“Insurance Doesn’T Care About The Patient”: An Institutional Ethnography Of The Influence Of Professional Autonomy On The Provision Care For Medicaid Dental Patients With Disabilities, Stephanie Lau

Theses and Dissertations

In terms of unmet needs for people with disabilities (PWD), dental care is number three behind residential care and employment (Fisher, 2012). Regardless of disability, oral healthcare traverses all disability diagnoses and can be a significant factor in quality of life (Deckler, 2011; Griffin et al., 2007; Norwood & Slayton, 2013). When attempting to secure oral healthcare, people with disabilities face many challenges, including lack of access, lack of provider education on proper care of PWD, and difficulty finding a willing dental provider (Deckler, 2011; Fisher, 2012; Kennedy, 2009).

The purpose of this study was to investigate professional practices and …

The Relationships Between Adolescents’ Future Aspirations And Postsecondary Enrollment: Finite Mixture Models, Chu Yi Lu Qiu

Theses and Dissertations

This study took person-centered statistical approaches to explore the multidimensional construct of adolescents' future aspirations and its associations with three covariates (i.e., gender, race, and SES) and a binary, distal outcome measure, postsecondary enrollment. Fourteen survey items representing the multidimensionality of adolescents' future aspirations were extracted from two-waves of Educational Longitudinal Study:2002 student data. The multidimensionality or the latent construct of the adolescents' future aspirations were explored using two finite mixture models called latent class analysis (LCA) and latent transition analysis (LTA). Based on the students' response patterns on the fourteen indicators, three latent classes representing three levels of aspiration …

Systematic Structure-Activity Relationship Studies Of Nalfurafine, Mengchu Li

Theses and Dissertations

Today’s opioid crisis is one of the most challenging public health emergency. Two million Americans suffer opioid addiction. Over 20 million adults are affected by daily pain without non-addictive analgesics.

Kappa opioid receptor (KOR) is one of the most studied new pain targets void of abuse liability. KOR agonists have shown potent analgesia and also potential in alleviating opioid addiction. The only approved KOR agonist in clinic is nalfurafine (NFU). Though not leading to addiction, the analgesic effects of NFU are accompanied by sedative side effects. Therefore, we designed a systematical structure-activity relationship study of NFU for developing non-addictive analgesics. …

Detrimental Role Of Irf1 In Myeloid Cells During Influenza Infection, Bianca L. Baum

Theses and Dissertations

The influenza virus is constantly evolving new ways to overcome both innate and vaccine-induced host defenses, making the innate immune response a critical therapeutic target for minimizing morbidity and mortality caused by infection. Here we examined the role that interferon regulatory factor 1 (IRF1) plays in regulating host innate immune responses in myeloid cells. We found that knocking out IRF1 from myeloid cells in mice (IRF1^DMy) led to a partial protection during IAV infection. Interestingly, recruitment of bone marrow derived myeloid cells as well as NLRP3 inflammasome expression were decreased in the lungs of IRF1^DMy mice, whereas …

Beyond Black Or White: An Examination Of Intersectional Identities, Blame Attribution, And Sexual Violence, Ashlynn D. Bell

Theses and Dissertations

While there may be more discussions of sexual violence than there have been in previous years, cases continually arise where the responsibility of those who have been assaulted is called into question (Alaggia & Wang, 2020). Secondary victimization, or victim blaming, is partially responsible for the continued misattribution of responsibility to survivors. These perspectives minimize the experiences of survivors, which dissuades individuals from the reporting of perpetrators. The current study aimed to evaluate whether particular intersecting identities influenced perceptions of responsibility, in a hypothetical scenario depicting an assault. The race, gender identity, as well as perceptions of respectability of the …

Canalpro Eal Accuracy Compared To The Root Zx Eal, Benjamin T. Brown

Theses and Dissertations

CanalPro Electronic Apex Locator Accuracy Compared to the Root ZX Electronic Apex locator

Benjamin Brown, Garry Myers, Caroline Carrico, Duane Schaefer

Department of Endodontics, Virginia Commonwealth University

Objectives: Electronic apex locators (EAL) are an effective instrument in measuring the working length of a canal. The Root ZX is considered the gold standard by many. The aim of this research is to compare the accuracy of the CanalPro EAL to the Root ZX.

