Digital Commons Network^™

The Patient Experience Of Language Discordance And Interpreter Services In The Emergency Department, Keri L. Baker

Theses and Dissertations

Background: Clear communication is critical to the interaction of a patient and medical provider. For non-English speaking patients, language discordance, described as the lack of proficiency in a shared language, with the medical team results in a poor patient experience and poor patient outcomes. The predominant solution to language discordance is the use of interpreter services, however these services are underused in the emergency department (ED). Studies examining underuse of interpreter services have primarily focused on the clinician and little is known about the patient’s influence on the use of interpreter services.

Methods: Semi-structured interviews were conducted with 12 Spanish-speaking …

Covid-19 Vaccine And Infection And The Relationship To Lichen Planus Flare-Ups: A Self-Reported Survey Study, Sara Kube

Theses and Dissertations

Purpose: The aim of this study was to determine if there is an increased occurrence of oral lichen planus flare-ups after COVID-19 vaccination or infection.

Methods: An 11-item questionnaire was dispersed to patients with a diagnosis of oral lichen planus. The survey contained questions regarding the patient’s history of COVID-19 vaccination and infection as it relates subjective oral lichen planus flare-ups (i.e. oral redness, oral ulcerations, and/or oral pain/discomfort).

Results: Self-reported flares were significantly associated with whether or not vaccine side effects were also reported (p-value=0.0053). For those who reported experiencing side effects (tiredness, headache, muscle pain, chills, fever, nausea), …

Utilizing Hemoglobin Binding Kinetics And X-Ray Crystallography In Sickle Cell Disease Drug Development, Ahmed Alghamdi

Theses and Dissertations

ABSTRACT

UTILIZING HEMOGLOBIN BINDING KINETICS AND X-RAY CRYSTALLOGRAPHY IN SICKLE CELL DISEASE DRUG DEVELOPMENT

By Ahmed Alghamdi, M.Sc. in Medicinal Chemistry

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Medicinal Chemistry at Virginia Commonwealth University.

Virginia Commonwealth University, 2024.

Director: Dr. Martin K. Safo Professor, Department of Medicinal Chemistry

Introduction: Sickle Cell Disease (SCD) is characterized by severe hemolytic anemia, recurrent painful crises, and chronic organ damage, posing significant challenges to patients' quality of life and longevity. While current FDA-approved therapies offer symptomatic relief, they do not address the underlying molecular …

Mechanistic Analysis Of Four-Way Dna Junctions And Cytokine-Binding Aptamers For Therapeutic Interventions, Roaa S. Mahmoud

Theses and Dissertations

DNA is inherently dynamic and topologically diverse and can fold into many different structures. Besides the canonical Watson-Crick structure, other higher-order structures such as G-quadruplexes (G4), i-motifs (iM), and four-way DNA junctions are possible. Although these high-order DNA structures are known to form transiently, they are important due to the crucial roles they play in many cellular processes including DNA replication, recombination, and repair. Among these DNA structures, 4-way junctions (also known as Holliday junctions, HJ) which are formed during the repair of double-strand DNA breaks (DSBs) and interact with proteins have garnered significant attention due to their central role …

Considering Personal And Professional Identities: The Collaborative Experiences Of School Speech-Language Pathologists, Imani Evans

Theses and Dissertations

My three-paper dissertation explored the interrelatedness between two critical issues in special education: interdisciplinary collaboration and sociocultural identity. I examined both through the perspectives of one discipline of specialized instructional support personnel (SISP). In the first paper, I conducted a systematic literature review examining the current empirical evidence on speech-language pathologists’ (SLPs) collaboration in schools. A key takeaway from the literature review was the need for qualitative research to better understand the depth and breadth of collaborative experiences. In the second paper, I utilized an exploratory qualitative design and pilot data to discuss school-based SLPs’ shared collaborative experiences, identifying common …

The Effect Of Local Anesthesia When Used In Dental Restorative Cases Under General Anesthesia On Control Of Postoperative Comfort, Elizabeth S. Kleefisch Dds

Theses and Dissertations

Purpose:

To determine the effect of local anesthesia on postoperative comfort in patients undergoing dental care under general anesthesia.

