Medicine and Health Sciences Commons^™

The Epidemiology Of Human Rabies Postexposure Prophylaxis In Virginia, 2002 And 2003, Marilyn Goss Haskell

Theses and Dissertations

Objective: To describe a sample that received human rabies postexposure prophylaxis (PEP) in Virginia as a result of animal exposures in 2002 and 2003 and to determine the extent to which PEP decisions were appropriate.Methods: PEP surveillance data were requested from 35 Virginia health districts within 5 regions. Retrospective chart review was used to gather demographic, exposure and source animal data from patient records and animal exposure reports. Descriptive statistics are presented. True exposures and appropriateness of PEP were defined using the 2004 Virginia Rabies Control Guidelines and the Recommendations of the 1999 Advisory Committee on Immunization Practices. The 2003 …

Identification And Characterization Of Low Ph-Triggered Conformational Changes In The Herpes Simplex Virus Glycoprotein B, Stephen Dollery

Theses and Dissertations

Herpesviruses can enter host cells by pH-dependent endocytic pathways in a cell-specific manner. The role of pH in herpesvirus endocytosis is unclear. Herpes simplex virus (HSV) is a paradigm for virus membrane fusion via a complex of glycoproteins. HSV glycoproteins B, D and the heterodimer H-L are necessary and sufficient for membrane fusion. This work analyzes the structure and function of HSV glycoproteins B, D, and H-L at neutral pH, and at the physiological low-pH encountered during endocytic entry. It is demonstrated that mildly acidic low pH triggers specific conformational changes in HSV gB at a pH of 5.7 to …

Evaluation Of A Training Intervention For Personal Care Assistants And The Effect Of Age And Extrinsic Job Satisfaction: Changes In Career Commitment And Job Satisfaction, Jason Rachel

Theses and Dissertations

Home care is a vital component of the United States healthcare delivery system. The demand for home care has steadily increased over the past decade and it is projected that this increase will continue over the next several decades. Moreover, the utilization of Medicaid waiver home and community-based care services has expanded to provide an alternative to the more costly institutional placement. In order to meet this growing demand while maintaining the cost-savings, the system relies primarily on the minimally trained, healthcare paraprofessionals known as Personal Care Assistants (PCAs). The present study examined the career commitment and job satisfaction of …

Acsl6 Is Associated With The Number Of Cigarettes Smoked And Its Expression Is Altered By Chronic Nicotine Exposure, Jingchun Chen, Darlene H. Brunzell, Kia J. Jackson, Andrew Van Der Vaart, Jennie Z. Ma, Thomas J. Payne, Richard Sherva, Lindsay A. Farrer, Pablo Gejman, Douglas F. Levinson, Peter Holmans, Steven H. Aggen, Imad Damaj, Po-Hsiu Kuo, Bradley T. Webb, Raymond Anton, Henry R. Kranzler, Joel Gelemter, Minf D. Li, Kenneth S. Kendler, Xiangning Chen

Psychiatry Publications

Individuals with schizophrenia tend to be heavy smokers and are at high risk for tobacco dependence. However, the nature of the comorbidity is not entirely clear. We previously reported evidence for association of schizophrenia with SNPs and SNP haplotypes in a region of chromosome 5q containing the SPEC2, PDZ-GEF2 and ACSL6 genes. In this current study, analysis of the control subjects of the Molecular Genetics of Schizophrenia (MGS) sample showed similar pattern of association with number of cigarettes smoked per day (numCIG) for the same region. To further test if this locus is associated with tobacco smoking as measured …

Genomic Analysis Of Individual Differences In Ethanol Drinking: Evidence For Non-Genetic Factors In C57bl/6 Mice, Jennifer T. Wolstenholme, Jon A. Warner, Maria I. Capparuccini, Kellie J. Archer, Keith L. Shelton, Michael F. Miles

