Medicine and Health Sciences Commons^™

A Real-World Characterization Of Patients Receiving Biologics For Type 2 Inflammatory Diseases In A Tertiary Rhinology Practice, T. Blaise Marshall, Matthew Lelegren, Joseph K. Han, Kent Lam

Eastern Virginia Medical Journal

Background: Biologic therapies, such as omalizumab, mepolizumab, dupilumab, and benralizumab, are increasingly used in the treatment of various type 2 inflammatory diseases, including chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and atopic dermatitis. While these biologic therapies have demonstrated efficacy and safety in their respective clinical trials, real-world characterization of the use of biologic therapies provides insight into how these treatments are prescribed and utilized among the general population.

Objective: We aim to characterize the patient population in a single tertiary otolaryngology practice that is receiving biologic therapies for all type 2 inflammatory diseases.

Methods: We conducted a retrospective chart …

Computational And Ai Tools For Understanding Telomere-Associated Cancer Mechanisms, Eleni Adam

Computer Science Theses & Dissertations

Telomeres are the protective caps of the human chromosomes and are critical for genome stability. Dysfunctional telomeres caused by their erosion with age and cell proliferation as well as by defects in their maintenance is a major early event leading to genome changes and cancer. Subtelomeres possess the critical role of regulating adjacent telomeres. Due to their complex repeat structure and high variance from one person to another, these areas have not been analyzed in detail. We present a set of computational and machine learning tools to aid in the understanding of subtelomere structure and its rearrangements in cancer.

Initially, …

The Mediating Role Of Hope In The Relationship Between Everyday Discrimination And Depression Among College Students, Busra Vurkun

Counseling & Human Services Theses & Dissertations

Research shows that marginalized populations experience disproportionately higher psychological distress (Budhwani et al., 2015; Bailey et al., 2019). Everyday discrimination, defined as chronic interpersonal mistreatment such as microaggressions and disrespect, is associated with greater depression and lower psychological well-being (Essed, 1991; Calabrese et al., 2015). Although the negative effects of discrimination are well established, less is known about protective factors that may reduce these outcomes. One such factor is hope, conceptualized by Snyder et al. (1991) as agency thinking and pathways thinking and linked to lower depression and greater resilience (Arnau et al., 2007; Banks et al., 2008). This study …

Strategies Black Male Students With Social Anxiety Use To Persist And Succeed At Rural Community Colleges, Gwendolyn F. Houston

Educational Leadership & Workforce Development Theses & Dissertations

Social anxiety, one of the more common types of anxiety, has been linked to poor concentration, impaired performance, and lower academic achievement (BlackDeer et al., 2021; Derakshan & Eysenck, 2009; Leigh et al., 2021). This study addresses the questions: “How do Black male students with social anxiety at rural community colleges in the Southeastern United States handle both academic and non-academic challenges and cope with these stressors?” and “How do Black male students with social anxiety navigate barriers during their journey at rural community colleges in the Southeastern United States, and what strategies do they use to manage these obstacles?” …

A Longitudinal Analysis Of Hospital Consumer Evaluation In Virginia, Tulay Akmandor Inac

Health Services Research Dissertations

Suboptimal patient experience signals a need to improve clinical efficacy, patient safety, and healthcare quality. The COVID-19 pandemic intensified hospital resource and staffing demands, reducing hospitals’ capacity to invest in patient experience improvement. Prior studies remain limited because many lack longitudinal structure and organized theoretical models, making temporal inference difficult and weakening analyses of patient experience disparities. To address these limitations, this dissertation incorporates three studies examining patient experience and pandemic-related effects.

In state-level markets comparable to Virginia, limited research has examined longitudinal patient experience trends across regional hospital systems using HCAHPS scores. The first study uses descriptive trend analysis …

A Qualitative Case Study Of Leadership Development In A Graduate Medical Laboratory Science Program, Demetra Castillo

EVMS School of Health Professions Theses & Dissertations

Leadership development is increasingly recognized as an essential component of healthcare education, particularly as medical laboratory professionals assume expanded responsibilities involving collaboration, decision-making, systems thinking, and organizational leadership. Despite this need, limited research has explored how leadership develops within graduate medical laboratory science (MLS) programs. This qualitative case study examined leadership development through the lens of Experiential Learning Theory (ELT). Two research questions explored how the program fostered leadership development through students’ professional biographies, leadership questionnaires, final reflection papers, and leadership credos and how leadership reflections demonstrated growth over time. Secondary data from five student cases were analyzed using deductive …

