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

Graduate Theses, Dissertations, and Problem Reports

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

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

Graduate Theses, Dissertations, and Problem Reports

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

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

Graduate Theses, Dissertations, and Problem Reports

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

Monitoring The Systemic Immune System To Understand And Improve The Efficacy Of Immunotherapy For Metastatic Osteosarcoma, Justin Edward Markel

Graduate Theses, Dissertations, and Problem Reports

Osteosarcoma (OS) is a complex tumor with no effective targeted therapies due to its genomic heterogeneity and pleomorphism. The immune response it creates, particularly against metastatic lesions, is considerable; however, various suppressive mechanisms induced by the tumor prohibit its effectiveness. The presence of infiltrating lymphocytes suggests that therapeutic disinhibition through checkpoint blockade could increase antitumor immunity, though none have been successful in clinical trials. The complexities of the immune response to OS tumors have yet to be unraveled; however, there is evidence to suggest that cell-mediated immunity (CMI, specifically T cells, Natural Killer [NK] cells, and myeloid-lineage cells [MLCs]) plays …

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

Graduate Theses, Dissertations, and Problem Reports

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

Examining The Pulmonary Response To Repeated Vishniacozyma Victoriae Exposure And Its Association With Allergic Airway Disease, Rachael Erin Rush

Graduate Theses, Dissertations, and Problem Reports

Allergic airway diseases such as asthma continue to increase in incidence in industrialized nations like the United States. These diseases are complex inflammatory processes involving numerous cells and mediators and are strongly influenced by fungal exposures. Recent developments in fungal detection methods have highlighted the contribution of Basidiomycota yeast species in indoor environments such as Vishniacozyma (syn. Cryptococcus) victoriae. However, despite the high levels of this yeast detected in indoor environments, very little is known about it or its role in respiratory morbidity. V. victoriae is phylogenetically similar to pathogenic Cryptococcus neoformans but lacks a capsule and is …

Investigating The Mitochondrial Protein Mitoneet In C. Elegans Models Of Aging And Alzheimer's Disease, Jacob Ryan Boos

Graduate Theses, Dissertations, and Problem Reports

Oxidative stress is an imbalance between reactive oxygen species production and elimination, favoring the former. Reactive oxygen species serve as important signaling molecules for physiological homeostasis. However, when produced in excess, these once important signaling molecules become detrimental, disrupting cellular functions, and ultimately leading to cell death. In aging, reactive oxygen species production is increased, accompanied with reductions in oxidative stress resistance, increasing the risk for developing age-related diseases including cardiovascular disease, cancer, stroke, and neurodegenerative diseases. The outer mitochondrial membrane iron-sulfur cluster containing protein mitoNEET (CISD1; gene CISD1) has shown to be a mediator of mitochondrial function and …

Vaping During Pregnancy: Effects On Vascular And Behavioral Outcomes In Offspring, Eiman A. Aboaziza

Graduate Theses, Dissertations, and Problem Reports

Electronic cigarette (e-cig) use is increasing due to aggressive marketing, tempting flavors, and seemingly higher acceptability in the community (lesser perceived social stigma) despite unproven claims of safety. In an alarming trend, pregnant women smokers have turned to novel “modified risk” products, such as e-cigs, in response to heavy marketing of e-cigs as safer alternatives to cigarettes and a tool to help quit smoking. This is despite proven detrimental effects of nicotine on a growing fetus, and scarcity of information regarding toxicity of e-liquid (with and without nicotine) on child development. Moreover, rampant e-cig use among youth (nearly 4 million …

Developing Artificial Intelligence Tools To Investigate The Phenotypes And Correlates Of Chronic Kidney Disease Patients In West Virginia, Marzieh Amiri Shahbazi

Graduate Theses, Dissertations, and Problem Reports

ABSTRACT

Developing Artificial Intelligence tools to investigate the phenotypes and correlates of Chronic Kidney Disease patients in West Virginia

Marzieh Amiri Shahbazi

Chronic kidney disease (CKD) is responsible for disrupting the lives of 37 million people just in the USA, which is about 1 in 7 adults. CKD results in a gradual loss of kidney function over time. Sometimes CKD doesn’t produce any significant symptoms until it reaches an advanced stage. On the other hand, acute kidney injury (AKI) accounts for a sudden decline in the kidney’s function. As a result, the kidneys fail to filter waste materials from the …

Understanding Vaccine-Induced Memory Responses To Develop The Next Generation Of Pertussis Vaccines, Kelly L. Weaver

