Medicine and Health Sciences Commons^™

Toothbrushing, Flossing, And Preventive Dental Visits By Richmond-Area Residents In Relation To Demographic And Socioeconomic Factors, Kim T. Isringhausen

Theses and Dissertations

Purpose. This study was conducted to identify factors that influence preventive dental behaviors and, from the results, target groups for intervention.Methods. Data were collected using the 1997 Behavioral Risk Factor Surveillance System (BRFSS) resulting in a probability sample of 399 dentate adults living in Richmond City, Henrico, Chesterfield and Hanover Counties in Virginia. All analyses were performed using the statistical software program STATA. Initial hypothesis testing was performed using univariate logistic regression models. Multivariate logistic regression models were used to test the significance of independent variables while controlling for other possible predictors of behavior.Results. Females were more likely than males …

Effect Of Repeated Dosing Of Delta 9-Tetrahydrocannabinol, The Major Psychoactive Ingredient Of Marijuana, On Memory In Mice, Floride Niyuhire

Theses and Dissertations

Purpose: Marijuana is the most widely used illicit drug in the United States. However, marijuana and cannabinoid derivatives have potential therapeutic uses. Studies in cannabis users have yielded contradictory results with regard to long-term effects on cognitive functions. There is no prospective study assessing this issue, and such studies may raise ethical issues in humans, whereas mice have been shown to exhibit similar cannabinoid-mediated behaviors as humans. The purpose of this study was to assess the consequences of chronic administration of Δ9-THC, the major psychoactive component of marijuana, in a mouse memory model. Methods: In Experiment 1, the dose-response relationship …

Rabies In Virginia, 1989-2003: With Particular Attention To Animals, Geographic Distribution, And Virus Variant, William Andrew Holzgrefe

Theses and Dissertations

Objectives: The description of the raccoon rabies epizootic in Virginia over fifteen years (1989-2003). Methods: Using simple statistical methods and a geographic information system (GIS)-based approach, and fifteen years worth of animal surveillance data, the progress of this epizootic has been charted in terms of the geographic spread of the disease, the major animal species affected by the disease and its spread, and the exposure and risk to humans and livestock animals presented by the expansion of the geographic range. Results: The resulting descriptive study illustrates the eastward expansion of the epizootic, the mushrooming of the disease in the northern …

Body Image And Attitudes Toward Obesity In College Students, Sarah Rebecca Goodwin

Theses and Dissertations

The current study was conducted in order to examine the impact of ethnicity on gender differences in body type preferences and perceptions and add to the literature examining racial differences in body type preferences and perceptions. The current study was an expansion of one by Gipson et al conducted at a historically Black university in 2004, in which responses and BMI measurements of 191 college students were examined for associations between BMI and gender, and body image and attitudes toward obesity. For the current study the sample of 176 college students enrolled at Virginia Commonwealth University, an ethnically diverse institution, …

Targeting The Male In Teen Pregnancy Prevention, Terri Burgan

Theses and Dissertations

Study Objectives: To examine demographic characteristics and contraceptive habits of young men.Methods: A descriptive study was conducted utilizing data analyzed from three waves of the National Survey of the Adolescent Male (NSAM) administered in 1988, 1991, and 1995. The first wave consisted of 1,880, never-married, noninstitutionalized 15-19 year old men living in the United States. The second wave consisted of 1,676 re-interviewed respondents who were 17-22 years old. The third wave consisted of 1,377 re-interviewed respondents who were 22-27 years old. Descriptive statistics were used to compare personal and demographic characteristics across each year group. Odds ratios, and their corresponding …

Antioxidants As Risk Factors For Gingival Bleeding, Hee-Jeong Bahng

Theses and Dissertations

Background: Studies of gingival bleeding and the effects of antioxidants on extracellular matrix and immunologic and inflammatory responses provide a rationale for hypothesizing that antioxidants reduce the risk for gingival bleeding.Methods: This study evaluated the role of antioxidants as contributing risk factors for gingival bleeding utilizing the Third National Health and Nutrition Examination Survey (NAHNES III). A sample of 18,825 adults (20 to ≥ 90 years of age), with dental measurement and assessment of serum levels of antioxidants were included in the study. Gingival bleeding was defined as those who had more than 30 percent of gingival bleeding in 28 …

