-Generated Oral Narrative On The Arrival And Integration Of The Device In The City, Ahmad Hamada

Theses and Dissertations

This study attempts to compose an account of television history in Kuwait, one that focuses on its integration into society and is told from the audience's perspective and experience. This study represents a cultural alternative to the overwhelmingly national, institutional, and biographical focus that accompanies television history works in Kuwait and the Arab world.

The narrative is gathered and generated through the individual oral stories of 25 Kuwaitis over the age of 50, who generally represent the six geographical districts of Kuwait. Through their oral stories, the narrators examine the different areas in which television has integrated itself into society …

Decreased Sound Tolerance (Dst): Prevalence, Clinical Correlates, And Development Of A Dst Assessment Instrument, Therese Verkerke Cash

Theses and Dissertations

Decreased sound tolerance (DST) conditions, including misophonia and hyperacusis, are emerging clinical conditions in behavioral medicine. Misophonia involves an extreme emotional response (often anger, disgust, or annoyance) to specific sounds (such as people chewing, swallowing, tapping their foot on the floor, etc.), while hyperacusis is defined by high sensitivity to sounds below normal sound sensitivity thresholds. Although research on these DST conditions is increasing, clearly defined prevalence rates, associations with other mental health conditions, and development of assessment tools that can identify and differentiate DST symptoms are needed. Research and clinical reports also suggest that DST problems are more likely …

Examination Of Basal Neuroendocrine Levels In Oif/Oef/Ond Veterans, Sage E. Hawn

Theses and Dissertations

Abstract

EXAMINATION OF BASAL NEUROENDOCRINE LEVELS IN OIF/OEF/OND VETERANS

By Sage E. Hawn, B.S.

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

Virginia Commonwealth University, 2015.

Major Director: Ananda B. Amstadter, PhD.

Associate Professor

Departments of Psychiatry, Psychology, & Human and Molecular Genetics

High rates of combat exposure exist among veterans of the recent conflicts, and are associated with debilitating mental health conditions, including posttraumatic stress disorder (PTSD). Numerous psychosocial and biologic factors are associated with PTSD, including the HPA-axis. The present study aimed to compare baseline neuroendocrine …

Conduction States Of The Human Dopamine Transporter, Krasnodara Cameron

Theses and Dissertations

Dysregulation of dopaminergic homeostasis has been established as the primary source of numerous neurological disorders including Parkinson’s and drug addiction. A tonic increase of dopamine (DA) in the nucleus accumbens is required for associating everyday events and behaviors with rewards. Yet many addictive exogenous compounds such as amphetamine (AMPH) and cocaine (COC) produce a much greater augmentation of synaptic DA levels that are linked to euphoria and a shift in behavior towards drug seeking. The protein responsible for maintaining extracellular levels of DA is the dopamine transporter (DAT). It is primarily located in the perisynaptic area at terminals of pre-synaptic …

Confederate Richmond: A City's Call To Arms, Tucker L. Modesitt

Theses and Dissertations

This work mainly focuses on putting the laborers of the Richmond Armory and the Tredegar Iron Works into the context of Civil War Richmond by focusing on their skills, backgrounds, and loyalties throughout the conflict. It highlights the similarities and differences between the two institutions and the legacies that they left behind in the years following the war. It also sheds light on some of the problems facing the Confederacy during the course of the war and its struggle to procure arms.

Can Fair Value Accounting Create A Cognitive Bias? The Effects Of Recognized Level 3 Fair Value On Manager Selling Decisions, Karen Y. Green

Theses and Dissertations

This study examines the effects of the discretion allowed in fair value accounting on manager selling decisions of Level 3 fair value assets and liabilities. Grounded in motivated reasoning and prospect theory, the discretion permitted for Level 3 fair value assets and liabilities is predicted to have behavioral consequences. The study employs a 2 X 2 between- participant design, manipulating a conservative level of the discretion used to ascertain the fair value (more or less conservative) and the volatility of the historically recognized fair value (low or high). Both graduate students and accounting professionals were asked to read a case …

Therapist Adherence To Cognitive Behavioral Therapy For Anxious Youth Across A Case, Julia R. Cox

Theses and Dissertations

The field has developed many evidence-based treatments (EBTs); the integrity of EBTs being delivered, however, has been studied less than rigorously. Because many treatment manuals are developed to be delivered session-by-session, one way to assess treatment adherence, specifically, is across the course of the case: do therapists deliver treatment components in the order prescribed? The goals of this study were to characterize how therapists deviate from prescribed order and how adherence to order relates to child characteristics. Therapy process data were collected from a subsample of children (N = 33, aged 7-15) that received cognitive behavioral therapy (CBT) to address …

Exploring Dimensions Of Well-Being Among Spouses Of Active-Duty Service Members, Lisa A. Gray

