Medicine and Health Sciences Commons^™

Improving The Care Of Infants With Neonatal Abstinence Syndrome By Implementing Rooming In, Tammi M. Clutter

Graduate Theses, Dissertations, and Problem Reports

Background: Opioid use and drug abuse has led to an increase in fetal exposure to illicit drugs in the United States, putting these infants at risk for developing neonatal abstinence syndrome (NAS). Parental involvement in the care of these infants during their hospitalization has become an essential part of the treatment process

Purpose: The purpose of this project is to implement rooming in for infants with in utero exposure to opioids as a quality improvement practice change.

Methods: A literature search relating to improving the care of infants with NAS was conducted. Educational handouts were provided to staff regarding the …

The Perception Of Management Support For Patient Safety After The Implementation Of A System Change, Janice M. Smith

Graduate Theses, Dissertations, and Problem Reports

Problem Statement Leadership scores on the AHRQ Hospital Patient Safety Culture Survey at a 268 bed teaching, acute care, nonprofit, non-governmental hospital in the South Atlantic Region of the United states have been decreasing for the past seven years. In those years there has been no plan to improve the scores. Safety scores published for this facility on public websites are mediocre or poor.

Theoretical Framework The Plan-Do-Study-Act (PDSA) conceptual model for rapid cycle improvement served as a foundation for the project. The model supported the project well with a plan, do (test the plan), study (analyze the results), act …

Environmental Regulation Of The Heart: The Role Of Non-Coding Rna And Epigenetics In Influencing Mitochondrial And Cellular Health, Quincy Alexander Hathaway

Graduate Theses, Dissertations, and Problem Reports

The mitochondrion, a small but ubiquitously distributed organelle in the cell, continues to be the focus of many disease pathogeneses, tissue and organ dysfunctions, and other morbidities that occur throughout the body. The purpose of this work was to understand how cardiac mitochondrion are altered in disease and pathological states, specifically in their adaptation to environmentally stimulated regulatory networks, such as epigenetic modifications and promotion/inhibition of non-coding RNAs. Acute stress to mitochondrial regulation (inhalation toxicology) as well as chronic (type 2 diabetes mellitus) was examined. Using a FVB transgenic microRNA-378a mouse knockout model, the cardiovascular impact derived from altering the …

Adaptation Of The Streptococcal Collagen-Like Protein 1, Scl1, Of Group A Streptococcus To Recognize Fibronectin Type Iii Repeats, Dudley H. Mcnitt

Graduate Theses, Dissertations, and Problem Reports

Background: Group A Streptococcus (GAS) is responsible more than 700 million infections worldwide each year. Most of these infections start with initial colonization of the throat and skin, which is augmented by surface adhesins. The streptococcal collagen-like protein 1 (Scl1) is a major adhesin expressed by GAS that contains an N-terminal sequence-variable (V) domain, protruded away from the cell surface by the collagen domain. The Scl-V domain is comprised of three pairs of anti-parallel α-helices interconnected by surface-exposed loops. For attachment, GAS adhesins require a portal of entry, such as a wound or breach in the epithelium, to enter …

Impact On The Pharyngeal Airway Space After Maxillomandibular Advancement Procedure For Obstructive Sleep Apnea Patients, Ghaddy Alsaty

Graduate Theses, Dissertations, and Problem Reports

Background and Objectives: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder, characterized by disrupted snoring and repetitive upper airway obstructions. Continuous positive airway pressure (CPAP) is considered the therapeutic mainstay for OSA patients. However, CPAP therapy has compliance limitations. An alternative treatment options is maxillomandibular advancement (MMA) surgical procedure. Genial tubercle advancement (GTA) is often performed concomitant with MMA for esthetic purposes. Cone-beam computed tomography (CBCT) provides the ability to visualize the upper airway and perform three-dimensional (3D) reconstructions. The purpose of this study is to evaluate the impact of MMA procedure with or without GTA on oropharyngeal …

The Association Of Attitude, Perceived Behavioral Control, And Intention With Fruit And Vegetable Intake Among Rural West Virginian Residents With Pre-Diabetes In Mineral And Hampshire Counties, Diana Leigh Niland

Graduate Theses, Dissertations, and Problem Reports

The Association of Attitude, Perceived Behavioral Control, and Intention with Fruit and Vegetable Intake among Rural West Virginian Residents in Mineral and Hampshire Counties with Pre-diabetes

Introduction: Pre-diabetes affects approximately 84.1 million adults in the United States. Pre-diabetes is one of the leading predictors of type 2 diabetes. West Virginia ranks number one in the prevalence of diabetes. Fruit and vegetable intake may assist in reducing risk for pre-diabetes. However, most adults do not consume the recommended daily amount. There are no studies investigating the fruit and vegetable intake (FVI) of rural West Virginian residents with pre-diabetes.

