Medicine and Health Sciences Commons^™

Losing Weight With Five A’S (5 A’S): Assess, Advise, Agree, Assist, Arrange Framework And Motivational Interviewing (Mi) For Health Behavior Change Counseling, Jacqueline Baer

Theses and Dissertations

According to the Centers for Disease Control and Prevention (CDC), obesity has reached epidemic levels and has associated with increased risk of morbidity and mortality rates. The increasing prevalence of obesity is a major public health concern. Researchers calculate that health care costs are 44% higher among moderately and severely obese older persons than for persons at normal weights. Seventy-five percent of African American (AA) women are overweight and obese according to data from the CDC and The State of Obesity: Better Policies for a Healthier America. Compared to any other racial ethnic group, AA women are more likely to …

Nurse Educators’ Perceptions Of Using High-Fidelity Simulation In Teaching, Marlene Whigham

Theses and Dissertations

Nurse Educators’ Perceptions of Using High-Fidelity Simulation in Teaching. Marline Whigham, 2017: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education. Keywords: nursing education, learning strategies, simulation, staff development, teaching styles.

High-fidelity simulation in nursing refers to the use of computerized manikins to offer realistic hands-on training to nursing students. The problem addressed by this dissertation was resistance among some faculty to the use of new computerized simulation technology in the nursing curriculum. The research question for this case study investigated how faculty members can incorporate simulation into the curriculum and barriers faced in setting the stage for …

Modulation Of Pkr Activity During Hiv Infection And Cellular Stress By Pact And Trbp, Evelyn E. Chukwurah

Theses and Dissertations

A crucial component of the cellular response to stress is the attenuation of protein synthesis to allow the cell to dedicate resources for the restoration of homeostasis or towards the induction of apoptotic cell death in case the stressors overwhelm the cell. This process is itself regulated by one of the four eIF2α kinases of which PKR (Protein Kinase R) is responsible for inhibiting general translation during viral infection, oxidative stress, ER stress, heat shock or serum withdrawal.

During viral infection, PKR is transcriptionally induced by interferon but remains latent until it interacts with dsRNA. This interaction induces a conformational …

Radioactive Contamination Of Natural Biological Systems: Oxidative Balance And Genetic Stability, Daniel Einor

Theses and Dissertations

The global demand for nuclear energy grows, and so do the risks of an accidental release of nuclear products into the environment. Therefore, understanding the health and ecological effects of contamination by radionuclides should be of great interest for biomedical specialists and the public. Empirical studies unequivocally show that high doses of ionizing radiation (IR) shift the redox-balance of many biological systems and increase the rates of genetic errors. However, the effects of chronic low doses of radiation vary significantly between tissues and between species. The present dissertation comprises the results of experimental and meta-analytical research of a variety of …

Prenatal Methylmercury Exposure In A South Carolina Coastal Cohort, Alexis Donohue

Theses and Dissertations

Objectives: Methylmercury is a neurotoxin that has the ability to cross the placenta and adversely affect the developing fetus. Our primary objective was to investigate whether prenatal methylmercury exposure varied longitudinally, and whether differences were associated with maternal characteristics.

Methods: Pregnant mothers were recruited in Charleston, South Carolina (8-17 weeks gestation) (n=78). Blood samples were collected during both early (11.8 ± 1.7 weeks) and late (35.3 ± 2.0 weeks) gestation. Blood total mercury and methylmercury concentrations were analyzed. Upon enrollment in the study, mothers filled out a sociodemographic questionnaire that included questions regarding maternal age, race/ethnicity, and education level. Additionally, …

Succination Impairs Protein Folding And Promotes Chop Stability In The Adipocyte During Diabetes, Allison Manuel

Theses and Dissertations

Type 2 diabetes mellitus has been diagnosed in ~21 million people in the United States and is closely correlated with obesity, prompting the need for a detailed understanding of adipocyte metabolism in the development of diabetes. The intake of excess nutrients surpasses the energy requirements of the cell and leads to increased mitochondrial stress in the adipocyte. We have shown that this is associated with increased levels of the mitochondrial metabolite fumarate. Fumarate can react with cysteine thiol groups to form the chemical modification S-(2-succino)cysteine (2SC), also termed protein succination. Succination is significantly increased in the adipose tissue of type …