The Association Between Prenatal Nicotine Exposure And Postpartum Depression, Reem Ali Sharaf-Alddin

Health Services Research Dissertations

Postpartum Depression (PPD) is the most common mental health complication of childbirth with 17% of women globally and 13% in the US experience PPD. The pathophysiology of PPD is not yet fully understood, with psycho-social, biological, and environmental factors, interplaying together and predisposing to PPD. One key modifiable risk factor is prenatal exposure to nicotine (PEN) including Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), and Electronic Nicotine Products (ENPs). Several studies investigated the association between prenatal ATS or SHS and PPD, however the findings were inconclusive. There is a lack of studies that assessed the overall PEN, and none of …

Physiological, Cognitive, Behavioral, And Perceptual Contributors To Falls Risk Across Middle And Older Adulthood, Jacquelyn Moxey

Rehabilitation Sciences Theses & Dissertations

Falls are multifactorial events influenced by physiological, cognitive, behavioral, and perceptual factors. Although falls prevention research has traditionally focused on older adults and objectively measured physical impairments, less is known about how cognitive performance, physical activity, and perceptions of ability collectively contribute to falls risk vulnerability across middle and older adulthood. This dissertation examined these relationships through three complementary studies.

Study 1 examined associations between cognitive screening performance and physiological falls risk in 315 community-dwelling older adults. Lower global cognitive performance was associated with greater physiological falls risk. Performance on items reflecting attention and visuospatial/executive function demonstrated the strongest domain-level …

Faculty Conceptualizations Of Recreational Therapy And Disability: Influences On The Formal, Hidden, And Null Curricula In Undergraduate Recreational Therapy Education, Shelly Lynne Beaver

Human Movement Studies & Special Education Theses & Dissertations

Undergraduate education is a bedrock of professional preparation for entry-level recreational therapists, shaping their scope of practice, philosophical orientations, and approaches to service delivery. While significant attention has been given to the development of a formal recreational therapy curriculum – explicitly taught knowledge, skills, and competencies – little is known about the hidden and null curricula that may implicitly or unintentionally shape students’ professional identities, values, and beliefs. While these less explicit curricular dimensions may have profound effects on how preservice recreational therapists conceptualize both recreational therapy and disability, their impact remains largely unknown. Therefore, the aim of this research …

Counselors’ Training Needs In Effectively Engaging With Psychedelic-Assisted Therapy, Elif Bor

Counseling & Human Services Theses & Dissertations

As public and scientific interest in psychedelic-assisted therapy (PAT) continues to grow, counselors are increasingly encountering clients who are exploring or engaging in psychedelic use for therapeutic purposes. Such encounters introduce new ethical, clinical, and professional considerations. Counselors must develop an informed understanding of psychedelics and their effects, recognize the emotional and cognitive processes that may emerge during psychedelic experiences, and be prepared to respond to potential risks or adverse reactions (Aicher et al., 2025). They also need to competently answer client questions, assess risk and suitability, facilitate the integration of psychedelic experiences, and collaborate with medical and other professionals …

Naturalistic Classroom And Home Practices To Support Executive Function And Self-Regulation Of Typically Developing Preschool Children Between The Ages Of 3-5 Years Old: A Mixed Method Study, Michelle Ann Burek

Rehabilitation Sciences Theses & Dissertations

Executive function (EF) and self-regulation (SR) are foundational developmental processes supporting young children’s participation in play, learning, social relationships, and everyday occupations. Although important to school readiness, social competence, health, and well-being, these skills are often examined in structured settings rather than the natural environments in which children develop. Guided by ecological, developmental, and occupational therapy perspectives, this dissertation examined EF and SR within children’s everyday participation and explored caregiver and teacher roles in supporting these processes.

This dissertation consists of three interconnected studies. The first was a systematic review of peer-based interventions to improve social participation among children and …

Building Bridges: Connecting Biomechanics And Lived Experience In Bertolotti's Syndrome, Andrea Morgan Muffly

Rehabilitation Sciences Theses & Dissertations

Bertolotti’s Syndrome (BSy), characterized by the presence of a lumbosacral transitional vertebra (LSTV), represents a complex clinical entity that affects not only the physical health of the individual, but the quality of their daily life. Prior research on BSy focused on epidemiology, not lived experience, revealing inconsistencies in diagnostic inconsistencies of LSTV morphology. A three-tiered diagnostic system is proposed to streamline the reporting of LSTV subtypes. We examined how BSy is diagnosed, its symptoms, presentation, and how this impacts individuals’ ability to participate in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). We conducted a multi …

