Digital Commons Network^™

Accuracy And Consistency Of Radiographic Interpretation Among Clinical Instructors In Conjunction With A Training Program, Sharon K. Lanning, Al M. Best, Henry J. Temple, Philip S. Richards, Alllison Carey, Laurie K. Mccauley

Periodontics Publications

There are inaccuracies and inconsistencies of radiographic interpretation among clinical instructors. The purpose of this investigation was to determine if a training program could improve the accuracy and consistency of instructors’ ratings of bone loss. A total of thirty-five clinical instructors consisting of periodontal faculty (periodontists and general dentists), dental hygiene faculty, and periodontal graduate students viewed projected digitized radiographic images and quantified bone loss for twenty-five teeth into four descriptive categories. Ratings of bone loss were made immediately before (pretest) and after (post-test 1) initiation of the training program and then again three months later (post-test 2). Ratings were …

Lactate Versus Non-Lactate Metabolic Acidosis: A Retrospective Outcome Evaluation Of Critically Ill Patients, Kyle J. Gunnerson, Melissa Saul, Shui He, John A. Kellum

Anesthesiology Publications

Introduction

Acid–base abnormalities are common in the intensive care unit (ICU). Differences in outcome exist between respiratory and metabolic acidosis in similar pH ranges. Some forms of metabolic acidosis (for example, lactate) seem to have worse outcomes than others (for example, chloride). The relative incidence of each type of disorder is unknown. We therefore designed this study to determine the nature and clinical significance of metabolic acidosis in critically ill patients.

Methods

An observational, cohort study of critically ill patients was performed in a tertiary care hospital. Critically ill patients were selected on the clinical suspicion of the presence of …

Survival Analysis Of Complete Veneer Crowns Vs. Multisurface Restorations: A Dental School Patient Population, Charles E. Janus, John W. Unger, Al M. Best

Prosthodontics Publications

The purpose of this study was to compare the longevity of crowns versus large multisurface restorations in posterior teeth. The investigation used the treatment database at Virginia Commonwealth University School of Dentistry. The inclusion criteria for the final data set used for analysis were: only one restored tooth per patient, premolars with three or more restored surfaces, molars with four or more restored surfaces, molars and premolars restored with complete veneer metal crowns, or crowns veneered with metal and porcelain. The Kaplan-Meier approach was used to visualize the survival curves, and the Cox proportional hazards model was used for analysis …

Acute Brochitis, Richard P. Wenzel, Alpha A. Fowler Iii

Internal Medicine Publications

A 40-year-old man with no underlying lung disease has a 7-day history of mild shortness of breath with exertion, as well as cough that is now productive of purulent sputum. He reports no paroxysms of cough and no contact with ill persons in his community. He does not appear to be in distress. His temperature is 37°C, his pulse 84 beats per minute, and his respiratory rate 17 breaths per minute. On auscultation of the lungs, no rales are heard; scattered wheezes are heard in the lung bases. How should he be evaluated and treated?

Summary and Recommendations

The patient …

Accuracy And Consistency Of Radiographic Interpretation Among Clinical Instructors Using Two Viewing Systems, Sharon K. Lanning, Al M. Best, Henry J. Temple, Philip S. Richards, Alllison Carey, Laurie K. Mccauley

Periodontics Publications

Accurate and consistent radiographic interpretation among clinical instructors is needed for assessment of teaching, student performance, and patient care. The purpose of this investigation was to determine if the method of radiographic viewing affects accuracy and consistency of instructors’ determinations of bone loss. Forty-one clinicians who provide instruction in a dental school clinical teaching program (including periodontists, general dentists, periodontal graduate students, and dental hygienists) quantified bone loss for up to twenty-five teeth into four descriptive categories using a view box for plain film viewing or a projection system for digitized image viewing. Ratings were compared to the correct category …

Empirical Validation Of The S-Score Algorithm In The Analysis Of Gene Expression Data, Richard Ellis Kennedy, Kellie J. Archer, Michael F. Miles

Biostatistics Publications

Background Current methods of analyzing Affymetrix GeneChip® microarray data require the estimation of probe set expression summaries, followed by application of statistical tests to determine which genes are differentially expressed. The S-Score algorithm described by Zhang and colleagues is an alternative method that allows tests of hypotheses directly from probe level data. It is based on an error model in which the detected signal is proportional to the probe pair signal for highly expressed genes, but approaches a background level (rather than 0) for genes with low levels of expression. This model is used to calculate relative change in probe …

