Medicine and Health Sciences Commons^™

The Utility Of Depression Screening Measures After Traumatic Brain Injury, Amy H. Riddick

Theses and Dissertations

Objectives: Identifying reliable, practical and easy to use tools to assess depression in patients with traumatic brain injury (TBI), is a necessary first step to addressing a high incidence problem. The intention of this study is to validate depression screening measures with a criterion-based structured interview among people with TBI. The final outcome will identify which measure is the best indicator of depression diagnosis in this population. Methods: 112 participants with TBI were administered the Beck Depression Inventory (BDI), Neurobehavioral Functioning Inventory (NFI), The Hamilton Rating Scale for Depression (Ham-D), and the Structured Clinical Interview for DSM-IV TR Axis I …

Virginia Dental Journal (Vol. 84, No. 1, 2007)

Virginia Dental Journal

No abstract provided.

Children With Special Needs Oral Health Quality Of Life Survey, Kristin Elizabeth Nelson

Theses and Dissertations

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life …

Virginia Dental Journal (Vol. 84, No. 3, 2007)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 84, No. 4, 2007)

Virginia Dental Journal

No abstract provided.

Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?, Nina E. Mclain

Theses and Dissertations

Researchers have studied memory recall of crisis-oriented or emotional events in non-educational settings. However, within the health care field, there has been a limited study of the the concept of recall of crisis oriented or emotional events in& health care education. Crisis-oriented events such as natural disasters, acts of bioterroism, and industrial accidents, have been reported to impact memory. Patient safety is a primary focus in anesthesia education, appropriate crisis management is imperative to quality anesthesia care. Due to the critical nature of anesthesia delivery, there is a strong, constant need to develop methods that will enhance, support, and improve …

Transition From Health Maintenance Organizations To Consumer Driven Health Plans: Measurement Of Initial Impacts For Members With Chronic Conditions, Carl F. Goff

Theses and Dissertations

New consumer driven health insurance products are designed to contain health care costs by making consumers more accountable for the care they receive through being responsible for more cost sharing, making decisions regarding health care providers they will use, and increasing exposure to and use of health information for services and providers. Potential benefits of consumer driven products include increased information regarding personal health and a more knowledgeable patient base. Potential drawbacks of consumer driven products include negative impacts on consumers with chronic and complex health conditions.

The purpose of this study was to ascertain differences in health services utilization …

An Examination Of The Relationships Among Health Literacy, Social Support, And Patient Activation In Community Residing Older Adults, Brenda L. Harding Hage

Theses and Dissertations

This study examined the relationships among the variables health literacy, social support, and patient activation. The subjects were 90 elderly, community residing adults meeting the inclusion criteria and who volunteered to participate in the study and completed three survey instruments: the Short Form of Functional Health Literacy (Parker, Baker, Williams & Nurss, 1995); the Medical Outcomes Survey (MOS) Social Support Survey Instrument (Sherboume & Stewart, 1991); the Patient Activation Measure (PAM) Short-Form (Hibbard, Mahoney, Stockard, & Tusler, 2005); and a demographic form.

A correlational design was used to test the hypotheses that social support and health literacy are positively related …

The Relapsing Fever Spirochete, Borrelia Hermsii, And Complement Regulatory Proteins, Kelley M. Hovis

Theses and Dissertations

Borrelia hermsii, the primary etiological agent of tick-borne relapsing fever in North America, binds the complement regulatory protein factor H (FH) as a means of evading opsonophagocytosis and the alternative pathway of complement. The sequence of the gene encoding the FH-binding protein has been determined. The protein is unique to B. hermsii and has been designated FhbA. Analyses of B. hermsii isolates revealed that FhbA is expressed by 24 of the 25 isolates tested. fhbA was demonstrated to be a single genetic locus through pulsed-field gel electrophoresis, restriction digest, and hybridization analyses, and all isolates possessing fhbA carry it on …

Cannabinoid Modulation Of Chemotaxis Of Macrophages And Macrophage-Like Cells, Erinn Shenee Raborn

Theses and Dissertations

Exogenous and endogenous cannabinoids have been reported to modulate functional activities of macrophages. It is recognized that macrophages express primarily the CB2 cannabinoid receptor, but recent studies indicate that its expression is differential in relation to activation state with maximal levels occurring when cells are in "responsive" and "primed" states. The functional activities of macrophages when in these states of activation are the most susceptible to the action of cannabinoids, at least in terms of a functional linkage to the CB2. To assess the effect of cannabinoid treatment on macrophage chemotaxis and test the hypothesis that cannabinoids inhibit the chemotactic …

