Raising Awareness Of Second Victim Phenomenon And Supportingyou: A Quality And Safety Initiative, Megan Renee Bryant

Graduate Theses, Dissertations, and Problem Reports

Current literature has established a need for practice change in management of healthcare-related critical incidents. Peer-support programs have been cited as the most impactful resource healthcare professionals request following a critical incident (Daniels & McCorkle, 2016). SupportingYOU, a peer-support program, is in the process of expansion at a large academic children’s hospital in northern West Virginia in anticipation for the opening of a new facility. The specific aim of this project was to raise awareness of second victim phenomenon (SVP), SupportingYOU, and perception of awareness of resiliency. Interventions included multi-formatted educational sessions on SVP and SupportingYOU via PowerPoints, brochures, flyers, …

Autonomous And Non-Autonomous Requirements For The C-Jun N-Terminal Kinase Signaling Pathway In Early Forebrain Development, Jessica G. Cunningham

Graduate Theses, Dissertations, and Problem Reports

The cerebral cortex is responsible for a wide variety of high-level functions including cognition, sensory perception, fine motor control, and the orchestration of body movements. The cortex is comprised of cortical excitatory neurons and inhibitory interneurons, which are arranged in a highly organized fashion into different layers and regions. These two types of cells operate in a delicate balance between excitation and inhibition, which is critical for proper cortical circuitry. In order for the cortex to execute its numerous functions, it must both send and receive input to other brain regions through axonal connections. The organization within the cortex and …

A Preoperative Intervention To Improve Glycemic Control In Surgical Patients With Diabetes, Kelsey L. Boyd

Graduate Theses, Dissertations, and Problem Reports

Perioperative hyperglycemia is reported in 20-40% of patients undergoing general surgery and is an independent risk factor for negative surgical outcomes. Patients with diabetes presenting to a local community hospital are at risk for negative surgical outcomes due to the lack of strategies to prevent perioperative hyperglycemia. This project aimed to implement and evaluate the usefulness of succinct diabetes education for preoperative total joint surgical patients with diabetes. The intervention was a nurse-led, face-to-face diabetes education session provided to total joint surgical patients with diabetes during a preoperative evaluation appointment, compared to usual care (no preoperative diabetes education). This project …

Implementing Trauma-Informed Care Through A Multi-Agency Learning Collaborative: A Theory-Driven Analysis Of Outcomes And Sustainability, Mira D H Snider M.S.

Graduate Theses, Dissertations, and Problem Reports

Learning collaboratives (LCs) are often used in large-scale implementation initiatives to promote evidence-based practice across provider networks. Although the outcomes and stakeholder perspectives of many LCs have been documented, support for the effectiveness of LCs is equivocal, and the means by which LCs achieve long-term improvements in clinical care are not understood. The current study investigated outcomes and sustainability of a multi-agency LC for implementing trauma-informed care in 23 rural Pennsylvania counties. Changes in outcomes (i.e., trauma symptom screening, trauma-informed care training attendance, clinician confidence with using trauma informed-care, utilization of trauma-related diagnostic codes, retention in service, service unit density) …

Do Different Learning Environments Influence Graduate Students’ Professional Communication?, Lacey M. Beam

Graduate Theses, Dissertations, and Problem Reports

Purpose: The purpose of this study was to investigate the impact of two educational environments (jigsaw learning activity and standardized patient encounters) on speech-language pathology students’ professional communication when assessing and treating a voice disorder case study. Jigsaw activities are cooperative learning experiences that provide students opportunities to learn from one another. Studies have shown that students have improvements in learning new material, self-confidence, and communication skills (Wong & Driscoll, 2008; Asif et al., 2021). A standardized patient encounter provides a real-life clinical experience for students. There has been a mixed response to students improving their communication skills through …

Screen Media Use Among Children And Adolescents – Applications Of Supervised And Unsupervised Machine Learning And Sentiment Analysis, Yifan Zhang

Graduate Theses, Dissertations, and Problem Reports

Screen media has become increasingly pervasive in our everyday lives and has profoundly changed the way people communicate and interact with each other. However, we are still unclear about the long-term influence of screen media use on our physical health, mental health, and social wellbeing. Children and adolescents are in an important stage of brain development and are susceptible to the environmental influence that screen media possess. This dissertation pursued three aims to address research gaps related to screen media use among children and adolescents: 1) identify topics and knowledge gaps in screen media use research among children and adolescents …