Pharmacology and Toxicology Publications

Genetic analysis of factors affecting risk to develop excessive ethanol drinking has been extensively studied in humans and animal models for over 20 years. However, little progress has been made in determining molecular mechanisms underlying environmental or non-genetic events contributing to variation in ethanol drinking. Here, we identify persistent and substantial variation in ethanol drinking behavior within an inbred mouse strain and utilize this model to identify gene networks influencing such “non-genetic” variation in ethanol intake. C57BL/6NCrl mice showed persistent inter-individual variation of ethanol intake in a two-bottle choice paradigm over a three-week period, ranging from less than 1 g/kg …

Ten Year Trends (1992 To 2002) In Sociodemographic Predictors And Indicators Of Alcohol Abuse And Dependence Among Whites, Blacks, And Hispanics In The U.S, Raul Caetano, Jonali Baruah, Karen G. Chartier

Social Work Publications

Background

The objective of this paper is to examine 10-year trends (1992–2002) in the number and type of indicators of DSM-IV abuse and dependence among Whites, Blacks and Hispanics in the U.S.

Methods

Data are from the 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001–2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population.

Results

Increases in the prevalence of alcohol abuse between 1992 and 2002seem associated to a rise in …

Faculty Impressions Of Dental Students’ Performance With And Without Virtual Reality Simulation, Riki Gottlieb, Sharon K. Lanning, John C. Gunsolley, Judith A. Buchanan

Periodontics Publications

This study compared faculty perceptions and expectations of dental students’ abilities using virtual reality simulation (VRS) to those who did not use virtual reality simulation (non-VRS) in an operative dentistry preclinical course. A sixteen-item survey with a ten-point rating scale and three open-ended questions asked about students’ abilities in ergonomics, confidence level, performance, preparation, and self-assessment. The surveys were administered three times to a small group of preclinical faculty members. First, faculty members (n=12, 92 percent response rate) gave their perceptions of non-VRS students’ abilities at the end of their traditional course. Secondly, faculty members (n=13, 100 percent response rate) …

Genetic Analysis Of The Neurosteroid Deoxycorticosterone And Its Relation To Alcohol Phenotypes: Identification Of Qtls And Downstream Gene Regulation, Patrizia Porcu, Todd K. O'Buckley, Soomin C. Song, Jo Lynne Harenza, Lu Lu, Xusheng Wang, Michael F. Miles, A. Leslie Morrow

Neurology Publications

Background

Deoxycorticosterone (DOC) is an endogenous neurosteroid found in brain and serum, precursor of the GABAergic neuroactive steroid (3α,5α)-3,21-dihydroxypregnan-20-one (tetrahydrodeoxycorticosterone, THDOC) and the glucocorticoid corticosterone. These steroids are elevated following stress or ethanol administration, contribute to ethanol sensitivity, and their elevation is blunted in ethanol dependence.

Methodology/Principal Findings

To systematically define the genetic basis, regulation, and behavioral significance of DOC levels in plasma and cerebral cortex we examined such levels across 47 young adult males from C57BL/6J (B6)×DBA/2J (D2) (BXD) mouse strains for quantitative trait loci (QTL) and bioinformatics analyses of behavior and gene regulation. Mice were injected with saline …

Air Pollution & The Brain: Subchronic Diesel Exhaust Exposure Causes Neuroinflammation And Elevates Early Markers Of Neurodegenerative Disease, Shannon Levesque, Michael J. Surace, Jacob Mcdonald, Michelle L. Block

Anatomy and Neurobiology Publications

Background

Increasing evidence links diverse forms of air pollution to neuroinflammation and neuropathology in both human and animal models, but the effects of long-term exposures are poorly understood.

Objective

We explored the central nervous system consequences of subchronic exposure to diesel exhaust (DE) and addressed the minimum levels necessary to elicit neuroinflammation and markers of early neuropathology.

Methods

Male Fischer 344 rats were exposed to DE (992, 311, 100, 35 and 0 μg PM/m³) by inhalation over 6 months.