Exploring The Experiences Of Women In Mental Health Therapy After The Occurrence Of Perinatal Loss, Courtney Allison Nishnick

Counseling & Human Services Theses & Dissertations

Perinatal loss encompasses losses of pregnancies at any gestational age, as well as deaths occurring within one year post-birth. In the United States, around 40 thousand stillbirths and infant deaths occur every year (Ely & Driscoll, 2025; Gregory et al., 2025), with about 23 million miscarriages also occurring annually worldwide (Quenby et al., 2021). Perinatal loss experiences lead to distressing mental health symptoms not limited to anxiety, depression, posttraumatic stress, and grief (Crockett et al., 2019; Wamser & Ferro, 2025). While there is extensive research on perinatal loss as it pertains to medical context, there is minimal research relating to …

The Impact Of Hypoxia And Androgen Inhibition On Prostate Cancer Cell Dedifferentiation And The Dna Damage Repair Response At Telomeres, Arooba Ayaz

Biomedical Sciences Theses & Dissertations

Long-term Androgen deprivation therapy (ADT) is used to treat Prostate cancer (PCa) but is often met with resistance & the development of Neuroendocrine (NE) PCa which is rarer but more aggressive. Antiandrogens are a part of ADT that work to inhibit androgen receptor in PCa cells. In vitro, PCa cells under long-term antiandrogen treatment become NE-like and adopt stem-like characteristics. The disruption of androgen signaling though the use of antiandrogens impacts many cellular processes that play a major role in cancer cell proliferation such as the DNA damage repair response (DDR) and telomere dysfunction. In vivo, PCa tumors have disorganized …

Mechanisms Of Synergy Between Nanosecond Pulsed Electric Field (Nspef) And Cold Atmospheric Pressure Plasma Discharge (Cap) In Pancreatic Cancer: The Role Of Ros-Mediated Oxidative Stress And Apoptosis, Zobia Minhas

Biomedical Sciences Theses & Dissertations

Pancreatic ductal adenocarcinoma is a highly lethal malignancy characterized by poor prognosis and resistance to conventional therapies. Novel treatment strategies are needed to overcome this resistance. Non-thermal physical modalities, including nanosecond pulsed electric field (nsPEF) and cold atmospheric pressure plasma discharge (CAP), have emerged as potential anticancer approaches; however, the mechanisms underlying their combined effects remain unclear.

This study evaluated whether nsPEF enhances CAP-induced cytotoxicity and investigated the associated molecular mechanisms using the murine Pan02 pancreatic cancer cell line. Cell viability was assessed by WST-1 metabolic activity assays and electric cell–substrate impedance sensing (ECIS). Intracellular reactive oxygen species (ROS) were …

From Invisible Injury To Measurable Impact: Exploring Associations Between Peripheral Biomarkers Of Neuroinflammation And Mental Health Outcomes After Mtbi, Lauren Leggett Smith

Psychology Theses & Dissertations

Mild traumatic brain injury (mTBI), often referred to as a “silent epidemic,” accounts for the majority of traumatic brain injuries worldwide and is increasingly linked to persistent psychiatric outcomes. Despite its prevalence, mTBI remains understudied due to diagnostic challenges, underreporting, and misperceptions of its clinical significance. The present study examined whether peripheral biomarkers of neuroinflammation and astroglial injury—tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and glial fibrillary acidic protein (GFAP)— mediate associations between mTBI history and psychiatric symptom severity, including depression, anxiety, and posttraumatic stress disorder (PTSD). Participants were 138 traumaexposed adults recruited from an urban university and surrounding community, with …

Measuring Time, Measuring Impact: Reimagining Protected Time In Graduate Medical Education, Rehan Qayyum

Eastern Virginia Medical Journal

This article does not have an Abstract.

Bio-Cybersecurity: Securing The Healthcare Industry, Amanda D. Coleman

Cybersecurity Undergraduate Research Showcase

Bio-cybersecurity refers to the aspect of cybersecurity that applies to the biological sciences and the protection of digital biomedical information. Today’s healthcare industry has evolved with the enhancement of internet and biomedical technology. While hospitals and private medical providers remain compliant with the Health Information Portability and Accountability Act (HIPAA) through traditional means of securing documented patient information, the emergence of beneficial internet-based healthcare services like virtual appointments and digital patient records requires new policies and healthcare cybersecurity frameworks to protect sensitive information from unauthorized access. This paper examines the role of cybersecurity in healthcare, the vulnerabilities that exist and …

Genotype-Dependent Response Of Huntington’S Disease Cells To Non-Contact Picosecond Pulsed Electric Fields (Pspef), Augustine U. Anthony, Mackenzie A. Tardif-Kunk, Martina Zamponi, Peter A. Mollica

Knowledge and Creativity Expo

Non-Contact Picosecond Pulsed Electric Fields (psPEF) improved metabolic function in mutant Huntington diseased isogenic cell lines.