Examining The Efficacy Of A Self-Paced Online Training For Goal Writing, Allison Rosborough

Graduate Theses, Dissertations, and Problem Reports

Educational goals can control critical aspects of intervention and progress monitoring for students with disabilities and as such are a central feature of Individualized Education Programs (IEPs). Despite its importance, school staff frequently report not receiving enough training or support on IEP documentation. Rosborough and Brandel (2020) investigated the quality of IEP goals written in the state of West Virginia. Findings indicated that professional development activities needed to be designed and analyzed related to immediate and long-term efficacy. The purpose of this study was to evaluate the efficacy of a self-paced, online training for goal writing. Participants were recruited by …

Low- And High-Wattage Vaping During Pregnancy Influence Aortic Structure And Function In Rat Offspring, James Ian Frazier

Graduate Theses, Dissertations, and Problem Reports

Introduction: Electronic cigarettes (e-cigs) are being marketed as a healthier alternative to traditional cigarettes, yet the health consequences of e-cig usage (also called vaping) are still being investigated. E-cigs are easily customized for user preferences. For example, the choice of flavors, nicotine concentration, and/or the temperature (i.e., wattage) used to heat the e-liquid can be selected in many devices. Emerging evidence suggests that vaping during pregnancy impairs cerebral vascular function in rodent offspring. In this study, we sought to investigate the potential effects of changes to e-cig device wattage (i.e., 5W vs. 30W) with maternal vaping during pregnancy on vascular …

Evaluation Of A Comprehensive Diabetes Mellitus Protocol At A Rural, Federally Qualified Health Center In Southern West Virginia, Hannah D. Davis

Graduate Theses, Dissertations, and Problem Reports

Background: Diabetes mellitus is a chronic disease that affects nearly 34 million Americans. In rural Appalachia, the population is affected disproportionately at a rate of 14% compared to the national average of 10%. Diabetes is a lifelong, chronic condition managed best by a multidisciplinary team-based approach to achieve optimal disease control. Best practices in the care of diabetes support the use of evidenced based care protocols and leveraging technology to decrease the burden of disease. Type 2 diabetes mellitus (T2DM) is the most common type, making it the focal population for evaluation.

Purpose: The purpose of this project was to …

Standardized Postoperative Handoff Tool To Improve Handoff Quality, Haley Durkacz

Graduate Theses, Dissertations, and Problem Reports

Abstract

Effective communication between healthcare providers is an essential element in the delivery of safe patient care. Loss of relevant information can occur during all phases of patient care but is most inclined to occur during the handoff from the operating room to the postoperative anesthesia care unit (PACU). Evidence has indicated that the transfer of patients by anesthesia providers remains informal and brief despite practice guidelines. When pertinent details are omitted during the anesthesia handoff there is a potential increase for medical errors, delayed treatment, and patient harm. The purpose of this project was to analyze the use of …

A Quality Improvement Initiative Regarding Ondansetron In The Prevention Of Spinal Anesthesia-Induced Hypotension, Kassidy Dell Nutter

Graduate Theses, Dissertations, and Problem Reports

Spinal anesthesia is an excellent choice as the primary anesthetic for lower abdominal, perineal, and lower extremity procedures. Spinal anesthesia boasts several distinct advantages over general anesthesia. However, it is important to note that spinal anesthesia does not come without risk. The most common adverse reaction of spinal anesthesia is hypotension. Anesthesia providers use several methods to combat the hypotension that is so commonly associated with spinal anesthesia. One emerging trend to prevent spinal anesthesia-induced hypotension (SAIH) is the administration of ondansetron, a serotonin 5-hydroxytryptamine3 antagonist. Evidence has shown that the administration of ondansetron just prior to spinal anesthesia administration …

A Quality Improvement Initiative For Intraoperative Low Dose Ketamine Utilization In Thoracotomy, Jason Wampler

Graduate Theses, Dissertations, and Problem Reports

The challenge of postoperative pain control following a thoracotomy is well noted among anesthesia providers. The intraoperative utilization of low-dose ketamine in several patient populations, including those undergoing a thoracotomy, has been deemed a viable intervention in the multi-modal analgesia plan at not only reducing postoperative pain scores for patients, but also reducing opioid consumption. This quality improvement project sought to increase provider awareness of this intervention among anesthesia providers in a community hospital with a goal to influence a practice change. This was completed using a pre-post design centered around an educational in-service, with an additional 60-day follow-up survey …