Methods:

This study was modeled as a double-blinded randomized control trial. Patients included healthy children under the age of 6 years scheduled for restorative dental treatment under general anesthesia (GA). Patient behavior was evaluated preoperatively and postoperatively using the Faces, Legs, Activity, Cry and Consolability (FLACC) or other pain score and postoperatively using the Parent’s Postoperative Pain Measure (PPPM). Intraoperatively, participants followed a standardized general anesthesia protocol and were given either local anesthetic (LA) infiltration using 2% Lidocaine 1:100,000 Epinephrine by …

The Influence Of Flavor On The Abuse Liability Of A Heated Tobacco Product And Its Feasibility As A Menthol Cigarette Substitute, Augustus White

Theses and Dissertations

Heated Tobacco Products (HTPs) purport to expose people that use cigarettes to fewer of the harmful or potentially harmful constituents of tobacco while still delivering reinforcing amounts of nicotine (Auer, Concha-Lozano et al., 2017). An exemplar of the HTP class, IQOS, and its three varieties of “HeatSticks” have been authorized by the Food and Drug Administration (FDA) as “Modified Risk Tobacco Products” (MRTP). However, as the FDA is planning to ban menthol as a characterizing flavor in cigarettes, questions remain regarding whether characterizing flavors should be permitted in HTPs (FDA, 2022e). New evidence regarding HTP abuse liability (i.e., the likelihood …

The Role Of Sleep And Social-Ecological Supports In The Association Between Racial Discrimination And Cardiometabolic Risk In Black Youth, Jelaina R. Shipman-Lacewell

Theses and Dissertations

Black youth are at an increased risk for poor short and long-term cardiometabolic health, including obesity, hypertension, and type 2 diabetes. Racial discrimination and poor sleep are theorized as key factors contributing to cardiometabolic health. While adult studies support sleep as a pathway through which discrimination is associated with health, there is a critical gap in our knowledge of this pathway in youth. Socio-ecological supports may protect Black youth against stressors, including racism. However, studies of the protective nature of these factors in Black youth have primarily focused on psychological and behavioral outcomes. Thus, the current study built upon previous …

Living The American Dream? College Experiences Of Undocumented Students In An Era Of Rising Xenophobia And Political Turmoil, Sandra Y. Ting Ph.D.

Theses and Dissertations

This research study sought to deepen the understanding of the journeys of undocumented and DACAmented college students in an era of escalated xenophobia and political unrest. Three noteworthy themes emerged from the sentiments expressed by participants. The experiences they described included: 1) the turmoil of undocumented status eliciting unique and empowering demonstrations of resourcefulness, creativity, and self-advocacy, 2) motivation and stress from their respective citizenship statuses existing as two mutually dependent facets of a unified whole, 3) a community of support from other undocumented and/or DACAmented peers as a necessity for wellbeing. These critical outcomes culminate in the conditioning to …

Relations Between Adverse Childhood Experiences And Substance Use In Adolescents And Emerging Adults: The Moderating Role Of Exposure To Community Violence And Community Support And Community Recognition, Kiara Brown

Theses and Dissertations

Due to historical and current systemic racial inequities, African American adolescents and emerging adults living in low-income urban communities bear the burden of higher rates of adverse childhood experiences (ACEs) and exposure to community violence. Both exposure to ACEs and community violence are linked to higher levels of substance use. However, limited research exists on how exposure to community violence exacerbates the association between ACEs and higher frequencies of substance use in adolescence and emerging adulthood. There is also a need to understand how community-level protective factors may weaken the relations between ACEs and higher rates of substance use. The …

“I Know What Nothing Means”: Nostalgia, Hope, And The Postmodern Search For The Sublime, Kathryn L. Donati

Theses and Dissertations

Amid simultaneous crises of self, nation, digital citizenship, global health, climate change, and socio-political polarization, to name but a few of the catastrophes that seem to define life in the global West in the twenty-first century, where do we find hope? Do we find it at all? Is there any hope to be found? These are the questions that serve as the genesis for this undertaking in which I locate the origin of these crises far before the events of the 2016 and 2020 elections, far before even the panic of Y2K. I begin my examination of hope in contemporary …

Validation Of A Screening Tool For Sleep Apnea In Children, Brandon Khor

Theses and Dissertations

Objective: The aims of this study were to (1) determine the ability of a pediatric obstructive sleep apnea (POSA) questionnaire to identify high-risk patients through confirmation with an at-home sleep apnea test (HSAT) and (2) to evaluate the correlation between high-risk patients as identified by the questionnaire (PM-STOP-Bang) and an already validated POSA screening tool.