Deficiency Of Cartilage-Associated Protein In Recessive Lethal Osteogenesis Imperfecta, Aileen M. Barnes, Weizhong Chang, Roy Morello, Wayne A. Cabral, Maryann Weis, David R. Eyre, Sergey Leikin, Elena Makareeva, Natalia Kuznetsova, Thomas E. Uveges, Aarthi Ashok, Armando W. Flor, John J. Mulvihill, Patrick L. Wilson, Usha T. Sundaram, Brendan Lee, Joan C. Marini

VCU Health Publications

Classic osteogenesis imperfecta, an autosomal dominant disorder associated with osteoporosis and bone fragility, is caused by mutations in the genes for type I collagen. A recessive form of the disorder has long been suspected. Since the loss of cartilage-associated protein (CRTAP), which is required for post-translational prolyl 3-hydroxylation of collagen, causes severe osteoporosis in mice, we investigated whether CRTAP deficiency is associated with recessive osteogenesis imperfecta. Three of 10 children with lethal or severe osteogenesis imperfecta, who did not have a primary collagen defect yet had excess post-translational modification of collagen, were found to have a recessive condition resulting in …

The Shepherd’S Center Of Richmond: Opportunities For Meaning And Personal Growth Through Service, Linda Frank

Case Studies from Age in Action

Educational Objectives

1. To inform Virginians about The Shepherd’s Center of Richmond, a non-profit service organization by, with, and for older adults.

2. To demonstrate the impact of volunteer service as a means to finding a sense of meaning and purpose in later life.

Parish Nursing: A Vital Piece To The Puzzle Of Care For Older Adults, Donna B. Coffman

Case Studies from Age in Action

Educational Objectives

1. To generate awareness of the emerging practice of faith community/parish nursing and its implications for the overall improvement of health care.

2. To explore specific ways parish nursing can help meet the holistic health needs of older adults in local congregations

Elderfriends: Relieving Loneliness Among Elders, Kiersten Seeger Ware, Sarah Coble

Case Studies from Age in Action

Educational Objectives

1. To discuss social isolation among older adults.

2. To promote awareness of the ElderFriends program, an intervention newly established in greater Richmond

3. To seek friendly visitors for the ElderFriends program.

Brain Health: Mending The Mind After Age 50, Susan Hardwicke

Case Studies from Age in Action

Educational Objectives

1. Increase understanding of brain function and its potential to improve with age.

2. Describe an application of neuroscience, cognitive training, and nutrition for solving a problem associated with aging.

3. Evaluate neural plasticity with aging.

Barriers For Latino Immigrants Seeking Health Care Services, Jennier Ng'andu

2006 Latino Health Summit

At the time of the presentation Ms. Ng'andu was Health Policy Analyst, National Council of La Raza.

This presentation was part of a larger track "Immigrants, Refugees, Asylees and the Undocumented: Understanding Laws that Impact their Health and Well-Being"

From the brochure:

Participants will gain a better understanding of the various status types (e.g., immigrants, refugees) of Latinos residing in the United States and learn how these status types impact individual legal rights. Specific areas to be addressed include employment, bad debt and collections, domestic violence, human trafficking, access to culturally and linguistically appropriate health care services, and access to …

Brochure And Schedule Of Events, Latino Health Summit, Virginia Commonwealth University

2006 Latino Health Summit

Brochure and Schedule of Events, including abstracts for the Latino Health Summit, November 16-17, 2006

Nectin-2-Mediated Entry Of A Syncytial Strain Of Herpes Simplex Virus Via Ph-Independent Fusion With The Plasma Membrane Of Chinese Hamster Ovary Cells, Mark G. Delboy, Jennifer L. Patterson, Aimee M. Hollander, Anthony V. Nicola

Microbiology and Immunology Publications

Background

Herpes simplex virus (HSV) can utilize multiple pathways to enter host cells. The factors that determine which route is taken are not clear. Chinese hamster ovary (CHO) cells that express glycoprotein D (gD)-binding receptors are model cells that support a pH-dependent, endocytic entry pathway for all HSV strains tested to date. Fusion-from-without (FFWO) is the induction of target cell fusion by addition of intact virions to cell monolayers in the absence of viral protein expression. The receptor requirements for HSV-induced FFWO are not known. We used the syncytial HSV-1 strain ANG path as a tool to evaluate the complex …

Surgical Infection Society Guidelines For Vaccination After Traumatic Injury, Thomas R. Howdieshell, Daithi Heffernan, Joseph T. Dipiro

Publications from the Office of the Dean

Background: Recommendations for vaccination of injured patients against infection are evolving. Newly-recognized infections, safety considerations, changing epidemiology, and redefinition of patient groups at risk are factors that may influence vaccine development priorities and recommendations for immunization. However, recommendations must often be formulated based on incomplete data, forcing reliance on expert opinion to address some crucial questions. These guidelines provide evidence-based recommendations for the prevention or treatment of infectious morbidity and mortality after traumatic injury, such as soft tissue wounds, human or animal bites, or after splenectomy.

