Medicine and Health Sciences Commons^™

Food Deserts And Pediatric Oral Health Status In An Under-Resourced Urban Community, Jessica T. Mcauliffe

Theses and Dissertations

Purpose: The aim of this analysis of survey data was to assess the influence of living within a food desert as a predictor of oral health problems among children of East Henrico County, Virginia.

Methods: Survey participants were recruited and questionnaires applied online. Residing in a food desert, using access to affordable produce as a proxy value, was the independent variable, while self- reported assessment of the child’s oral health status was the primary outcome variable. Analyses controlled for other indirect factors of pediatric oral health. Logistic regression was used to model the association between the self-reported access to healthy …

The Impact Of Medicaid Reform On Dental Practice Setting, Barrett W. R. Peters

Theses and Dissertations

Purpose: To assess the impact of dental Medicaid reform in Virginia on dental practice settings (private practice, corporate practice and safety net clinics). Methods: This retrospective cohort study of 16.2 million dental claims is from the Virginia Department of Medical Assistance Services, which included claims for providers participating in Virginia’s Medicaid program during a 10-year period (2002-2012). The dividing date for the reform was July 1, 2005. The outcome measure was mean claims per participating provider. A Poisson regression model was used to predict the mean number of claims per provider with the following predictors: reform period, practice setting, provider …

Dental Plan Performance With Medicaid Reform In Virginia, James Reed

Theses and Dissertations

Purpose: To assess the effect of dental Medicaid reforms in the state of Virginia on dental plan performance. Methods: This project is a retrospective cohort study of 825,000 dental claims obtained from the Virginia Department of Medical Assistance Services. This cohort includes dental claims for children enrolled in Virginia’s Medicaid program from July 1, 2002 through June 30, 2008. The independent variable was enrollment pre or post policy reform with July 1, 2005 as the period dividing date. The dependent variable was dental benefit utilization measured as the average number of restorative, preventative, and total procedures. Statistical methods include Welch’s …

Developing A Comprehensive Youth Obesity Initiative For The State Of Virginia, Jennifer Thompson

Theses and Dissertations

The 2009 Virginia General Assembly Session unanimously voted to change the legislation governing the Virginia Tobacco Settlement Foundation to create the Virginia Foundation for Healthy Youth (VFHY) and incorporate childhood overweight and obesity prevention and reduction in its mission. In order to successfully meet the requirements of this legislation, VFHY needed assistance developing a strategic plan for the obesity initiative and a knowledge base to draw from. A comprehensive assessment of the status of Virginia’s childhood obesity problem was conducted, including the prevalence of the illness, the barriers existing to and the benefits to obesity prevention programs, the need for …

Fluoride Varnish Use Among Dentists In Virginia, Amanda Bowen Kuhn

Theses and Dissertations

Purpose: The purpose of this study was to asses fluoride varnish use by dental practitioners in Virginia. Methods: Using a cross sectional survey design, all dentists in Virginia who are members of the Virginia Dental Association (VDA) were sent an online survey about usage and knowledge of fluoride varnish. Results: The majority of the respondents were general dentists (79%) followed by pediatric dentists (12%). Fluoride varnish use increased with year of graduation from dental school. Dentists who thought fluoride varnish was more effective and less time consuming use it more than other topical fluorides. Dentists who thought their patients prefer …

The Association Between Adult Self-Reported Asthma & Potential Exposures To Asthma Triggers In Virginia Workplaces: An Ecological Study, Jeanette R. Bowman

Theses and Dissertations

Introduction: Work-related asthma (WRA) is thought to be the most common occupational lung disease in the U.S., but there is no standard case definition of WRA. Most states, including Virginia, do not require WRA diagnoses to be reported to health departments. At present, there is too little epidemiological data on WRA in Virginia to direct public health planning efforts. Objectives: The first objective of this study was to estimate potential exposure to workplace asthma triggers in each of Virginia's 35 health districts. The second objective was to examine associations at the health district level between workplace asthma triggers, other asthma …

Has Richmond, Virginia Become Safer In The Past Five Years (2002-2006)?: An Analysis Of Ambulance Data Regarding Penetrating Trauma Incidents, Ashleigh K. Mccabe