Method: After IRB …

Systematic Control Of Aged Skeletal Muscle Following High-Intensity Stretch-Shortening Contraction Exercise Training: Epigenomic Regulation And Signaling Factors Underpinning Adaptation, Marshall Alan Naimo Jr.

Graduate Theses, Dissertations, and Problem Reports

Sarcopenia, the age-related decline in skeletal muscle mass, results in a loss of strength and functional capacity, which subsequently increases the risk of disease, disability, frailty, and all-cause mortality. Exercise is known to be an efficacious paradigm for improving health and attenuating or preventing many chronic diseases. For the previous two decades, our laboratory has established an in vivo rodent dynamometer model to explore the effects of various skeletal muscle training paradigms following stretch-shortening contractions (SSCs).The responses tohigh-intensity resistance-type exercise training (RTET) using this physiological model ranges from adaptation, characterized by enhanced skeletal muscle performance along with increased muscle mass, …

Accessible Design In Rural Health Care: Usability Profile Of Outpatient Health Care Facilities In Rural West Virginia., Jordan E. Miller

Graduate Theses, Dissertations, and Problem Reports

The Americans with Disabilities Act (ADA) became law in 1990. Since then, research has shown that people with disabilities continue to experience environmental, systematic, and structural barriers to health care. The purpose of this research is to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like age and purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using a survey to understand building characteristics and a tool to measure essential features for a facility to be considered ‘usable’. Findings included a negative correlation …

Critical Physicochemical Properties For Nanoparticle Toxicity: Impact Of Surface Coating And Size On Particle-Induced Cell Transformation And Inflammatory Response, Tiffany Kornberg

Graduate Theses, Dissertations, and Problem Reports

Nanoparticles, which measure 100 nm in at least one dimension, have surged in development, production, and use for a wide range of applications. However, the rapid pace of development for these emerging materials with unclear/unknown toxicity profiles makes it difficult to adequately assess health risk associated with exposure. One critical obstacle which limits scientific research to fill these critical knowledge gaps is the lack of accurate and predictive models for nanotoxicology studies, particularly those which involve occupationally relevant exposure scenarios (pulmonary exposure to low dose of particles in the circulating air). Typically, animal models are used to assess potential systemic …

Evaluating The Consistency Of A Breathing Flow Recording Device Across Different Elastomeric Half-Mask Respirators, Samuel Jennings Munnis

Graduate Theses, Dissertations, and Problem Reports

The National Institute of Occupational Safety and Health (NIOSH) is the organization in charge of approving respiratory devices in the United States, as permitted by 42 CFR Part 84. Standards that NIOSH uses to certify powered air-purifying respirators (PAPRs) are based on respiratory data collected before the 21^st century. With new technologies, it is possible to gain a more accurate understanding of breathing flow of healthcare workers (HCWs). A new portable breathing flow recording device developed by The S.E.A. Group was intended for use with a Sundström SR100 mask with a P100 filter. This study tests the device with …

Pain Relief Knowledge, History, And Expectations Among Emergency Dental Patients, Daniel C. Brawley

Graduate Theses, Dissertations, and Problem Reports

Introduction

Dentists frequently treat and manage patients with acute dental pain. Patients often seek care to treat their pain. As a part of that treatment, it is common for providers to use both prescription and non-prescription medications in the management of the patient’s dental pain. This study focused on understanding the patient’s knowledge, history and expectations regarding prescription and non-prescription medication in the management of their dental pain.

Methods

A self-report survey was developed, using Likert-type scales, consisting of 32 items, including standardized, psychometrically-tested instruments. The survey was administered to 108 adult outpatients who reported to the West Virginia University …

Appalachian Caregivers Of Persons With Dementia Non Use Of Services, Kristina M. Childers

Graduate Theses, Dissertations, and Problem Reports

Abstract

Background: The purpose of this current study was to explain factors most strongly associated with Caregiver (CG) of Person with Dementia (PWD) non-use of formal and informal services in Appalachia.

Methods: A correlational explanatory design using validated self-report surveys was used to explain the association of the substructed Andersen’s Behavioral Model for Health Services Use in Appalachian CG non-use of formal and informal services. Data were analyzed using descriptive statistics and ANOVA tests considering eight independent variables in total from each research question, using a sample of 43 CG/CR dyads.