Results

DE exposure resulted in elevated levels of TNFα at high concentrations in all regions tested, with the exception …

Chronic Apocynin Treatment Attenuates Beta Amyloid Plaque Size And Microglial Number In Happ(751)Sl Mice, Melinda E. Lull, Shannon Levesque, Michael J. Surace, Michelle L. Block

Anatomy and Neurobiology Publications

Background

NADPH oxidase is implicated in neurotoxic microglial activation and the progressive nature of Alzheimer's Disease (AD). Here, we test the ability of two NADPH oxidase inhibitors, apocynin and dextromethorphan (DM), to reduce learning deficits and neuropathology in transgenic mice overexpressing human amyloid precursor protein with the Swedish and London mutations (hAPP(751)SL).

Methods

Four month old hAPP(751)SL mice were treated daily with saline, 15 mg/kg DM, 7.5 mg/kg DM, or 10 mg/kg apocynin by gavage for four months.

Results

Only hAPP(751)SL mice treated with apocynin showed reduced plaque size and a reduction in the number of cortical microglia, when compared …

The Streptococcus Sanguinis Competence Regulon Is Not Required For Infective Endocarditis Virulence In A Rabbit Model, Jill E. Callahan, Cindy L. Munro, Todd Kitten

Philips Institute for Oral Health Research Publications

Streptococcus sanguinis is an important component of dental plaque and a leading cause of infective endocarditis. Genetic competence in S. sanguinis requires a quorum sensing system encoded by the early comCDE genes, as well as late genes controlled by the alternative sigma factor, ComX. Previous studies of Streptococcus pneumoniae and Streptococcus mutans have identified functions for the >100-gene com regulon in addition to DNA uptake, including virulence. We investigated this possibility in S. sanguinis. Strains deleted for the comCDE orcomX master regulatory genes were created. Using a rabbit endocarditis model in conjunction with a variety of virulence assays, …

Fto And Mc4r Gene Variants Are Associated With Obesity In Polycystic Ovary Syndrome, Kathryn G. Ewens, Michelle R. Jones, Wendy Ankener, Douglas R. Stewart, Margrit Urbanek, Andrea Dunaif, Richard S. Legro, Angela Chua, Ricardo Azziz, Richard S. Spielman, Mark O. Goodarzi, Jerome F. Strauss Iii

Obstetrics and Gynecology Publications

Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility in women. It is also associated with metabolic disturbances that place women at increased risk for obesity and type 2 diabetes. There is strong evidence for familial clustering of PCOS and a genetic predisposition. However, the gene(s) responsible for the PCOS phenotypes have not been elucidated. This two-phase family-based and case-control genetic study was designed to address the question of whether SNPs identified as susceptibility loci for obesity in genome-wide association studies (GWAS) are also associated with PCOS and elevated BMI. Members of 439 families having at least one …

Challenges And Benefits Of Using A Virtual Community To Explore Nursing Concepts Among Baccalaureate Nursing Students, Linnea L. Carlson-Sabelli, Jean F. Giddens, Louis Fogg, Ruth A. Fiedler

School of Nursing Publications

This research study examines learner perceptions of benefits and challenges associated with the Neighborhood (NBH), an innovative pedagogy that fosters learner engagement and integration of nursing concepts using a “virtual community” as an alternative to lecture. First-semester students from five baccalaureate nursing programs that used the NBH intervention were divided into high (N = 78) and low faculty use (N = 203) groups. Qualitative analysis revealed that the NBH intervention promoted application of concepts to real life situation was engaging and “eye-opening,” allowing students to understand health care issues from a variety of perspectives. A major challenge was busy work …

Tryptophan Degradation In Women With Breast Cancer: A Pilot Study, Debra E. Lyon, Jeanne M. Walter, Angela R. Starkweather, Christine M. Schubert, Nancy L. Mccain

