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Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Regulation Of Osseous Healing By Macrophage-Derived Wnt Ligands, Jefferson Overlin Abaricia

Theses and Dissertations

Osseous healing is regulated by various classes of cells and signaling mechanisms. Of these, Wnt signaling has long been known to be critically important in directing the differentiation of mesenchymal stem cells (MSCs) into osteoblasts during bone healing. However, the source of these Wnt ligands is not known. Recently, a body of literature has arisen finding both beneficial and detrimental effects of macrophage-derived Wnt ligands on the regeneration of other tissues (liver, kidney, heart, and intestine), often by regulating inflammatory activation and stem cell behavior. As macrophages have been well-characterized as orchestrators of healing, their use of Wnt signaling to …

Analyzing Electronic Health Records With Time-To-Event Endpoints: Propensity Scores And Semiparametric Approaches, Jonathan W. Yu

Theses and Dissertations

For analyzing large electronic health records (EHR) with time-to-event endpoints, such as in kidney transplantation, a major challenge is to provide an accurate risk analyses, while accounting for a multitude of epidemiological and statistical complexities. Motivated by a right-censored kidney transplantation EHR dataset derived from the United Network of Organ Sharing (UNOS), this dissertation, through a culmination of two interrelated yet distinctly different projects, focuses on developments of novel statistical procedures and methodologies to address some pressing issues arising in EHR-based research. In the first project, we aim to decouple the causal effects of treatments (here, studying subgroups, such as …

Cloaca Palace, Connor Marie Stankard

Theses and Dissertations

In this thesis, I trace the compulsive fear of holes, known as trypophobia, from an uncontrollable obsession to a pleasurable preoccupation. The body’s physical porousness makes us receptive to our surroundings, allowing external matter in and destabilizing the boundaries of self and other. Matter invades us, encoding itself into our DNA and transforming humans into chimeric creatures.

Through paintings and multi-media installations, I encourage viewers to reflect on their own bodies as a series of holes, vulnerable receptors to the world. I use the figure of a woman to personify a human hole which has been infected by the outside, …

The Role Of Insurance Coverage In Outpatient Substance Use Disorder Treatment Referral, Utilization, And Outcomes, Huyen Pham

Theses and Dissertations

Opioid-related overdoses increased dramatically in recent years. Medicaid plays a predominant role in paying for opioid use disorder (OUD) treatment. However, there is a critical gap in understanding the role of Medicaid coverage in referrals to treatment, treatment utilization, and treatment retention. The three studies used observational and quasi-experimental (i.e., natural experiment) designs leveraging state and year variation in Medicaid expansion to characterize the role of Medicaid coverage in OUD treatment. We found that individuals with OUD with Medicaid insurance were more likely to use outpatient treatment, whereas those who were uninsured were more likely to use self-help groups only. …

Identifying Genes Downstream Of Mef2 That Influence Ethanol Sedation In Drosophila Melanogaster, Ananya Talikoti

Theses and Dissertations

Alcohol use disorder is a global public health issue that affects millions across the world. It can result in negative physical and mental health outcomes, and currently treatment options are limited and rates of relapse are high. Identifying genes that affect aspects of ethanol behaviors in model organisms, such as Drosophila melanogaster, can serve to eventually develop more robust therapeutic interventions for those experiencing alcohol dependence. Previous studies have identified a relationship between a person's initial sensitivity to alcohol and their abuse potential for the drug in later life. Therefore, we can study sedation behaviors in Drosophila melanogaster to …

Impact Of Physical Activity And Cardiorespiratory Fitness On Vascular Homeostasis In Premenopausal Women Consuming A Westernized High-Fat Meal, Lauren N. Pedersen

Theses and Dissertations

A large percentage of adults in industrialized nations consume a Westernized dietary pattern, which contributes to fasting dyslipidemia and increased risk for atherosclerotic cardiovascular disease. Evidence suggests that a single Westernized meal containing high saturated fat may induce alterations in blood lipids as well as disturb multiple factors regulating peripheral vascular homeostasis, including innate immune cell function, oxidative stress, and vascular function. Conversely, participation in acute and chronic exercise may beneficially impact an individual’s postprandial response. Therefore, this dissertation contains three manuscripts seeking to describe how acute exercise, cardiorespiratory fitness, and physical activity level impact the lipemic and vascular homeostatic …

Characterization Of Cytochrome P450 3a4 Structure And Ligand Binding Mechanism In Anionic Nanodiscs, David T. Sweeney

Theses and Dissertations

The Cytochromes P450 superfamily are ubiquitous throughout life and are present in some viruses. Humans encode for 57 of these enzymes that are involved in the metabolism of ~90% of all chemicals. These membrane-bound monooxygenase enzymes utilize a heme protoporphyrin at their active site to activate molecular oxygen and oxidize their substrates through an intermediate deemed nature's most powerful oxidizer. They are a powerful system at our disposal yet understanding of their structure and ligand binding mechanisms in the presence of a lipid bilayer remains poorly understood. The focus of this work is on Cytochrome P450 3A4 (CYP3A4). We set …

Patient Blood Management Programs And Their Association With Patient And Organizational Outcomes, Sandra L. Lamm

Theses and Dissertations

Blood transfusions are the most common hospital procedure. However, many transfusions may be unnecessary. These unnecessary transfusion may expose patients to the potential risks of transfusion without improving patient outcomes Patient blood management (PBM) programs emphasize conserving a patient’s own blood resources and only transfusing the minimum amount needed. This study examined the organizational and environmental factors associated with a hospital having a PBM program, or having processes based on PBM, and their impact on organizational and patient outcomes potentially affected by blood transfusions.

