Medicine and Health Sciences Commons^™

Variability In Antifungal Utilization Among Neonatal, Pediatric, And Adult Inpatients In Academic Medical Centers Throughout The United States Of America, Jeremy S. Stultz, Rose Kohinke, Amy L. Pakyz

Pharmacotherapy and Outcomes Science Publications

Background
Identification of factors associated with antifungal utilization in neonatal, pediatric, and adult patient groups is needed to guide antifungal stewardship initiatives in academic medical centers.

Methods
For this hospital-level analysis, we analyzed antifungal use in hospitals across the United States of America, excluding centers only providing care for hematology/oncology patients. Analysis of variance was used to compare antifungal use between patient groups. Three multivariable linear regression models were used to determine independent factors associated with antifungal use in the neonatal, pediatric, and adult patient groups.

Results
For the neonatal, pediatric, and adult patient groups, 54, 44, and 60 hospitals …

Virginia Dental Journal (Vol. 95, No. 2, 2018)

Virginia Dental Journal

No abstract provided.

Oral Cancer Has A New Risk Factor: Hpv, Tira Hanrahan, Shillpa Naavaal

Dental Public Health and Policy Publications

No abstract provided.

Vcu Health Nursing Inquiry Process Diagram (Version 2), Roy E. Brown

VCU Libraries Faculty and Staff Publications

This diagram outlines the nursing inquiry process to help answer questions that arise in the clinical setting. The diagram further helps a nurse understand how to distinguish whether a situation calls for evidence-based practice, performance improvement or research. It also guides a nurse through clarifying the initial question, gathering the evidence, and through each step in the subsequent process.

Virginia Dental Journal (Vol. 95, No. 1, 2018)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 95, No. 3, 2018)

Virginia Dental Journal

No abstract provided.

Circulation First – The Time Has Come To Question The Sequencing Of Care In The Abcs Of Trauma; An American Association For The Surgery Of Trauma Multicenter Trial, Paula Ferrada, Rachael A. Callcut, David J. Skarupa, Therese M. Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M. Nygaard, Martin A. Schreiber, Toby Enniss, Michelle Mcnutt, Herb Phelan, Kira Smith, Forrest O. Moore, Irene Tabas, Joseph Dubose, Aast Multi-Institutional Trials Committee

Surgery Publications

Background

The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence.

Methods

This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee. We performed a retrospective analysis of all patients that presented to trauma centers with presumptive hypovolemic shock indicated by pre-hospital or emergency department …

Training Neurodegenerative Disease Support Group Leaders: A New Support Group Functioning Scale, Therese V. Cash, Christopher Kilbourn, Sarah K. Lageman

Neurology Publications

Support group leaders play pivotal roles in maintaining healthy community support groups; however, these leaders also have personal support needs and typically lack formal training in managing complex behaviors of neurodegenerative disorders. A support group well-being questionnaire, assessing support group functioning, was developed and piloted among participants of an educational training program designed for support group leaders of various neurodegenerative disorder-specific support groups. An exploratory factor analysis evaluated the questionnaire’s psychometric properties and identified a reliable single factor five-item solution, which was titled the Support Group Functioning Scale (SGFS). Preliminary interpretation guidelines were proposed. Development of this scale is a …

The Year In The Rear-View Mirror, Edward F. Ansello

Director's Editorials from Age in Action

The year 2018 is the Virginia Center on Aging's 40th anniversary. Our programs and activities have evolved over time but we have remained true to the charges given us in the Code of Virginia, essentially to conduct interdisciplinary studies, including training practitioners and offering educational opportunities for older adults, conducting research on and advancing knowledge about dementia, and serving as an information resource to those committed to the well-being of older adults. Our current operations feature four program areas: abuse in later life (domestic violence and elder abuse); dementia research; geriatrics and gerontology education; and lifelong learning.