Exploring The Perceptions Of United States Dentists And Dental Hygienists Towards Implementation Of New Workforce Shortage Policies, Hite N. Jones

Dental Hygiene Theses & Dissertations

Background: There is a perceived national dental hygiene shortage causing delays in receiving preventive treatment and potentially increasing oral disease risk. States are proposing alternative pathways to allow less-trained individuals to provide dental hygiene care to fill this perceived gap. There is no research to support whether such measures would mitigate the shortage issue. Purpose: Therefore, the purpose of this study was to examine the perceptions of United States (U.S.) dentists and dental hygienists (DH) towards the implementation of new workforce shortage policies and contributing factors and solutions to the workforce shortage. Methods: This descriptive, cross-sectional study included a convenience …

Modeling Early Indicators For Success In An Associate Degree In Nursing Program, Joseph D. Moss

Educational Leadership & Workforce Development Theses & Dissertations

Persistent nursing workforce shortages across the United States have increased the importance of Associate Degree in Nursing (ADN) programs as primary entry points into the profession. Community colleges prepare a substantial portion of the nursing workforce; however, attrition within ADN programs limits the number of graduates entering practice. Understanding factors associated with academic performance and program completion is essential for strengthening nursing education pathways and supporting workforce development. The purpose of this quantitative study was to examine early academic and sociodemographic factors associated with successful completion of an ADN program at a suburban community college.

Guided by Becker’s Human Capital …

Ptsd Symptoms And Cannabis Use Among College Students: Examining The Role Of Trauma-Related Cannabis Use To Cope, Christopher T. Latourrette

Psychology Theses & Dissertations

Individuals with posttraumatic stress disorder (PTSD) are more than four times as likely to develop cannabis use disorder (CUD) as those without PTSD. This common co-occurrence is often interpreted through a self-medication framework in which cannabis is used to manage PTSD symptoms. Prior work has relied heavily on veteran samples, includes measures of cannabis coping that are not specific to PTSD, and has most commonly examined total PTSD symptom severity, limiting precision in understanding how discrete symptom clusters relate to cannabis outcomes. The present study sought to examine associations between individual PTSD symptom clusters and cannabis use severity and to …

“Recollecting The Told Story”: Storytelling, Activism, And The Black Maternal Health Emergency, Lamaya C. Williams

English Theses & Dissertations

Storytelling is a foundational component of Black knowledge creation and transmission. This dissertation centers Black women’s stories of birth and mothering—drawing on both primary source birth stories and fictional narratives—to examine the United States’ Black Maternal Health Emergency (BMHE). The BMHE is a complex and urgent issue wherein structural racism, medical bias, and intersecting social determinants disproportionately endanger the health of Black mothers. As such, Black mothers in the United States are three times more likely to die from a pregnancy-related condition compared to their white counterparts.

This study examines the birth stories of women who survived the BMHE and …

"On The Same Rope": An Exploratory Study Of Staff Experiences At The Mountain Seed Foundation's Healing Base Camp Program, Jill C. Kivikoski

Counseling & Human Services Theses & Dissertations

Since the escalation of Russia’s invasion of Ukraine in 2022, Ukrainians have faced significant social and public health challenges, particularly among Service Members, Veterans, and their Families (SMVF), including disability, traumatic stress, and barriers to mental health care (Kostenko et al., 2024; Krasnodemska et al., 2023; O’Grady & Galouchka, 2023). Retreat based programs grounded in shared military identity may offer an accessible form of support (Barrett & Currin, 2024). Mountain Seed Foundation’s (MSF) Healing Base Camp (HBC) was developed to promote healing and resilience among Ukrainian SMVF (Mountain Seed Foundation, n.d.).