Determinants Of Prenatal Care And Supplement Use: The Case Of Honduras, Catherine E. Henze

Theses and Dissertations

Context: Literature suggests that prenatal care and prenatal supplement use improves pregnancy outcomes. However, we do not know the factors associated with prenatal care and supplement use in Honduras.Objective: To identify characteristics of Honduran women who are the least and most likely to use prenatal care and supplements.Methods: Data from a 2001 Honduras cross-sectional survey of women was used to assess their use of prenatal care and supplements. All data was weighted, resulting in a sample size of n = 5647 women who had a live birth since January 1996. Bivariate and multivariate analyses were used to examine factors associated …

Association Between The Frequency Of Physical Education Classes And The Prevalence Of Overweight/Obesity In Adolescents, Collin N. Rice

Theses and Dissertations

Background/Objective: Overweight and obesity has been steadily on the rise in the United States for all groups. The prevalence of obesity for adolescents has tripled since 1980. The purpose of this study is to determine an association between the frequency of physical education classes and the prevalence of overweight/obesity in adolescents in the United States.Methods: This was a cross-sectional study that used the 2001 Youth Risk Behavior Survey (YRBS) of the Center for Disease Control. The outcome variable for the study was Body Mass Index (BMI). A BMI of 25 or greater was considered overweight or obese. The main independent …

Evaluation Of The Hayes E. Willis Health Center In South Richmond -- Has It Served Its Targeted Population?, Shannon Nicole Shaw

Theses and Dissertations

Objective: The Hayes E. Willis Health Center (HWHC) was opened in a neighborhood of South Richmond in October 1993 to remove the barriers that prevented South Richmond residents from accessing primary healthcare services. The major objective of this study was to determine the effectiveness of the HWHC in providing primary care to the South Richmond Community deemed to be in need. An additional objective was to describe the changes in characteristics of clinic users and illnesses seen over time.Methods: Patient data was compared from the HWHC�s first full year of operation in which patient data was collected (1995) to the …

Is Number Of Pregnancies A Risk Factor For Heart Attack In Women?, Pavan Kumar Irukulla

Theses and Dissertations

Background: Studies regarding number of pregnancies and coronary heart disease have shown inconsistent results. In the present study, we assessed the association between number of pregnancies and heart attack (HA) in women.Methods: Using data from NHANES III a cross sectional data analysis of 10634 women aged 17 and above was conducted. We considered socio-demographic factors and other potential risk factors including physical activity, smoking, alcohol, diabetes, hypertension, hypercholesterolemia, BMI, age, and family history of heart attack. We conducted Bivariate analysis to determine prevalence and crude odds ratios. Multivariate logistic regression analysis was used to adjust for confounding variables using SPSS. …

Obesity And Health Status Among Urban Vs. Suburban Elderly In Philadelphia And Surrounding Counties, Ockidde Dufayne Harris

Theses and Dissertations

Obesity is a dangerous health condition affecting approximately 30% of all Americans and can be attributed to 300,000 deaths a year. Obesity has been found to disproportionately affect Blacks, Latinos, and those with lower SES. Although obesity is a problem for all age groups, its prevalence is highest among those 60-74 years of age. Studies have shown that there is an association between obesity and chronic conditions such as cardiovascular disease, arthritis, cancers, and type-2 diabetes. According to the Centers for Disease Control, chronic health conditions affect 80% of all elderly persons, many times limiting function and decreasing quality of …

The Determinants Of Post-Discharge Healthcare Utilization And Outcomes For Veterans With Posttraumatic Stress Disorder: A Social Ecological Perspective, Shyuemeng Luu

Theses and Dissertations

Posttraumatic stress disorder (PTSD) has a persistent nature: PTSD troubles patients

even decades after the occurrence of traumatic events. The “health behavioral model” is

adopted to examine the effects of external environmental, predisposing, enabling, and

need for care factors on the use of VA post-discharge ambulatory care and readmissions.