School of Nursing Publications

Background

Altered tryptophan metabolism and indoleamine 2,3-dioxygenase activity are linked to cancer development and progression. In addition, these biological factors have been associated with the development and severity of neuropsychiatric syndromes, including major depressive disorder. However, this biological mechanism associated with both poor disease outcomes and adverse neuropsychiatric symptoms has received little attention in women with breast cancer. Therefore, a pilot study was undertaken to compare levels of tryptophan and other proteins involved in tryptophan degradation in women with breast cancer to women without cancer, and secondarily, to examine levels in women with breast caner over the course of chemotherapy. …

Decreasing Mortality In Severe Sepsis And Septic Shock Patients By Implementing A Sepsis Bundle In A Hospital Setting, Sandra C. P. L. Shiramizo, Alexandre R. Marra, Marcelino S. Durao, Angela T. Paes, Michael B. Edmond, Oscar Fernando Pavao Dos Santos

Internal Medicine Publications

Background

The Surviving Sepsis Campaign (SSC) guidelines for the management of severe sepsis (SS) and septic shock (SSh) have been recommended to reduce morbidity and mortality.

Materials and Methods

A quasi-experimental study was conducted in a medical-surgical ICU. Multiple interventions to optimize SS and SSh shock patients' clinical outcomes were performed by applying sepsis bundles (6- and 24-hour) in May 2006. We compared bundle compliance and patient outcomes before (July 2005-April 2006) and after (May 2006-December 2009) implementation of the interventions.

Results

A total of 564 SS and SSh patients were identified. Prior to the intervention, compliance with the 6 …

The Living Textbook Project For Affordable Higher Education, Dayanjan S. Wijesinghe

Surgery Presentations

A blue print for ensuring that community college education remains affordable to the future generations via elimination of the cost of textbooks.

Bound Water At Protein-Protein Interfaces: Partners, Roles And Hydrophobic Bubbles As A Conserved Motif, Mostafa H. Ahmed, Francesca Spyrakis, Pietro Cozzini, Parijat K. Tripathi, Andrea Mozzarelli, J. Neel Scarsdale, Martin A. Safo, Glen E. Kellogg

Medicinal Chemistry Publications

Background

There is a great interest in understanding and exploiting protein-protein associations as new routes for treating human disease. However, these associations are difficult to structurally characterize or model although the number of X-ray structures for protein-protein complexes is expanding. One feature of these complexes that has received little attention is the role of water molecules in the interfacial region.

Methodology

A data set of 4741 water molecules abstracted from 179 high-resolution (≤ 2.30 Å) X-ray crystal structures of protein-protein complexes was analyzed with a suite of modeling tools based on the HINT forcefield and hydrogen-bonding geometry. A metric termed …

Ventricular Tachyarrhythmias After Cardiac Arrest In Public Versus At Home, Myron L. Weisfeldt, Siobahn Everson-Stewart, Colleen Sitlani, Thomas Rea, Tom P. Aufderheide, Diane L. Atkins, Blair Bigham, Steven C. Brooks, Christopher Foerster, Randal Gray, Joseph P. Ornato, Judy Powell, Peter J. Kudenchuk, Laurie J. Morrison

Emergency Medicine Publications

Background

The incidence of ventricular fibrillation or pulseless ventricular tachycardia as the first recorded rhythm after out-of-hospital cardiac arrest has unexpectedly declined. The success of bystander-deployed automated external defibrillators (AEDs) in public settings suggests that this may be the more common initial rhythm when outof-hospital cardiac arrest occurs in public. We conducted a study to determine whether the location of the arrest, the type of arrhythmia, and the probability of survival are associated.