This qualitative dissertation used a single-case study design (Yin, …

Electromyography, Prosthetic Properties, And Running Biomechanics In Recreationally Active Persons With Lower Extremity Amputation, Paige M. Agnew

Rehabilitation Sciences Theses & Dissertations

Lower extremity loss affects nearly 150,000 individuals in the United States yearly yielding extreme health care costs annually. Typically, prosthetic devices are prescribed for 5-8 years despite known changes to an individual’s gait as time progresses. Patients can expect to undergo approximately 8-12 weeks of gait retraining to improve their comfort and efficiency. Biomechanical changes occur when running with a specific running prosthetic including considerable biomechanical and neuromuscular interlimb asymmetries and alterations in loading patterns. The purpose of this dissertation was to investigate the biomechanical demands for lower extremity prosthesis users during running. The first study synthesized peer reviewed evidence …

Education And Training In Water Operator Certification And Its Role In Water Utility System Performance, Heath A. Edelman

Educational Leadership & Workforce Development Theses & Dissertations

Access to safe and reliable drinking water is a foundational component of public health and environmental protection. The United States drinking water sector is highly regulated and increasingly challenged by workforce shortages, aging infrastructure, and variability in operator training requirements across states. Despite the federal mandate for operator certification under the Safe Drinking Water Act Amendments of 1996, empirical evidence on the effectiveness of certification policies in improving regulatory compliance outcomes remains limited.

This study examined the relationship between operator certification policies and drinking water compliance outcomes under the Safe Drinking Water Act, with particular attention to differences across violation …

Learning In Motion: How Small Groups Can Promote Self-Regulated Learning In Physical Therapy Students, Sara Mclaren

STEMPS Theses & Dissertations

Self-regulated learning (SRL) is a critical skill for success in rigorous graduate health professions programs, where students must independently manage complex academic demands. Despite its importance, limited research has examined SRL processes among Doctor of Physical Therapy (DPT) students in the didactic phase of training. Guided by Zimmerman’s cyclical model of self-regulated learning, this study examined SRL behaviors among second-year DPT students and explored how small group learning contexts may influence engagement in SRL processes and academic performance.

This mixed-methods study included 39 DPT students enrolled in a physical therapy program at a public university in the southeastern United States. …

The Effects Of Covid 19 Job Demands On Public Sector Employees’ Organizational Commitment: The Mediating Roles Of Work Engagement And Job Burnout, And The Moderating Role Of Supervisor Support, Benjamin R. Kaufman

Psychology Theses & Dissertations

United States citizens rely on state government employees to provide essential public services. During the COVID-19 pandemic, these employees responded by administering both routine and novel procedures to protect public health, often placing them on the frontlines and at increased risk of contagion. Concurrently, the pandemic-driven economic downturn created budget shortfalls that threatened the job and financial security of the state workforce. Together, these conditions substantially increased job demands for state government employees.

Guided by the Job Demands–Resources (JDR) Model, this study examined how COVID‑19-related job demands influenced state employees’ work engagement, job burnout, and organizational commitment, and whether supervisor …

Perceptions Of Virginia Dentists And Dental Hygienists Towards Emerging Alternative Dental Hygiene Workforce Provider Models, Lauren B. Mangum

Dental Hygiene Theses & Dissertations

Background: A perceived shortage of dental hygienists in the United States has been linked to delays in preventive care and concerns about declining oral health outcomes. In response, some states have proposed alternative pathways permitting internationally trained dentists, dental students, and oral preventive assistants (OPAs) with limited or inconsistent education requirements to provide dental hygiene services. Limited evidence exists regarding whether these strategies would effectively address access to care and workforce challenges. Concerns have also been raised about the potential effects of expanding scope of practice for providers with limited education or training on patient safety and quality of care. …

Recombinant Gelonin: Purification And Functional Validation For Electroporation-Assisted Delivery, Eleni Zivla, Giedrė Šilkūnienė, Andrei G. Pakhomov, Mantas Šilkūnas, Olga N. Pakhomova

Knowledge and Creativity Expo

Type I ribosome-inactivating proteins, such as gelonin, are enzymatically potent toxins but are effectively non-toxic under physiological conditions because they are unable to cross the plasma membrane[1]. Pulsed electric fields (PEF) overcome this delivery barrier by transiently permeabilizing the plasma membrane, allowing direct cytosolic entry. This enhances gelonin cytotoxicity by several thousand-fold, highlighting gelonin’s potential as an electrochemotherapy candidate[2]. Here, we present a recombinant gelonin (rGel) expression platform in E. coli with HPLC-based purification that enables reproducible protein production and structure-guided engineering.

The mature gelonin sequence (residues 47–297) was cloned into pET-32a(+) with an N-terminally fused Trx-6×His tag and TEV …