Methods: A panel of experts conducted a thorough review of published literature, …

Virginia Dental Journal (Vol. 83, No. 4, 2006)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 83, No. 2, 2006)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 83, No. 3, 2006)

Virginia Dental Journal

No abstract provided.

Serum Anti-Phosphorylcholine And Anti-Cardiolipin Concentrations Following Periodontal Scaling And Root Planing, Reve W. Chaston

Theses and Dissertations

Atherosclerosis is an insidious disease with serious morbidity and mortality including ischemic heart disease, stroke, and myocardial infarction. This condition is progressive and can start early in life eventually leading to large plaques and arterial occlusion. Two key components of this process are the immune system and lipids; in particular, LDL which accumulates within the arterial walls and macrophages which recognize and engulf oxidized-LDL (oxLDL) to form foam cells. Knowing that certain antibodies directed against bacterial antigens such as phosphorylcholine (PC) and cardiolipin (CL) show opsonizing cross-reactivity with oxLDL it can be proposed that there is a link between immune …

The Effect Of Media Advertising On Consumer Perception Of Orthodontic Treatment Quality, Daenya T. Edwards

Theses and Dissertations

A survey instrument was designed to evaluate factors influencing consumer selection of an orthodontist and consumer perception of different forms of media advertising (radio, television, newspaper, magazine, direct mail, and billboard) by orthodontic practices. The surveys were distributed by 8 orthodontic offices in and around the Richmond, Virginia area. Out of 676 surveys, 655 (97%) were returned. Respondents most often cited dentist and patient referrals as how they learned of the orthodontic practices they visited (50%- 57%). However, a caring attitude and good practitioner reputation were cited as the top reasons influencing selection of an orthodontist (53% and 49% respectively). …

Perceived Deprivation In Active Duty Military Nurse Anesthetists, Julie Ann Pearson

Theses and Dissertations

Problem: There is a shortage of military certified registered nurse anesthetists (CRNAs). The exodus from military service to civilian careers could be a result of relative deprivation (the discrepancy that one perceives between what one has and what one could or should have). Relative deprivation is a perception of unfairness dependent on feelings (subjective data) as well as facts (objective data). Purpose: The purpose of this study was to measure relative deprivation in active duty military nurse anesthetists, to explore variables which correlate with relative deprivation, and to validate or refute the theory of relative deprivation in active duty military …

Electronic Medical Records In Acute Care Hospitals: Correlates, Efficiency, And Quality, Abby Jo Swanson

Theses and Dissertations

The purpose of this dissertation is to examine the organizational and environmental correlates of hospital EMR use and to examine the relationship between hospital EMR use and performance. Using a theoretical framework that combines resource dependence theory with Donabedian's structure, process, outcome model, a conceptual model is created. To test the hypotheses of this model, logistic regression and Data Envelopment Analysis (DEA) are used. The data included in this analysis come from the AHA, HIMSS, CMS, ARF, and HQA. In the analysis of hospitals correlates of EMR use, three hypotheses were supported, and one was partially supported. Hospital system affiliation, …

Organic Anion And Cation Transporter Expression And Function During Embryonic Kidney Development And In Organ Culture Model Systems, Douglas H. Sweet, Satish A. Eraly, Kevin T. Bush, Sanjay K. Nigam

Pharmaceutics Publications

Background

Organic anion and cation transporters (OATs, OCTs and OCTNs) mediate the proximal tubular secretion of numerous clinically important compounds, including various commonly prescribed pharmaceuticals. Here, we examine the ontogeny of these transporters in rat embryonic kidney in detail, both in vivo and in two in vitro organ culture models of kidney development, whole embryonic kidney (WEK) culture and culture of induced metanephric mesenchyme (MM).

Methods

We used QPCR to determine expression levels of transporter genes in rat embryonic kidneys on each day of gestation from ed13 to ed18, in induced and un-induced MM, and on each day of one …

Metro Richmond Latino Health Services & Resource Guide – 2006, Virginia Commonwealth University

2006 Latino Health Summit

This Guide was produced by the VCU Institute for Women’s Health, VCU Center on Health Disparities, and CLAS Act Virginia as a resource for the fall 2006 Latino Health Summit: Latino Cultures and Beliefs in Health Care. The purpose of this Guide is to provide a practical tool for community health care professionals to use in their work by assisting in cataloguing key provider and patient resources and services. The guide will be posted on the VCU Institute for Women’s Health and VCU Center on Health Disparities websites, which will be updated on a regular basis.

