Ph. D.

Ed. D.

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This thesis focuses upon the practice and realities of 19th century rural medical practitioners located throughout segments of southwestern Virginia. The study particularly examines the career of Montgomery County physician Robert T. Ellett, M.D. Despite opening a practice located far from his family home, Ellett's medical career gradually thrived despite operating within an arduous social and geographic environment. Initially Ellett's entrance into Montgomery County society depended solely upon his elite stature and adherence to their established "common interests." However, as time passed his identity became increasingly multidimensional. Ellett carefully crafted fruitful doctor/patient relationships by cautiously negotiating the domestic sphere. Patients and family members alike thought of Ellett as a healer and a "man of medicine." Meanwhile, Ellett sustained the financial growth needed to support his large family by holding numerous local patronage positions. Ironically, while Ellett's domestic relationships constructed his professional identity, that role was preserved by constantly manipulating positions gained through that trust. Therefore, country physicians depended upon much more than personal character in building their practices. Instead, successful practitioners in similar social environments achieved stability by balancing a multidimensional identity that ultimately subscribed to both local and personal interests. / Master of Arts

Critics of Virginia Woolf's fiction have tended to focus their arguments on one of the following five cruxes: Woolf's personal biography, the role of art, the nature of reality, the structure of her novels, or they focus their arguments on gender-based criticism. Often, when critics attempt to explain Woolf through any of these categories, they succeed in constructing borders around her writing that minimize the multiplicities outside them. Post-structuralist theory helps to open up difference in Woolf's writing, specifically, the theories of Giles Deleuze and Félix Guattari. Their book, A Thousand Plateaus, allows readers of Woolf's novel, To the Lighthouse, outside the confines some past critics have put around it. I apply select Deleuze and Guattarian metaphors to Woolf's To the Lighthouse in order that multiplicities of the novel stand out. The Deleuze and Guattarian metaphors that are most successful in opening up difference in To the Lighthouse are strata; the Body without Organs; becoming; milieu and rhythm; and smooth and striated spaces. / Master of Arts

The purposes of this study were to explore the work of midwives and their experiences with the medical community, and to examine their goals and hopes for the profession of midwifery in Virginia. To facilitate this purpose, the guiding research questions included: What do midwives believe the role of a midwife is? What are their experiences with the medical community? What are their hopes and goals for the future of midwifery in Virginia? Through interviews, focus groups and participating as a researcher-observer, I found that both certified nurse-midwives and certified professional midwives believe the role of midwife is one of support. Furthermore, midwives' experiences with the medical community are both restrictive and supportive, and both groups are pursuing the advancement of midwifery acceptance and practice through building relationships and advocating for midwifery. The dominance of medical authoritative knowledge of childbirth in the United States creates struggles for midwives. Consequently networking and consumer advocacy are cited as vehicles for the growth of midwifery. / Master of Science

M.S.

Records of production for 1168 cows were obtained from six herds tested in Dairy Herd Improvement Associations in Virginia for this study. The records were corrected to a mature equivalent basis, converted to four per cent fat-corrected milk, and averaged for each of the 862 cows used in the 89 families in the six herds. Each group of cows with three or more consecutive generations with records of production were identified and called “families”. The original cow in each family was called the “foundation cow”. The statistical analysis of the data for milk production, reproductive efficiency, and longevity was made by the method of analysis of variance. Significant differences between families were observed in Herd 4 and Herd 6 for milk production; however, when the data were classified by sire and by family, the variability between sires was highly significant and the variability between families was not significant. The other four herds did not exhibit any significant family differences. Only Herd 4 showed any significant difference between families for reproductive efficiency; the differences between families for the remaining five herds were not significant. No significant differences for longevity were observed between families in any of the six herds. Average relationship within a family was estimated for each family in a herd. In this study, average relationship within families ranged from 15 per cent for 34 animals in Herd 6 to 52 percent for 6 animals in Herd 5. Herd 2, Herd 4, and Herd 5 had higher within family relationship values than the remaining three herds. The herds with high family relationship values used inbreeding and linebreeding to concentrate the relationship within the families while the remaining three herds use sires not so closely related. Reproductive efficiency for the six herds ranged from 12.2 months to 14.5 months calving intervals, with an average of 15..9 months for all herds. Longevity for the six herds ranged from 6.4 years to 5.5 years with an average of 7.5 years for all herds. / M.S.