A Novel Computational Network Methodology For Discovery Of Biomarkers And Therapeutic Targets, Qing Ye

Graduate Theses, Dissertations, and Problem Reports

Lung cancer has the second highest cancer incidence rate and the top cancer-related mortality worldwide. An estimate from the American Cancer Society shows that, in 2022, there will be about 236,740 lung cancer cases (117,910 men and 118,830 women) in the US. To date, there are no prognostic/predictive biomarkers to select chemotherapy, immunotherapy, and radiotherapy in individual non-small cell lung cancer (NSCLC) patients. There is an unmet clinical need to identify patients with early-stage NSCLC who are likely to develop recurrence and to predict their therapeutic responses. This dissertation developed a novel computational methodology for modeling molecular gene association networks …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Influences Of Disrupted Circadian Rhythms On Stroke Outcome, Jennifer A. Liu

Graduate Theses, Dissertations, and Problem Reports

The circadian system is composed of a subset of temporal oscillators that function through a transcriptional and post-translational molecular and functional negative feedback loop cycling approximately every 24 hours. The central clock located in the suprachiasmatic nucleus is responsible for entrainment using light as the key timekeeper (zeitgeber); it is responsible for synchronizing and optimizing physiological behavior and function to the environment. Exogenous information, such as day length and light-dark cycles, provide critical temporal cues for adjusting to environmental conditions. Proper alignment to natural light dark cycles and circadian rhythms is optimal for vital health, fitness, and survival in organisms. …

Current Practices Used To Increase The Success Rate Of The Inferior Alveolar Nerve Block In Mandibular Molars With Symptomatic Irreversible Pulpitis, Nishtha Chauhan

Graduate Theses, Dissertations, and Problem Reports

Introduction: Pain control during endodontic access is important to ensure patient comfort. Achieving adequate anesthesia in an acutely inflamed mandibular molar poses a treatment challenge as the reported failure rate is 30- 83%. A number of pre-medications, anesthetic techniques and adjuncts have been researched to determine their effect on the anesthetic success of the inferior alveolar nerve block (IANB). The purpose of this research was to describe the current clinical practices used by the members of the American Association of Endodontists in pain control of inflamed mandibular molars.

Methods: A cross-sectional observational study design was used. The study …

Development Of A Transition Program For Young Adults With Type 1 Diabetes Progressing From Pediatric To Adult Care – A Feasibility Study, Elizabeth Ann Minchau

Graduate Theses, Dissertations, and Problem Reports

ABSTRACT

Development of a Transition Program for Young Adults with Type 1 Diabetes Progressing from Pediatric to Adult Care – A Feasibility Study

Elizabeth A. Minchau

Background: Emerging adulthood requires a delicate balance of the competing social, educational, occupational, and financial demands typical of this developmental stage. This time period presents special challenges for adolescents with type 1 diabetes (T1D), who must also prioritize consistent medical follow-up and ongoing intensive self-care. Emerging adults with T1D struggle with glycemic control that is further exacerbated by an often-times disorganized transfer of care between pediatric and adult endocrinology practices. Substantial gaps in care …

Implementation Of Standardized Handoff Reporting To Improve Communication Among Certified Registered Nurse Anesthetists And Postanesthesia Care Unit Nurses In The Postanesthesia Care Unit, Lauryn G. Macfawn

Graduate Theses, Dissertations, and Problem Reports

Standardization of handoff reporting has been proven to increase the quality of information being transferred and improve patient safety. Poor quality handoff between providers increases morbidity and mortality, hospital length of stay, healthcare costs, as well as decreases patient satisfaction The aim of this Doctor of Nursing Practice quality improvement (QI) project was to implement the situation, background, assessment, recommendation (SBAR) handoff reporting tool in the postanesthesia care unit (PACU) at a hospital in Western Maryland. There was no standardized handoff process in place between certified registered nurse anesthetists (CRNAs) and PACU registered nurses (RNs) at the facility. The participants …

Implementation Of A Training Program To Improve The Crna Precepting Experience At An Academic Medical Center, Megan Jean Gillespie

