Medicine and Health Sciences Commons^™

Factors Contributing To Teacher Attrition From The Perspectives Of Teachers Who Left The Profession, Malik Padgett

Theses and Dissertations

This applied dissertation examined teacher attrition, a persistent challenge in K–12 education. Nearly 20% of teachers leave by their third year, with up to 50% departing by the fifth year. High turnover disrupts learning, strains resources, and diminishes educational quality, particularly in under-resourced communities. Addressing these issues is crucial for improving retention and fostering stability.

The study explored key factors driving attrition, including inadequate compensation, excessive workload, insufficient professional development, and limited administrative support, especially in the post-COVID era. Grounded in transformational leadership theory, the research highlighted the role of leadership in fostering morale and ethics rather than merely transactional …

Examining Multiple Stakeholder Perspectives On The Acceptability Of Pain-Mitigation As A Tool To Manage Needle Fear, Sarah C M Morton

Theses and Dissertations

Needle fear affects up to 63% of the global adult population and is associated with significant fear-based medical care avoidance (e.g., blood donation refusal, vaccine hesitancy, insulin injection adherence). Current behavioral treatments have low acceptance in this population, and often fail to address the experience of pain associated with needle procedures. Despite the existence of evidence-based pain-mitigation for needle procedures, these interventions are not commonly used in clinical settings. The current study used qualitative methods to examine patient and provider perceptions of: 1) current methods of needle fear management, and 2) the acceptability of pain-mitigation as an effective tool to …

Improving Telehealth Education And Training: A Needs Assessment Of Healthcare Providers And Trainees, Conor Duffy

Theses and Dissertations

Telehealth utilization has increased dramatically since the start of the COVID-19 pandemic. There are many positive impacts of this shift to telehealth, including increasing access to care and reducing patient burden. However, healthcare providers report several consistent challenges that limit their ability to deliver telehealth, such as effective communication, technological difficulties, and difficulty performing physical examinations. To address these concerns, it is necessary to integrate telehealth education and training into healthcare professional training programs and healthcare systems. While many institutions have implemented telehealth education and training since the start of the pandemic, there is little consistency in the content, duration, …

Lis1 Depletion In Adult Mouse Projection Neurons Causes Neurodegeneration And Severe Neurological Phenotypes, Anne Ventrone

Theses and Dissertations

Proper LIS1 function is crucial for human brain development, as mutations in LIS1 lead to lissencephaly, a severe neurodevelopmental disorder caused by defective proliferation, differentiation and migration of neural precursors. Our understanding of LIS1's functions after brain development is limited. LIS1 regulates cytoplasmic dynein 1 (dynein), an essential microtubule motor protein in cell division and migration, but also a cellular transport motor. We previously showed that tamoxifen (TX)-induced global knockout of LIS1 using a Cre/Lox system (Act-Lis1iKO) in young adult mice results in severe neurological defects and rapid lethality. This strongly supports LIS1's critical post- developmental role, but the underlying …

Asymmetric Synthesis Of The Hiv Protease Inhibitor Tmc-126 And An Anti-Malarial Agent Via A Titanium Tetrachloride Mediated Asymmetric Glycolate Aldol Addition Reaction. Redefining The Curtius Rearrangement Reaction Via Dehomologation Of Carboxylic Acids Bearing Alpha-Leaving Groups, Kweku Amaning Affram

Theses and Dissertations

Acquired Immune Deficiency Syndrome (AIDS) and malaria are two devastating infectious diseases caused by HIV and Plasmodium parasites. AIDS is caused by HIV-1 and HIV-2, transmitted through sexual contact, blood transfusions, needle sharing, and perinatal routes. Malaria, caused by plasmodium parasites through mosquito bites. Today, millions of people around the world have been infected with HIV and malaria and much research has been done to treat it. However, despite advancements in therapeutic options, these diseases remain a significant global health threat, particularly in developing countries due to the emergence of drug-resistant strains for both HIV and malaria complicating eradication efforts. …

Birthing While Black: The Color Of Care And Black Women’S Lived Experiences Giving Birth In The United States, Portia Cowlings

Theses and Dissertations

Black women in the United States face disproportionate maternal health outcomes during pregnancy, childbirth, and postpartum compared to other racial and ethnic groups. Despite advancements in healthcare, the United States continues to report the highest maternal mortality rates among high-income developed nations, with Black women experiencing rates up to three times higher than their White counterparts. This phenomenological study explores the lived experiences of Black women in the United States to understand how they navigate the continuum of maternal healthcare, from preconception through postpartum. Guided by the social determinants of health (SDOH) theoretical framework, childbirth was examined through four interconnected …