Theses and Dissertations

Introduction: The World Health Assembly declared violence as a worldwide public health problem. Homicides have been identified as a leading cause of death in the United States across all age groups. The national homicide rate for 2004 and 2005 are 5.5 and 5.6 per 100,000 population, respectively. The reported rates for Virginia are 5.2 (2004) and 5.6 (2005) per 100,000 population, showing a 16.9% increase. Richmond has been ranked as high as the sixth most dangerous among similar cities in the United States. This study examines penetrating trauma injuries identified through 9-1-1 calls as an indicator of the incidence of …

Examination Of Birth Outcomes With Mode Of Delivery For Breech Presentation, Kelly Marie Arey

Theses and Dissertations

Introduction: Approximately 3% to 4% of all pregnancies at term will have a fetus with a breech presentation. Studies have shown that the US has almost completely abandoned vaginal delivery for breech presentation through the influence of the "Term Breech Trial" (TBT) which concluded that a policy of planned caesarian section would reduce perinatal mortality, late neonatal mortality, and serious neonatal morbidity by approximately two-thirds for term fetuses. However, the recommendations are still being challenged by others.Objectives: The purpose of the study was to describe who in Virginia is having a vaginal delivery for a breech presentation and to determine …

Trend Analysis Of Automobile Collision Amongst 15-19 Year Olds In Virginia, 2000-2004, Imo F. Ndem

Theses and Dissertations

Purpose. This research study on automobile collision in Virginia amongst fifteen to nineteen (15-19) year olds looked into the trend analysis over a five (5) year period of 2000 to 2004. Trend analysis is usually done for aggregates of all injuries—either intentional or unintentional injuries, or both. The primary objective of this research study was to examine the trend in hospitalization rates and mortality rates for males and females independently. It further looked into the trend, if any, in hospitalization rates, mortality rates, and case-fatality rates, for both males and females combined. The different Tables illustrate the extent and the …

A Needs Assessment For Annual Physical Examination For Selected Richmond Public School Children, Aimee Gibbs

Theses and Dissertations

Introduction: The following risk factors have found to be associated with inadequate health care and have been found to affect the well-being of children: racial or ethnic minority, poverty status, median family income, family structure of household, maternal education level, and parental employment status. Also, there has found to be health indicators including, teen pregnancy, asthma hospitalization, and lead poisoning cases that affect the well-being of a child and are associated with the presence of these risk factors in a population. Objectives: The objectives of this study is to (1) compare the presence of risk factors and health indicators in …

Predictors Of Primary Elective Cesarean Delivery Among Apparently Healthy Pregnant Women In Virginia, Brooke W. Rossheim

Theses and Dissertations

Objectives. The purpose of this cross-sectional study was to evaluate whether certain maternal variables were associated with the performance of a primary cesarean delivery rather than a spontaneous vaginal delivery among apparently healthy pregnant women in the Commonwealth of Virginia.Methods. This study utilized the 2004 Virginia Statistics File for Live Births which contained 103,830 records. From this dataset, the following groups of women were excluded: multiparous women, women who had had a previous delivery by any method, women with medical and obstetric problems, women with any labor and delivery complications, women with premature births and women with multiple gestations. The …

Oral Health Needs Of Virginia Schoolchildren By Hmo Regions, Holly Christel Hall

Theses and Dissertations

Purpose: This study examined differences in oral health status and dental treatment needs by HMO regions in Virginia. Methods: The Division of Dental Health (DDH), Virginia Department of Health (VDH), completed the 1999 Virginia Oral Health Needs Assessment (VSOHNA) with the cooperation of the Virginia Department of Education. The survey used a probability proportional to size (PPS) sample design in selecting school children from public schools in the Commonwealth of Virginia. Surface (DMFS/dfs) and tooth-level (DMFT/dft) data were collected as indicators of dental disease on all children. Child-level data was also recorded for each student consisting of age, race, gender, …

Trends In Canine Lyme Disease On The Eastern Shore Of Virginia, 2000-2005, Ellen Garrett Hillyer

Theses and Dissertations

Introduction: Lyme disease is caused by the tick-borne spirochete Borrelia burgdorferi. Research has shown that dogs can be used as sentinels for human infection of Lyme disease. The purpose of this 5-year, retrospective study was to determine if there was any evidence that the incidence of canine Lyme disease has increased between 2000 and 2005 in Accomack and Northampton counties. An increased incidence in Lyme disease in dogs may indicate an increased present or future risk of Lyme disease in humans.Methods: Cases of canine Lyme disease were identified via practice invoicing systems and dogs that received doxycycline were entered into …

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 …