Results: The analyses of four research questions …

An Educational Intervention For Skin Cancer Prevention With Hospital Staff: A Pilot Project For System Change, Amy Fran Bruce

Graduate Theses, Dissertations, and Problem Reports

PURPOSE: The purpose of this project was to design, implement, and evaluate an educational intervention provided to health care professionals using the Sun Smart U Curriculum created by the Skin Cancer Foundation (2017).

METHODS: Using a pretest-posttest design with a convenience sample (N=40), this intervention targeted the health professionals and staff from a residential/acute care facility caring for pre-adolescent, adolescent, and adult populations. Aims of this project included: (1) the staff’s baseline level of knowledge regarding sun protective behaviors using the Sun Smart U Curriculum, (2) the staff’s level of knowledge regarding sun protective behaviors post educational intervention …

Regulation Of The Long Non-Coding Rna Fam83h-As1 By Human Papillomavirus In Cervical Cancer, Jamie Ann Barr Ph.D.

Graduate Theses, Dissertations, and Problem Reports

Non-coding RNAs (NcRNAs), such as long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been found to be involved in a variety of critical biological processes, and dysregulation of ncRNAs have been involved with several human diseases including cancer.

High-risk human papillomavirus (HPV) infection is one of the first events in the process of carcinogenesis in cervical and a subset of head and neck cancers. The expression of the viral oncoproteins E6 and E7 is essential in this process by inactivating the tumor suppressor proteins p53 and Rb, respectively, in addition to their interactions with other host proteins and regulation of …

Development Of Improved Acellular Pertussis Vaccines Through Inclusion Of The Rtx Antigen Or Induction Of Mucosal Immunity, Dylan Tyler Boehm

Graduate Theses, Dissertations, and Problem Reports

Pertussis is a human respiratory disease, primarily caused by the Gram-negative pathogen Bordetella pertussis. The infection is most severe and can be life-threatening in young children and infants where it manifests as a series of paroxysmal coughs. The disease is more commonly known as whooping cough, due to the whoop omitted during a massive inspiratory effort to bring air back into the lungs. Pertussis is a toxin-mediated disease that persists due to an early release of toxins that allow that bacteria to evade the cells of the innate immune response. The inhibition of the host response continues as toxin activity …

Description Of Motor Control Using Inverse Models, Anton Sobinov

Graduate Theses, Dissertations, and Problem Reports

Humans can perform complicated movements like writing or running without giving them much thought. The scientific understanding of principles guiding the generation of these movements is incomplete. How the nervous system ensures stability or compensates for injury and constraints – are among the unanswered questions today. Furthermore, only through movement can a human impose their will and interact with the world around them. Damage to a part of the motor control system can lower a person’s quality of life. Understanding how the central nervous system (CNS) forms control signals and executes them helps with the construction of devices and rehabilitation …

The Effect Of Bovine Galectin-1, A Conceptus Secretory Protein, On The Endometrial Transcriptome, Lindsay Faye Grose

Graduate Theses, Dissertations, and Problem Reports

Early embryonic loss in cattle is detrimental to reproduction thus, the profitability of both the beef and dairy industries. Therefore, an important aspect of study is to find techniques that beef or dairy producers could use to decrease early embryonic loss Galectin-1, the protein that was investigated in this research is important in modulating the maternal immune system in rodent and human early pregnancies by promoting fetomaternal immune tolerance. The role of galectin-1 within the reproductive tissues has not been thoroughly investigated in cattle. Galectin-1 is located in the caruncular and intercaruncular regions of the bovine endometrium, specifically the maternal …

A Comprehensive Evaluation Of A Home Visitation Program Model's Prenatal Physical Activity Curriculum Modules Delivered Primarily To Low-Income Women, Angela Marie Dyer

Graduate Theses, Dissertations, and Problem Reports

Background. Many low-income pregnant women receive prenatal physical activity (PA) curricula modules through home visitation programs. However, there is a lack of scientific evidence on the structural capacity, processes, and outcomes relating to these modules. Aims. The objective of this dissertation project was to examine the aforementioned in a single home visitation program model - the Maternal Infant Health Outreach Worker (MIHOW) program. More precisely, the aims of this study were to: (Aim 1) examine home visitors’ (i.e., Outreach Workers [OWs]) competencies in implementing the MIHOW program’s prenatal PA curriculum modules (i.e., structural capacity), (Aim 2) …

Ferritin: An Iron Deficiency Biomarker In Collegiate Female Distance Runners, Ty Bigelow

