Gastrointestinal Microbiota Modulate Antinociceptive Tolerance Development In Mice With Chronic Morphine Exposure, Ryan A. Mischel

Theses and Dissertations

In October 2017, the United States government declared a state of public health emergency in response to the burgeoning prescription opioid epidemic. Opioid analgesics are the gold standard of therapy for moderate to severe pain, but their clinical utility is greatly limited by analgesic tolerance – a primary driver of diminished pain control and opioid dose escalations. Integral in this process are primary afferent sensory neurons in dorsal root ganglia (DRG), the first-order components of nociceptive sensation. With surmounting evidence that morphine and other narcotics can alter gut microbial composition and promote bacterial translocation to other tissues, a question arises …

The Periodontal Specialty: A Survey Regarding Our Future, John H. White

Theses and Dissertations

Purpose: To determine the characteristics influencing periodontal practices in Virginia and report on the anticipated changes in practice.

Methods: A REDCap survey was emailed to Virginia based American Academy of Periodontology (AAP) members assessing personal and practice demographics, trends in dental treatment and practice models, and how periodontists will adjust to account for these trends.

Results: The response rate was 31% (n=46). Respondents report greater referrals from more experienced general practitioners (GPs). Student debt was associated with age. Respondents ranked biologic advances, treatment of peri-implantitis, digital dentistry, development of corporate and group practice models, and GPs incorporating more periodontal …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

Longitudinal Relations Between Adhd Symptoms And Substance Use Across The Transition To College And Evaluation Of Promotive And Protective Factors, Melissa R. Dvorsky

Theses and Dissertations

The prevalence of substance use and related problems increases during adolescence and peaks in young adulthood with substantial increases during the transition from high school to college (Johnston et al., 2018). However, these increases are not universal for all students (White et al., 2006), and there is substantial variation in rates of substance use during the first year of college (Borasri et al., 2007; Frisher et al., 2007). It is important to identify the individual and environmental factors that serve as risk factors for substance use as well as factors that may promote or protect against use during the high …

Investigating The Presence And Correlates Of Anti-Thin Bias In Adults, Alexandria Davies

Theses and Dissertations

Weight stigma is associated with negative health outcomes across the BMI continuum. However, few studies have examined weight discrimination targeting people with low body weights. This investigation explored the presence of anti-thin bias, defined as the belief that people with low BMIs have undesirable personality characteristics. Participants were randomly assigned to read one of six vignettes about women that differed by race (White and Black) and weight status (slightly underweight, normal weight, and slightly overweight). Negative personality characteristics were more likely to be ascribed to both underweight and overweight women, compared with normal weight women. Furthermore, participants were significantly more …

A Comparison Of The Antimicrobial Efficacy Of Silver Diamine Fluoride And Silver Nitrate: An In Vitro Study, Nicholas L. Luke

Theses and Dissertations

A COMPARISON OF THE ANTIMICROBIAL EFFICACY OF SILVER DIAMINE FLUORIDE AND SILVER NITRATE: AN IN VITRO STUDY

By: Nicholas L Luke, D.D.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University, May 2018

Thesis Advisor: William O. Dahlke Jr., D.M.D.

Pediatric Dentistry, Department Chair

Purpose: To determine the antimicrobial efficacy of SDF and SN/NaF.

Methods: Three bacterial species were combined to create an in vitro biofilm. Treatment was completed with SN, SN/NaF, SDF, SDF½ or untreated (control).