Barriers To The Use Of Guardrails On Iv Smart Pumps, Ivory Williams

Theses and Dissertations

Medication errors involving hospitalized patients have been an evolving challenge for decades. Moreover, errors related to intravenous (IV) medication administration continue to rise in hospitals despite implemented policies governing the use of Guardrails™ for safe IV medication infusion via smart pump technology. An organizational investigation was performed to identify barriers to the use of Guardrails™ among nursing staff. From 2015 through 2017, multiple interventions that aimed to identify barriers and increase nurses’ use of the safety features on IV smart pumps were implemented in the hopes of reaching a compliance goal of 90-100%. This quality improvement project assesses Guardrails™ compliance …

Improving Leadership Communication In Nurse-Physician Dyad Teams, Lisa James

Theses and Dissertations

Background: Changes in the delivery of healthcare services in the United States have been driven by cost containment over the last 20 years. To have a thriving organization within the current healthcare environment, nurses and physicians need to closely collaborate. As healthcare organizations prepare for the value-based era, new leadership models need to be implemented. This project addressed collaboration between nurse and physician leaders with a focused communication strategy to improve team performance, engagement, and quality outcomes in the acute care setting.

Method: A quality improvement project was designed to improve communication between front line team members and …

Exploration Of The Impact Of Childhood Obesity And The Correlation With Parents, Emilee L. Leslie

Theses and Dissertations

This review and analysis explored the prevalence of childhood obesity within the United States and other countries around the world, as well as the correlation between childhood obesity and parents. Method: I originally planned to conduct a survey study within the Muscogee-Columbus County School District (MCSD); however, I was unable to get the correct signatures in order to proceed with the Institutional Review Board (IRB) approval process. At that time I got approval from the Honors Dean and my Thesis Director to conduct an in-depth literature review and analysis on the impact of childhood obesity and the correlation with parents. …

Effects Of Estrogens On Astrocytes Exposed To Stressors, Bridget N. Smith

Theses and Dissertations

Hormone replacement therapy (HRT), used by many women to alleviate menopausal symptoms such as hot flashes and mood swings, is often a combination of horomones such as estrogens, progesterone, and conjugated equine estrogens (CEE), extracted from the urine of pregnant mares. Previous studies have found positive correlations between estradiol and cellular protection, but recent research has concluded CEE provide less protective mechanisms as compared to endogenous hormones. This research sought to compare the effects of estrogen treatments (single and combined estrogen) on viability when astrocytes were induced with stressors (epinephrine, cortisol, and low oxygen concentration). Cultured human astrocytes were treated …

Hydrogen Sulfide Regulation Of Kir Channels, Junghoon Ha

Theses and Dissertations

Inwardly rectifying potassium (Kir) channels establish and regulate the resting membrane potential of excitable cells in the heart, brain and other peripheral tissues. Phosphatidylinositol- 4,5-bisphosphate (PIP2) is a key direct activator of ion channels, including Kir channels. Gasotransmitters, such as carbon monoxide (CO), have been reported to regulate the activity of Kir channels by altering channel-PIP2 interactions. We tested, in a model system, the effects and mechanism of action of another important gasotransmitter, hydrogen sulfide (H2S) thought to play a key role in cellular responses under ischemic conditions. Direct administration of sodium hydrogen sulfide (NaHS), as an exogenous H2S source, …

Type 2 Immune Responses In The Context Of Helminth Infection, Asthma, Dendritic Cells, And Myeloid Derived Suppressor Cell Function, Sheela Ruby Damle

Theses and Dissertations

Type 2 (T_H2) immune responses evolved to respond to helminth parasite infections by the production of T_H2 cytokines, which stimulate anti-helminth immunity. Macrophage migration inhibitor factor (MIF) is a pleiotropic cytokine, which is produced by many cell types. We demonstrate that mice deficient in MIF have enhanced clearance of a helminth parasite. MIF deficiency in CD4⁺ T cells was found to be the most important for mediating parasite clearance. We mimicked MIF deficiency by administering an inhibitor of the MIF tautomerase activity, sulforaphane, and this also increased parasite clearance (Section I).