Methods: The actual length of 43 single rooted extracted teeth were measured with a #10 hand file when the tip was visualized at the foramen under a microscope. …

Validation Of A Screening Tool For Pediatric Obstructive Sleep Apnea: A Pilot Study, Julia A. Giardina

Theses and Dissertations

Purpose: The purpose of this study was to evaluate the Pediatric-Modified-STOP-Bang (PM-STOP-Bang) as a screening tool to assess sleep related breathing disorders (SRBD) within a pediatric population. The specific aims of this study were: 1) compare the PM-STOP-Bang scores with those from the validated Pediatric Sleep Questionnaire (PSQ), 2) determine the ability of the PM-STOP-Bang and the PSQ screening tools to accurately detect children of high risk for SRBD from a one-night home sleep apnea test (HSAT).

Methods: Orthodontic patients were screened using the PM-STOP-Bang at VCU Graduate Clinic. Patients (n=10) who were recruited and enrolled. Five were determined to …

Virtual Reality Tool For Visualizing The Oral Microbiome, Alexus M. Harris

Theses and Dissertations

There are limited teaching tools for helping both students and patients understand the oral microbiome. It is important to understand the oral microbiome as it heavily influences the health of your oral cavity and the dysbiosis of disease. The oral microbiome influences other aspects of health and serves as an indicator for health. With a greater understanding of the oral microbiome, patients can make healthier lifestyle changes and dentists can better educate their patients. For that reason, the goal of this project was to create a virtual reality tool for visualizing the oral microbiome. The assets for the VR tool …

Modulation In Nmda Receptor Function Alleviates Safety Learning Deficit In Females Who Experienced Chronic Stress During Adolescence, Zuby C. Okafor

Theses and Dissertations

Anxiety disorders disproportionately impact women and are more prevalent in people with a history of chronic stress. Post-traumatic stress disorder (PTSD) is a type of stress and trauma-related disorder that is largely characterized by hyperarousal to fear-based cues. The inability to dissociate the fear-response from a non-threatening cue is known as impaired safety learning. Given that N-methyl-D-aspartate (NMDA) receptors are key mediators of learning behaviors, we examined the role of NMDAr function in deficient safety learning. Previous studies have shown that female rats with a history of stress have altered NMDAr gene expression and altered glutamatergic signaling; therefore, we hypothesized …

The Effect Of Local Anesthesia When Used In Dental Restorative Cases Under General Anesthesia On Control Of Intraoperative Physiologic Parameters And Post-Operative Comfort, Kathryn S. Skarda

Theses and Dissertations

Purpose:

To determine the effect of local anesthesia on post-operative pain and physiologic parameters intraoperatively in patients undergoing dental care under general anesthesia.

Methods:

This study was modeled as a double-blinded randomized control trial. Patients included healthy children under the age of six scheduled for restorative dental treatment under general anesthesia. Patient behavior was evaluated pre and post-operatively using the FLACC score and post-operatively using the Parental Pain Score Measure. Intraoperatively, all participants followed a standardized general anesthesia protocol and were given either local anesthetic infiltration by the dental surgeon performing the surgery or no anesthesia was utilized. Intraoperatively physiologic …

Opioid System's Involvement In Ketamine's Antidepressant-Like Effects, Fan Zhang

Theses and Dissertations

Depression is one of the most debilitating disorders in the world. The currently available medications typically have a 2-4 week delay in their therapeutic effects and are ineffective for about 40% of patients. In 2000, a subanesthetic dose (0.5 mg/kg i.e.) of the dissociative anesthetic ketamine was reported to have both rapid and robust antidepressant effects in in treatment-resistant depressed patients. However, the mechanisms responsible for ketamine’s antidepressant effects remain unclear. In 2018, a clinical study reported that pretreatment with the nonselective opioid antagonist naltrexone attenuated the rapid antidepressant effect of ketamine in depressed patients. The current study investigated the …

Cognitive Debiasing Intervention For Assessment Of Prolonged Grief Disorder, Farah Aslanzadeh, M.S.