Results: The untreated group demonstrated significantly higher …

Strengthening Social Networks Of Youth Aging Out Of Foster Care: Promoting Positive Adult Outcomes, Rachel D. Rosenberg

Theses and Dissertations

During the transition to adulthood, youth often rely on the people in their life for support. However, for transition-aged foster youth, these supports may not be available or may look different than supports available to youth in the general population. Relationships with supportive adults have been found to help former foster youth transition to adulthood, but little is known about the adults youth have in their network. Foster youth who report increased levels of social capital have been shown to experience higher levels of success in young adulthood. However, as former foster youth transition to adulthood, a lack of in-depth …

Prevalence And Factors Of Sibling-Recurrent Dental Treatment Under General Anesthesia, Brandy N. Edmonds

Theses and Dissertations

Objective/Aims: Assess the prevalence of sibling recurrent dental general anesthesia (DGA) at VCU Pediatric Dentistry. Assess factors that contribute to sibling recurrent dental general anesthesia. Methods: The guardian of patients with siblings were provided a questionnaire to assess the prevalence and factors associated with recurrent DGA. Results: A total of 40 families with a child presenting for GA and at least one sibling were included in the study. Of these, 45% had sibling-recurrent GA treatment (20% in one sibling; 25% in 2 or more siblings). Additionally, 13% of the children currently presenting for GA had already been treated under GA, …

Assessment Of Pediatric-Focused Brief Motivational Interviewing Training Of Dental Students And Pediatric Dental Residents, Victoria M. Onesty

Theses and Dissertations

Purpose: To assess dental students and pediatric dental residents’ knowledge and attitudes towards motivational interviewing and evaluate the efficacy of a pediatric-focused brief motivational interviewing training program.

Methods: A total of 66 participants were enrolled; 35% were third year dental students, 46% were fourth year dental students and 18% were pediatric dental residents. Participants completed three questionnaires: the first before the training, the second immediately after the training and the third approximately 3.5 months after the training.

Results: A significant increase in correct responses was found for 4 of the 5 questions assessing participants’ knowledge. Participants were satisfied with the …

Assessing Feasibility And Effectiveness Of Pediatric Dental Provider’S Role In Oral Health And Prevention Education In The Care Of Children With Leukemia, Hannah Rustin

Theses and Dissertations

Purpose: Pediatric dentists could serve a role in care of children with leukemia. Oral sequelae of cancer therapies are well documented. The purpose of this study is to assess the feasibility and effectiveness of the pediatric dentist in the care of patients with leukemia. Methods: Pediatric Hematology and Oncology at Virginia Commonwealth University was educated on the proposed protocol and administered a questionnaire to assess feasibility of implementing prevention education by the pediatric dentist. Patients were randomized into two groups at diagnosis: one receiving current oral health protocol and those receiving one-on-one prevention education with the pediatric dentist at three …

Anxiety In Menopause: A Qualitative Inquiry, Eleanor Bremer

Theses and Dissertations

Background: Anxiety is one of the mood symptoms experienced by menopausal women; however, anxiety symptoms during menopause have received little attention in the literature despite the potential impact on quality of life. Many of the tools used to evaluate and measure anxiety associated with menopause assume that menopausal anxiety shares similar criteria as anxiety disorders and this may not be entirely true. There are very few studies that have assessed anxiety in the context of menopause leaving the concept of menopausal anxiety not well defined and raising the question: Is menopausal anxiety a unique and distinctly different syndrome? The purpose …

Metabotropic Glutamate Receptor 2 Activation: Computational Predictions And Experimental Validation, Amr Ellaithy

Theses and Dissertations

G protein-coupled receptors (GPCRs) are the largest family of signaling proteins in animals and represent the largest family of druggable targets in the human genome. Therefore, it is of no surprise that the molecular mechanisms of GPCR activation and signal transduction have attracted close attention for the past few decades. Several stabilizing interactions within the GPCR transmembrane (TM) domain helices regulate receptor activation. An example is a salt bridge between 2 highly conserved amino acids at the bottom of TM3 and TM6 that has been characterized for a large number of GPCRs. Through structural modeling and molecular dynamics (MD) simulations, …

A Multi-Objective Framework For Information Security Public Policy: The Case Of Health Informatics, Kane Smith

