Medicine and Health Sciences Commons^™

A Qualitative Case Study Exploring The Implementation And Influence Of An Inter/Intragenerational Digital Equity Training Program, Josie Santilli

Open Access Dissertations

Background: Many older adults are unable to fully engage in society because of the digital divide, leaving them disconnected from essential services, social networks, and community engagement. This lack of access to technology leads to greater isolation and loneliness, significantly increasing their risk of physical and mental health issues. It also threatens their ability to age in place, as they struggle to navigate everyday tasks like managing healthcare, finances, and communication. Without digital literacy, maintaining independence becomes an increasingly difficult challenge, leaving them vulnerable and reliant on others for support. The purpose of the research completed in manuscript 1 …

The Effects Of Ph And Oncometabolites On Dna Repair Mediated By Alkb Family Enzymes, Quentin Mylie

Open Access Dissertations

Modifications of DNA and RNA, in particular methylations - such as N⁶-methyladenine (m6A), 5-methylcytosine (m5C), 1-methyladenine (m1A), and 3-methylcytosine (m3C) are crucial for gene regulation, genome integrity, and cellular adaptation. This dissertation investigates the role of the ALKB family of alpha-ketoglutarate (αKG) and iron-dependent dioxygenases in modulating these modifications, with a focus on how their activity is influenced by pH and metabolic factors, underscoring the connection between environmental conditions and epigenetic and genetic stability.

Chapter 1 provides a comprehensive literature review on the epigenetic and genetic regulation of DNA and RNA modifications, with a particular focus on methylation …

"Understanding Obesity Experiences And Treatment Decision-Making In Hispanic-Latino Communities”, Viviane Fornasaro-Donahue

Open Access Dissertations

Obesity disproportionately affects Hispanic-Latino adults in the United States, yet rates of metabolic and bariatric surgery (MBS) remain lower in this population compared with non-Hispanic White adults. This dissertation comprises three interconnected phases aimed to (I) explore perceptions of obesity, obesity treatment, and patient-provider communication, (II) inform the development of a culturally responsive bilingual educational material about obesity and MBS, and (III) evaluate its acceptability among Hispanic-Latinos adults with obesity.

Phase I involved a qualitative exploration using semi-structured interviews with Hispanic-Latino adults (n=26) recruited from a community and a clinical MBS setting. These interviews explored participants’ perceptions of …

Skeletal And Dental Effects Of The Carriere Motion Appliance™ In Non-Growing Class Ii Patients: A Cephalometric Study, Anna Cathlyn Giles

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background and Objectives: Dental and skeletal Class II discrepancies are commonly associated with orofacial disharmony, and therefore appear in orthodontic clinics frequently. Class II correction for adults is generally limited to camouflage treatment with extractions, Class II elastics, Class II correctors, distalization, or orthognathic surgery in severe cases. The orthodontic field is constantly innovating to find efficient and effective means to correct class II malocclusions. The Carriere Motion Appliance TM was introduced in 2004 as an effective “distalizing” appliance to be used as a non-extraction approach to Class II correction for adolescent and adult patients. Recent clinical evidence suggests that …

Therapeutic Roles For Alkaline Phosphatases To Target Intestinal Dysfunction In Mouse Models Of Experimental Sepsis And Ischemic Stroke, Rhiannon V. Macom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Therapeutic Roles for Alkaline Phosphatases to Target Intestinal Dysfunction in Mouse Models of Experimental Sepsis and Ischemic Stroke

Rhiannon V. Macom

Stroke is a disease that primarily affects the brain; however, ongoing research continues to show that stroke has far reaching systemic effects that can affect both short- and long-term recovery. The gastrointestinal tract has been shown to be affected post-stroke, and these effects are likely due to the bidirectional communication between the gut and the brain via the gut-brain-axis. Alkaline phosphatases (APs) are common membrane bound enzymes that are known to have a role in mitigating inflammation. The …

Sensory Evaluation And Consumer Acceptance Of A Protein Enriched Energy Bar, Brennah T. Groves

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Sensory Evaluation and Consumer Acceptance of a Protein Enriched Energy Bar

Brennah Groves

This study evaluated the sensory properties and consumer acceptance of a protein enriched energy bar. The objectives of this study were to 1) formulate a high-protein energy bar containing at least 20 g of protein per 100 g serving, and 2) determine whether increasing the protein content in an energy bar would enhance the sensory evaluation and improve consumer acceptance among collegiate athletes. The control energy bar featured a shortbread base, date caramel with whey protein, a nougat layer, and a chocolate coating. Additional collagen protein …