Theses and Dissertations

Cognitive debiasing is an approach to reducing diagnostic decision-making errors resulting from the misuse of cognitive heuristics and biases. This study built on prior research that has successfully used a multi-modal debiasing approach to reduce diagnostic errors. Clinicians were recruited and randomized into a general presentation on the changes in the stress and trauma section of ICD-11 (including the diagnostic criteria of prolonged grief disorder [PGD]) or the same general presentation plus and a cognitive debiasing intervention for PGD. All clinicians were then asked to diagnose three patient vignettes in which biases/potential decision-making errors were embedded in the text. Results …

A Mixed Methods Approach To Examine Racial Disparities In Adherence To Surveillance Mammography Among Breast Cancer Survivors, Megan C. Edmonds

Theses and Dissertations

PURPOSE: Annual surveillance mammography is a critical part of routine cancer care for breast cancer (BC) survivors; reducing mortality by 39%. However, disparities exist with regard to adherence to surveillance mammograms among BC survivors; Black women are 44% less likely to adhere than their White counterparts. Despite the existence of this racial disparity for over a decade, little is known about factors that explain reasons for Black BC survivors’ non-adherence. This is because most studies have not evaluated the role of healthcare delivery or psychosocial factors. Guided by the Behavioral Model for Vulnerable Populations, the purpose of this mixed methods …

A Non-Inferiority Randomized Controlled Trial Comparing Behavioral Sleep Interventions In Women Veterans: A Secondary Analysis Of Pain Outcomes, Scott Ravyts

Theses and Dissertations

Women are disproportionally more likely to experience both insomnia and chronic pain. While these two conditions frequently co-occur, a wealth of literature suggests that insomnia is a stronger predictor of pain than pain is of insomnia. Preliminary research indicates that sleep apnea may also lead to adverse pain outcomes, with the combination of insomnia and sleep apnea contributing to an adverse synergistic effect on pain. Despite the clinical implications of such findings, knowledge regarding the interrelations between sleep disorder complexity and pain remain limited, especially among women. Additionally, interventions seeking to improve pain by targeting insomnia have yielded inconsistent results …

Math Leaders’ Perceptions Of Social Justice Pedagogy: Implications For Professional Development On Teaching Mathematics For Climate And Environmental Justice, Angela M. Allen

Theses and Dissertations

Two significant crises facing communities of color are climate and environmental injustices (Schlosberg & Collins, 2014) and the achievement gap in standardized test performance as an impact of inequitable educational experiences rooted in a history of social inequities (Agarwal, 2011; Milner, 2020). Previous studies on teaching mathematics for social justice demonstrate positive student outcomes from this practice (Berry, 2008; Gutstein, 2006). Existing literature also points to benefits when focusing on a specific social justice topic during mathematics instruction (Bartell, 2013; Stocker, 2012). However, few studies focus on math leaders’ perceptions of teaching mathematics for climate and environmental justice (TMCEJ).

This …

The Role Of Autophagy And Senescence In The Responses Of Non-Small Cell Lung Cancer Cells To Chemotherapy And Radiation, Nipa H. Patel

Theses and Dissertations

Cancer-associated deaths account for the second-highest mortality rates in the United States. Primary modalities of treatment often include surgery, radiation, and chemotherapy, and may also incorporate targeted therapy and immunotherapy. However, resistance to these treatments remains high, resulting in disease reoccurrence and poor survival rates. While apoptosis or cell death of tumor cells is the ideal outcome for anti-cancer therapy, this is often not the case, and in fact cancer cells may upregulate several pathways, such as autophagy and senescence, as a means to undergo alternative cell fate and evade apoptotic cell death. An essential tumor suppressor gene, TP53, …

Genetics And Alcohol Interventions In Youth, Zoe E. Neale

Theses and Dissertations

Alcohol is the most commonly used substance among youth, and risky alcohol use is associated with harmful consequences such as accidents, academic consequences, and physical and emotional health problems. Alcohol use disorders are approximately 50% heritable, yet most efforts to prevent and intervene upon youth alcohol use focus only on environmental factors. Furthermore, current prevention and intervention programs tend to have modest effects and are not uniformly effective for all individuals. Gene-by-intervention (GxI) studies offer an opportunity to expand current understanding of interventions by examining whether underlying genetic risk may contribute to differential program effects. Much of the current GxI …

Preclinical Pharmacokinetic Studies Of Pterostilbene, And Its Human Pharmacokinetic Prediction Using Physiologically Based Pharmacokinetic Modeling, Palak S. Phansalkar

Theses and Dissertations

This dissertation research aimed to determine the preclinical pharmacokinetics of pterostilbene in vitro and develop a physiologically based pharmacokinetic (PBPK) model to simulate the animal and human PK profiles for pterostilbene. The in vitro PK characteristics of pterostilbene, including Caco-2 cell permeability, plasma protein binding, and metabolic stability were determined using rat and human intestinal & hepatic S9 subcellular fractions. The in vitro metabolic parameters determined in rat subcellular fractions were extrapolated to in vivo values to predict the oral bioavailability (F_oral) in rats. The predicted F_oral was found to be 43.0 %, which is similar 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 …