Graduate Theses, Dissertations, and Problem Reports

Context: Iron deficiency is a concern in distance runners due to the implications that hemoglobin production becomes impaired limiting oxygen uptake and tissue oxidation in the body. Ferritin is a biomarker used to diagnose iron deficiency. The related signs and symptoms of iron deficiency are associated with decreased performance and prolonged recovery. Objective: The purpose of this study was to investigate whether the change in ferritin levels affect measures of performance, measures of recovery, and rate of perceived exertion in female endurance runners. Design: The study was a descriptive longitudinal study. Setting: The study was conducted at a Mid-Atlantic Division …

The Life And Work Of Alex Klein, Ramon Thiago Mendes De Oliveira

Graduate Theses, Dissertations, and Problem Reports

Alex Klein is one of the best-known figures of the American oboe school. He is the winner of multiple international competitions, including the first prize at the Geneva’s Concours International d’Execution Musicale. Appointed principal oboe at the Chicago Symphony Orchestra in 1995, Klein is one of the most highly regarded musicians hired during the Barenboim era. His recording of Richard Strauss’ oboe concerto with the CSO was awarded Best Instrumental Soloist Performance (with Orchestra) at the 44th Grammy Awards. In 2004, his tenure at CSO was interrupted due to the onset of Focal Dystonia; which affected multiple fingers in …

Evaluating The Impact Of An Intervention To Promote Empathy For Patients With Substance Use Disorder In A Rural Emergency Department, Theresa Poling

Graduate Theses, Dissertations, and Problem Reports

Background

Negative attitudes of health professionals towards patients with SUD are common and contribute to suboptimal health care for this marginalized group of patients (Van-Boekel, Brouwers, Van-Weeghel & Garretson, 2013).

Objectives

Promoting empathy in the Emergency Department (ED) has the potential to increase nursing staff’s awareness of their attitudes and perceptions toward patients with SUD, thereby decreasing the stigma associated with addiction and improving patient care and patient outcomes. The rationale for implementing this project was to evaluate a tool to promote empathy. This tool was developed by the student researcher based on a literature search and analysis.

Design

This …

A Study Of Gastrointestinal Pathophysiology, Emily Minor

Graduate Theses, Dissertations, and Problem Reports

Though the duodenum is the primary site of iron absorption, the colon also contains iron transporters and participates in iron absorption. The purpose of this study was to characterize colonic iron absorption in control patients and those with ulcerative colitis (UC), a disease that frequently results in iron deficiency. Using RT-qPCR and western blot analysis, we found that colonic expression of the apical iron importer, divalent metal transporter 1 (DMT1), is equal to duodenal expression. However, colonic expression of ferroportin 1 (FPN1), an iron exporter, is only about one-quarter that of the duodenum. Patients with active ulcerative colitis were found …

The Effect Of Occlusal Pressure On Vertical Force Generation On Dentate And Edentulous Subjects, Matthew Thomas Harper

Graduate Theses, Dissertations, and Problem Reports

Objectives: To determine 1) the difference in lower extremity power obtained from a vertical jump in individuals who are dentate or edentulous (implants or dentures) and 2) the difference occlusal pressure makes on lower body force output. Variables included jump height, maximum kicking force, maximum push off force, take off velocity, flight time, jump impulse, and maximum velocity. Groups included dentate, implant overdenture, and conventional denture.

Methods: Counter movement jumping with force plate collection was utilized to test the three populations in this study. The three populations were dentate, mandibular implant overdenture opposing maxillary complete denture, and conventional maxillary and …

Coaches' Preparedness For Sudden Death Conditions In Secondary School Athletics In West Virginia, Jillian Mary Sarm

Graduate Theses, Dissertations, and Problem Reports

Context: Coaches in the secondary school setting may encounter and be expected to provide emergency medical care for student athletes in the absence of a healthcare professional such as athletic trainers. The National Athletic Trainers’ Association (NATA) categorized ten sudden death conditions which are common in athletics and may warrant a medical emergency. Since the coaches may not be cognizant of these common sudden death conditions, they may not be prepared to handle a medical emergency which threatens the life of student athletes. Objective: Determine if West Virginia Secondary School Activities Commission (WVSSAC) coaches are aware and prepared to provide …

Service Dogs For Veterans With Ptsd: Taxonomy, Work Stress Reduction, And Matching, Lindsay Parenti

Graduate Theses, Dissertations, and Problem Reports

Research suggests that many veterans with post-traumatic stress disorder (PTSD) struggle with reintegration (Sayer et al., 2010), but are unlikely to seek help or complete treatment (Schottenbauer et al., 2008). To make matters worse, available treatment options are often time consuming, challenging, and/or associated with negative side effects (Carafano & Hutchinson, 2017). Using animals as a treatment modality for veterans with PTSD is an emerging topic of interest and has shown promise (Owen, et al., 2016; Richie et al., 2016). However, several factors have hindered the advancement of this field. Obstacles include a lack of standard terminology and classification system, …