Methods

Between 2005 and 2007, we conducted a prospective cohort study of out-of-hospital cardiac arrest in adults in 10 North American communities. We assessed the frequencies of …

Early Versus Later Rhythm Analysis In Patients With Out-Of-Hospital Cardiac Arrest, Ian G. Stiell, Graham Nichol, Brian G. Leroux, Thomas D. Rea, Joseph P. Ornato, Judy Powell, James Christenson, Clifton W. Callaway, Peter J. Kudenchuk, Tom P. Aufderheide, Ahamed H. Idris, Mohamud R. Daya, Henry E. Wang, Laurie J. Morrison, Daniel Davis, Douglas Andrusiek, Shannon Stephens, Sheldon Cheskes, Robert H. Schmicker, Ray Fowler, Christian Vaillancourt, David Hostler, Dana Zive, Ronald G. Pirrallo, Gary M. Vilke, George Sopko, Myron Weisfeldt

Emergency Medicine Publications

Background

In a departure from the previous strategy of immediate defibrillation, the 2005 resuscitation guidelines from the American Heart Association–International Liaison Committee on Resuscitation suggested that emergency medical service (EMS) personnel could provide 2 minutes of cardiopulmonary resuscitation (CPR) before the first analysis of cardiac rhythm. We compared the strategy of a brief period of CPR with early analysis of rhythm with the strategy of a longer period of CPR with delayed analysis of rhythm.

Methods

We conducted a cluster-randomized trial involving adults with out-of-hospital cardiac arrest at 10 Resuscitation Outcomes Consortium sites in the United States and Canada. Patients …

A Trial Of An Impedance Threshold Device In Out-Of-Hospital Cardiac Arrest, Tom P. Aufderheide, Graham Nichol, Thomas D. Rea, Siobhan P. Brown, Brian G. Leroux, Paul E. Pepe, Peter J. Kudenchuk, Jim Christenson, Mohamud R. Daya, Paul Dorian, Clifton W. Callaway, Ahamed H. Idris, Douglas Andrusiek, Shannon W. Stephens, David Hostler, Daniel Davis, James V. Dunford, Ronald G. Pirrallo, Ian G. Stiell, Catherine M. Clement, Alan Craig, Lois Van Ottingham, Terri A. Schmidt, Henry E. Wang, Myron L. Weistfeldt, Joseph P. Ornato, George Sopko

Emergency Medicine Publications

Background

The impedance threshold device (ITD) is designed to enhance venous return and cardiac output during cardiopulmonary resuscitation (CPR) by increasing the degree of negative intrathoracic pressure. Previous studies have suggested that the use of an ITD during CPR may improve survival rates after cardiac arrest.

Methods

We compared the use of an active ITD with that of a sham ITD in patients with out-ofhospital cardiac arrest who underwent standard CPR at 10 sites in the United States and Canada. Patients, investigators, study coordinators, and all care providers were unaware of the treatment assignments. The primary outcome was survival to …

Right Ventricular Dysfunction Following Acute Myocardial Infarction In The Absence Of Pulmonary Hypertension In The Mouse, Stefano Toldo, Herman J. Bogaard, Benjamin W. Van Tassell, Eleonora Mezzaroma, Ignacio M. Seropian, Roshanak Robati, Fadi N. Salloum, Norbert F. Voelkel, Antonio Abbate

VCU Health Publications

Background

Cardiac remodelling after AMI is characterized by molecular and cellular mechanisms involving both the ischemic and non-ischemic myocardium. The extent of right ventricular (RV) dilatation and dysfunction and its relation to pulmonary hypertension (PH) following AMI are unknown. The aim of the current study was to evaluate changes in dimensions and function of the RV following acute myocardial infarction (AMI) involving the left ventricle (LV).

Methods

We assessed changes in RV dimensions and function 1 week following experimental AMI involving the LV free wall in 10 mice and assessed for LV and RV dimensions and function and for the …

Alterations In The Interleukin-1/Interleukin-1 Receptor Antagonist Balance Modulate Cardiac Remodeling Following Myocardial Infarction In The Mouse, Antonio Abbate, Fadi N. Salloum, Benjamin W. Van Tassell, Elena Vecile, Stefano Toldo, Ignacio M. Seropian, Eleonora Mezzaroma, Aldo Dobrina

VCU Health Publications

Background

Healing after acute myocardial infarction (AMI) is characterized by an intense inflammatory response and increased Interleukin-1 (IL-1) tissue activity. Genetically engineered mice lacking the IL-1 receptor (IL-1R1-/-, not responsive to IL-1) or the IL-1 receptor antagonist (IL-1Ra, enhanced response to IL-1) have an altered IL-1/IL-1Ra balance that we hypothesize modulates infarct healing and cardiac remodeling after AMI.