Influence Of Metal Sleeves In The Accuracy Of Dental Implant Placement Using Guided Implant Surgery, Coleman Adams

Theses and Dissertations

The fabrication of implant surgical guides through stereolithographic 3D printing has become a staple in dental implant guided surgery over the last couple decades. These surgical guides have typically utilized metal sleeves to assist in guidance of the drills during osteotome preparation. The metal sleeves can be costly and potentially cause deviations if improperly placed during post-processing of the guide. This research explored a novel method for the utilization of sleeve-free surgical guides by comparing the dimensional and angulational deviations between the implant guides with and without a metal sleeve. To achieve this goal, two separate aims were pursued. Our …

Owning Our Story: An Interior Exploration To Foster Self-Reflection, Hannah Bulow

Theses and Dissertations

With emerging technologies in the 21st century, Millennial and Gen Z adults have a complicated relationship with these new technologies when it comes to creating and sustaining personal relationships (Dalessandro, 2018). When persons aged 18-35 forged new relationships without the presence of technology, relationships were more organic, natural, and led to less conflicts. Neuroimaging of the brain has also shown that neurocognitive development during early adolescence and adulthood contributes to self-consciousness and vulnerability. Adolescents are called to develop their own identity separate from their parents and understanding how others are actually evaluating them (Sebastian, 2008)

Brene Brown states that most …

Structural Reorganization Of The Cisternal Organelle In Neuroinflammatory Disease, Myshak S. Abdi

Theses and Dissertations

The axon initial segment (AIS), an axonal sub compartment located immediately distal to the soma, is an important structure in mediating action potential generation and modulation. The morphology of this domain can be altered by a wide variety of activity-dependent, environmental, and pathological triggers. Dysregulation of axonal calcium (Ca²⁺) concentrations, and subsequent enzymatic degradation of AIS cytoskeletal architecture have been reported to underlie structural modifications of the AIS. Moreover, pharmacological inhibition of neuronal Ca²⁺ channels have been shown to mitigate the disruptive effects of neuroinflammation on AIS structural integrity. Here we investigate the Cisternal Organelle (CO), a …

Interpersonal Trauma And Mental Health Among Lgbq+ College Students: Examining Social Support And Trauma-Related Drinking As Mediators, Eryn Delaney

Theses and Dissertations

Despite the increased risk of childhood, adulthood, and lifetime interpersonal trauma among LGBQ+ individuals, existing research that has examined the influence of interpersonal trauma on mental health has primarily focused on LGBQ+ adolescents and samples of LGBQ+ community-based adults, and less on LGBQ+ emerging adults in college. Additionally, limited work has focused on mechanisms that might explain the relations between these variables. Thus, the current study tested the relations between interpersonal trauma (i.e., childhood sexual abuse, adulthood sexual victimization, and lifetime physical assault and IPV) and mental health outcomes (i.e., anxiety symptoms, depressive symptoms, and PTSD symptoms), and examined social …

Conformational Modulation Of Α-Helical N-Acetylated Α-Synuclein, Ricardo Fernandez

Theses and Dissertations

Human N-acetylated α-synuclein (^NAcαSyn) has long been accepted as an intrinsically disordered protein (IDP) predominantly found in terminal nerve regions in healthy subjects. ^NAcαSyn structural fluidity enables the formation of transient or dynamic assemblies. Some of these assemblies may serve functional, yet undefined purposes. ^NAcαSyn is highly susceptible to the surrounding environment, leading to misfolding under high cytosolic oxidative stress conditions, which in turn assemble in the form of toxic oligomers or amyloid fibrils. These ^NAcαSyn inclusions along with their accretion and migration within neurons, are pathological hallmarks of Parkinson’s disease (PD), dementia, and multiple …

Bisphosohoglycertae Mutase: A Potential Target For Sickle Cell Disease, Anfal S. Aljahdali

Theses and Dissertations

Bisphosphoglycerate mutase (BPGM) is a part of the erythrocyte glycolysis system. Specifically, it is a central enzyme in the Rapoport-Leubering pathway, a side glycolytic pathway involved in the regulation of the concentration of the natural allosteric effector of hemoglobin (Hb), 2,3-bisphosphoglycerate (2,3-BPG). BPGM catalyses the synthesis and hydrolysis of 2,3-BPG through its synthase and phosphatase activities. The synthase activity is the main role of BPGM, while the phosphatase activity is low and is activated by the physiological effector, 2-phosphoglycolate (2-PG) with the latter mechanism poorly understood.