Graduate Theses, Dissertations, and Problem Reports

Formal preceptorship training has been shown to improve the comfort and confidence with precepting across many disciplines. Currently, there is no training program in place for the Certified Registered Nurse Anesthetist (CRNA) preceptors at a large academic medical center in West Virginia. The overarching goal of this quality improvement (QI) project was to implement a formal preceptorship training for the CRNAs at the facility of interest. The training, or intervention, was the Preceptor Essentials Parts I and II on NetLearning. This project followed the pre-intervention-post-survey design. The participants were self-selected CRNAs. The survey results were analyzed using the Mann-Whitney U …

Implementation Of A Nonverbal Scrub Cap Identification System To Improve Communication And Perception Of Patient Safety Among Unfamiliar, De-Identified Staff Members In The Operating Room., Keri Ann Roskowinski

Graduate Theses, Dissertations, and Problem Reports

Background: Operating room (OR), professionals deliver patient care with brief introductions, and roles were not always identified, and although team members wear identification (ID) badges, they were usually covered by sterile gowns and other routine personal protective equipment (PPE). Purpose: The aim of this Doctor of Nursing Practice (DNP) project was to determine if a simple intervention to apply the individual’s name and role to a scrub cap could improve identification, OR team communication, and consequently, patient safety. The participants in this project consisted of nurses, physicians, anesthesia providers, scrub technicians, students, medical sales representatives, and those that identified as …

Targeting Vulnerabilities In Cell State And Calcium Signaling For The Treatment Of Lung Cancer, Clark Jones

Graduate Theses, Dissertations, and Problem Reports

Lung cancer remains the deadliest of all cancers due to the high mutational burden associated with the disease. Combating mutational drivers and drug resistance proves to be essential in the development of novel therapies to improve patient outcomes. A first-in-class cyclic peptide known as MTI-101 has been shown to induce necrotic cell death in a caspase independent manner. MTI-101 was derived from the linear peptide known as HYD1 that was found in a high throughput screen to block cell adhesion with the extracellular matrix. The compound was further optimized and cyclized to the currently used MTI-101 that was found to …

Exploiting Modulation Of The Blood-Brain And Blood-Tumor Barrier Permeability By Translational Focused Ultrasound For Therapeutic Delivery To Cns Metastases, Tasneem A. Arsiwala

Graduate Theses, Dissertations, and Problem Reports

Transcranial low-intensity focused ultrasound is a unique technology to modulate the integrity of tight endothelial junctions and transiently increase BBB/BTB permeability to enhance therapeutic delivery. Despite promising early studies, present literature lacks agreement on key experimental conditions, which restricts our knowledge and the technique's widespread translation. This dissertation first provides a critical review of the current gaps in knowledge regarding the universal use of LiFUS in preclinical and clinical use. We then identify key parameters for translational and predictable opening of the BBB using a 3T MRI coupled with a clinical device. Our investigation highlights that passive permeability of the …

Utilizing The K18-Hace2 Mouse Model To Develop Protective Covid-19 Vaccines, Ting Y. Wong

Graduate Theses, Dissertations, and Problem Reports

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic is caused by the respiratory virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Similar to other respiratory viruses, SARS-CoV-2 is transmitted through inhalation of respiratory droplets and aerosols from infected individuals. Once inhaled, SARS-CoV-2 utilizes the receptor binding domain (RBD) on the spike protein to bind to human Angiotensin Converting Enzyme 2 (hACE2) receptor to gain entrance into host cells to begin viral replication. SARS-CoV-2 infection can result in mild to severe cases of COVID-19 ranging from asymptomatic infections, cold or flu like symptoms to respiratory failure. The onset of the pandemic in …

Knowledge And Training In Language Sample Analysis Of Us Speech-Language Pathology Graduate Students, Allegra Cornaglia

Graduate Theses, Dissertations, and Problem Reports

Purpose: Speech-language pathologists (SLPs) play an integral role in identification and treatment of developmental language disorders (DLD). Best practices include the use of language sample analysis (LSA) as part of a comprehensive evaluation. However, LSA requires a specific set of foundational morphological and syntactic knowledge. Previous studies have shown a knowledge gap for both SLPs and SLP graduate students for other areas of morphosyntax and phonology. This study examined the language analysis skills of current SLP graduate students on a test of Mean Length of Utterance (MLU) analysis and Clausal Density (CD) and whether there were possible factors associated with …