Association Between Breastfeeding Duration And Type Of Birth Attendant, Jordyn T. Wallenborn, Saba W. Masho

Family Medicine and Population Health Publications

Introduction. Healthcare providers play an integral role in breastfeeding education and subsequent practices; however, the education and support provided to patients may differ by type of provider. The current study aims to evaluate the association between type of birth attendant and breastfeeding duration. Methods. Data from the prospective longitudinal study, Infant Feeding Practices Survey II, was analyzed. Breastfeeding duration and exclusive breastfeeding duration were defined using the American Academy of Pediatrics’ national recommendations. Type of birth attendant was categorized into obstetricians, other physicians, and midwife or nurse midwife. If mothers received prenatal care from a different type of provider than …

Evaluation Of Image Registration Accuracy For Tumor And Organs At Risk In The Thorax For Compliance With Tg 132 Recommendations, Christopher L. Guy, Elisabeth Weiss, Shaomin Che, Nuzhat Jan, Sherry Zhao, Mihaela Rosu-Bubulac

Radiation Oncology Publications

Purpose
To evaluate accuracy for 2 deformable image registration methods (in-house B-spline and MIM freeform) using image pairs exhibiting changes in patient orientation and lung volume and to assess the appropriateness of registration accuracy tolerances proposed by the American Association of Physicists in Medicine Task Group 132 under such challenging conditions via assessment by expert observers.

Methods and Materials
Four-dimensional computed tomography scans for 12 patients with lung cancer were acquired with patients in prone and supine positions. Tumor and organs at risk were delineated by a physician on all data sets: supine inhale (SI), supine exhale, prone inhale, and …

Would You Recognize Lupus?, Sydney C. Smith, Maegan Simms, Barbara Brown

Dental Hygiene Student Scholarship

Systemic Lupus Erythematosus, or SLE, is a chronic autoimmune disease which significantly affects various organs of the body and the oral cavity. According to various studies, SLE can cause an increased risk of periodontitis, fungal infections, and dental caries within the oral cavity. Periodontitis is an inflammatory condition mediated by an infectious etiology which affects the supporting tissues of the periodontium and alveolar bone. With SLE being an inflammatory condition as well, recent studies have emerged hypothesizing the possible association between SLE and periodontitis. Other effects on the oral cavity such as fungal infections including lichen planus and angular cheilitis …

Hours Lost To Planned And Unplanned Dental Visits Among Us Adults, Uma Kelekar, Shillpa Naavaal

Dental Public Health and Policy Publications

Introduction

Poor oral health is associated with lost hours at work or school, which may affect a person’s productivity. The objective of our study was to estimate work or school hours lost to dental visits among adults aged 18 and older by the types of visits (emergency or unplanned; routine, planned, or orthodontic; or cosmetic) and to determine the factors associated with hours lost.

Methods

We used the most recent Oral Health Supplement data, from the 2008 National Health Interview Survey (NHIS), to estimate the total hours lost at work or school for dental visits among adults in the United …

Estimating The Cost Of School Sealant Programs With Minimal Data, Susan O. Griffin, Kari Jones, Shillpa Naavaal, Joan M. O'Connell, Christina Demopoulos, Dawn Arlotta

Dental Public Health and Policy Publications

Objective: Develop methodology to estimate the annual cost of resources used by school sealant programs (SSPs) and demonstrate its use.

Methods: We used existing literature and expert opinion to identify SSP cost components and the most appropriate units for their measurement (e.g., per operator) and collection frequency (e.g., per day). For equipment and reusable instruments, costs were sufficiently homogenous across SSPs that we could provide default per unit cost estimates (2016 US$) that SSPs can use in lieu of collecting their own data. We also provide default costs for supply items such that SSPs can estimate total supply costs with …

Variations In Cigarette Smoking And Quit Attempts By Health Insurance Among Us Adults In 41 States And 2 Jurisdictions, 2014, Shillpa Naavaal, Ann Malarcher, Xin Xu, Lei Zhang, Stephen Babb

Dental Public Health and Policy Publications

Objectives: Information on the impact of health insurance on smoking and quit attempts at the state level is limited. We examined the state-specific prevalence of cigarette smoking and past-year quit attempts among adults aged 18-64 by health insurance and other individual- and state-level factors.

Methods: We used data from 41 states, the District of Columbia, and Puerto Rico, the jurisdictions that administered the Health Care Access module of the 2014 Behavioral Risk Factor Surveillance System. Data on quit attempts included current smokers with a past-year quit attempt and former smokers who quit during the past year.

