Medicine and Health Sciences Commons^™

Functional Characterization Of Rai1 In Zebrafish, Joshua S. Beach

Theses and Dissertations

Smith-Magenis Syndrome (SMS; OMIM #182290) is a multiple congenital abnormality and intellectual disability (ID) disorder caused by either an interstitial deletion of the 17p11.2 region containing the retinoic acid induced-1 (RAI1) gene or a mutation of the RAI1 gene. Individuals diagnosed with SMS typically present characteristics such as ID, self-injurious behavior, sleep disturbance, ocular and otolaryngological abnormalities, craniofacial and skeletal abnormalities, neurological and behavioral abnormalities, as well as other systemic defects and manifestations. Previous work by Vyas in 2009 showed temporal expression of rai1 in zebrafish embryos as early as 9 hpf. We hypothesize that there is maternal …

Effects Of Nicotinic Acetylcholine Receptor Agonists In Assays Of Pain-Stimulated And Pain-Depressed Behavior In Rats, Kelen Freitas

Theses and Dissertations

Though a host of analgesics have been developed to alleviate pain, especially acute pain, significant side effects and a lack of long-term efficacy have encouraged research attempts to pursue novel targets that may be associated with fewer side effects or a more sustained efficacy. Among these new targets are members of the nicotinic family of acetylcholine receptors (nAChRs). The non-selective nAChR agonists nicotine and epibatidine have been shown to function as potent antinociceptive drugs in many acute and chronic preclinical pain models, while nicotine has produced analgesic effects in humans. However, these non-selective nAChRs agonists also produce various side effects, …

Evaluation And Comparison Of Theoretical Models’ Abilities To Explain And Predict Colorectal Cancer Screening Behaviors, Anthony J. Molisani

Theses and Dissertations

BACKGROUND: Colorectal cancer (CRC) is the fourth most common and second most deadly cancer in the United States. However, it is highly preventable and treatable if detected at the precancerous or local stage of development. There exists multiple screening methods each with varying sensitivity, required effort, and recommended frequency of use. Complete adherence to screening guidelines by the recommended, at-risk population would halve the current mortality rate. Unfortunately, screening adherence remains the lowest of all screened cancers with a median state screening adherence rate of about 65%. To understand what individual-level factors influence an individual’s decision to be screened, health …

Lowering The Number Of False Positive Responses To Electric Pulp Tests By Qualifying Patient Response, Katherine Js Lee

Theses and Dissertations

The electric pulp test (EPT) has been shown to be a valuable tool in assessing pulp vitality. One of its drawbacks, however, is its high number of false positives. The purpose of this study was to determine if qualifying the type of sensation elicited by the test could lower the percentage of false positive responses. A retrospective chart review of an eleven-month period was conducted, examining all patients with necrotic teeth tested with the EPT. Of 189 teeth, when the patient responded to EPT at first sensation 23.3% of teeth were incorrectly identified as vital. When the patient was asked …

Predicting Depression Symptoms Among College Students: The Influence Of Parenting Style, Sarah Whitmire Clark

Theses and Dissertations

This study examined parenting style variables in predicting college students’ depression symptoms. Participants were 989 college students who participated in the first wave of the Spit for Science project (Dick et al., 2011). This study described the prevalence of depression symptoms, including the percentage of the sample endorsing various depression symptoms, and the frequency depression scores were elevated at multiple time points. A hierarchical multiple regression was conducted to examine whether two dimensions of parenting style, Autonomy Granting and Parental Involvement, would interact in predicting depression symptoms in the Junior year. The present study demonstrates that parenting style predicts a …

The Role Of Leukocyte-Platelet Rich Fibrin In Human Alveolar Ridge Preservation: A Randomized Clinical Trial, Thomas F. Glazier, Thomas C. Waldrop, John C. Gunsolley, Robert Sabatini

Theses and Dissertations

PURPOSE: The aim of this study is to examine the healing of intact extraction sockets grafted with leukocyte-platelet rich fibrin (L-PRF) as compared to sockets grafted with freeze-dried bone allograft (FDBA) and a resorbable collagen barrier membrane (RCM).