Theses and Dissertations

During an era when the United States has been engaged in the longest waging wars in U.S. history, military families have been exposed to extraordinary amounts of stress and have had to learn to adapt in a culture where repeated deployments, recurrent family separations, and frequent relocations have become the norm. A surge in research in recent years on the families of Service members has brought increased attention to the unique challenges and demands of spouses, raising concerns about how to best meet their needs. Despite the increased attention, few studies have focused on spousal well-being. Acknowledging this lack of …

Social Studies, Donna B. Evans

Theses and Dissertations

Artist Statement

In my mixed media work, I focus on people who are in the process of being uprooted and exiled from their home. My work reflects the limbo refugees experience while they search for balance and a new place to settle. The cultural diaspora affects the transplanted individuals as well as the host communities. Everyone experiences and needs to adapt to change.

My abstracted images are created by manipulating layers of acrylic paint, photo gel transfers, gel medium, and tempera paint. I combine human forms with layers of English and foreign text while exploring concepts of displacement. I use …

Into The Fray, Frances Pearce

Theses and Dissertations

My sculpture and prints are about dismemberment and the destruction caused by war. To address the high cost of war, I make works that present the threat of injury, amputation, and prosthetics. I use Classical Greek art history references to address contemporary political, military, and social issues. I include images such as Amazonian women, horses, and doves. These images are coupled with references to the damage caused by conflict. While my work concerns destruction, paradoxically, my process involves additive construction. I take a mixed media approach to both my sculptures and my prints, and use a wide range of materials …

African American Women’S Perceptions Of Hiv Prevention Communication With Their Reproductive Health Providers, Valerie Burge-Hall

Theses and Dissertations

In spite of a decline in HIV incidence rates among African American women, they still bear the most significant disease burden among U.S. women. Findings from numerous studies indicate probable explanations for the disparity, such as the impact of poverty, limited healthcare access, low literacy, and living in areas with high HIV rates. Additionally, many study results provide insight regarding prevention strategies. However, the aim of this study is to explore African American women’s perceptions regarding what HIV prevention communication, if any, occurred with their reproductive health providers (RHPs). In this study, 20 African American women with unknown HIV status …

Vitamin C: A Potential Regulator Of Inflammatory Response, Bassem M. Mohammed

Theses and Dissertations

Introduction: Neutrophils (PMNs) and Macrophages are the first responders recruited consecutively to the site of injury/inflammation. PMNs’ response/fate as well as macrophage reprogramming ultimately determine the course of resolution of inflammation. Physiologic wound healing has a significant inflammatory component. An exaggerated inflammation however is self-defeating leading to delayed healing. Parenteral vitamin C (VitC) attenuated inflammation in murine sepsis models and in patients with sepsis. However information about the mechanisms by which VitC regulates these events is limited.

Methods: Humanized mice lacking VitC synthesis capability (Gulo^-/-) were used. VitC sufficient and deficient mice were challenged with sterile inflammation, or …

Ceo Managerial Ability, Corporate Investment Quality, And The Value Of Cash, Huiqi Gan

Theses and Dissertations

This study investigates how CEO managerial ability affects investment quality, investment efficiency, and the value of cash. Specifically, I examine whether higher managerial ability is associated with higher M&A quality, more efficient capital investments, and higher value of cash. Investment decision-making and implementation can signal a CEO’s managerial ability (Stein 2003), and shareholders assign more value to the cash of those firms with high ability CEOs. Thus, I predict that more able CEOs conduct higher quality M&A and make more efficient capital investment decisions. I also propose that the value of cash is higher for firms with more able CEOs. …

Determinants Of Turnover Intent In Higher Education: The Case Of International And U.S. Faculty, Jaehee Park

Theses and Dissertations

In spite of the increase in the number of the international academic workforce and their potential benefits, international status has been relatively under-studied in Public Management and Higher Education literature in comparison with studies of age, gender, and race. Given these realities, the present study identifies characteristics of internal and external variables that influence international and U.S. faculty turnover intentions in a large public South Eastern research university.

To understand the variations in short-term and long-term turnover levels while controlling for various demographic, structural, and external variables, eight Ordinary Least Square (OLS) regression analysis were performed using turnover intentions as …

Investigating The Effects Of Obesity Prevention Campaigns, Courtney C. Simpson

Theses and Dissertations

Public health campaigns might not be universally helpful and could have detrimental consequences. The current investigation explored the effects of obesity prevention campaigns. Their impact was assessed using an experiment in which participants were randomized to view either weight focused obesity prevention campaigns or obesity prevention campaigns that did not use weight related terms. Results demonstrated that compared with campaigns without weight related terminology, weight focused campaigns increased negative perceptions of obesity and decreased self-efficacy for health behavior change. No differences in body satisfaction, thin-ideal internalization, state anxiety, or frequency of positive health behaviors were found based on the type …