A Comparison Of Flexural Fracture Of Three Different Nickel-Titanium Rotary File Systems, Matthew Warren Lloyd

Theses and Dissertations

The purpose of this study was to compare the number of rotations to failure of three different rotary file systems. ProFile, Sequence, and Liberator files in sizes 25 and 40 with 0.04 taper were divided into groups of five and rotated against a grooved metal block mounted to a Universal testing machine at 31 and 34 degrees. Each file was rotated at 300 rpm until fracture occurred. The number of rotations to fracture were calculated. Use of a three-way ANOVA and Tukey's HSD multiple comparison tests revealed significant differences for the angle of deflection, size, and type of file. An …

Stress And Anxiety In Adhd: Links To Sensory Over-Responsivity, Stacey E. Reynolds

Theses and Dissertations

Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study …

On The Binding Of N1-Substituted Tryptamines At H5-Ht6 Receptors, Abner Nyamwaro Nyandege

Theses and Dissertations

Serotonin was first discovered in the late 1940s as a vasotonic factor and is now considered a principal neurotransmitter in the nervous system. 5-HT6 receptors are one of the most recently identified members of the serotonin receptor family which consists of seven classes (5-HT1-5-HT7). 5-HT6 receptors are G-protein coupled, positively coupled to an adenylate cyclase second messenger system and are primarily found in the central nervous system (CNS). The exact functional role of 5-HT6 receptors has not been determined, but is implicated to have possible involvement in certain neuropsychiatric disorders and cognition. To investigate the functional role of these receptors, …

Characterization Of The Factors Associated With Sccmec Mobility In Staphylococcus Aureus, Michael James Noto

Theses and Dissertations

The gene encoding resistance to β-lactam antibiotics in the staphylococci is found on the chromosome in a genomic island designated Staphylococcal Chromosome Cassette mec or SCCmec. In addition to the resistance gene, mecA, SCCmec also contains site specific recombinase genes, ccrAB, that are capable of catalyzing the chromosomal excision and integration of SCCmec. The increasing prevalence of methicillin-resistant Staphylococcus aureus infections may be due, in part, to the transfer of SCCmec into successful methicillin-sensitive S. aureus lineages. In this work we attempt to better characterize the factors associated with SCCmec transfer, beginning with CcrAB-mediated SCCmec excision in a collection of …

Improving Life Satisfaction Of Elders Through Oral History: The Narrator's Perspective, Mary B. Ligon

Theses and Dissertations

Oral history is a method of preserving historical information through in-depth interviews. Because the process requires narrators to use remote recall while sharing their life experiences, it can also be considered a reminiscence-related activity. Before this study, the positive effects on narrators of providing an oral history were noted in the research literature but had not been evaluated through quantitative methods. Based on theoretical constructs of Erikson and Butler, it was hypothesized that participation in oral history interviews would improve the life satisfaction of narrators. Life satisfaction was operationalized and measured using the Life Satisfaction Index Version A (LSIA). The …

Sodium Hypochlorite's Effect On Nickel-Titanium Rotary Instruments And Its Effect On Resistance To Fracture, Michael Shane Smith

Theses and Dissertations

The purpose of this study was to examine the effect of partial and total immersion in sodium hypochlorite on nickel-titanium rotary files and to determine whether resistance to fracture was influenced by the immersion time. One hundred K3™ and 100 ProFile® rotary files were either partially or totally immersed in 5.25% sodium hypochlorite for zero, one, five, thirty, or sixty minutes. After immersion, files were subjected to cyclic fatigue testing. Time to fracture was recorded and analyzed by a two-way ANOVA. Tukey's honest significant difference was used to identify any differences in immersion times. Within all ProFile groups and partial …

Immunohistochemical Study Of Phenotypes Of Dendritic Cells In Dental Pulps From Non-Carious And Carious Teeth, Melissa A. Harmon

Theses and Dissertations

Mature dendritic cells (DCs) in inflamed tissues may promote inflammation but the status of DCs in pulpitis is not known. We hypothesized that DC maturation would correlate with carious lesion depth and that CD4+ cells would be found in association with mature DCs. Pulps were collected from teeth exhibiting: (I) no caries (n=9), (II) shallow dentinal caries (n=5), and (III) deep caries (n=9). Pulpal tissues were cryo-sectioned and positive cells were examined with immunohistochemistry, Mature DCs (CD83+) were almost exclusively restricted to pulps from deep caries. Furthermore, CD209+ DCs in deep caries were elevated over other groups and CD209+ cells …