Theses and Dissertations

Detailed holistic patient data is critical for healthcare organizations to better serve their patient populations. This information allows healthcare organizations to create a detailed and holistic record of a patient’s health. However, this large aggregation of personally identifiable patient data raises serious privacy and security concerns amongst patients. For this reason, patient concerns around the privacy and security of information retained by healthcare organizations must be addressed through the development of effective public policy. This research, therefore argues that any decision making process aimed at developing public policy dealing with patient data privacy and security concerns should not only address …

The Influence Of Clinically Meaningful Factors On The Performance Of The Recommended Annual Diabetic Foot Screening, Trisha A. Sando

Theses and Dissertations

Background: Diabetic foot ulcers are the result of multiple complications from hyperglycemia and lead to poor quality of life and high healthcare costs. The annual diabetes foot screening exam (ADFSE) and prevention interventions can reduce DFUs up to 75%. In 2015, 71% of the US population received the ADFSE.

Objectives: The main objectives of this dissertation were: 1) to determine the association between adherence to diabetes self-management behaviors and the ADFSE, 2) to determine the association between concordant and discordant comorbidities and the ADFSE and 3) to determine the association between the performance of diabetes preventive care processes, number of …

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

Comparison Of Hiring Strategies Of Orthodontic Private Practitioners, Steven C. Petritz

Theses and Dissertations

COMPARISON OF HIRING STRATEGIES OF ORTHODONTIC PRIVATE PRACTITIONERS

By Steven C. Petritz, D.D.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University

Virginia Commonwealth University, 2018

Thesis Director: Bhavna Shroff, D.D.S., M.Dent.Sc., M.P.A.

Virginia Commonwealth University Department of Orthodontics Program Director

Purpose: Evaluate factors that influence hiring outcomes of clinical and non-clinical staff in orthodontic private practices.

Methods: Orthodontists (n=1968) were surveyed regarding their hiring methods and outcomes. Responses were summarized using descriptive statistics. Chi-square tests were used to compare between hiring strategies and outcomes. …

Predictors Of Resilient Outcomes Among Juvenile Offenders, Kristina A. Mcguire

Theses and Dissertations

Research on resilience has almost completely bypassed the juvenile justice literature. Using data on 1,354 youth from the Pathways to Desistance study, the present study examined associations between individual, community, and familial risk and promotive factors and resilient outcomes, specifically gainful activity, in juvenile offenders. Results of both logistic and hierarchical regression models indicated significant associations between resilient outcomes in each domain: specifically individual (age at first arrest, motivation to succeed), community (geographic location, exposure to violence), and family (socioeconomic status, parental monitoring) predictors. Finally, this paper discusses reasons for non-significant findings and directions for future research on resilience among …

Evaluation Of Fit For 3d Printed Retainers As Compared To Thermoform Retainers, David J. Cole

Theses and Dissertations

ABSTRACT

EVALUATION OF FIT FOR 3D PRINTED RETAINERS AS COMPARED TO THERMOFORM RETAINERS

By David Cole, D.M.D.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University

Thesis Directors: Eser Tüfekçi, D.D.S., M.S., Ph.D., M.S.H.A.

Professor, Department of Orthodontics

Sompop Bencharit, D.D.S., M.S., Ph.D.

Associate Professor and Director of Digital Dentistry, Department of General Practice

Introduction: Despite recent advances in three-dimensional (3D) printing, little information is available on 3D printed retainers

Methods: Three reference models were used to fabricate traditional vacuum formed, commercially-available vacuum formed, and 3D printed …

Potential Antimicrobial Methods For Provisionalizing Teeth After Endodontic Treatment, Laura T. Garden

Theses and Dissertations

POTENTIAL ANTIMICROBIAL METHODS FOR PROVISIONALIZING TEETH AFTER ENDODONTIC TREATMENT

By Laura T. Garden, DDS

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University, 2018

Thesis Advisor: Garry Myers, DDS

Department of Endodontics

Objective:To evaluate the effectiveness of a Chlorhexidine soaked cotton pellet on bacterial leakage.