Factors Associated With Hospital Commitment To Provide Child/Adolescent Psychiatric Services, Lea Anne Gardner

Theses and Dissertations

General acute care hospitals play a particularly important role in the delivery of children's mental health given the extant lack of alternatives to long term hospitals for patients requiring a restrictive treatment environment (Glied and Cuellar, 2003). This cross-sectional study identifies environmental and organizational factors associated with general acute care and children's hospitals in the United States that provide hospital-based child/adolescent psychiatric services and the number of services. Two macro-level theories, Resource Dependence Theory and Institutional Theory were used to identify environmental and organizational factors. A nationwide sample of hospitals was drawn from the 2003 AHA annual survey. Data from …

The Prevalence Of The Need For Esthetic Crown Lengthening In Post Orthodontically Treated Subjects, Bryan Marc Konikoff

Theses and Dissertations

Prevalence information on excessive gingival display in post-orthodontic patients is limited. By studying one aspect, namely the size relationship of the clinical crowns of teeth, in an orthodontic population, we can begin to quantify their need for periodontal plastic surgery. In this two part study, 200 plaster models were used as subjects, followed by a clinical exam of 31 of those subjects. These models represented patients before and directly after orthodontic therapy, and the Part 2 clinical exams were performed at least five years later. The lengths and widths of the six anterior teeth were measured and these values were …

Glutamate Excitotoxicty Activates A Novel Calcium Permeable Ion Channel In Cultured Hippocampal Neurons, Laxmikant Sudhir Deshpande

Theses and Dissertations

Glutamate excitotoxicity is the predominant mechanism implicated in neuronal cell death associated with neurological disorders such as stroke, epilepsy, traumatic brain injury and ALS. Excessive stimulation of NMDA subtypes of glutamate receptors leads to protracted intracellular calcium elevations triggering calcium mediated neurotoxic mechanisms culminating in delayed neuronal cell death. In addition, glutamate excitotoxicity induces a NMDA dependent extended neuronal depolarization mediated by continuous calcium influx that correlates with delayed neuronal death. Attempts to prevent neuronal death by blocking calcium entry into the neurons using calcium channel blockers or NMDA receptor antagonists have failed to provide any beneficial effects in clinical …

What Cost Hospital Quality: Performance Uncertainty Under Market Reform, Ronald L. Fisher

Theses and Dissertations

Healthcare is an organizational field that has undergone profound change in the last few decades, an era characterized by market reform. Healthcare production has revealed both economic and quality problems in past eras, and reporting on these problems can be seen to have contributed to pressures for social reform. Yet, the move toward more market-oriented governance structures and design solutions also reflects a wider isomorphic institutional tendency for organizing social order.The conceptual frame work of this study takes a pessimistic stance on whether the market reform has achieved the intended goals with respect to advancing organizational quality performance. The framework …

Relationship Between Cb1 And S1p Receptors In The Central Nervous System, Lauren Michele Collier

Theses and Dissertations

There is significant sequence homology and anatomical co-distribution between cannabinoid (CB1) and sphingosine-1-phosphate (S1P) receptors in the CNS, but potential functional relationships between these lysolipid receptors have not been examined. Therefore, to investigate possible relationships between these two systems at the level of G-protein activation, agonist-stimulated [35S]GTPγS binding and autoradiography were conducted. Autoradiographic studies were first performed to localize receptor-mediated G-protein activation in mouse brain. Coronal brain slices were processed for stimulation of [35S]GTPγS binding using the synthetic cannabinoid agonist WIN 55,212-2 (WIN) or SIP. High levels of WIN- and S1P-stimulated [35S]GTPγS binding were observed in the caudate putamen, hippocampus, …

The Corbett Pain Scale: A Multidimensional Pain Scale For Adult Intensive Care Patients, Gina M. Corbett

Theses and Dissertations

There are no reliable tools that evaluate pain in adult critical care patients who cannot communicate as a result of sedation or illness. This was an observational study in which postoperative cardiothoracic intensive care patients were assessed for pain using both the newly devised Corbett Pain Scale (CPS) and the Numerical Pain Scale (NPS). The CPS was evaluated for content validity, criterion validity, construct validity, test re-test reliability and internal consistency. Thirteen male and seven female patients (n=20) were enrolled and underwent a maximum of five pain assessments each. The mean total scores of the CPS (.740, SD+1.03) and the …