Caspases Protect Against Hyperglycemia Induced Necroptosis-Like Cell Death In Brain Endothelial Cells, Aleena S. Mathew

Theses and Dissertations

Acute diabetes characterized by high spikes in blood glucose levels in association with severe hyperglycemia can lead to an increased risk of ischemic stroke in the brain. To better understand high blood glucose levels, hyperglycemia, in the brain we explored its effects on endothelial cells. Endothelial cells line the inner walls of blood vessels and are directly impacted in hyperglycemia. Brain endothelial cells are a major component of the blood brain barrier (BBB) which tightly regulates the brain’s microenvironment. The type of cell death such as apoptosis, caspase dependent, or necroptosis, caspase independent, can exacerbate diabetes associated complications. There is …

An Evaluation Of Frank Brown's Free Market, Leigh Ann Mccormick

Theses and Dissertations

Background: This study aimed to conduct an in-depth evaluation of Frank Brown Hall, Free-Market (Food Pantry), within the grant timeframe from January to April 2024. The central objective was to examine the distinct resource demands of students limited to selecting three items each day. By employing careful observation, effective communication, and active listening, we successfully obtained essential student feedback that enhanced our understanding of their needs and preferences, improving the support provided during that semester. Methods: Throughout the grant, data were systematically classified according to the chosen items, the students’ academic majors, and the cumulative number of visits to the …

Flavorful Foes: Assessing Students’ Perceptions Of Processed And Fast Food And Its Health Implications., Soumi Roy Banerjee

Theses and Dissertations

High fast-food consumption is a common public health concern due to its link to a number of non-communicable diseases and mental health, but increased consumption of processed food, rapid urbanization, and changing lifestyles have led to a shift in dietary patterns. People are consuming more foods high in energy fats and free sugars. This mixed methods study was conducted at a college campus in Georgia, to assess knowledge and understanding of the students between the ages of 18 and 22 years about highly processed Fast Food, and its effects on health. Forty student participants were chosen through convenience sampling and …

Why A Healthy Diet Is Important For Women's Health, Halley Doster

Theses and Dissertations

Nutrition plays a critical role in women’s reproductive health, yet many women face barriers to maintaining a balanced diet. This study aimed to examine the relationship between nutritional intake and reproductive health outcomes among women of reproductive age, as well as to assess their knowledge and challenges related to healthy eating. Using a cross-sectional survey design, data were collected from 50 women at a community health center and analyzed using SPSS to generate descriptive statistics and explore patterns through chi-square and regression analyses. Findings revealed that most participants had moderate to low fruit and vegetable intake, and fewer than half …

Attacking Diabetes One Day At A Time, Kyla Duncan

Theses and Dissertations

The "Attacking Diabetes One Day at a Time" initiative targets the growing concern of public health, type 2 diabetes, among under-reserved communities. This comprehensive care program emphasizes the importance of prevention through education, improving lifestyles, and access to care. Based on insights from the Self-Care Management Theory, this initiative seeks to provide individuals with sound, culturally tailored strategies that reduce disease risk and help them manage healthy lifestyles. Major components include educational workshops, and resource navigation. The success of this program, from community engagement through evaluation on a phased implementation plan, is guaranteed. The expected outcomes of this work will …

The Diseased Extracellular Matrix In Chronic Obstructive Pulmonary Disease Modeling, Leigh-Ann M. Antczak

Theses and Dissertations

Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death in the world, with an increasing prevalence as the world’s population ages. In the distal regions of the lungs, COPD is characterized by progressive emphysema due to an imbalance of proteases that continuously degrade essential extracellular matrix (ECM) proteins within the alveolar walls, causing fatal tissue impairment. This dissertation examines the unique properties of this diseased lung ECM in two parts: (1) As a key constituent in inflammatory signaling that leads to increased inflammation and progression of COPD, and (2) as a tool in three-dimensional (3D) in …

Smear Layer Removal By Irrigation Adjuncts: A Scanning Electron Microscopy Study, Triet D. Vuong

Theses and Dissertations

Purpose: This study aimed to compare the intracanal smear layer removal ability of two adjunctive irrigation modalities: the AdvErL EVO laser, the GentleWave^® Procedure, and their combination, after minimally invasive canal instrumentation.