T_H2 immune …

Contribution Of A Class Ii Ribonucleotide Reductase To The Manganese Dependence Of Streptococcus Sanguinis, John L. Smith

Theses and Dissertations

Manganese-deficient Streptococcus sanguinis mutants exhibit a dramatic decrease in virulence for infective endocarditis and in aerobic growth in manganese-limited media. Loss of activity of a manganese-dependent, oxygen-dependent ribonucleotide reductase (RNR) could explain the decrease in virulence. When the genes encoding this RNR are deleted, there is no growth of the mutant in aerobic broth culture or in an animal model. Testing the contribution of the aerobic RNR to the phenotype of a manganese transporter mutant, a heterologous class II RNR from Lactobacillus leichmannii called NrdJ that requires B₁₂ rather than manganese as a cofactor was previously introduced into an …

Characterization Of Staphylococcal Nuclease And Tudor Domain Containing Protein 1 (Snd1) As A Molecular Target In Hepatocellular Carcinoma And Non-Alcoholic Steatohepatitis, Nidhi H. Jariwala

Theses and Dissertations

CHARACTERIZATION OF STAPHYLOCOCCAL NUCLEASE AND TUDOR DOMAIN CONTAINING PROTEIN 1 (SND1) AS A MOLECULAR TARGET IN HEPATOCELLULAR CARCINOMA AND NON-ALCOHOLIC STEATOHEPATITIS

Nidhi Jariwala, PhD

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Integrative Life Sciences

Virginia Commonwealth University, 2017

Devanand Sarkar, M.B.B.S., PhD.

Associate Professor, Department of Human and Molecular Genetics

Virginia Commonwealth University

Richmond, Virginia

SND1, a subunit of the miRNA regulatory complex RISC, has been implicated as an oncogene in hepatocellular carcinoma (HCC). Oncoprotein SND1 regulates gene expression at a post-transcriptional level in multiple cancers including hepatocellular carcinoma (HCC). …

Study Of Molecular Interactions Of Glycosaminoglycans And Glycosaminoglycan Mimetics With Their Protein Targets, Daniel K. Afosah

Theses and Dissertations

Glycosaminoglycans (GAGs) are complex linear chain carbohydrate molecules found on virtually all animal cell surfaces. Owing to their negatively charged nature, GAGs interact with a number of different proteins. Thus, although they have great potential as therapeutic agents, their apparent promiscuous interactions increase their side effect risk. GAG mimetics, including GAG oligosaccharides and non-saccharide GAG mimetics (NSGMs) are viable approaches to address this. This work discusses sulfated benzofuran thrombin inhibitors with submaximal protease inhibition, sulfated diflavonoid inhibitors of plasmin and GAG oligosaccharides with selectivity for human neutrophil elastase (HNE).

Anticoagulants are very important for the treatment of thrombotic diseases. The …

Silver Diamine Fluoride And Oral Health-Related Quality Of Life, Nazafarin Javdan

Theses and Dissertations

Purpose: The purpose of this study was to study the association between Silver Diamine Fluoride (SDF) and Oral Health-Related Quality of Life as assessed by “The Early Childhood Oral Health Impact Scale” questionnaire. Methods: Parents of healthy children (ASA I and II) ages 1-5 with early childhood caries with reversible pulpitis who had application of SDF filled out a questionnaire at baseline and again after one month. The questionnaire was designed to evaluate the child’s behavior, physical abilities, pain, temperament, and how well the child gets along with others. Results: Wilcoxon Signed Rank Test was used to …

Amixicile Inhibits Anaerobic Bacteria Within An Oral Microbiome Derived From Patients With Chronic Periodontitis, Kane Ramsey

Theses and Dissertations

Periodontitis is a chronic inflammatory disease caused by pathogenic bacteria residing in a complex biofilm within a susceptible host. Amixicile is a non-toxic, readily bioavailable novel antimicrobial that targets strict anaerobes through inhibition of the activity of Pyruvate Ferredoxin Oxidoreductase (PFOR), a major enzyme mediating oxidative decarboxylation of pyruvate. Our study aimed to evaluate the efficacy of amixicile, when compared to metronidazole, in inhibiting the growth of bacteria present in a microbiome harvested from patients with chronic periodontitis.