Graduate Theses, Dissertations, and Problem Reports

Bordetella pertussis is a Gram-negative respiratory pathogen that can infect individuals of all ages and is notably responsible for infant fatalities. Pertussis (whooping cough) is a vaccine-preventable respiratory disease for which vaccines have been available in the United States since the 1940s. Whole cell pertussis vaccines kept incidence of pertussis under 5,000 cases per year, but were associated with reactogenicity issues. Following the introduction of less reactogenic acellular pertussis vaccines in the late 1990s, there have been noteworthy outbreaks of pertussis. For example, in 2012 there were over 50,000 reported cases of pertussis and 20 deaths in the U.S. The …

Ero1Α Promotes Tumorigenesis In Egfr Driven Nsclc, Brennan D. Johnson

Graduate Theses, Dissertations, and Problem Reports

Non-Small Cell Lung Cancer (NSCLC) is a pulmonary malignancy most commonly associated with smoking, or exposure to asbestos or Radon. Approximately, 1.6 Million deaths occur each year due to lung cancer. Lung Cancer is categorized by two main types, Small Cell Lung Cancer (SCLC) and NSCLC. NSCLC accounts for approximately 85% of all lung cancer cases and is subdivided into three sub-categories: Adenocarcinoma, the most common and leading cause of death in the United States; Squamous Cell Carcinoma (SCC), and Large Cell Carcinoma. Though NSCLC treatment regimens have shown increasing clinical benefit over the last two decades with targeted therapies. …

Implementation Of Stress Management And Resiliency Training To Address Nursing Burnout In A Neuroscience Critical Care Unit, Jessica May Marie Hughes

Graduate Theses, Dissertations, and Problem Reports

In the United States, over one-third of nurses experience symptoms of burnout (Reith, 2018). If left unchecked, poor stress management and resiliency skills can contribute to nursing burnout, leading to costly employee turnover. Stress management and resiliency training (SMART) provides the tools necessary to develop resiliency, improve stress management and decrease burnout (Resilient Option, 2020). Nursing staff under the age of 36, who work in a Neurosciences Critical Care Unit (NCCU) demonstrate lower resiliency scores and a higher risk of burnout. This project aimed to evaluate: (a) the effects of a SMART program on the wellbeing of nursing staff in …

Equipping Advanced Practice Providers: Interprofessional Pediatric Airway Management Course, Kenton M. Schrock

Graduate Theses, Dissertations, and Problem Reports

Background: Developmental differences between pediatrics and adults requires intervention adjustments for airway management. Segregated intraprofessional training and limited provider exposure could result in poor collaboration and low-quality management. Patient outcomes depend on the proficient collaborative application of skill and knowledge. Purpose: The interprofessional pediatric airway management course paired unique airway considerations with interprofessional training strategies to equip providers to deliver safe airway management. Intervention: The course was delivered as a 3-hour training session. Participants completed team simulations and skill/concept stations. Pre- and post-intervention competency and confidence scores were measured and analyzed. Methods: Baseline confidence and competency scores in managing a …

Evaluating The Feasibility Of A Collaborative Care Clinical Pathway For The Treatment Of Adolescent Depression And Anxiety In Rural Pediatric Primary Care, Kayla R. Watson

Graduate Theses, Dissertations, and Problem Reports

Evaluating the Feasibility of a Collaborative Care Clinical Pathway for the Treatment of Adolescent Depression and Anxiety in Rural Pediatric Primary Care

Kayla Watson

Background: Due to a national shortage of Child and Adolescent Psychiatrists (CAP), Primary Care Providers (PCP) are often required to manage patients with mental health disorders despite a lack of focused training and lower self-efficacy or confidence in the management of these disorders. Referral to CAPs for management following the diagnosis of adolescent depression and anxiety is a common practice. The integration of mental health services within the primary care setting can overcome many of these …

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

Graduate Theses, Dissertations, and Problem Reports

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

The Effects Of Script Therapy In A Patient With Old Chronic Aphasia, Busra Ensar

Graduate Theses, Dissertations, and Problem Reports

There are some gaps in the literature regarding the efficacy of script therapy in patients with chronic aphasia, particularly chronic aphasia that lasts for several years post-onset, in terms of treatments to improve functional communication during daily activities. This study investigates the relationship between script therapy and communication effectiveness and communicative efficiency. In this context, communication effectiveness was measured by the percent script correct, and communicative efficiency was measured by the total duration to produce the script and the mean duration of pauses at the beginning of sentences.