Methods: Fifty-one extracted teeth, including six controls, were instrumented, obturated, and sealed with either a cotton pellet (CP), 2% Chlorhexidine soaked cotton pellet (CHX), or a Permaflo orifice barrier (OB). Each root was suspended between two chambers: the …

Orthodontists’ And Patients’ Preferences In Website Design In The Selection Of An Orthodontic Practice: A Comparative Study, Taylor R. Brown

Theses and Dissertations

Objective: To determine which website characteristics are preferred by orthodontists, adult patients, and parents of patients.

Materials and Methods: 1,000 active members of the American Association of Orthodontists and 750 active orthodontic patients/parents were sampled. Participants rated the importance of website characteristics, indicated presence of those characteristics on the current website, and ranked sample website images. Preferences were compared between orthodontist and the patient/parent group using t-tests and sample websites were compared using ANOVA models and Tukey’s adjusted post-hoc tests. Significance level was set at 0.05.

Results: 11 of the 16 website features showed significant differences between patients/parents and orthodontists. …

Experimental Evaluation Of Uranyl Transport Into Mesoporous Silica Gel Using Fluorescence, Brandon M. Dodd

Theses and Dissertations

This research investigated parameters that can affect the use of nanoporous silica gel as a media for accumulating a detectable amount of uranium. The unique fluorescence of the Uranyl (UO₂²⁺) ion was used to evaluate the transport kinetics and accumulation within silica gel in a static fluid and under pressure driven flow. The addition of fluid flow decreased the time constant from on the order of an hour to approximately 2s with a very low fluid velocity of 0.36cm/s. The 0.36cm/s fluid velocity was found to be the critical velocity above which there was no gain in …

Change In Working Length At Different Stages Of Instrumentation As A Function Of Canal Curvature, Mei Tang

Theses and Dissertations

The aim of this study was to determine the change in working length (∆WL) before and after coronal flaring and after complete rotary instrumentation as a function of canal curvature. One mesiobuccal or mesiolingual canal from each of 43 extracted molars had coronal standardization and access performed. Once the access was completed, canal preparation was accomplished using Gates Glidden drills for coronal flaring and EndoSequence files for rotary instrumentation. WLs were obtained at 3 time points: pre-instrumentation (unflared), mid-instrumentation (flared) and post-instrumentation (concluded). Measurements were made via direct visualization (DV) and the CanalPro apex locator (EM) in triplicate by a …

Acting Mindfully, Dawn Souza

Theses and Dissertations

Acting Mindfully, is a form of embodiment pedagogy that investigates the ways in which actors can explore their craft through a lens that connects them closer to their mind, body, and voice. The document draws content from a wide variety of theatrical movement and vocal practitioners in combination with mindfulness techniques including yoga, meditation, and energy work. Embodiment pedagogy allows the acting student to approach and perform scenes and monologues with truth and authenticity; while allowing them the ability to tell their own stories.

In order to explore this work, a course, Acting and Mindfulness, was introduced at Virginia …

The Contribution Of Sarm1 To Axonal Degeneration In Cns Inflammatory Disorders, Daniel C. Njoku

Theses and Dissertations

BACKGROUND: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS) that results in demyelination and axonal loss. Efficiently targeting mechanisms of axonal degeneration in MS has the potential to reduce disability but remains an unmet need. Prior research has identified the protein sterile alpha and TIR motif containing 1 (SARM1) as a critical factor that promotes axonal destruction in the program of axonal degeneration known as Wallerian degeneration. SARM1 inactivation reduces axonal degeneration in a variety of contexts including traumatic and toxic injury, but it remains unknown to what extent SARM1 is involved in axonal degeneration …

Comparing Online English Language Learning And Face-To-Face English Language Learning At El Bosque University In Colombia, Marta L. Montiel-Chamorro