Methods: Orthodontic patients aged 12-17 who met the inclusion criteria were consecutively enrolled in the study (n=16). At the initial orthodontic appointment, the clinician filled out the PM-STOP-Bang questionnaire. Subsequently, participants were invited to complete a one-night HSAT (WatchPat, WP-Itamar-Medical, Caesarea, Israel), which recorded diagnostic …

Factors Important To Underrepresented Minority Applicants In Ranking Orthodontic Programs, Alyssa Patterson

Theses and Dissertations

Purpose: To determine if there was a difference in desirability of various factors used by applicants ranking orthodontic programs depending on their racial or ethnic background.

Method: A survey was distributed to orthodontic residents to assess overall preferences, and differences in desirability of various factors between underrepresented minority (URM) and non-URM applicants.

Results: For applicants overall, “clear aligner therapy training”, “good quality of clinical faculty” and “high number of cases started” had the highest mean desirability. “Racial and ethnic diversity among current and former residents”, “racial and ethnic diversity among faculty” and “participation in care of Medicaid patients” were significantly …

Shinners, Alexis E. Mabry

Theses and Dissertations

Shinners is a project that aims to examine the position of women in subcultures and capture conversations of women in subcultural sports. Within feminism, sociological constructs, campy horror, and personal experience I am manifesting the physical and mental obstacles faced in the subcultural sport of Bicycle Motocross (BMX) through photography, painting, collage, video, and sculpture. I interpret images posted to social media of injuries obtained while riding BMX as forms of empowerment, bodily gore as extreme evidence of participation, performative violence, valorizing the understanding of both the physical and psychological pain of failure, and the use of failure as a …

Using Natural Language Processing To Understand The Lived Experiences Of People Identifying With Adhd: What Themes Emerge In Social Media Posts?, Gabby C. Scalzo

Theses and Dissertations

Compared to the amount of research conducted on how to identify and understand children with Attention-Deficit Hyperactivity Disorder (ADHD), there has been relatively little work done to understand the lived experiences of adults with ADHD. Increased understanding of how adults with ADHD conceptualize themselves in the context of their diagnosis would help clinical experts tailor research and treatments to better serve these communities. However, there are several barriers towards conducting high-quality qualitative research, including time- and labor-intensity. This study, informed by qualitative research traditions, used innovative data sources (i.e., social media) and analytic techniques (i.e., machine learning) to reduce these …

On The Rebound: Resilience And Subjective Cognitive Symptoms In Cancer, Giuliana V. Zarrella

Theses and Dissertations

Recent studies have shown a strong connection between resilience and subjective cognitive symptoms in clinical populations. However, there is limited understanding of this relationship in cancer survivors, and no studies examine whether resilience training could alleviate subjective cognitive symptoms in these patients. This study examined the relationship between subjective cognitive function and resilience in non-CNS cancer survivors who participated in a resiliency training intervention, at baseline and from pre- to post-intervention, as well as investigated potential influences of change in subjective cognition. Adult cancer survivors (N=275) participated in the Stress Management and Resilience Training-Relaxation Response Resilience Program (SMART-3RP) …

A Critical Perspective On Supporting Parents In Facilitating Informal Steam Learning On Children's Early Literacy Development, Suzanne G. Alexandre

Theses and Dissertations

Considering that parents/caregivers and home environment play an influential role in a child’s school readiness and future academic success, this study sought to support parents in using facilitation strategies to engage their child in informal learning at home. In order to examine if access to support for parents of preschoolers influenced parents’ confidence in their ability to facilitate informal learning at home, the project used informal STEAM learning, for context. The study also examines the potential impact of informal STEAM learning on children's school readiness and early literacy skills and the intersections of parent involvement, STEAM, and school readiness through …

Exploring The Experiences Of Refugee Youth In Public Schools: An Ethical Phenomenological Inquiry, Hilary T. Stim

Theses and Dissertations

The study outlined in this dissertation focuses on the intersection between refugee youth between the ages of 13-18 and the United States public school, specifically the manner in which refugee youth experience institutionalized education. It utilizes ethical phenomenology as a means to amplify the voices of refugee students and to centralize the students' experiences, thoughts, and ideas related to education The study was framed by one research question that is addressed to the participants: “What is it like being a student in a public school?” Seven students took part in the study. Collaborative dialogues took place with the participants across …

Exploring Drivers Of Sex-Based Disparities In Relapsing Multiple Sclerosis, Stephanie K. Buxhoeveden