METHODS: This prospective randomized, examiner blinded pilot study included 17 subjects randomized to two treatment groups. Serum total cholesterol, low density lipoprotein (LDL), 25-hydroxyvitamin-D₃, and platelet counts were determined preoperatively in all subjects. The experimental arm consisted of 8 posterior tooth-bounded intact extraction sites receiving L-PRF plugs. The control group consisted of 9 posterior tooth-bounded intact extraction sites receiving FDBA …

Growing Up In Ireland: Factors Impacting Sleep Patterns Of Preterm Infants, Joanne Fallon

Theses and Dissertations

GROWING UP IN IRELAND: FACTORS IMPACTING SLEEP PATTERNS OF PRETERM INFANTS

By Joanne Fallon MS, OT, PhD

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2015.

Major Director: Shelly J. Lane, PhD, Professor, Department of Occupational Therapy

Preterm infants represent the largest child patient group in the European Union (EU), accounting for 5.5-11.4% of all births (European Foundation for the Care of Newborn Infants, 2011b). Preterm birth is defined as birth prior to 37 weeks gestation. Infants born late preterm (34-36 weeks) are considered more …

Psycholinguistics In Fluency Disorders: Prearticulatory Speech Planning In Stuttering And Cluttering, Emily O’Dell Garnett

Theses and Dissertations

The Covert Repair Hypothesis (CRH) is an account for speech errors in normally fluent speakers, and also hypothesizes errors in the phonological encoding stage in people who stutter (PWS). Previous research has shown that PWS exhibit poorer performance compared to typically fluent adults (TFA) on linguistic tasks designed to tap into the level of phonological encoding, such as phoneme monitoring. Stuttering and cluttering often co-occur, thus the field can benefit from extending this methodology to study people who clutter (PWC). Experiment 1 in Chapter 2 used phoneme monitoring to study phonological encoding in PWS and PWC, with three conclusions: (1) …

Ethnic Discrimination: Measurement And Associations With Smoking-Related Outcomes Among Arab Male Current And Former Smokers In Israel, Amira Osman

Theses and Dissertations

We evaluated the psychometric properties of two instruments used to assess ethnic discrimination among Arabs in Israel. The “Experiences of Discrimination” (EOD) scale was adapted to assess interpersonal ethnic discrimination (EOD-A) and a new measure was developed to assess perceptions of institutional group discrimination (IGD) against Arabs as an ethnic group. Then, we examined the association between each form of ethnic discrimination (interpersonal and institutional) and smoking outcomes among Arab men from Israel, and whether social support and coping efficacy moderate these associations. Data were analyzed from a cross-sectional study of Arab male current and former smokers, aged 18-64. A …

Patient And Provider Characteristics And Practice Patterns Of Primary Care Physicians Of Weight-Related Counseling, Kolby T. Redd

Theses and Dissertations

Background: The United States Preventive Services Task Force (USPSTF) recommends three types of health education counseling for use in primary care practices for adult, obese patients. While these recommendations are well known, a low percentage of physicians provide this counseling to their patients on a consistent basis. There are inconsistencies in past studies in regards to what aspects of the health encounter influence the likelihood of receiving health education counseling during a primary care visit. The objective of this study was to (1) investigate the patterns of these three types of counseling occurring within primary care practices and to …

Food Security Status And Life Events Among Households With Children In The Midlands Of South Carolina, Erin Rebekah Drucker

Theses and Dissertations

Purpose: Food insecurity is a major public health problem in the United States (US) with 14.5% of US households having experienced some level of food insecurity in 2012. Among households with children, 20% experienced low food security in 2012, and in half of these households, both the children and adults were affected. Food insecurity among children can have lifelong negative health and mental effects. Life events are defined as self-­‐reported life changes, which create a strain on resources and an opportunity for food insecurity, Methods: The Midlands Family Study (MFS) was a cross-­‐ sectional study that surveyed households …

Goal Achievement In Young Adults With Asperger Syndrome And High Functioning Autism, Melissa Racobaldo

Theses and Dissertations

Purpose: This study aimed to evaluate perspectives of young adults with Asperger syndrome (AS) and High Functioning Autism (HFA) regarding supports and services, future goals, and confidence in their success. The goal of this study was to identify valuable supports and areas in which this support was lacking. Identifying areas of support for young adults with AS/HFA transitioning into adulthood aids in providing consistent services for successful goal achievement. The study has value among genetic counselors as the discovery of genetic etiologies of autism has led to referral of families with ASD to the genetics clinic. Methods: Young adults with …