Plaque samples were harvested from patients with severe chronic periodontitis and cultured under anaerobic conditions. The microbiomes were grown in the presence …

Po2 Dependence Of Oxygen Consumption In Skeletal Muscle Of Hypertensive And Normotensive Rats, Habiba Shah

Theses and Dissertations

Human essential hypertension affects over 75 million people in the United States, and can lead to death due to its several serious health complications such as hypertension-related cardiovascular disease. The purpose of this research was to understand how hypertension could cause physiological changes to the microcirculation, specifically the PO₂ dependence of oxygen consumption (VO₂) in skeletal muscle of normotensive and hypertensive rats. The Spontaneously Hypertensive Rat (SHR) strain was used as the diseased model, and Wistar-Kyoto (WKY) rats were used as controls to conduct this study. The SHR strain develops hypertension between 5-6 weeks after birth with …

Identifying United States And Territory Requirements For Childhood Vaccination Exemptions, Emily Groth Dunn

Theses and Dissertations

Background: Children are required by law to receive vaccinations to enter school. States and territories offer exemptions for parents who refuse to vaccinate their children. Types of exemptions vary by state or territory, as does the exemption claiming process. The purpose of this research was to identify the various education-related processes implemented by states and territories which allow parents to exempt children from vaccinations. Methods: A questionnaire was distributed to immunization managers in the 50 United States, District of Columbia, the United States Indian Health Service, and eight United States territories. Managers reported vaccination requirements for their jurisdiction (collectively referred …

The Perceived Utility Of Personalized Genomic Medicine In Individuals With A Family History Of Heart Disease: A Pilot Study, Dana Margaret Mittag

Theses and Dissertations

According to the World Health Organization (2005), cardiovascular disease (CVD) is the number one cause of death in most countries. Assessing a patient’s risk for heart disease may include incorporating factors such as their gender, age, weight, tobacco history, cholesterol, blood pressure, family history, and more recently, genetics. Genome-wide association studies (GWAS) have made it possible to identify risk loci for many of the common, complex disorders, including coronary artery disease (CAD). As the medical genetics community undergoes a shift from a genetics focus to a genomics oriented focus, genomic medicine is becoming more accessible. Research has begun to examine …

Muscarinic Acetylcholine Receptor M1’S Impact On Fear Extinction Learning, Joshua R. Mcelroy

Theses and Dissertations

Post-Traumatic Stress Disorder (PTSD) is a mental health disorder that can occur following a traumatic event like combat, assault, or disaster. Individuals with PTSD are unable to extinguish fear memories which can become chronic and disabling. However, it remains unclear why some individuals exposed to a traumatic event develop PTSD while others are resilient. Acetylcholine plays a critical role in fear learning, but its role in fear extinction is less well understood. In this investigation, we used a rat model of fear extinction to determine if individual differences in extinction learning are correlated with markers of cholinergic signaling. Cholinergic markers …

Inflammatory Potential Of Diet And Pancreatic Cancer Risk: Interaction And Mediation Analysis In Two Prospective Cohorts, Jiali Zheng

Theses and Dissertations

Background: Inflammation plays a pivotal role in pancreatic cancer etiology and can be modulated by diet. We aimed to examine the association between inflammatory potential of diet, assessed with the Dietary Inflammatory Index (DIITM), and pancreatic cancer risk in two prospective cohorts, the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial and the National Institutes of Health American Association of Retired Persons (NIH-AARP) Diet and Health Study. We explored effect modification by important inflammation-related lifestyle factors, and investigated whether type-2 diabetes mediated the association in a pooled analysis of both studies.

Methods: A total of 101,449 and …

Exercise Recommendations For Active Adults At Risk For Sudden Cardiac Death: “Can I Continue To Exercise?”, Kacie Lynn Baker

Theses and Dissertations

Sudden arrhythmic death syndrome (SADS) is due to genetic conditions associated with cardiac ion channelopathies and cardiomyopathies. Many of these conditions have exercise guidelines regarding eligibility and disqualification recommendations for competitive athletes through the American Heart Association and the American College for Cardiology. This study investigates how medical professionals communicate these exercise recommendations to patients, and in turn, how well patients understand these recommendations. The study also explores motivations for either continuing or discontinuing an exercise practice after a diagnosis. A questionnaire was distributed through cardiac disease-focused support groups and organizations. Data from 67 individuals with a SADS condition were …