Methods: Forty molars were accessed, the mesiobuccal canals of maxillary and mandibular molars were prepared up to apical size 25.04 using rotary instrumentation, then irrigated using: conventional needle irrigation (CNI), laser-assisted irrigation (LAI), the GentleWave^® Procedure (GWP), and LAI followed by GWP (LAI+GWP). The teeth were then decoronated and split longitudinally. One-half of each root was selected for preparation and analysis under scanning electron microscope. Blinded …

Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

Addressing Barriers To Preventive Healthcare Access Through Community Outreach In Underserved Populations, Deneisha Sparks

Theses and Dissertations

Access to preventive healthcare is a significant public health challenge, particularly for underserved populations in Muscogee County, Georgia. This project addresses systemic barriers such as transportation, limited health education, and economic constraints, which contribute to health disparities and reliance on emergency room services. Guided by the Social Determinants of Health (SDOH) framework and the Health Belief Model (HBM), the project aims to enhance access to preventive care, improve health literacy and identify barriers to healthcare access.

This program evaluation report examined a community-based initiative that utilized a mobile health unit to improve access to preventive healthcare in underserved areas of …

Examining Healthcare Access Disparities: Social Determinants And Patient Experiences At Valley Healthcare, Mikaila Larmond

Theses and Dissertations

Persistent disparities in healthcare access continued to affect low-income, rural, and underserved populations across the United States. This capstone project explored these disparities within Valley HealthCare, a regional provider in Columbus, Georgia, by examining how social determinants such as income, education, geography, and transportation shaped healthcare engagement among adult patients. A mixed-methods case study design was used to analyze survey data, patient satisfaction feedback, and organizational reports from a sample of 80 adult patients between January and March 2025.

The results showed that patients residing in lower-income or geographically isolated areas reported significantly higher rates of missed appointments. Individuals with …

Prevalence Of Hypertension Among Low-Income Individuals In Muscogee County Columbus, Georgia, Amelia K. Fallah

Theses and Dissertations

This study investigates the prevalence and predictors of elevated blood pressure (BP) among 409 low-income adults in Muscogee County, Columbus, Georgia—a population disproportionately burdened by hypertension. The findings reveal that elevated BP is significantly more prevalent among African Americans (71.4%) compared to non-African Americans (27.1%), highlighting the role of racial disparities influenced by systemic inequities, healthcare access, and chronic stress. Gender differences were modest, with females exhibiting a slightly higher prevalence (77.9%) than males (76.7%), potentially due to age-related hormonal changes post-menopause. Older adults (50+ years) represented most of the sample and showed significantly higher hypertension rates, consistent with established …

Lived Experience Of Middle School Science Teachers During The Covid-19 Pandemic, David E. Abbott Jr.

Theses and Dissertations

The COVID-19 pandemic significantly disrupted education worldwide, compelling schools to adopt remote teaching and learning. This phenomenological study examined the lived experiences of six middle school science teachers in an Alabama school district during this period. Data were collected through interviews and reflective journals maintained for 2 weeks following the interview. The research investigated how teachers navigated shifting instruction to remote settings, engaged students, assessed and monitored their progress, and managed challenges. Guided by the technological pedagogical and content knowledge (TPACK) framework, findings revealed that teachers leveraged a combination of technological, pedagogical, and content knowledge to adapt their instruction. Despite …

Emotions And Cognition, Krystal D. Becks

Theses and Dissertations

Background: Cognitive functioning is linked to emotional processes, with this relationship shaped by various biological (e.g., age, sex, diseases, and genetics), psychological (e.g., emotional well-being, coping strategies, mental health), and sociological (e.g., income and education) factors. Understanding these interactions is critical for advancing research on cognitive-emotional health across diverse populations. Purpose: To examine the relationship between positive and negative emotions and cognitive functioning among healthy adults. Methods: This was a cross-sectional analysis of data from the Aging Brain Cohort (ABC) study (n=434). The independent variables were subsets from the NIH toolbox emotional battery. The dependent variables were from the NIH …

Investigating The Role Of Rps3 In The Homologous Recombination Dna Repair Pathway, Jerome Robert Dorsey