Molecular Mechanisms Underlying Environmental Enrichment-Induced Neuroprotection In Vulnerability To Nicotine Addiction, Adrian Michael Gomez

Theses and Dissertations

Tobacco use is the number one preventable cause of death in the world. Nicotine is the principal, addictive component in tobacco responsible for its reinforcing properties that drive the behavioral manifestations of nicotine addiction. Environment is becoming increasingly implicated in nicotine susceptibility. However, the molecular mechanisms that underlie susceptibility to nicotine addiction remain unknown. An ideal animal model that addresses environmental factors uses rats raised in an enriched condition (EC), a standard condition (SC), and an impoverished condition (IC); which differ in novelty, social cohorts, handling, and physical activity. EC rats exhibit a neuroprotective-like phenotype in the behavioral resistance to …

Dysregulation Of Micrornas In Blood As Biomarkers For Diagnosing Prostate Cancer, Rhonda W. Daniel

Theses and Dissertations

Prostate cancer is the most common noncutaneous cancer among men, yet current diagnostic methods are insufficient and more reliable diagnostic markers need to be developed. The answer that can bridge this gap and enable more efficient diagnoses may lie in microRNAs. These small, single stranded RNA molecules impact protein expression at the translational level and regulate important cellular pathways. Dysregulation of these small RNA molecules can have tumorigenic effects on cells and lead to many types of cancers.

Currently the Prostate-Stimulating Antigen (PSA) is used as a diagnostic marker for prostate cancer. However, many factors can elevate PSA levels such …

Synthesis, Surface Functionalization, And Biological Testing Of Iron Oxide Nanoparticles For Development As A Cancer Therapeutic, Stanley E. Gilliland Iii

Theses and Dissertations

Iron oxide nanoparticles are highly researched for their use in biomedical applications such as drug delivery, diagnosis, and therapy. The inherent biodegradable and biocompatible nanoparticle properties make them highly advantageous in nanomedicine. The magnetic properties of iron oxide nanoparticles make them promising candidates for magnetic fluid hyperthermia applications. Designing an efficient iron oxide nanoparticle for hyperthermia requires synthetic, surface functionalization, stability, and biological investigations. This research focused on the following three areas: optimizing synthesis conditions for maximum radiofrequency induced magnetic hyperthermia, designing a simple and modifiable surface functionalization method for specific or broad biological stability, and in vitro and in …

Accreditation As An Organizational Response: Exploring The Influence Of Leadership And Institutional And Task Environments On The Accreditation Process In Communication Sciences And Disorders Programs, Jeffrey Charles Adams

Theses and Dissertations

Influences on the accreditation process in communication sciences and disorder (CSD) programs were examined using a cross case comparative qualitative analysis among four successfully accredited academic departments in the southern United States. Program chairs, CSD administrators, clinic directors and faculty were interviewed. Four institutional sites were selected for the case studies based upon the outcome of the program’s most recent accreditation site visit, the date of the accreditation site visit, number of available faculty, and institutional type. The four institutions included one master’s granting private institution, one master’s granting (larger) program, one doctoral/research medical university, and one doctoral/research university (very …

Diffusion Of Innovations Of Videoconference Technology: An Instrumental Case Study Concerning Undergraduate Degree-Seeking Nontraditional Learners, Bruce G. Campbell

Theses and Dissertations

This applied dissertation is an instrumental case study based on diffusion of innovations theory designed to gather student opinions regarding videoconference (VC) technology use in facilitating courses to undergraduate degree-seeking nursing students. The author of diffusion of innovations theory, Rogers (2003), recommended that more qualitative studies be conducted in education. Rogers and Jain (1968) recommended these studies should be conducted from the aspect of “receivers of innovation diffusion” (p.1) to provide feedback instrumental to implementation of technological innovations in academe. Further, Rogers stated that multiple data points should be used during the process of trialing an innovation. Therefore, a current …

Exploring Communication Patterns In The Discussion Of Maternal Pku Syndrome Between Parents And Daughters, Hannah Beth Andrews

Theses and Dissertations

Maternal PKU syndrome is the collection of features and birth defects that arise from uncontrolled phenylalanine levels in a pregnant woman with phenylalanine hydroxylase (PAH) deficiency, previously known as phenylketonuria (PKU). Currently, the literature is lacking in exploring what young women are being told about maternal PKU syndrome. In this study, communication patterns between parents and their daughters about maternal PKU syndrome were investigated through an online survey completed by parents. The survey assessed parents’ level of comfort with this topic, the information they discussed with their daughter and the resources they accessed. Followup interviews were conducted with participants to …