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black/Hispanic …

Investigation On Genetic Modifiers Of Age At Onset Of Major Depressive Disorder, Huseyin Gedik

Theses and Dissertations

Major Depressive Disorder (MDD) is a complex multifactorial disorder, which would lead to disability. Environmental and genetic factors are involved in MDD etiology. The aim of this project was to identify loci modifying age at onset (AAO) of MDD using survival models after adjusting for Childhood Sexual Abuse (CSA). To achieve this aim, a dataset was made available by the China Oxford and VCU Experimental Research on Genetic Epidemiology (CONVERGE) consortium. The study population had 5,220 controls and 5,282 cases with MDD. We performed two univariate association analyses using Cox Proportional Hazard (Cox PH) models. These two are Full Sample …

The Lived Experiences Of Academic Advisors With Counseling Degrees In Addressing Wellness With College Student-Athletes, Jennifer M. Gerlach

Theses and Dissertations

The purpose of this qualitative phenomenological study was to investigate the lived experiences of academic advisors who have master’s degrees in counseling in addressing wellness with college student-athletes. Of particular note was to explore if they addressed wellness and, if so, how they addressed wellness. Extant literature is replete with evidence documenting the numerous challenges and stressors student-athletes experience due to their athlete status. Prior to this study, the role of the academic advisor in addressing wellness has not been represented in the literature. This study examined the lived experiences of 10 academic advisors with counseling degrees, or currently enrolled …

E-Cigarettes And Smoking Cessation: Economic Impact On Current Smokers With Chronic Obstructive Pulmonary Disease, Anal A. Shah

Theses and Dissertations

Introduction:

Awareness and usage of Electronic cigarettes (e-cigs) among smokers have increased rapidly over the past few years, majorly in quitting smoking. The main objectives for this study were: 1) To estimate the prevalence and study sociodemographic predictors for e-cigs use among individuals with Chronic Obstructive Pulmonary Disease (COPD) 2) To examine the predictors and estimate the total healthcare costs among current smokers with COPD 3) To estimate the economic impact of adopting e-cigs as a smoking cessation tool among current smokers with COPD.

Methods:

The National Health Interview Survey data from the year 2014 was utilized to estimate the …

Epigenetic Editing To Validate Findings From Methylome-Wide Association Studies Of Neuropsychiatric Disorders, Robin F. Chan

Theses and Dissertations

DNA methylation is necessary for learning, memory consolidation and has been implicated in a number of neuropsychiatric disorders. Obtaining high quality and comprehensive data for the three common forms of methylation in brain is challenging for methylome-wide association studies (MWAS). To address this we optimized a panel of enrichment methods for screening the brain methylome. Results show that these enrichment techniques approach the coverage and fidelity of the current gold standard bisulfite based techniques. Our MBD-based method can also be used with low amounts of genomic material from limited human biomaterials. Psychiatric disorders have high prevalence and are often chronic …

Computational Fluid Dynamics In A Terminal Alveolated Bronchiole Duct With Expanding Walls: Proof-Of-Concept In Openfoam, Jeremy Myers

Theses and Dissertations

Mathematical Biology has found recent success applying Computational Fluid Dynamics (CFD) to model airflow in the human lung. Detailed modeling of flow patterns in the alveoli, where the oxygen-carbon dioxide gas exchange occurs, has provided data that is useful in treating illnesses and designing drug-delivery systems. Unfortunately, many CFD software packages have high licensing fees that are out of reach for independent researchers. This thesis uses three open-source software packages, Gmsh, OpenFOAM, and ParaView, to design a mesh, create a simulation, and visualize the results of an idealized terminal alveolar sac model. This model successfully demonstrates that OpenFOAM can be …

Designing Effective Messages To Promote Future Zika Vaccine Uptake, Jeanine Guidry

Theses and Dissertations

The Zika virus is associated with the devastating birth defect microcephaly, and while a vaccine was not yet available in early-2017, several were under development. It is imperative to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age. Moreover, though the Zika outbreak has received much social media attention, little is known about these conversations on Instagram. The purpose of this dissertation, therefore, was to understand current Zika-focused communication on Instagram and to inform effective communication strategies to promote future Zika vaccine uptake intent.

The study aims were: (1) explore Zika conversations …