Theses and Dissertations

Although there is significant research surrounding online foreign language education, there are still questions on whether the outcomes are comparable to those obtained in the traditional face-to-face classroom. This study examined four classes, two online and two face-to-face, where students took the second course of a 6-level program of English as a Second Language at El Bosque University in Colombia. The International Test of English Proficiency (iTEP) was administered to students before classes started in order to establish a baseline, and then again after the courses finished. This test evaluates English language proficiency per skill: speaking, listening, reading, writing and …

The Effects Of Amixicile On Sub-Gingival Biofilm Cultured From Humans, Kian Azarnoush

Theses and Dissertations

Periodontitis is an inflammatory disease of the oral cavity induced by anaerobic bacteria, that remains to be the primary cause of tooth loss in adults worldwide. Finding an anti-microbial therapeutic to selectively target periodontal pathogens has proven to be difficult, and current treatment modalities only provide a transient benefit. Amixicile is a non-toxic, readily bioavailable novel antimicrobial that targets strict anaerobes through inhibition of the activity of Pyruvate Ferredoxin Oxidoreductase (PFOR), a major enzyme mediating oxidative decarboxylation of pyruvate, a critical step in metabolism. Our study aimed to evaluate the efficacy of amixicile in inhibiting the growth of bacteria harvested …

Targeting Bcl-2 Family Members In The Cell Death Pathway To Treat Head And Neck Cancer, Erin L. Britt

Theses and Dissertations

Head and neck cancer accounts for approximately 3 percent of all cancers in the United States, and over 90% of them are head and neck squamous cell carcinoma (HNSCC). Chemotherapeutic drugs that treat HNSCC can activate BCL-2 family dependent apoptosis. Pro-apoptotic NOXA induced by adenovirus (Ad-NOXA) or fenretinide inactivates anti-apoptotic MCL-1, while ABT-263 can inactivate other anti-apoptotic BCL-2 family members such as BCL-2 and BCL-X_L. We used p53 inactive HN8 and HN12, p53 wild-type UMSCC1, and HPV-positive UMSCC47 human HNSCC cell lines and five mouse HNSCC cell lines. Cells were treated with Ad-NOXA, ABT-263, and fenretinide alone or …

Complexities Of Chronic Opioid Exposure, Maciej Gonek

Theses and Dissertations

Studies on repeated exposure to opioids have been carried out for decades yet the mechanisms for certain phenomena such as tolerance are still not fully understood. Furthermore, different medications, such as frequently prescribed benzodiazepines, or different disease states, such as HIV, have their own effects and interactions with chronic opioid exposure that are not fully understood. The overall objective of this dissertation was to investigate the complexities of chronic opioid exposure and how different disease states and medications may modulate the effects of chronic opioids. Our findings demonstrate that the administration of diazepam, at doses that are not antinociceptive or …

Patterns Of Molecular Population Genetic And Phenotypic Variation Associated With Urbanization In The Western Black Widow Spider, Lindsay Miles

Theses and Dissertations

In urban population genetic studies, the "urban fragmentation model" predicts that urbanization acts as a barrier that isolates native populations, and can lead to reduced gene flow and increased genetic drift between populations. The “urban facilitation model” predicts urban areas act as corridors to increase dispersal among urban areas, and can lead to higher genetic diversity within and lower differentiation between urban areas.

In a review of the current literature, we found that there is no consistent signature of reduced within-population genetic diversity or increased between-population genetic differentiation. Analyses that investigate the urban barriers to gene flow also found no …

Observations Of Trends And Successes Of Revascularization Therapy At Virginia Commonwealth University: A Retrospective Study, Richard W. Sedwick

Theses and Dissertations

The aim of this study was to determine the trends in protocol, success rates, and consistency in follow up of revascularization procedures in a controlled environment. Patients of the Virginia Commonwealth University School of Dentistry were identified who were offered revascularization therapy as a treatment option on immature permanent teeth from January 1, 2010 to May 31, 2017. A total of 77 patients and 78 teeth were evaluated for revascularization therapy. For patients accepting treatment, records were reviewed for outcome assessment and consistency of follow up. A total of 30 patients (31 teeth) were treated following revascularization protocols, with only …