A PBM survey was created for this study and used to gather information on hospitals having …

Associations Between Social Determinants Of Health And Chlamydia Infections Among Georgia Counties, Bre'auna K. Beasley

Theses and Dissertations

Chlamydia is a growing public health concern that disproportionately impacts southern states. While social determinants of health are not direct causes of chlamydia infections, studies have found that these determinants do influence infections by creating environments that promote or hinder health seeking behaviors, as well as exposure to risk factors. Guided by the Social Ecological Model of Public Health and the Healthy People 2030 Social Determinants of Health Conceptual Framework, this dissertation study aimed to examine the associations between social determinants of health and chlamydia infections among Georgia counties. This study employed a correlational research design. Aggregate-level secondary data for …

Examining The Effect Of Item-Writing Flaws On The Psychometric Parameters Of Pharmacy Therapeutics Examinations, Veronica P. Shuford

Theses and Dissertations

Colleges and schools of pharmacy (C/SOP) use direct measures of assessment to provide evidence of student learning, with multiple-choice questions (MCQs) being one the most common formats used in health sciences education to assess students’ knowledge, skills, and abilities (Pate & Caldwell, 2014). This study examined the occurrence of item-writing flaws (IWFs) in the Clinical Therapeutics Module (CTM) sequence of courses at a college of pharmacy at an academic health center in the southeastern United States. The goals of the study were to: (1) identify the most common item-writing flaws on examinations in the CTM sequence of courses, (2) determine …

Feeling The Squeeze: The Association Between Multigeneration Caregiving And Informal Caregivers’ Health, Christine L. Patterson

Theses and Dissertations

While U.S. public policy and research has focused on the health needs of the aging population, less attention has been given to the consequences informal caregivers face caring for this generation. With the segment of the population aged 65 years or older growing rapidly, it is important to understand the factors that place informal caregivers at risk for poor health outcomes and health behaviors. Since multigeneration caregivers balance more personal, work, and caregiving demands than single-generation informal caregivers of older adults, they may be at higher risk for poor health outcomes. The aim of this study was to examine the …

Il-36g Cytokine Induction In Oral Epithelial Cells Triggered By Treponema Denticola And Their Role In Chronic Periodontitis, Christopher Blake

Theses and Dissertations

Periodontal disease is a polymicrobial disease affecting 10-15% of the population. Periodontal disease affects the quality of life by reducing mastication and potentially causing tooth loss. Periodontal disease is also linked to more severe, systemic diseases such as cardiovascular disease and rheumatoid arthritis. Development of the diseased state occurs when the plaque biofilm shifts from healthy to dysbiotic. The shift to a dysbiotic biome brings with it a shift in bacterial presence, specifically an increase in gram-negative bacteria, such as T. denticola. T. denticola is a gram-negative, anaerobic spirochete whose relationship with oral epithelial cells is poorly understood. Preliminary data …

Pushing The Limits: Increasing The Speed And Specificity Of Sars-Cov-2 Testing, Grayson Way

Theses and Dissertations

The prevalence and spread of the current COVID-19 pandemic have highlighted the importance of continual improvements upon current microbiological testing methods. Rapid and accurate testing can help mitigate spread by improving on the time to quarantine and quarantine duration required. As of the writing of this thesis, COVID-19 has been responsible for more than 500,000 deaths in the United States of America, and greater than 2 million deaths globally. The work done in this thesis has shown improvements in the current SARS-CoV-2 testing methodology by reducing the time it takes for patient testing while maintaining accuracy and the sensitivity required …

Commonwealth Times 2020-10-21

Commonwealth Times, 1969-

No abstract provided.

Commonwealth Times 2020-10-14

Commonwealth Times, 1969-

No abstract provided.

Commonwealth Times 2020-09-30

Commonwealth Times, 1969-

No abstract provided.

Commonwealth Times 2020-09-09

Commonwealth Times, 1969-

No abstract provided.

A Model-Based Investigation Of The Role Of Density Dependence In Juvenile Mosquito Development And Survival, Melody Walker Ms, Lauren M. Childs, Michael A. Robert

Biology and Medicine Through Mathematics Conference

No abstract provided.

Modeling Vaccination Strategies To Control White-Nose Syndrome In Little Brown Bat Colonies, Eva Cornwell, David Elzinga, Shelby R. Stowe, Alex Capaldi

Biology and Medicine Through Mathematics Conference

No abstract provided.