Results: Overall, smoking prevalence …

Improving Temporal Accuracy Of Human Metabolic Chambers For Dynamic Metabolic Studies, Shanshan Chen, Erica Wohlers, Eric Ruud, Jon Moon, Bin Ni, Francesco S. Celi

Biostatistics Publications

Metabolic chambers are powerful tools for assessing human energy expenditure, providing flexibility and comfort for the subjects in a near free-living environment. However, the flexibility offered by the large living room size creates challenges in the assessment of dynamic human metabolic signals—such as those generated during high-intensity interval training and short-term involuntary physical activities—with sufficient temporal accuracy. Therefore, this paper presents methods to improve the temporal accuracy of metabolic chambers. The proposed methods include 1) adopting a shortest possible step size, here one minute, to compute the finite derivative terms for the metabolic rate calculation, and 2) applying a robust …

Implementing Parallel Spreadsheet Models For Health Policy Decisions: The Impact Of Unintentional Errors On Model Projections, Stephanie L. Bailey, Rose S. Bono, Denis Nash, April D. Kimmel

Health Policy Publications

Background

Spreadsheet software is increasingly used to implement systems science models informing health policy decisions, both in academia and in practice where technical capacity may be limited. However, spreadsheet models are prone to unintentional errors that may not always be identified using standard error-checking techniques. Our objective was to illustrate, through a methodologic case study analysis, the impact of unintentional errors on model projections by implementing parallel model versions.

Methods

We leveraged a real-world need to revise an existing spreadsheet model designed to inform HIV policy. We developed three parallel versions of a previously validated spreadsheet-based model; versions differed by …

The Relationship Between Body Mass Index, Binge Eating Disorder And Suicidality, Kristal Lyn Brown, Jessica Gokee Larose, Briana Mezuk

Health Policy Publications

Background
While restrictive and compensatory eating disorders (e.g. anorexia and bulimia) are associated with elevated risk of suicide, less is known about binge eating disorder (BED). There is suggestive evidence of a U-shaped relationship between body mass index (BMI) and completed suicide, but fewer studies on suicidal ideation or attempts. This study examined the association between BED, BMI, and suicidality, and assessed whether these relationships varied by gender.

Methods
Data come from the Collaborative Psychiatric Epidemiologic Surveys (N = 14,497). Binge episodes and BED were assessed using the Composite International Diagnostic Inventory (CIDI). BMI was calculated from self-reported height …

Triangulating Abuse Liability Assessment For Flavoured Cigar Products Using Physiological, Behavioural Economic And Subjective Assessments: A Within-Subjects Clinical Laboratory Protocol, Catherine S. Wall, Rose S. Bono, Rebecca C. Lester, Cosima Hoetger, Thokozeni Lipato, Mignonne C. Guy, Thomas E. Eissenberg, Warren K. Bickel, Andrew J. Barnes, Caroline O. Cobb

Health Policy Publications

Introduction
In the USA, Food and Drug Administration regulations prohibit the sale of flavoured cigarettes, with menthol being the exception. However, the manufacture, advertisement and sale of flavoured cigar products are permitted. Such flavourings influence positive perceptions of tobacco products and are linked to increased use. Flavourings may mask the taste of tobacco and enhance smoke inhalation, influencing toxicant exposure and abuse liability among novice tobacco users. Using clinical laboratory methods, this study investigates how flavour availability affects measures of abuse liability in young adult cigarette smokers. The specific aims are to evaluate the effect of cigar flavours on nicotine …

Social Determinants Of Smoke Exposure During Pregnancy: Findings From Waves 1 & 2 Of The Population Assessment Of Tobacco And Health (Path) Study, Elizabeth K. Do, Tiffany L. Green, Elizabeth C. Prom-Wormley, Bernard F. Fuemmeler

Health Policy Publications

Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18–54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014–2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was …

Mandatory Minimum Sentencing Policies And Cocaine Use In The U.S., 1985–2013, Lauryn Saxe Walker, Briana Mezuk

Health Policy Publications

Background: As of May 2017, the United States federal government renewed its prioritization for the enforcement of mandatory minimum sentences for illicit drug offenses. While the effect of such policies on racial disparities in incarceration is well-documented, less is known about the extent to which these laws are associated with decreased drug use. This study aims to identify changes in cocaine use associated with mandatory minimum sentencing policies by examining differential sentences for powder and crack cocaine set by the Anti-Drug Abuse Act (ADAA) (100:1) and the Fair Sentencing Act (FSA), which reduced the disparate sentencing to 18:1.