Evaluating Changes In Patient Anxiety Regarding Classic Cancer Genetic Testing Versus Expanded Multiplex Cancer Genetic Testing, Andrew Todd Alfonso

Theses and Dissertations

Multiplex cancer genetic testing by next generation sequencing (NGS) offers genetic counselors and patients new options for testing multiple genes beyond BRCA1 and BRCA2, increasing both the yield of positive results and the number of variants of uncertain significance (VUS). This pilot study explored three psychosocial questions related to multiplex cancer genetic testing: 1). Do anxiety levels differ in patients with results of familiar single gene testing versus those with results of multiplex cancer genetic testing of unfamiliar genes? 2). Do different results (i.e., negative, positive, or VUS) affect patient anxiety levels in the post-results period? 3). Is patient anxiety …

Variant Reclassification In Cancer Genetic Testing: Are Genetic Counselors Prepared? A Review Of Current Practices, Niamh Gemma White

Theses and Dissertations

Purpose: Cancer genetics has emerged as a critical specialty within the field of genetic counseling. Advancements in research are constantly uncovering new insights into the genetics of cancer and inherited cancer syndromes. It is crucial that genetic counselors and the institutions in which they work are in sync with these advancements. Currently, multiplex or multi-gene cancer testing is rapidly being adapted into the cancer genetic counseling setting. The ‘hot topic’ of an increased likelihood of receiving variant results following such testing has been explored in depth in the literature. However, research surrounding genetic counseling practices and the reclassification of VUS …

An Evidence-Based Approach To Prepare Interdisciplinary Team Members For Implementation Of The Abcde Bundle, Jessica Murner Hamilton

Theses and Dissertations

Quality improvement projects contribute to the development of evidence-based management strategies for successful implementation of evidence-based practices in health care, thus reducing the risk of change implementation failure. This study assessed practice change implementation strategies for the awakening and breathing trial coordination, delirium assessment and management, early exercise and mobility (ABCDE) bundle. The ABCDE bundle is an evidence-based, interdisciplinary framework for managing pain, agitation, and delirium, reducing the duration of mechanical ventilation, and supporting early mobility in critically ill patients. The purpose of this study was to implement a nurse-driven initiative to design and put into place an evidence-based approach …

Eye Movements Of Individuals With Aphasia During Reading And Scene Viewing, Kimberly G. Smith

Theses and Dissertations

Purpose: This project characterized eye movements of individuals with aphasia and age-matched participants during reading and scene viewing.

Methods: Individuals with aphasia (N=24) and age-matched controls participants (N=24) completed three eye tracking studies. Study 1 examined task-related changes in eye movements for scene search, scene memorization, text-reading, and pseudoreading. Ex-Gaussian, analysis of variance, and correlational analyses were used to compare differences in eye movements across tasks and participant groups. Study 2 examined how oculomotor and linguistic processing influence eye movements for textreading and pseudo-reading. In addition to the statistical analyses used in Study 1, four case studies were carried out …

Exploring The Association Between Network, Cognitive, Structural Social Capital And The Risk Of Clinical Depression In Taiwan, Yun-Hsuan Wu

Theses and Dissertations

Depression is the one of most common mental health conditions in Taiwan. Although evidence suggests that social capital is associated with depression, few studies have comprehensively explored the influence of social capital on depression. Also evidence in Taiwan is limited in comparison to other Western countries. Data from the 1997 Taiwan Social Change Survey (n=2,598), which is the only dataset that contains the best available information to measure and compare all three dimensions of social capital (network, cognitive, and structural social capital), were used to examine the association between three dimensions of neighborhood- and individual-level social capital and depression among …

Environmental Exposures And Childhood Pulmonary Function, Pallavi Prakash Balte

Theses and Dissertations

Fetal origins of adult disease hypothesis states that adverse influences early in developmental period and particularly during intrauterine life can result in permanent changes in physiology which may lead to increased disease risk of chronic diseases in adulthood. Both fetal and adolescent period are critical time periods for development of lungs. Any adverse environmental exposures during these critical periods of lung growth is a form of programming which can have long term effects on pulmonary function. The purpose of this dissertation was to examine the association between different environmental exposures and pulmonary function in children and late adolescents. The first …