Enhancing Vocational Services Through Support Of Direct Care Staff For Adults With Intellectual Disabilities, Katelyn D. Cardwell

Graduate Theses, Dissertations, and Problem Reports (ETD)

This mixed-method cohort study focused on supporting direct support professionals through burnout education modules. Burnout is a psychological phenomenon characterized by mental, physical, and emotional exhaustion in response to chronic stress in the workplace. Direct support professionals (DSP) provide services that include independent living and vocational skill education to adults with intellectual disabilities. Burnout has negative impacts on work quality, efficiency, and can led to high turnover rates. This project aimed to provide DSP’s with resources to mitigate the risk of burnout. The study utilized semi-structured interviews to help guide the development of education modules for staff. Based on findings …

Sensory Integration In The Intensive Care Unit Environment, Kara M. Lee

Graduate Theses, Dissertations, and Problem Reports (ETD)

Those admitted to the intensive care unit (ICU) commonly experience deficits in areas linked with cognition, mental health, and physical functioning (Rapolthy-Beck et al., 2023). Delirium is the most common complication among individuals who are mechanically ventilated, which can be associated with adverse outcomes, including increased mortality, cognitive decline, and decreased functional outcomes (Martinez et al., 2017). The primary purpose of the capstone project was to create a sensory-based program for patients admitted into the ICU. The program aimed to enhance the quality and consistency of care, ultimately reducing the prevalence of delirium. By doing so, it seeks to improve …

Facilitating Independence: Developing A Hands-On Life Skills Program For Youth In Residential Treatment, Shayna Rexrode

Graduate Theses, Dissertations, and Problem Reports (ETD)

Life skills competency in adolescence can be an important predictor of success in adulthood. Educational and training programs focused on life skills can help youth develop the skills that they need to live independently. Though occupational therapy literature surrounding these types of programs is limited, occupational therapy practitioners are qualified to provide intervention in life skills based on the profession’s scope of practice.

This capstone project focused on the development and evaluation of a new life skills program, the Life Skills Practice Program, at a residential treatment facility for youth with substance use and behavioral diagnoses. Stakeholders at the facility …

Manualized Interventions For Individuals Experiencing Or At-Risk For Adverse Life Experiences, Sierra P. Mcnicol

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Occupational practitioners have a role in providing holistic and client-centered care to promote occupational performance, engagement, and satisfaction through occupations. Many individuals are impacted in the engagement of occupations secondary to adverse life experiences that have caused mental distress, difficulties in cognitive processing, limited social support, and disruptions in social determinants that have made accessing services complicated. Purpose: Due to the increased likelihood of individuals who have experienced adverse life experiences experiencing occupational distress and performance limitations, the capstone student aimed to develop an understanding of adverse life experiences, provide insight into the needs of the population, and develop …

Effectiveness Of A Cumulative Pediatric-Based Practical Examination At Increasing Student Perceived Competence And Confidence In Working With Pediatric Populations, Nicholas J. Passarelli

Graduate Theses, Dissertations, and Problem Reports (ETD)

Current literature highlights the importance of utilizing practical examinations and actual patients and covering vast pediatric content within occupational therapy curricula. The needs assessment conducted within The West Virginia University Division of Occupational Therapy revealed that the division currently employs all three of these factors within their curriculum, however a gap presented in the combination of these three factors together. This project aimed to diminish this gap through the development, implementation, and execution of a pediatric practical examination, utilizing actual pediatric patients, to determine whether the examination is effective in increasing student perceived competence and confidence in working with pediatric …

A Comparative Study On The Accuracy And Reliability Of Artificial Intelligent Lateral Cephalogram Tracing Programs, Stuart Mills

Graduate Theses, Dissertations, and Problem Reports (ETD)

Objective: To compare the accuracy and reliability of two commercially available Artificial Intelligent (AI) cephalogram tracing software programs to doctor traced cephalograms.