BPGM activity and 2,3-BPG levels in red blood cells (RBCs) have a significant role …

Copper Sulfide Manganese Nanoparticles For Multimodality Imaging And Therapy, Ali S. Gawi Ermi

Theses and Dissertations

Abstract

COPPER SULFIDE MANGANESE NANOPARTICLES FOR MULTIMODALITY IMAGING AND THERAPY

By Ali S. Gawi Ermi, MSc

Inorganic nanoparticles (NPs) are compatible with metal-based multi-modality molecular imaging and targeted therapy. Copper sulfide nanoparticles (CuS NPs) are attractive photoacoustic and photothermal agents and are amenable to incorporation of radionuclides and paramagnetic elements to facilitate image-guided therapy. The aim of this work is to develop manganese (Mn)- doped CuS NP, intrinsically radiolabeled with radionuclides such as (Zirconium-89 (⁸⁹Zr), Copper-64/67 (^64/67Cu) and Manganese-52/55 (^52/55Mn)). This novel approach combines Photoacoustic (PA), Positron emission tomography (PET), Single-photon emission computed tomography …

Theorizing #Girlboss Culture: Mediated Neoliberal Feminisms From Influencers To Multi-Level Marketing Schemes, Frankie Mastrangelo

Theses and Dissertations

I define girlboss feminism as emergent, mediated formations of neoliberal feminism that equate feminist empowerment with financial success, market competition, individualized work-life balance, and curated digital and physical presences driven by self-monetization. I look toward how the mediation of girlboss feminism utilizes branded and affective engagements with representational politics, discourses of authenticity and rebellion, as well as meritocratic aspiration to promote cultural interest in conceptualizing feminism in ways that are divorced from collective, intersectional struggle. I question the stakes involved in reducing feminist interrogations and commitments to discourses of representation, visibility, and meritocracy. I argue that while girlboss feminism may …

Nature-Inspired Material Strategies Towards Functional Devices, Sayantan Pradhan

Theses and Dissertations

Naturally sourced, renewable biomaterials possess outstanding advantages for a multitude of biomedical applications owing to their biodegradability, biocompatibility, and excellent mechanical properties. Of interest in this dissertation are silk (protein) and chitin (polysaccharide) biopolymers for the fabrication of functional biodevices. One of the major challenges restricting these materials beyond their traditional usage as passive substrate materials is the ability to combine them with high-resolution fabrication techniques. Initial research work is directed towards the fabrication of micropatterned, flexible 2D substrates of silk fibroin and chitin using bench-top photolithographic techniques. Research is focused on imparting electrochemical properties to silk proteins using conducting …

Interventions To Slums And Informal Settlements: A Case Study Of The Integrated Housing Development Program In Addis Ababa, Ethiopia, Nathan Teklemariam

Theses and Dissertations

Rapid urbanization is currently taking place in developing regions that have yet to address already existing and persistent inequities within their urban centers. There is perhaps no urban policy issue more critical for governments of the global South than the elimination of slums and informal settlements, along with the development of equitable access to affordable housing for low-income residents. Ethiopia has taken on this challenge through its Integrated Housing Development Program (IHDP), which incorporates slum clearance and resettlement through a government-led development of condominium housing targeting those displaced and other low and middle-income residents in the city.

Since the launch …

Expand Your Horizon: Investigating An Online Intervention For Weight Bias Internalization, Alexandria Davies

Theses and Dissertations

Weight bias internalization (WBI; i.e., self-directed weight stigma or the degree to which individuals apply negative weight-based stereotypes to themselves), is problematic because it is associated with increased stress, emotional eating, healthcare avoidance, and exercise avoidance. Thus, WBI exacerbates health disparities and there is an urgent need to create treatments that address this concern. The current study examined the preliminary effectiveness of a previously developed online body gratitude journaling intervention (i.e., Expand Your Horizon) compared to an active control writing condition in emerging adult women with WBI. Racially/ethnically diverse women (N=100; n=49) or Expand Your Horizon ( …