Theses and Dissertations

Females are three times more susceptible to relapsing multiple sclerosis (MS) and males typically have more severe disease, but the molecular underpinnings of these sex-based disease disparities are unknown and represent a critical knowledge gap.Subject Population: Blood samples from a demographically homogenous group of treatment naïve males and females with relapsing-MS and healthy controls. Research Design: Cross-sectional combinatorial omics pilot study. Instruments: Whole transcriptomic analysis with messenger RNA (mRNA) expression profiling using next generation sequencing (RNA-seq) and micro-RNA (miRNA) expression using NanoString technology. Aim 1) Identify and compare the actively expressed mRNAs in the transcriptome of males and …

Exploring The Relationship Of Intact Limb Knee Joint Loading With Step Lengths And Step Length Symmetry In Individuals With Lower Limb Amputation, Edward D. Syrett

Theses and Dissertations

Individuals with unilateral lower limb amputation (LLA) frequently experience intact limb knee pain, dysfunction, and osteoarthritis. These problems can worsen pre-existing reductions in mobility and quality of life that this population regularly experiences. It is widely accepted that knee joint loading is implicated in the development of knee joint issues, and intact limb knee joint load alterations are thought to be widespread in individuals with LLA. Prior work suggests that gait deviations frequently present in this population may be a contributory cause of these altered forces. These deviations can take many forms, but individuals with LLA commonly demonstrate alterations in …

Optimizing Deep Inspiration Breath Hold Technique For Personalized Breast Cancer Radiotherapy, Srinidhi Rajagopalan

Theses and Dissertations

The purpose of this research is entrenched in advancing the practice of 3D Conformal Radiation Therapy (3D CRT) for breast cancer patients by meticulously evaluating the impact of different Deep Inspiration Breath Hold (DIBH) techniques on dosimetric parameters. This study aims to ascertain the quantitative benefits of varied breathing techniques, primarily focusing on the 'Ultimate DIBH' method's efficacy in sparing critical organs such as the heart and lungs.

The comprehensive analysis of different DIBH techniques in this research is not merely an academic exercise but is geared towards substantiating the hypothesized advantages of these techniques with empirical data. By generating …

Evaluation Of Cervical Dentin Removal After Orifice Shaping In Maxillary Premolars: A Micro Ct Study, Abdulaziz Mallik

Theses and Dissertations

Objective: The research aims to compare the volume and percentage of pericervical dentin removed by Gates Glidden Drills, ProTaper SX, and a 20-06 Rotary File.

Methods: A total of 24 extracted two-rooted maxillary first premolars were divided into three groups (n=8) and were coronally flared using either Gates-Glidden Drills, ProTaper Gold SX, or a 20-06 Brasseler Endosequence CM Rotary File. Pre- and post-flaring micro-CT scans were obtained. The dentin volume of the buccal canals was measured from the chamber floor and 2 mm apically in the buccal canal only. Data were analyzed using the ANCOVA test to compare dentin removal …

Levofloxacin Incorporated Extracellular Matrix Nanoparticles For Pulmonary Cystic Fibrosis Infections, Raahi Patel

Theses and Dissertations

Cystic fibrosis (CF) is a progressive genetic disorder that affects around 40,000 people in the United States. CF is characterized by a mutation in the CFTR protein that causes dysregulated ion transport across epithelial cells, producing viscous mucus in the lung that increases bacterial invasion, causing persistent infections and subsequent inflammation. Pseudomonas aeruginosa and Staphylococcus aureus are two of the most common infections in CF patients that are resistant to antibiotics. One antibiotic approved to treat these infections is levofloxacin (LVX) that functions to inhibit bacterial replication, but can be further developed into tailorable particles. Nanoparticles are an emerging inhaled …

Spatial Transcriptomics Unravels Palmitoylation And Zonation- Dependent Gene Regulation Of Aeg-1 In Mouse Liver, Alissa Saverino

Theses and Dissertations

Obesity-induced metabolic dysfunction-associated steatohepatitis (MASH) leads to hepatocellular carcinoma (HCC). Astrocyte-elevated gene-1/Metadherin (AEG-1/MTDH) plays a key role in promoting MASH and HCC. AEG-1 is palmitoylated at residue cysteine 75 (Cys75) and a knock-in mouse representing mutated Cys75 to serine (AEG-1-C75S) showed activation of MASH- and HCC-promoting gene signature when compared to wild-type littermates (AEG-1-WT). The liver consists of 3 zones, periportal, midlobular, and pericentral, and zone-specific dysregulated gene expression impairs metabolic homeostasis in the liver, contributing to MASH and HCC. Here, to elucidate how palmitoylation influences AEG-1-mediated gene regulation in regards to hepatic zonation, we performed spatial transcriptomics (ST) in …