In Vitro Metabolism Of The Synthetic Cannabinoids Px-1, Px-2, Px-3 And A Comparison Of Their Clearance Rates In Human Liver Microsomes, Travon Cooman

Graduate Theses, Dissertations, and Problem Reports

Detection of SCs in body fluids continue to be a challenge because of limited metabolism data, lack of standards and reference mass spectrometry data. In vivo and in vitro experiments help elucidate metabolite markers for novel psychoactive substances and can prompt synthesis of standards to verify proposed metabolites. In this study, metabolism of three SCs N-(1-amino-1-oxo-3-phenylpropan-2-yl)-1-(5-fluoropentyl)-1H-indole-3-carboxamine (PX-1), N-(1-amino-1-oxo-3-phenylpropan-2-yl)-1-(5-fluropentyl)-1H-indazole-3-carboxamide (PX-2), and N-(1-amino-1-oxo-3-phenylpropan-2-yl)-1-(cyclohexylmethyl)-1H-indazole-3-carboxamide (PX-3) were investigated using human liver microsomes. Previous studies showed PX-3 as the most potent CB1 and CB2 receptor agonist.

Half-life and clearance data were acquired using liquid chromatography- tandem mass spectrometry. Metabolite elucidation was performed using liquid chromatography …

Effect Of Shear Bond Strength With Novel Apc™ Flash-Free Brackets And Different Bonding Protocol: An In Vitro Study, Carl Bernstein

Graduate Theses, Dissertations, and Problem Reports

Background and Objectives: In today’s time, there is an increasingly crowded field of competition vying over a small subset of the population. Now, more than ever it is imperative to compete with efficiency and esthetics. Each step for orthodontic bonding procedures increases the chance for error to occur. However, orthodontic bracket, etchant, sealant, and adhesive material has the ability to improve bond strength and final outcome for the patient and provider. The aim of this study was to determine effective bonding protocols for Advanced Clarity APC™ Flash-Free Brackets and to determine if adhesive remains on enamel or orthodontic bracket after …

Judged Facial Attractiveness Of Extraction And Non-Extraction Orthodontic Treatment In Repose And Smiling, Nicolette R. Chahin

Graduate Theses, Dissertations, and Problem Reports

Background and Objectives: More so than ever, the public is becoming exceedingly aware of esthetics, and will evaluate their treatment outcome based upon the improvement to their smile and overall enhancement of their facial appearance. There exists a debate in orthodontics, as to whether or not extractions harm the profile. The aim of this study was to determine if facial attractiveness is harmed in subjects having completed orthodontic treatment involving the extraction of four premolars both in repose and smiling when viewed in lateral profile. Another objective is to identify any impact upper incisor retraction has on facial attractiveness. …

Differences In Sexual Delay Discounting Among In-Treatment Adults With Opioid Use Disorder, Jonathan J.K. Stoltman

Graduate Theses, Dissertations, and Problem Reports

Previous research has found impulsive decision-making to be a core component of addiction (Moody, Franck, Hatz, & Bickel, 2016). One way to measure impulsive choice is through the use of a delay discounting task. The delay discounting task provides a way to measure choice of immediate, smaller rewards compared to delayed, larger rewards (Odum, 2011b). An emerging area of research in addiction science is the intersection of addiction and sexual health. Previous sexual delay discounting research has focused on whether attractiveness or STD risk can shift the likelihood of waiting until a condom was available (Johnson & Bruner, 2012). This …

Role Of Sox9 In Cancer Stem Cell Regulation In Lung Cancer Chemoresistance And Particle-Induced Carcinogenesis, Maria Voronkova

Graduate Theses, Dissertations, and Problem Reports

Lung cancer is a leading cause of cancer-related death worldwide. Every year it claims more lives than other common malignancies, breast, prostate, and colorectal cancers, combined. And despite recent improvements in disease diagnostics and treatment, drug resistance and tumor relapse remain major contributors to low patient survival. Both issues have been largely attributed to the existence of cancer stem-like cells (CSCs) or tumor initiating cells (TICs). CSCs are a small cell population within heterogeneous tumors that is inherently resistant to apoptosis, chemo- and radiation therapy. Thus, it is critical to elucidate CSC-specific signaling pathways and identify early biomarkers for therapeutic …