Materials and Methods: A sample of 100 pretreatment cephalograms were analyzed with AI based software programs, Angel Aligner iCeph and WebCeph, then compared to images traced by an orthodontist using Dolphin Imaging. Of the 100 samples, 50 were skeletally Class I and 50 were skeletally Class II. For each cephalogram produced, the American Board of Orthodontics 11 measurements were acquired from each of the three tracing programs. One way analysis of variance (ANOVA) followed by Tukey’s HSD test …

Xanthine Oxidoreductase, Uric Acid, And Iron Homeostasis: Discovering A Therapeutic Vulnerability In Breast Cancer, Matthew G. Chapa

Graduate Theses, Dissertations, and Problem Reports (ETD)

Breast cancer remains the most frequently diagnosed malignancy and the leading cause of cancer related deaths in women. This is primarily due to distant metastases, which highlight the necessity to understand factors that contribute to breast cancer progression. Emerging evidence associates decreased tumor xanthine oxidoreductase (XOR) expression with a poorer prognosis, increased recurrence, and a more aggressive phenotype. While healthy liver, intestines, kidneys, and breast tissue have robust XOR expression and activity, there is a tendency for this to be ablated in carcinogenesis. This dissertation investigates XOR's role in breast cancer and identifies its product, uric acid (UA), as possessing …

A Quality Improvement Project To Assess The Impact Of A Patient Acuity Tool On Nurse Satisfaction In Equitable Patient Assignments In Nurse Workload And Perceived Quality Care Provided, Claire Alexandra Rodgers

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Traditional nursing staffing models used to create patient-care assignments do not account for patient acuity. As patient acuity increases, nurse workload increases. When patient-care assignments do not account for acuity, nurses are unable to provide quality care to patients. Utilizing a patient acuity tool (PAT) has been shown to improve nurse satisfaction and equity in assignments while also enhancing the ability for nurses to provide quality care.

Purpose: The project aims to assess the impact of a PAT to improve nurse satisfaction in equitable patient assignments based on nurse workload and perception of quality of care provided to patients …

Identifying Factors Associated With Time To Diagnosis For Symptomatic Intestinal Malrotation In Pediatric Patients, Katie E. Corcoran

Graduate Theses, Dissertations, and Problem Reports (ETD)

Intestinal malrotation is a rare condition in which the intestines rotate improperly during embryonic development. Intestinal malrotation is typically diagnosed in pediatric patients with an upper gastrointestinal imaging (UGI) series. Longer time to diagnosis of intestinal malrotation increases the risk of mortality and severe morbidity. While the need for timely diagnosis is well-established in the literature, the correlates of time to diagnosis are largely unknown. The classic medical presentation for intestinal malrotation is an infant presenting with green bilious emesis. I hypothesize that time to diagnosis of intestinal malrotation will be longer in symptomatic pediatric patients when they present differently …

Implementation Of An Evidenced Based Enteral Nutrition Protocol For Mechanically Ventilated Patients: A Quality Improvement Initiative, Hannah R. Nuzum

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementation of an Evidenced Based Enteral Nutrition Protocol for Mechanically Ventilated Patients: A Quality Improvement Initiative.

Hannah Nuzum

Background: Mechanically ventilated patients require supplemental nutrition as an important factor for their overall recovery. Malnutrition in hospitalized patients is reported as high as 35% (Ikram et al., 2022).

Purpose: Lack of an enteral nutrition (EN) protocol has contributed to variability in initiation of EN for post-intubated mechanically ventilated patients.

Intervention: The project interventions are threefold: the development of an EN protocol, EN initiated within 24 to 28 hours for post-intubation patients, and staff understands that EN should be initiated within …

Keep It Quiet: A Quality Improvement Initiative To Reduce Noise In The Operating Room During Anesthesia Induction, Ghislaine Fasseu Kameni

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem: Excessive noise during the critical phase of anesthesia induction in operating rooms (OR) can significantly impact anesthesia providers' ability to focus, potentially compromising patient safety and quality of care.

Objectives: This project aimed to reduce anesthesia providers' perception of distraction caused by noise during induction by implementing educational interventions and visual cues. The objectives included educating anesthesia and surgical staff on the impact of noise, introducing visual reminders to minimize distractions, and evaluating the effectiveness of these strategies through survey data collection.

Methods: A quality improvement initiative was conducted in the OR department of a nearby hospital. Certified registered …

Does Education On Aseptic Non-Touch Technique Affect Nurse Knowledge On Aseptic Technique When Placing Ultrasound Guided Peripheral Intravenous Lines? A Quality Improvement Initiative, Hannah G. Keyser

Graduate Theses, Dissertations, and Problem Reports (ETD)

This Doctor of Nursing Practice (DNP) project attempted to increase nurse’s knowledge of aseptic technique when placing USG-PIVs in hospitalized adult patients after educational training on the Aseptic Non-Touch Technique Clinical Practice Framework (ANTT CPF). Implementation of the ANTT CPF in the cardiovascular intensive care unit (CVICU) at Ruby Memorial Hospital, as a didactic educational session for nurses already trained to place ultrasound-guided peripheral intravenous lines, was utilized for this DNP project. Pre- and post-surveys were employed to determine changes in knowledge scores as well as feelings of comfort and knowledge related to the CPF. Results remained stable for survey …