Passive Self-Ligating Brackets Vs. Conventional Brackets: Is There A Difference In The Transverse Dimension? A Systematic Review And Meta-Analysis, Justin Scott Tenbrook

Graduate Theses, Dissertations, and Problem Reports

Background and Objectives:

Self-ligating brackets have risen in popularity in clinical orthodontics, but many claims made by their manufacturers have been made without substantial evidence. Any differences among the bracket types are very small when consulting new peer reviewed literature testing their differences. Nevertheless, self-ligating brackets are still purported to be able to increase the dental transverse dimension more effectively than conventional brackets. In 2018, Yang et al. performed a systematic review on the transversal changes, space closure, and efficiency of conventional and self-ligating appliances. Since then, there were several clinical trials published in the literature comparing the mandibular arch …

Immediate Loading Of 4 Guided Implants Supporting A Maxillary Overdenture Using A Novaloc Retention System, Doheum Choi

Graduate Theses, Dissertations, and Problem Reports

The purpose of this study was to test the treatment concept of maxillary overdenture retained by four unsplinted implants placed using a flapless guided approach and immediate loading with Novaloc® attachments. Subjects with fully edentulous maxillae received 4 BLX implants (Roxolid®, SLActive®, 3.75mm diameter, Institut Straumann AG, Basel, Switzerland) to support an immediately loaded overdenture. Implants were connected with Novaloc® attachments (Institut Straumann AG, Basel, Switzerland) immediately following surgery if insertion torque (IT) reached 20 N/cm or above. The primary outcome variable was the radiographic bone level change at 6- and 12-months following implant placement. Secondary outcome variables were peri-implant …

Preconception Substance Use And Risk Of Unintended Pregnancy, Saima Shafique

Graduate Theses, Dissertations, and Problem Reports

Background: In the United States, unintended pregnancy is a serious public health issue due to its persistent high prevalence. In the series of three studies, our first two investigations examined the risk and potential determinants of unintended pregnancy among substance and polysubstance using women of childbearing age. In the third study, we conducted a systematic review (SR) with meta-analysis (MA) to assess the association of illicit and recreational drugs to the risk of unintended pregnancy.

Methods: We performed a secondary data analysis on a subset of Pregnancy Risk Assessment Monitoring System (PRAMS) 2016-17 phase 8 data (n=75,543). The outcome variable …

Factors Associated With Service Utilization In Injured Workers In West Virginia, Brandy Brown

Graduate Theses, Dissertations, and Problem Reports

Introduction: Minimal research has been conducted on healthcare utilization among injured workers residing in rural areas. These workers are often at high risk for work-related injury due to the industries in which they work and commonly experience barriers to accessing healthcare. The first study in this dissertation series explored general characteristics of injured workers receiving care at occupational medicine clinics in West Virginia (WV). The second and third studies explored the moderating effects of rurality, pain medication, and psychiatric medication on sociodemographic and health status factors and number of medical encounters.

Methods: Each study used a cross-sectional design with data …

Experience Of Parents Caring For A Child With An Acquired Disability, Brad E. Phillips

Graduate Theses, Dissertations, and Problem Reports

Background: Parents caring for a child with an acquired disability often report a negative impact on physical, psychological, emotional, and spiritual health associated with caregiver burden related to their child’s complex health needs. This is further complicated by additional challenges related to the loss of a previously healthy child. Traditional patterns of loss follow linear, time-bound stages that have been observed to be unrelated to the experiences of these specific parents and their families. Therefore, the concept transforming loss has been developed to better understand how these parents navigate loss and find meaning in spite of their suffering.

Purpose: The …

Cbct Use In Orthodontic Residency Programs In Usa, Su Min Han

Graduate Theses, Dissertations, and Problem Reports

Background and Objectives: Cone beam computed tomography (CBCT) scans in dentistry have been up and coming forms of x-ray technology that allows cross-sectional images to form a comprehensive 3-dimensional representation of the mouth. While the typical use for CBCT imaging is reported to be for implant dentistry, there are many contexts in which it is indicated in orthodontics. There are various schools of thought regarding when CBCT is indicated for specific diagnosis of problems or general use in the collection of initial, progress and post-treatment orthodontic records. There are programs that follow the Radiology guidelines for taking CBCT scans10 and …