The Effects Of Various Nanoplastics On The Inflammatory Response In Primary Alveolar Epithelial Cells, Eunice J. Pak

Theses and Dissertations

As plastic pollution begins to multiply in the environment and the workplace, gradual degradation of these plastics creates an unseen threat to biological health: nanoplastics. These nanoplastics are common in day-to-day life, and have been found in various internal organs of the human body. The biological and health effects of these nanoplastics are still widely unknown, and only recently has research focused on the impacts of these particles on human health at the cellular level.

In this thesis, poly(methyl methacrylate) and three forms of polystyrene (carboxyl-modified, amine-modified, and neutral surface charge) have been tested on submerged primary C57BL/6 mouse alveolar …

The Effect Of Experienced Compassion At Work On Nursing Home Certified Nursing Assistants' Well-Being And Turnover Intentions, Kristin M. Macdonald

Theses and Dissertations

Statement of problem and objectives: Could experienced compassion at work alleviate nursing home certified nursing assistant (CNA) burnout? This study investigates whether experienced compassion at work predicts higher well-being (meaningfulness of work, psychological vitality, and resilience) for CNAs, and if well-being predicts lower turnover intentions.

Procedure followed: This is a prospective, observational, survey-based study with three timepoint data collection. Convenience sampling of Kansas and Virginia NHs was conducted (n=13). All CNAs working at the NHs were study eligible. CNAs received gift cards with laddered incentives for ongoing participation. There was in-person administration of a CNA survey at each timepoint. …

Drugging The Histone Acetyltransferase Ep300 Modulates Alternative Splicing At Schizophrenia Risk Genes, Shravani Malay

Theses and Dissertations

Purpose. We will evaluate the effects of drugging the epigenetic histone acetyltransferase (HAT) enzyme p300, encoded by the schizophrenia risk gene EP300, on genome-wide gene expression in neural cells. We hypothesize that drugging p300 will affect gene expression and alternative splicing of other schizophrenia risk genes. Our motivation is to identify potential new epigenetic treatment avenues for schizophrenia.

Methods. Prior to my joining the lab, an experiment was conducted using the novel p300 HAT inhibitor, A-485, to modulate genomic regulation in a neural cell line (SH-SY5Y). SH-SY5Y cells were exposed to 10μM of A-485 or vehicle (DMSO) for 24 …

Biophilia: Developing A Taste For Care, Che'leah Shannon

Theses and Dissertations

People in materially developed cultures spend over 90% of their lives in buildings (Evans & McCoy, 1998). Commencing with the industrial revolution these materially developed cultures see most of their populus moving from the countryside to the city in search of work and better lives. The city, an urban and modern development of densely packed peoples, buildings, and infrastructure, has developed as an efficient solution to meet the needs of a cosmopolis.

The city has developed widely without a necessity or place for nature. The ground outside is paved with concrete, efficient and comfortable for travel, buildings are built high …

Learning Curve: Designing An Inclusive Early Childhood Learning Center, Sarah Alrumayh

Theses and Dissertations

This research centers on the improvement of early childhood education environments in hopes to reduce the disparities in outcomes among children aged 2-6, widely known as "the achievement gap." It sheds light on designing an inclusive, child-centered school for students with specific learning disabilities (SLD) and speech or language impairments (SLI). Drawing on the IDEA (Individuals with Disabilities Education Act), it underscores the benefits of integrating students with special education needs into mainstream education, thereby fostering inclusive learning environments. (IDEA, 1975).

The research question probes how to create a nurturing and adaptable school environment tailored to the diverse needs of …

In Shame I Will Find Paradise, Taehee Whang

Theses and Dissertations

As a Korean American non-binary digital artist and designer, my recent explorations have focused on using voice as a medium to articulate nuanced feelings of displacement and the intricate relationships between language, identity, and expression. This journey expands beyond my personal experiences with gender dysphoria, delving into the lives of non-binary and transgender individuals undergoing gender-affirming voice therapy. Through my thesis research, I have developed interactive multimedia installations inspired by dialogues with individuals such as Umico Niwa, who traveled to Korea for voice feminization surgery, and Jeong Yoon Lee from Hyperlink Press, a four-year participant in Hormone Replacement Therapy (HRT). …