The Quantitative Genetics Of Neurodevelopment: A Magnetic Resonance Imaging Study Of Childhood And Adolescence, James Eric Schmitt

Theses and Dissertations

Understanding the causes of individual differences in brain structure may give clues about the etiology of cognition, personality, and psychopathology, and also may identify endophenotypes for molecular genetic studies on brain development. We performed a comprehensive statistical genetic study of anatomic neuroimaging data from a large pediatric sample (N=600+) of twins and family members from the Child Psychiatry Branch at the NIMH. These analyses included variance decomposition of structural volumetric endophenotypes at several levels of resolution, voxel-level analysis of cortical thickness, assessment of gene by age interaction, several multivariate genetic analyses, and a search for genetically-mediated brain-behavioral relationships. These analyses …

Effects Of Ankle Support On Time To Stabilization Of Subjects With Stable Ankles, Raquel Elise Martin

Theses and Dissertations

The purpose of this study was to determine if prophylactic ankle tape and/or ankle braces improve dynamic stability in TTS measure. All subjects were healthy and had no prior history of ankle injuries. Data collection consisted of each subject performing a single leg jump-landing with ankle tape, ankle brace, combination of the two, and control (no tape or brace) conditions. Dynamic stability was assessed with time to stabilization force plate measure. Significant plane by ankle tape interaction (p=0.045) was found. No significant plane by ankle tape by ankle brace interaction (p=0.637), no significant ankle tape by ankle brace interaction (p=0.483), …

An Invitro Leakage And Viscosity Analysis Of Root End Filling Materials, Paul D. Clark

Theses and Dissertations

The purpose of this study was to determine if the viscosity of MTA Angelus Fluid is lower than that of Pro Root MTA and MTA Angelus; and to compare the viscosity, leakage and particle size of these materials to determine whether a relationship exists between these properties. The viscosity of each material was measured and compared with the Student's t test. MTA Angelus Fluid's viscosity was significantly lower than the other two materials tested. Microleakage of root end fillings was assessed in a passive diffusion model. Leakage groups were compared with a one-way ANOVA (p < 0.05). No significant difference was found. Particle size and shape were evaluated with the SEM. MTA Angelus Fluid has a lower viscosity than the other materials tested. There was no significant difference in the sealing ability of the three materials tested and there was no apparent variation in each material's particle size or shape.

The Role Of Inhibitory Interneurons In A Model Od Developmental Epilepsy, Patrick James Wolfgang

Theses and Dissertations

Epilepsy, defined by recurrent seizures, is the one of the most prevalent neurological disorders worldwide (World Health Organization 2007). While many forms of epilepsy are well-controlled by anti-epileptogenic medications, a significant portion of patients have intractable, i.e. untreatable, seizures. The etiology of these seizures is varied, but a significant cause, particularly for patients with intractable epilepsy is developmental malformation. In these cases, an error or interruption during the development of the neocortex produces a structural alteration. Such patients may have other neurological problems, but seizures are the most common symptom. The neuronal mechanisms that link malformation and cortical hyperexcitability are …

Analysis Of Mouse Eklf/Klf2 E9.5 Double Knockout: Yolk Sac Morphology And Embryonic Erythroid Maturation, Tina Kathy Lung

Theses and Dissertations

Krüppel-like factors (KLFs) are a family of transcription factors with 3 Cys2/His2 zinc fingers that regulate cell differentiation and developmental processes. EKLF is involved in primitive and definitive erythropoiesis; KLF2 is implicated in the development of primitive erythroid and endothelial cells of the vasculature. Using light and electron microscopy, the yolk sacs and dorsal aortae from EKLF/KLF2 double knockout (KO) E9.5 (embryonic day 9.5) were examined to determine whether these KLFs have compensatory functions in morphology of blood cells and vessels. EKLF/KLF2 double KO E9.5 erythroid, endothelial, and mesothelial cells had more severely abnormal morphology than WT and KLF2-/-. Flow …

Relationship Between Facial Attractiveness And Occlusal Treatment Outcomes: A Retrospective Study, Chad Eric Fowler

Theses and Dissertations

The goal of this study was to determine if a relationship exists between pretreatment facial attractiveness and posttreatment occlusal outcome in orthodontic patients. A randomized sample of forty-seven patients (26 males, 21 females) was selected for inclusion in this study. Orthodontic evaluators rated pretreatment patient photographs (frontal smile, frontal, profile) using a 100 mm visual analog scale (VAS). Occlusal outomes were evaluated using percentage reduction in weighted Peer Assessment Rating (PAR) index scores and the American Board of Orthodontics objective grading system (ABO-OGS). Spearman correlation coefficients were calculated to assess the relationship between pretreatment VAS attractiveness ratings and posttreatment occlusal …