Background: Equine granulocytic anaplasmosis (EGA), caused by the organism Anaplasma phagocytophilum, is a tick-borne disease of clinical importance in Southwest Virginia. The disease is recognized worldwide and causes pyrexia, anorexia, limb edema, and lethargy. Diagnosis in endemic areas is often based on clinical signs, but confirmation of infection can be made via detection of morulae on a peripheral blood smear or polymerase chain reaction analysis (PCR) at the time of disease or by serologic detection of antibodies 2-4 weeks post infection. There is growing interest in stall-side methods for diagnosis of various equine diseases which has led to an increased use of the SNAP 4DX Plus Test® for vector-borne diseases. Objectives: Determine seroprevalence of antibodies to A. phagocytophilum in the equine population of Southwest Virginia and changes in seroprevalence compared to samples taken 6 years earlier. Determine the percentage of horses with clinical signs consistent with EGA that were positive for A. phagocytophilum infection and assess common presenting clinical signs, hematologic variables, and confirmatory diagnostic test results. Animals: Seroprevalence was evaluated in horses presented for routine annual Coggins testing in 2013 and 2019-2020. Clinical features of disease and diagnostic test results were evaluated in horses presenting with clinical signs compatible with A. phagocytophilum infection from September 2019-August 2020. Methods: Seroprevalence was determined using the IDEXX SNAP 4DX Plus Test® on serum collected from horses presenting for annual Coggins testing in 2013 and 2019-2020. Samples collected in 2013 had been stored at -7580 degrees F since collection. Age, sex, county of residence, and month of sampling were statistically analyzed in the seroprevalence population. Horses presenting with clinical disease consistent with EGA from September 2019-August 2020 had the following diagnostic tests performed: complete blood count (CBC), blood smear for morulae detection, polymerase chain reaction (PCR) analysis, immunofluorescence antibody testing (IFAT), and the IDEXX SNAP 4DX Plus Test®. Results: Seroprevalence of A. phagocytophilum in the equine population of Southwest Virginia increased from 8.5% in 2013 to 11.2% in 2019-2020, although this increase was not statistically significant. In the 2019-2020 population, month of sampling was significantly associated with presence of antibodies to A. phagocytophilum. Positive samples were more common from November-February than other times of the year. When the two sample time periods were combined, sex was significantly associated with presence of antibodies to A. phagocytophilum with geldings more likely to be seropositive. Within the clinical case population, 35% of horses with clinical signs compatible with equine granulocytic anaplasmosis had confirmed infection. The most common hematologic abnormality in affected horses was thrombocytopenia. PCR analysis was the most sensitive diagnostic test to diagnose infection followed by identification of morulae on blood smears. Conclusions: Seroprevalence of A. phagocytophilum is similar to other endemic areas in the United States and appears to be increasing over time. In active clinical cases, diagnosis is best made via PCR or detection of morulae on a blood smear. The SNAP 4DX Plus Test® was not appropriate for diagnosis of active EGA in acute cases. Seroprevalence of Anaplasma phagocytophilum in the equine population of Southwest Virginia / Master of Science / Equine granulocytic anaplasmosis (EGA) is a common tick-borne disease in the United States and worldwide. The causative bacteria, Anaplasma phagocytophilum, also infects humans, dogs, and various domestic animal species. In horses, signs of disease include fever, decreased appetite, leg swelling, and depression. Diagnostic testing that is both accurate and timely is still lacking. The point-of-care SNAP 4DX Plus Test® used to diagnose vector-borne infectious disease in dogs has been suggested for similar use in horses. The objectives of the current study were to determine seroprevalence of antibodies to A. phagocytophilum in the equine population of Southwest Virginia and to characterize the clinical signs and diagnostic test findings of horse with clinical signs of EGA. Seroprevalence was determined using the SNAP 4DX Plus Test®. Serum samples were obtained from horses presenting for annual Coggins testing in 2019-2020. Samples from 2013 were also tested to determine if seroprevalence had increased. Horses presenting with clinical signs consistent with A. phagocytophilum were examined by a veterinarian and had blood drawn for a complete blood count (CBC), blood smear evaluation, polymerase chain reaction analysis (PCR), immunofluorescent antibody testing (IFAT), and the SNAP 4DX Plus Test®. Seroprevalence in 2019-2020 was 11.2% and 8.5% in 2013. This is similar to other endemic areas in the United States and Europe. In horses sampled from 2019-2020, the month of sampling was significantly associated with presence of antibodies to A. phagocytophilum with most of the positive samples being identified in November through February. Geldings were more likely to be seropositive than mares. Thirty five percent of horses with signs consistent with EGA were confirmed to have the disease. Within this population, PCR analysis and/or detection of morulae on the blood smear were reliable indicators of disease while diagnostic techniques utilizing serology were unreliable. This is the first study to determine seroprevalence of A. phagocytophilum in Southwest Virginia. In the actively infected population, PCR and blood smear evaluation remain the most sensitive methods of diagnosis. While the SNAP 4DX Plus Test® is useful for serologic data collection, it was not appropriate for acute diagnosis of EGA.

The object in compiling this material is to help the rural home maker in selecting and arranging the furnishings of her home to produce the most livable conditions, to provide comfort, convenience and happiness to the family, and to minimize the waste of her physical energy. It is our plan, also, to show the wisest use of old furniture, a selection of other furnishings that are suitable to go with these pieces already at hand, and to produce a very livable and enjoyable home with a minimum expenditure of money. / M.S.