Statewide Scale-Up Of Group Prenatal Care In South Carolina, Kristin M. Van De Griend

Theses and Dissertations

Background: Poor birth outcomes and racial disparities in birth outcomes in South Carolina are widely recognized problems. To improve maternal and child health outcomes, especially among vulnerable groups, universal access to timely, appropriate, and effective care should remain a priority through increased availability and accessibility. An interagency collaborative in South Carolina expanded CenteringPregnancy (CP) from two to five medical practices throughout the state. CenteringPregnancy is associated with improved birth outcomes and reduced rates of racial disparities in preterm birth throughout the United States. Important questions in the literature remain about strategies and determinants of scaling up sexual and reproductive …

Characterization Of Stard4 And Stard6 Proteins In Human Ovarian Tissue And Human Granulosa Cells And Cloning Of Human Stard4 Transcripts, Aisha Shaaban

Theses and Dissertations

Progesterone is essential hormone for pregnancy, which is produced by the human corpus luteum in early pregnancy until the placenta assumes this function. Transport of the cholesterol from the outer to the inner mitochondrial membrane is the rate limiting step for the de novo synthesis of pregnenolone (the precursor to progesterone), a process mediated by STARD1. STARD1 contains a C-terminal lipid binding domain which binds cholesterol and an N-terminal domain targeting STARD1 to the mitochondrial membrane. Unlike STARD1, STARD4 and STARD6 proteins lack a mitochondrial targeting sequence; however, they can bind cholesterol and increase steroidogenesis in model systems. In this …

Best Practice For A Standardized And Safe Registered Nurse Shift Handoff, Nancy Rankin Ewing

Theses and Dissertations

One of the most important times for the delivery of patient care occurs during the change of shift handoff between professional nurses. This complex interchange of information and responsibility carries with it distinct possibilities for error that can adversely affect a patient’s hospitalization, safety, and the quality of patient care outcomes (Blouin, 2011; Hilligoss & Cohen, 2011). Communication errors, including errors during shift handoff, account for more than 70% of sentinel events that occur in the provision of healthcare in the acute care setting (Federwisch, 2007; Streeter, 2010). Poorly conducted and unstructured shift handoffs are known to result in delayed …

Evaluating The “Family-Centered” Approach Of Pediatric Multidisciplinary Down Syndrome Clinics: A Parents’ Perspective, Devon A. Haynes

Theses and Dissertations

Down syndrome is the most common genetic cause of intellectual disability. Individuals with Down syndrome usually display mild to moderate intellectual disability, developmental delay, characteristic facial features, and an increased risk for birth defects and various medical problems. Multidisciplinary clinics were established to address the multi-system health concerns for Down syndrome, increase adherence to medical management guidelines, and provide coordinated and comprehensive care for the patient. Research has examined the beneficial effect of a multidisciplinary approach to patient care and medical outcomes; however, no studies have been done which evaluate the psychosocial aspect of the care provided.

We hypothesized that …

Exploring How The Risk Of Sudden Cardiac Death Is Discussed In Families With A Diagnosis Of A Sads Condition, Kristin Anne Wiley

Theses and Dissertations

Sudden arrhythmic death syndrome (SADS), where death is secondary to cardiac arrhythmia, is associated with several cardiac ion channelopathies, including long QT syndrome and Brugada syndrome, as well as cardiomyopathies such as hypertrophic cardiomyopathy and dilated cardiomyopathy. Many of these conditions often present in childhood or adolescence. This study investigates how diagnoses of cardiac diseases associated with SADS are communicated within families. A questionnaire was distributed through cardiac disease-focused support groups and organizations. Data from 114 parents who have a child with a SADS condition were used for analysis. Based on the responses, parents explained the risk of SADS in …

Cluster Analysis With Batch Effect, Yifan Tang

Theses and Dissertations

Clustering, as a fundamental process in data science, is frequently used in preliminary data analysis. Batch effects are a powerful source of variation that can come from many sources in data collection, and influence data. We propose a method to simultaneously remove batch effects and perform cluster analysis. We see a batch effect as a fixed value added on to each batch, and do not make assumptions about the distribution of batch effects. We represent the data using a Gaussian mixture model, and use the EM algorithm to estimate the cluster means, the cluster covariance matrices, and the batch effects, …