The Role Of Repeat Infection In The Dynamics Of A Simple Model Of Waning And Boosting Immunity, Laura F. Strube, Maya Walton, Lauren M. Childs

Biology and Medicine Through Mathematics Conference

No abstract provided.

Mathematical Modeling Of The Car T-Cell Therapy, Emek Kose, Elizabeth Zollinger, Samantha Elliott

Biology and Medicine Through Mathematics Conference

No abstract provided.

In Silico Mouse Model Of Infection And Immunity, Daniel Jonas, Michael Kirby, Alan R. Schenkel

Biology and Medicine Through Mathematics Conference

No abstract provided.

Performance Of Phenomenological Models For Real-Time Forecasting The Covid-19 Epidemic, Kimberlyn Roosa, Gerardo Chowell

Biology and Medicine Through Mathematics Conference

No abstract provided.

Commonwealth Times 2020-02-05

Commonwealth Times, 1969-

No abstract provided.

Interleukin‐1 Blockade Inhibits The Acute Inflammatory Response In Patients With St‐Segment–Elevation Myocardial Infarction, Antonio Abbate, Cory R. Trankle, Leo F. Buckley, Michael J. Lipinski, Darryn Appleton, Dinesh Kadariya, Justin M. Canada, Salvatore Carbone, Charlotte S. Roberts, Nayef Abouzaki, Ryan Melchior, Sanah Christopher, Jeremy Turlington, George Mueller, James Garnett, Christopher Thomas, Roshanak Markley, George F. Wohlford, Laura Puckett, Horacio Medina De Chazal, Juan G. Chiabrando, Edoardo Bressi, Marco Giuseppe Del Buono, Aaron Schatz, Chau Vo, Dave L. Dixon, Giuseppe G. Biondi-Zoccai, Michael C. Kontos, Benjamin W. Van Tassell

Internal Medicine Publications

Background

ST‐segment–elevation myocardial infarction is associated with an intense acute inflammatory response and risk of heart failure. We tested whether interleukin‐1 blockade with anakinra significantly reduced the area under the curve for hsCRP (high sensitivity C‐reactive protein) levels during the first 14 days in patients with ST‐segment–elevation myocardial infarction (VCUART3 [Virginia Commonwealth University Anakinra Remodeling Trial 3]).

Methods and Results

We conducted a randomized, placebo‐controlled, double‐blind, clinical trial in 99 patients with ST‐segment–elevation myocardial infarction in which patients were assigned to 2 weeks treatment with anakinra once daily (N=33), anakinra twice daily (N=31), or placebo (N=35). hsCRP area under the …

Prevalence Of The Hypervirulent Nap1/Bi/027 Strain Of C. Difficile In Southwestern Virginia And Risk Factors Associated With Infection, Andrew O. Hanna, Anthony Baffoe-Bonnie, Shikha Vasudeva

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

C. difficile infection (CDI) incidence has increased over the last several decades. The BI/NAP1/027 ribotype was discovered in 2005 and has since been responsible for multiple outbreaks in the US and Canada. This subtype of C. Difficile is known to be more virulent in vivo and produce more severe disease. Limited regional data of the prevalence of this ribotype is available, which could help guide treatment. Using infection control data from a large regional hospital and a VA medical center, this study documented the prevalence of the 027 ribotype in Southwest Virginia. Patients were included if they were tested at …

A Game-Theoretic Model Of Monkeypox To Assess Vaccination Strategies, Sri Vibhaav Bankuru, Samuel Kossol, William Hou, Parsa Mahmoudi, Jan Rychtář, Dewey Taylor

Mathematics and Applied Mathematics Publications

Monkeypox (MPX) is a zoonotic disease similar to smallpox. Its fatality rate is about 11% and it is endemic to the Central and West African countries. In this paper, we analyze a compartmental model of MPX dynamics. Our goal is to see whether MPX can be controlled and eradicated by voluntary vaccinations. We show that there are three equilibria—disease free, fully endemic and previously neglected semi-endemic (with disease existing only among humans). The existence of semi-endemic equilibrium has severe implications should the MPX virus mutate to increased viral fitness in humans. We find that MPX is controllable and can be …

Gut Microbiome And Opioid-Induced Analgesic Tolerance, Sach D. Thakker, Karan H. Muchhala

Biology Publications

The gut microbiome plays an important role in maintaining health and homeostasis. Chronic usage of opioids leads to microbial dysbiosis in the gut. This dysbiosis leads to several severe diseases such as irritable bowel syndrome (IBS), diabetes, cancer, and obesity. Here, we discuss the literature on how opioids affect the gut-microbiome axis and how these changes alter the ability of morphine to produce analgesic tolerance. Chronic morphine exposure leads to increases in gut permeability due to disruption of tight junction proteins and increases in inflammation due to release of proinflammatory cytokines, both of which promote tolerance to morphine. Additionally, it …

Telemedicine Hcv Treatment In Department Of Corrections Results In High Svr In Era Of Direct-Acting Antivirals (Daa), Taseen A. Syed, Reena Cherian, Lewis Shawn, Richard K. Sterling

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

No abstract provided.