Methods: Using …

School Hours Lost Due To Acute/Unplanned Dental Care, Shillpa Naavaal, Uma Kelekar

Dental Public Health and Policy Publications

Objective: We estimated the school-hours lost for acute/unplanned dental care and examined the associated factors among children aged 5-17 years using 2008 National Health Interview Survey data.

Methods: We used bivariate and multivariate regression models to investigate the associations between school hours lost and socioeconomic and oral health factors (p < .05).

Results: Acute/unplanned dental care accounted for a loss of 34 million school-hours annually. Compared to children with very good oral health, children with fair/poor oral health were 2.8 times more likely to lose ≥1 hours. Children in high-income families had 31% less likelihood of losing any school …

Framing And Visual Type: Effect On Future Zika Vaccine Uptake Intent, Jeanine P.D. Guidry, Kellie E. Carlyle, Jessica G. Larose, Paul Perrin, Mark Ryan, Marcus Messner, Jay Adams

Richard T. Robertson School of Communication Publications

Introduction: The Zika virus is associated with the birth defect microcephaly, and while a vaccine was not available in early- 2017, several were under development. This study’s purpose was to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age.

Design and methods: In order to study the effects of Zika message framing (gain vs. loss) and visual type (photo vs. infographic) on future Zika vaccine uptake intent, a 2×2 between-subjects experiment was performed via an online survey in 2017 among 339 U.S. women of reproductive age (18-49 years). Participants were …

How Can The Humanities Treat Hiv/Aids? An Interview With Dale Smith, Amita Rao, Emily Furlich, Dale Smith

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

No abstract provided.

Breastfeeding As A Mechanism To Reduce Postpartum Depression With Weight As A Major Contributing Factor In Hispanic Women, Celia Wilson

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Postpartum Depression (PPD) is the most common childbearing-related illness around the globe affecting both mothers and their children; yet minimal longitudinal research has been done to study the effect of depressive symptomatology on breastfeeding. This study analyzes how the benefits of breastfeeding past six months, postpartum, can be used as a treatment mechanism for postpartum depression (PPD) with the major contributing factor of gestational weight gain (GWG) in Hispanic women recently immigrated to the United States. I investigated journal articles in four main domains: the likelihood of women presenting with depressive symptomatology as a result of weight gain to initiate …

Adherence Mechanism Analysis: The Role Of Prsa Gene In Lactobacillus Acidophilus And Other Infectious Microorganisms, Nujuma Moussa

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

No abstract provided.

The Use Of Rhyme, Rhythm, And Melody As A Form Of Repetition Priming To Aid In Encoding, Storage, And Retrieval Of Semantic Memories In Alzheimer’S Patients, Faiz Plastikwala

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Millions are diagnosed with Alzheimer’s disease annually which can have debilitating effects on patient memory. Thus, finding new ways to help facilitate memory in these patients, especially through non-pharmaceutical means, has become increasingly important. I examined the use of melody, rhyme, and rhythm as encoding mechanisms to aid in the retrieval of long term semantic information by juxtaposing scholarly articles detailing experiments, each of which examined the effects of various facets of memory facilitation; this helped produce an idea of which devices are most effective. Additionally, I surveyed studies highlighting limitations of song implementation to craft an effective plan to …

Researching The History Of Hiv/Aids: An Interview With Christopher Ewing, Emily Furlich

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

No abstract provided.

Investigation Into The Role Of Manganese In The Growth Of The Opportunistic Pathogen Streptococcus Sanguinis, Brittany Spivey

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

While Streptococcus sanguinis plays a beneficial role in the oral cavity as a competitor of Streptococcus mutans and Streptococcus sobrinus, the bacteria that produce dental caries, it can cause deadly infective endocarditis if given the opportunity to colonize the vegetations that form over damaged endocardial tissue. Pre-existing heart conditions, surgery, and intravenous drug use predispose individuals to endocarditis. S. sanguinis growth and consequential virulence is significantly impeded by restriction to manganese. This is due to the resulting overwhelming oxidative stress and formation of reactive oxygen species which damage DNA and other cellular components. Manganese is essential for S. sanguinis proteins …

Change In Working Length At Different Stages Of Instrumentation As A Function Of Canal Curvature, Mei Tang, Garry L. Myers, Richard D. Archer, Al M. Best

Graduate Research Posters

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 …