Self-Care And Quality Of Life In Patients With Heart Failure, Chantira Chiaranai

Theses and Dissertations

Although it is well known that self-care reduces the frequency of hospital admissions and exacerbations and enhances quality of life (QOL) in heart failure (HF) patients, little is known about self-care in this population. Therefore, the study purpose was to examine relationships among selected individual characteristics (demographics, severity of illness, comorbidities, and social support), self-care strategies, and QOL using Reigel's Model of Self Care in Patients with Heart Failure as the guiding framework. In this descriptive correlational study, self-care was measured using the Self-Care of Heart Failure Index (SCHFI), which measures self-care maintenance (SC-Mt), self-care management (SC-Mn), and self-care self-confidence …

Visual Contributions To The Vestibulo-Ocular Reflex During Balance Recovery Tasks, Mark D. Diehl

Theses and Dissertations

Introduction: The Vestibulo-ocular reflex (VOR) is quantified by computing the ratio of head angular velocity and eye angular velocity (VOR Gain). This measure only includes head angular movements; linear translations are not accounted for. These investigations postulate an alternative method of VOR quantification, one that assesses retinal image stability during head angular and linear movements (Foveal fixation (FF)). This method was used to assess the role of vision in balance reactions. Methods: Experiment 1 : Ten Young subjects were fitted with an eye tracker linked to an EM kinematic recording system. This allowed for the recording of head, trunk and …

Cd23'S Role As A Negative Regulator Of Allergic Disease: In Vivo Effects Of Murine Cd23 Destabilization And Allelic Mutations, Jill Wallace Ford

Theses and Dissertations

Through underexpression and overexpression studies, CD23 has been shown to negatively regulate IgE production. To investigate CD23 destabilization and its effects on CD23 shedding and IgE synthesis in vivo, we utilized an anti-CD23 stalk monoclonal (19G5) which has previously been shown to enhance proteolysis of CD23 in vitro. Compared to isotype control-treated mice, mice injected with 19G5 displayed enhanced serum soluble CD23 and IgE. Because 19G5 injection substantially enhanced CD23 shedding, it was useful in investigating the identity of the CD23 sheddase. 19G5 enhanced CD23 shedding in ADAM8-/-, ADAM9-/-ADAM15-/-, and ADAM9-/-ADAM12-/-ADAM15-/- mice, ruling out these ADAMs as candidate CD23 sheddases. …

Resilience And Risk-Taking Behavior Among Thai Adolescents Living In Bangkok, Thailand, Patcharin Nintachan

Theses and Dissertations

The major purposes of this study were to determine the relationships among resilience, risk-taking behavior and personal characteristics of Thai adolescents living in Bangkok and to examine the differences in risk-taking behavior by school grades or gender. To accomplish these, a cross-sectional correlational research design was conducted. Resilience was measured by using the State-Trait Resilience Inventory developed by Hiew, Mori, Shirnizu and Torninaga.Risk-taking behavior was measured by the Risk-taking Behavior Questionnaire for Thai Adolescents which is a modified version of the 2003 Youth Risk Behavior Survey (YRBS) originally developed by the U.S. Centers for Disease Control and Prevention. In order …

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 …

The Effect Of Income Level On The Relationship Between The Personal Support Matrix And Sustained Breastfeeding, Sandra Mann Gossler

Theses and Dissertations

The Healthy People 2010 Objectives for the population of the United States include the objective for women to sustain breastfeeding at a higher rate than they are currently.The American Academy of Pediatrics (AAP) now recommends that all infants be fed human milk for the first year of life instead of the previously recommended first six months of life. Breastfeeding initiation rates are rising, but breastfeeding duration rates continue to fall. It was hypothesized that the support system of the women may play a role in the duration of breastfeeding. The purpose of this research study was to investigate the support …

Supporting Personhood In Dementia: Examining The Impact Of Volition On Function In Everyday Occupations, Christine L. Raber

Theses and Dissertations

Understanding volition and preferences for occupation is a critical underpinning of effective occupational therapy services that promote and preserve identity for persons with moderate dementia. Although it has been posited that this population has significant difficulty expressing volition for daily occupations, little research has examined the role of volition in guiding engagement in occupations. This phenomenological study provides an in-depth description and analysis of volition in eight persons with moderate dementia. Guiding questions related to understanding patterns of past life interests, outward demonstration of volition, volitional continuity. and the relationship of the social environment to volition and engagement in daily …