Theses and Dissertations

Ribosomal proteins have been demonstrated to perform extra-ribosomal functions beyond protein synthesis, including roles in cell signaling, transcription regulation, apoptosis, and DNA repair. Ribosomal protein S3 (RPS3), in particular, has been implicated in DNA repair and apoptosis pathways, suggesting a critical role in maintaining genomic stability. However, the specific mechanisms involving RPS3 are still unknown, particularly in the context of double-stranded break (DSB) repair. DSBs are among the most severe types of DNA damage, often resulting in chromosomal instability or cell death if not properly repaired. Nonhomologous End Joining (NHEJ) and Homologous Recombination (HR) are the two primary DNA repair …

Comparative Evaluation Of Three Endodontic Rotary File Systems In S-Shaped Root Canals: An In-Depth Analysis, Mudher Bahar

Theses and Dissertations

Objective: This study compares three endodontic file systems—XP‐3D Shaper⁺, EdgeFile X7 and WaveOne Gold in S‐shaped simulated canals in resin blocks. It aimed to quantify canals volumetric changes post‐instrumentation to guide clinical selection of a system that preserves tooth structure while efficiently shaping root canals.

Methods: Thirty S‐shaped canals in resin blocks were divided into three groups (n=10) for instrumentation with XP‐3D Shaper⁺, EdgeFile X7 or WaveOne Gold using the crown‐down technique and manufacturers recommended settings. A no‐treatment control provided a baseline for volumetric changes measured via CBCT scans analyzed with ITK‐SNAP. Data were analyzed using ANOVA and Tukey’s test …

Subgingival Microbiomes Of Healthy And Periodontitis Subjects, Tareq Abdulrasoul

Theses and Dissertations

Background: Periodontitis is a common chronic inflammatory disease triggered by the dysbiosis of the subgingival microbiome. 16s rRNA sequencing has been used to profile the subgingival plaque samples in healthy and periodontitis subjects. Here, we have collected subgingival plaque samples from subjects and analyzed the microbiome profile from 16s rRNA sequencing. We hypothesized that periodontitis patients will have a different subgingival microbiome profile than that of healthy subjects.

Methods: Subgingival plaque samples were collected from periodontitis and healthy subjects who were indicated for periodontal surgeries (osseous resective and regenerative surgery for periodontitis patients or crown lengthening for healthy …

Development Of A Mediation Model Of Pain Cognition In Adult Patients With Sickle Cell Disease, Daniel M. Sop

Theses and Dissertations

Pain is a hallmark of Sickle Cell Disease (SCD), a genetic hemoglobinopathy characterized by chronic hemolytic anemia, vaso-occlusion, and organ damage. While acute vaso-occlusive crises (VOC) have been extensively studied, the mechanisms underlying chronic pain and its interplay with brain function remain unclear. This dissertation investigates the relationships between cerebral blood flow (CBF), fluid cognition, and pain sensitivity in adults with SCD, utilizing advanced imaging techniques and validated assessment tools.

Arterial spin labeling (ASL) and functional magnetic resonance imaging (fMRI) were employed to measure CBF and brain activity, respectively. Pain sensitivity was assessed using the Pain Sensitivity Questionnaire (PSQ), and …

Immersive Medical Practice And Clinical Training: Virtual And Mixed Reality In Pharmacy And Orthopedic Surgery, Silas Semprini De Toledo Contaifer

Theses and Dissertations

Extended‑reality (XR) technologies including virtual reality (VR) and mixed reality (MR) offer new ways to improve training and surgical precision. This thesis evaluates their educational and clinical impact through two complementary studies.

Specific Aim 1 compared an immersive 360° video VR module with conventional training for teaching USP < 797> sterile‑compounding skills to second‑year PharmD students (N = 36). VR trainees raised their knowledge from 6.14 ± 1.55 to 8.69 ± 1.07, yet the overall post‑test advantage versus control was not statistically significant (U = 71.50, p = 0.21). Item‑level McNemar testing showed significant VR‑exclusive gains on three critical questions (K5, K6, …

Hafnium Oxide-Based Nanoheterostructures For Catalytic Radiosensitization And Enhanced X-Ray Radiotherapy, Marlen Dariela Calix Quezada

Theses and Dissertations

Orthovoltage X-ray beams are attractive for surface and intra-operative radiotherapy. Yet, their clinical utility is constrained by rapid attenuation and the limited dose that can be delivered without harming healthy tissue. High-Z hafnium oxide (HfO₂) nanoparticles can boost local energy deposition through the photoelectric effect, while catalytic surface defects accelerate water radiolysis. Harnessing both mechanisms in a single nano-heterostructure could enable potent radiosensitization at diagnostic-range energies.