Nephrocheck Implementation And Its Impact On The Incidence Of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery, Michael Maccourtney

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

NephroCheck Implementation and its Impact on the Incidence of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery

Michael C. MacCourtney

Problem Statement: Acute kidney injury occurs in up to 50% of patients after cardiac surgery (Meersche et al., 2017). This contributes to significant morbidity, mortality, and costs (Helgadottir et al., 2016). At the time of the project implementation, the standard of care involved measuring renal function utilizing serum creatinine (SCr) and urine output (UOP) without NephroCheck. These renal function labs do not represent a timely and accurate assessment of the patient’s current renal status because they do not …

Effects Of High-Frequency Repetitive Transcranial Magnetic Stimulation On Impulse Control Disorders In Patients With Parkinson’S Disease On Dopamine Replacement Therapy, Katherine Muksuris

Graduate Theses, Dissertations, and Problem Reports (ETD)

Parkinson’s Disease (PD) is a debilitating neurodegenerative disorder that causes motor deficits, cognitive impairment, and depression. The mainstay treatment for motor symptoms is dopamine replacement therapy (DRT). DRT takes the form of levodopa or dopamine receptor agonists (DAs) and can be associated with impulse control disorders (ICDs). Currently, the approach to mitigating these side effects is to decrease or stop DRT, which may cause motor symptoms to return, making the management of the disorder more difficult. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation treatment for multiple disorders, including its approved use for smoking cessation. It has also shown …

Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative, Haley Lynne Johnson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Reassessing Hourly Neurological Assessments: A Quality Improvement Initiative

Haley Lynne Johnson, BSN, RN

Background: Stroke and brain injuries remain among the leading causes of mortality in the United States, accounting for 162,890 deaths in 2021 (Centers for Disease Control and Prevention [CDC], 2021). Although frequent neurological assessments are essential for monitoring patient status, limited evidence supports the prolonged use of hourly neuro-checks (LaBuzetta et al., 2022). Excessive neuro-check frequency has been linked to sleep deprivation, an increased risk of delirium, and inefficient resource utilization (Kishore et al., 2021).

Purpose: This project aimed to assess the impact of …

Development Of High-Performance Coaches And Burnout, Amy Cashin

Graduate Theses, Dissertations, and Problem Reports (ETD)

Coach education is imperative, especially as coaching moves towards professionalization (Lara-Bercial, 2022). The literature has shown that high-performance coaches are closest to fitting the criteria of a profession (Lara-Bercial et al., 2022) while also being at risk of experiencing burnout due to the high level of stress faced within their job (Bentzen et al., 2014; Olusoga & Kenttä, 2016). The purpose of this study was twofold. First to have a more comprehensive understanding of Australian Athletics high-performance coaches’ wants and needs regarding coaching education as it pertains to coach wellbeing and burnout; and second, to have an in-depth exploration of …

Computational Approaches For Diagnosing Neurological Impairments And Restoring Functional Movement, Serhii Bahdasariants

Graduate Theses, Dissertations, and Problem Reports (ETD)

Movement is the primary means by which the nervous system converts intention into interaction with the environment. Voluntary limb motion enables standing, walking, reaching, and grasping—actions that underpin self‑care, communication, and economic participation. When diseases or injuries disrupt the pathways that couple neural commands to muscle forces—whether through cortical stroke, spinal cord injury, or peripheral nerve damage—mechanical outcomes such as weakness, loss of coordination, and ultimately reduced mobility emerge. These impairments cascade into secondary complications, increased dependence on caregivers, and diminished quality of life. Quantifying how the lesion alters the mechanics of movement is therefore essential for designing targeted interventions …

A New Electronic Handoff Tool To Facilitate Patient Transfer From The Or To Sicu: A Quality Improvement Initiative, Kaylan Jean Kerrigan

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Transfer of care is a vulnerable time for patients. Continuity of care depends on good communication from the transferring team to the receiving team. Communication failures contribute to frustration among medical staff and poor patient outcomes. Purpose: The purose of this project was to improve handoff communication and satisfaction between the anesthesia team in the operating room (OR) and the receiving surgical intensive care unit (SICU) nurses. Intervention: A new electronic handoff tool was developed for the Epic electronic health record (EHR) to provide SICU nurses with patient information (name, age, allergies), procedure and diagnosis, intubation status, reversal status, …