Methods

IL-1R1-/- and IL-1Ra-/- male mice and their correspondent wild-types (WT) were subjected to permanent coronary artery ligation or sham surgery. Infarct size (trichrome scar size), apoptotic cell death (TUNEL) and left ventricular (LV) dimensions and function (echocardiography) were measured prior to …

Forever Young, Edward F. Ansello

Director's Editorials from Age in Action

Gerontologists theorize that each of us is shaped by the influences of cohort and historical time. If there's a oneness of who we were and who we are, then Bob Dylan's music is in many of us. Forever Young is not a paean to age denial. Rather, it seems to invoke virtues or characteristics that never grow old: charity to others, acceptance of kindness, hope, righteousness, courage, fortitude, industriousness, and joy.

Falls, Edward F. Ansello

Director's Editorials from Age in Action

Falls are common, affecting about one third of community-dwelling adults over age 65 and about half over age 80. The risk factors for falling are complex, and falls may themselves be a signal for other troubling conditions. When fear of falling emerges as an issue for some elders, they are likely to reduce their activities, thinking that this will reduce their risk, and isolation and depression can ensue. There are teaching roles for nurses, physicians, and physical therapists in sharing with other professions how to assess gait, vision, or dizziness.

Baby Boomers And Stereotypes, Edward F. Ansello

Director's Editorials from Age in Action

With age we become more and more like ourselves. This would mean millions and millions of individual Baby Boomers, each with his or her own characteristics and life trajectory. Stereotyping would, therefore, be wrong, but it is happening.

The Most Terrible Poverty, Edward F. Ansello

Director's Editorials from Age in Action

Caring, private individuals and agency employees and volunteers in "direct" or "human" services regularly deliver what can be called love, the antidote to the poverty of loneliness. Let's acknowledge the essential importance of people in various forms of human services who reach out to others who are alone.

The Impact Of Providing Rehab Mobility Equipment To Those In Need, Bruce Stelmack, Brian Leitten

Case Studies from Age in Action

Educational Objectives

1. Discuss the need to provide rehabilitation mobility equipment at no cost to those who have no other means to obtain it.

2. Assess the impact on a community when mobility equipment for underinsured impaired persons (“at risk”) cannot be secured.

3. Describe a successful recycling program that provides free rehabilitation mobility equipment.

4. Explain the importance of a community- based model to provide rehabilitation equipment.

Universal Design In Housing, Steve Hansler, Beth Glas

Case Studies from Age in Action

Educational Objectives

1. Show how an aging population increases the need for housing that is accessible and adaptable.

2. Define visitability, universal design, and accessible design.

3. Explain ways to approach universal design including key factors.

4. Illustrate how universal design can be used in both renovation and new construction.

Alcohol, Medications, And Older Adults, Mailtreyee Mohanty, Patricia Slattum

Case Studies from Age in Action

Educational Objectives

1. Describe patterns of simultaneous use of alcohol and Central Nervous System (CNS) - acting medications among older adults.

2. Understand the mechanisms of interaction between alcohol and CNS-acting medications and their consequences.

3. Identify strategies to prevent alcohol-medication interactions among older adults.

4. Recommend resources for older adults and service providers for identifying and managing problematic alcohol and medication use.

Habilitation Therapy In Dementia Care, Paul Raia

Case Studies from Age in Action

Educational Objectives

1. To describe the goal of Habilitation Therapy and how it differs from other methods of dementia care, including rehabilitation.

2. To identify areas or domains in which we have opportunities to bring about and sustain positive emotions.

3. To discuss four communication strategies to use with mid- to laterstage Alzheimer’s patients.