This thesis develops and evaluates HfO₂-based nanoheterostructures, both bare and Au-decorated, as catalytic radiosensitizers.

Two types of HfO₂ were evaluated, one was synthesized following a specific route and the …

Enhancing Clinical Trial Matching In Molecular Diagnostics: Using Natural Language Processing And Clustering Approaches In Hematological Malignancies, Gillian Fanning

Theses and Dissertations

Clinical trial matching is a critical component of personalized medicine, particularly in the management of hematologic malignancies. At Virginia Commonwealth University (VCU) Health, the Molecular Diagnostics (MDX) Lab produces somatic variant reports and recommends clinical trials based on the presence of clinically significant mutations. However, the current manual trial recommendation process is time-intensive and lacks scalability.

This study introduces a computational framework to streamline and standardize clinical trial matching using natural language processing (NLP) and unsupervised clustering. Trial brief descriptions were analyzed to extract frequent terms, and trials were grouped based on term similarity using joint dimensionality reduction and clustering. …

Rare Variant Analysis Of Electronic Health Record-Defined Major Depressive Disorder In The All Of Us Research Program, Stephen Emil Vieno

Theses and Dissertations

The underlying pathogenesis of MDD remains poorly understood, with multiple competing hypotheses regarding its exact etiology. As a heterogeneous disorder with relatively low heritability, large-scale genome-wide association studies of MDD have relied on increasingly large sample sizes to identify common genetic variants associated with the disorder. However, the rare variant genetic architecture of MDD is still largely unknown. The aim of the present analysis was to use the AoU—a United States-based biobank that integrates healthcare records from over 50 healthcare systems and possesses whole genome sequencing data for participants—to perform a gene set–based analysis of MDD. This analysis presented several …

Modeling Vaccination Strategies And Intervention Impacts On Infectious Disease Dynamics, Elizabeth B. Amona

Theses and Dissertations

This dissertation explores how mathematical and statistical modeling can inform vaccination strategies and evaluate the impact of interventions during infectious disease outbreaks. Motivated by the challenges observed during the COVID-19 pandemic, the research integrates compartmental modeling, Bayesian inference, and agent-based simulation to assess policy effectiveness and disease control across varying contexts. The first study develops a SEIRDV model that incorporates government interventions and vaccination rollout to examine COVID-19 dynamics in Qatar. A Bayesian approach is used to estimate parameters and compute time-varying transmission rates. The model captures shifts in transmission following policy changes and quantifies the reduction in deaths attributable …

Automated Treatment Planning Framework For Cervical Cancer In Brachytherapy, Suman Gautam

Theses and Dissertations

Brachytherapy (BT) is a critical treatment modality for cervical cancer that delivers ionizing radiation directly to the tumor using intracavitary (IC) and/or interstitial (IS) applicators. In high dose-rate (HDR) BT, a remote afterloader guides the radioactive source to specific dwell positions for defined durations, known as dwell times, allowing for a conformal dose to the tumor while minimizing exposure to surrounding organs at risk (OAR). However, due to the inherent nature of ionizing radiation, some dose to OARs is unavoidable, creating a fundamentally conflicting objective in treatment planning: maximizing tumor coverage while minimizing OAR dose. This characterizes the problem as …

Scopolamine-Induced Modulation Of Serotonin And Dopamine Transporters Activity: Behavioral And Molecular Insights Into Rapid Antidepressant Action, Deepak Karunakaran

Theses and Dissertations

Major depressive disorder (MDD) affects over 350 million individuals worldwide and is characterized by profound dysregulation of serotonin (5-HT) and dopamine (DA) systems that govern mood, reward processing, and motivation. The serotonin transporter (SERT) and dopamine transporter (DAT), both dynamically regulated through phosphorylation, serve as critical determinants of synaptic monoamine signaling. Despite decades of therapeutic development, current antidepressants require 4-6 weeks to achieve efficacy, and approximately one-third to half of patients develop treatment-resistant depression. The emergence of rapid-acting antidepressants like ketamine represents a paradigmatic shift, demonstrating symptom relief within hours; however, ketamine's therapeutic potential remains constrained by abuse liability, dissociative …