Data were obtained from the Patient Treatment File (PTF) and the Outpatient Care File

(OPT), the Area Resource File (ARF), American Hospital Association data sets (AHA), and the Uniform Crime Report (UCR).

The use of VA post-discharge ambulatory care is analyzed by using structural equation modeling (SEM). The readmission to VAMCs …

The Structural Response And Performance Of General Hospitals In A Managed Care Environment, Denise M. Mccollum

Theses and Dissertations

The study purpose is to link hospital structure, represented by each hospital’s professional contingent, service mix, and inpatient capacity; and its environment, characterized by the penetration of managed care enrollees. The secondary purpose is to test the relationship between hospital structural change and subsequent hospital performance.

The study employs a non-experimental panel design, with a sample of 1882 community hospitals (service type: general medical and surgical). Environmental variables are measured for the base year 1989. Hospital structural variables are measured for 1989 and 1994, with change variables computed. Performance variables are measured for 1989 and 1995, with change computed for …

Determinants Of The New Entry Of Hmos Into A Medicare Risk Contract: A Resource Dependence-Diversification Model, Chih-Wen Pai

Theses and Dissertations

The purpose of this study is to examine the determinants of the new entry of an HMO into a Medicare risk contract using a resource dependence—diversification model. This study is conducted through a non-experimental, panel design With one year time lag. An HMO’s market is defined as the service area. The primary sample for this study is composed of 440 HMOS that do not have a Medicare risk contract as of January 1994.

Data for the variables are extracted from the 1994 and 1995 InterStudy and Group Health Association of America (GHAA) directories, the 1996 Area Resource File, the 1994 …

Organizational Slack, Efficiency, And Quality Of Care In Acute Care Hospitals, Kyung Ii Youn

Theses and Dissertations

The relationship between technical efficiency and quality of care in hospitals is studied in the context of resource availability in hospital organizations. The resource availability of hospitals is conceptualized by organizational slack.

An integrated model is developed encompassing the source of organizational slack, its impact on technical efficiency and on quality of care, and its impact on the relationship between efficiency and quality. Organizational threat as an environmental factor affecting the level of slack is measured by the level of competition and regulation. Organizational slack is measured using financial and operational indicators of the hospitals. Technical efficiency is estimated by …

Hospital Quality Assurance And Outcomes Of Hospitalization, Patricia A. Rowell

Theses and Dissertations

This study was undertaken to address the need of professionals responsible for assuring the quality of hospital care for a framework for understanding and evaluating quality assurance mechanisms and their impact on hospital quality of care. Primary data were collected from 70 Virginia short term acute care general hospitals on the design and resources of their quality assurance programs in 1986. Adverse outcome data for 1986 were collected from the Medical Society of Virginia Review Organization. Hospital structural data were obtained from the American Hospital Association computer data base and the Federal Register. The intermediate outcome variables are: rate of …

The Financial Performance Of System Acquired Hospitals, Janet Lynch

Theses and Dissertations

This study investigated the financial performance of not-for-profit hospitals in 10 Southern states acquired by either the for-profit or not-for-profit multihospital systems between the years 1978 through 1982. The impact of system affiliation on acquired hospitals was investigated by looking at average financial performance from the two years before acquisition to 1984/1985. Differences between the performance of hospitals acquired by for-profit and not-for-profit multihospital systems were examined as well. with regard to the latter, major findings revealed both for-profit and not-for-profit multihospital systems increased debt in acquired hospitals and made improvements to plant and equipment. For-profit multihospital systems additionally increased …

Control Of Hospital Strategy In Small Multihospital Systems, Lora Hanson Warner

Theses and Dissertations

Hospitals are joining multihospital systems (MHSs) with growing frequency. About 80% of MHSs are small, composed of 2-7 hospitals. An important management issue in MHSs is the extent to which member hospitals retain control over their own strategic directions.

Using a contingency framework, this study uses both system and hospital—level determinants to explain the extent to which hospital members of MHSs control their own strategies. Survey and secondary data from 272 member hospitals of 62 small multi hospital systems (size 2-7 hospitals) are analyzed. System dispersion, size, ownership, strategic type, and age along with hospital occupancy, size, relationship to the …