The efficacy of intensive script training on discourse effectiveness and efficiency was …

Survival Rate Of Dental Implants Placed In Alveolar Ridge Preservation Sites - Systematic Review, Sravanthi Papisetti

Graduate Theses, Dissertations, and Problem Reports

Introduction: It is not known so far performing Alveolar Ridge Preservation (ARP) in a freshly extracted socket with intact walls would improve clinical outcomes of implants placed in these sites. It is not known whether different biomaterials and techniques would affect the survival of dental implants.

Aim: The current systematic review is undertaken to assess the survival rate of dental implants placed in these sockets and to assess different socket graft materials as well as techniques of ridge preservation with regard to the survival of implants.

Material methods: Search for relevant articles was done in Medline (PubMed). No …

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

Graduate Theses, Dissertations, and Problem Reports

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

Examining The Spatial Relationship Between Maternal Morbidity, Access To Health Care, And Community Characteristics In West Virginia, Sarah E. Woolard

Graduate Theses, Dissertations, and Problem Reports

Maternal-related morbidity rates in the United States have risen almost three fold since the early 1990’s. Issues related to rurality, socioeconomic disparities, and pre-existing health conditions increase the risk of poor pregnancy outcomes and introduce barriers to accessing advanced maternal health care. West Virginia (WV) has higher maternal morbidity rates than many other states in the United States (US), and is considered to be driven by all 55 counties being classified as Appalachian, possessing the highest prenatal smoking rate in the US, and having disparities in access to health care. Despite this, no previous studies have evaluated maternal morbidity in …

Psychosocial Influences On And Behavioral Characteristics Of Young Adult Food Addiction, Rachel A. Wattick

Graduate Theses, Dissertations, and Problem Reports

Introduction. Research on food addiction has increased in recent years, but there are few studies focusing on college-attending young adults, who may be at risk of developing food addiction due to the stress of the college environment. Additionally, causes and characteristics of food addiction are under-explored.

Aim. This dissertation aims to 1) determine the impact of adverse childhood experiences (ACEs) and other early life influences on the development of food addiction in college-attending young adults and 2) determine the psychosocial and behavioral characteristics of young adults with food addiction.

Methods. A sequential explanatory mixed-methods design was used for aims 1 …

Cytotoxic Effects Of Potential Irrigants For Endodontic Surgery, Kaiying Haggard

Graduate Theses, Dissertations, and Problem Reports

Purpose: The aim of this study is to investigate if hypochlorous acid (Vashe and Endocyn), Ozone, sodium hypochlorite (0.5% NaOCl), chlorhexidine (0.12% CHX), and MTAD can be used as a disinfectant for endodontic surgery without causing bone tissue toxicity by comparing their cytotoxic effects to saline on osteoblasts in vitro.

Methods: Human Fetal Osteoblast Cells (hFOB 1.19, ATCC CRL-11372) were used. The cells viability after 10-minute exposure of Vashe, Endocyn, Ozone, NaOCl (0.5%), CHX (0.12%), MTAD, and saline at concentrations of 10, 30, 60, 90 % volume ratio were measured using CCK8 analysis and the absorbance were measured at 450 …

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

Graduate Theses, Dissertations, and Problem Reports

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

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

Graduate Theses, Dissertations, and Problem Reports

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

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

Graduate Theses, Dissertations, and Problem Reports

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

Purpose: The purpose of this project was to …

Standardized Postoperative Handoff Tool To Improve Handoff Quality, Haley Durkacz

Graduate Theses, Dissertations, and Problem Reports

Abstract

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

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

Graduate Theses, Dissertations, and Problem Reports

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

Implementation Of An Advanced Training Program To Increase Nurses’ Knowledge Of Continuous Renal Replacement Therapy Management, Shane M. Brost

Graduate Theses, Dissertations, and Problem Reports

Background: Continuous renal replacement therapy (CRRT) is a complex, life-preserving treatment for unstable patients who require hemodialysis in the intensive care unit (ICU). Nurses responsible for managing the CRRT machine in this large academic medical center’s cardiovascular ICU (CVICU) complete a one-hour basic training course focused on setting up the machine, responding to basic alarms, and changing out the CRRT circuit when necessary. Staff nurses, advanced practice providers (APPs), and nursing administrators agree that training is insufficient. Research evidence supports rigorous staff training as essential to improving the quality of CRRT delivery. Purpose: This Doctor of Nursing Practice (DNP) project …

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

Graduate Theses, Dissertations, and Problem Reports

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

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

Graduate Theses, Dissertations, and Problem Reports

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

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

Graduate Theses, Dissertations, and Problem Reports

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

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