A Quality Improvement Initiative To Decrease Sugammadex Expenditures, Jordan Austin Gardo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

A Quality Improvement Initiative to Decrease Sugammadex Expenditures

Jordan Gardo

Introduction/Background: The manufacturer’s suggestion in the dosing of the Sugammadex is

generally dosed at 2-4 mg/kg of total body weight (TBW) depending on the extent of

neuromuscular blockade. Evidence suggests that in the morbidly obese population, this

can lead to excessive dosing due to the drug's hydrophilic properties, making it less cost-

effective. Dosing based on adjusted body weight (ABW) leads to dose reductions while

achieving full reversal of neuromuscular blockade as measured by quantitative train-of-

four monitoring, resulting in lower costs from decreased vial usage.

Purpose: The purpose …

Leveraging Physiological Signal Activity And Self-Report Data To Assess Students’ Trust In “My Friendly Mind” App And Its Impact On Their Mental Health Knowledge: A Mixed-Method Phase 1 Clinical Trial Focusing On Depression And Attention Deficit Hyperactivity Disorder From Human Factors Standpoint., Yeganeh Shahsavar

Graduate Theses, Dissertations, and Problem Reports (ETD)

Mental health issues have become a significant global public health concern, especially among younger generations. The growing number of mental health challenges, combined with limited access to quality care, makes the problem even worse. Studies reveal that over 70% of individuals worldwide in need of mental health services do not receive appropriate care. Digital health technologies have the potential to enhance mental health services by making them more accessible and affordable. Despite the increasing popularity of mental health mobile applications (mHealth), there remains a lack of robust evidence of their effectiveness and the level of user trust, particularly in areas …

Exploration Of Coping And Mental Health In West Virginia Farmers, Jodi Meadows Richmond

Graduate Theses, Dissertations, and Problem Reports (ETD)

Compared nationally, West Virginia currently ranks lowest for life expectancy, highest for drug related deaths and 35^th for access to adequate health (WV DHHR Organization Assessment & Strategic Plan, 2022). The state also ranks first in the nation for depression with one in four adults experiencing some form of depressive condition each year (CDC, 2020). The rurality of the state may limit social interaction and availability of medical treatment facilities (Brew et al., 2016).

The situation is even more dire for those in farming-related occupations. Farmers often struggle with management stress, utilizing appropriate coping strategies, and accessing mental health …

The Effect Of Carrier Type And Material Used On Results Of 1,1,1,2-Tetrafluoroethane Application To Teeth, Jonathon Logan Williams Dds

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: The formulation of a pulpal diagnosis is crucial to prescribe appropriate treatment recommendations for endodontics. The application of a cold stimulus to the tooth’s surface utilizing the refrigerant 1,1,1,2-Tetrafluoroethane (R-134a) is a common way to obtain a pulpal diagnosis. Cotton as a form of applicator is used to absorb the R-134a and create a temperature change in the pulp. There is limited research if there is a better material than cotton to generate this cold response. No studies to date have been found to determine if a sponge as an applicator would generate a more significant cold response than …

Improving Timely Palliative Care Consultation In The Micu: A Nurse-Driven Quality Improvement Initiative, Sandy Louise Gray

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Improving Timely Palliative Care Consultation in the MICU: A Nurse-Driven Quality Improvement Initiative

Sandy L Gray

Background: Early palliative care in intensive care units improves outcomes and reduces costs, yet referrals are often delayed. At J.W. Ruby Memorial Hospital’s medical intensive care unit (MICU), baseline median time to consultation was 112 hours (mean=246), exceeding recommended benchmarks and highlighting the need for a standardized process.

Purpose: This quality improvement project evaluated a nurse-driven screening tool to improve timeliness and consistency of palliative care consultations in the MICU.

Intervention: The tool was embedded in the electronic health record (EHR) …

Rational Design Of Small Molecules Targeting Mitochondrial Redox Proteins, Matheus Barbosa Belchior

Graduate Theses, Dissertations, and Problem Reports (ETD)

Reactive oxygen species play a crucial role in many cellular processes. Despite being a natural byproduct of cellular metabolism, overexpression of these species causes damage to the cell, leading to cell dysfunction. Central to the regulation of these highly reactive molecule is the mitochondria. Impairment in its function has been associated with oxidative stress within the cell. Herein, a ligand-based and structure-based approach to design new small molecules to inhibit mitochondrial redox proteins associated with oxidative stress and reactive oxygen species. In the first project two molecules were synthesized and characterized as potential monoamine oxidase B inhibitors. Results showed two …