Medicine and Health Sciences Commons^™

Evaluation Of The Program Delivery Of Every Women's Life In Virginia, Landolt Susan Kenney

Theses and Dissertations

Introduction: Among women, breast cancer is the most prevalent cancer and the second leading cause of cancer death. Although technology advances have improved survival rates for breast cancer overall, improvements have not been universally experienced by all socioeconomic and racial groups. Known determinants of breast cancer care disparities include socioeconomic status, race, age, and social support. As a part of the Breast and Cervical Cancer Mortality Prevention Act of 1990 and with the help of CDC funding, the Virginia Breast and Cervical Cancer Early Detection Program (BCCEDP) or Every Woman’s Life (EWL) was created. EWL provides breast cancer screening to …

Relationship Between Parental Role-Modeling Of Physical Activity And Child's Physical Activity, Katherine Culver

Theses and Dissertations

Trends in childhood obesity have lead to a generation that has a shortened lifespan, where excessive weight may decrease life expectancy by as much as five years. Physical inactivity is a major risk factor for childhood obesity as well as cardiovascular disease, osteoporosis, and cancer. Addressing inactivity in children could help keep the obesity epidemic from continuing to grow as well as help address other health concerns. The specific aims of this study are 1) To examine the effect of parental role-modeling of exercise on children’s activity level by specifically looking at the role of the mother and the father, …

Novel Analogs Of M-Chlorophenylguanidine As 5-Ht3 Receptor Ligands, Katie Alix

Theses and Dissertations

Serotonin receptors play a variety of functional roles in the body. Some indications and treatment claims for one of the classes of serotonin receptors, the 5-HT3 receptor family, include: anxiety, depression, chemotherapy- and radiation-induced emesis, constipation, irritable bowel syndrome, pain, drug addiction, and satiety control. A 5-HT3 receptor partial agonist, MD-354, served as a lead compound in the development of new 5-HT3 receptor ligands. Using halogenated analogs the study investigated their effect on binding to the 5-HT3 receptor. Conformationally-constrained analogs (quinazolines) were shown to be a novel class of 5-HT3 receptor antagonists. The log P values were determined for several …

History Of Pregnancy Termination As A Risk Factor For Preterm Birth, Virginia 2000-20007, Jennifer Macdonald

Theses and Dissertations

Abstract Objectives: The objective of this study was to determine if an association exists between prior induced and prior spontaneous pregnancy termination (PIPT and PSPT) and preterm birth (PTB) of first live births in Virginia. Methods: Data was collected by linking maternal data from Virginia’s live birth and fetal death registries. All first live, singleton births occurring in Virginia from 2000-2007 were analyzed. Logistic regression models that controlled for various demographic, medical and obstetric history factors were used to determine associations among prior pregnancy termination types. Results: Compared with women who had no history of previous pregnancy terminations, women who …

Delayed And Forgone Care For Children With Special Health Care Needs In Virginia: A Cross-Sectional Study Using 2005-2006 Ns-Cshcn, Nevena Skoro

Theses and Dissertations

Objectives The objectives of our study were to: 1) summarize illness characteristics and functional ability difficulties among Children With Special Health Care Needs (CSHCN) in Virginia, 2) examine the distribution of socio-demographic, health insurance, and health-related factors among Virginia’s CSHCN, 3) quantify the influence of these socio-demographic, health insurance, and health-related factors on delayed and forgone care of CSHNC in Virginia, and 4) analyze reasons for delayed and forgone care among Virginia’s CSHCN. Methods Data from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) were used for this study. Three categories of predictor variables were studied: …

Perception Of Power Dynamics And Risky Sexual Behavior In Indian Men, Amber Haley

Theses and Dissertations

Background: Women account for about a third of all new cases of HIV in India. Based on research examining trends of HIV infection in women, male perception and behaviors have emerged as strong potential risk factors. However, there has been limited research examining the relationship between male’s attitudes toward women and their sexual risk-taking behaviors. This study examined the degree to which men’s beliefs about power dynamics in heterosexual relationships are related to risky sexual behaviors in Indian men. Methods: Data on Indian men from the 2005-2006 National Family Health Survey (NFHS-3) was analyzed (N= 44,727). The outcome variable, risky …

A Culturally-Relevant, Emergent Approach To Exploring The Needs, Strengths, And Priorities Of Tribal Communities In Virginia, Amy Prorock-Ernest

Theses and Dissertations

Little is known about the health of the indigenous peoples in Virginia. When compared to the total U.S. population, indigenous peoples nationwide disproportionately experience disparities in health status across multiple health indicators. Research shows that these disparities are largely due to the inequitable distribution of social and economic determinants present within indigenous communities. Because the indigenous peoples of Virginia are affected by inequitable social and economic conditions, there is reason to believe that health indicators may mirror that of the indigenous population at-large. Outlined in this paper is a framework for exploring the needs, strengths, and priorities of indigenous communities …

The Use Of Lactobacillus In The Treatment Of Clostridium Difficile Infection In Hospitalized Adult Patients, Ali Alhammad

Theses and Dissertations

Objective To describe the use of Lactobacillus by hospitalized patients and to examine its relationship with various Clostridium difficile infection (CDI) related outcomes. Methods The characteristics of Lactobacillus users and non-users and the initiation of Lactobacillus with respect to initiation of antibiotic therapy and CDI treatment were described using national hospital discharge database. The relationships between Lactobacillus use and post-CDI length of stay, mortality, switch of CDI therapy, and readmission were analyzed. Results Lactobacillus users and non-users were different in most characteristics. Metronidazole and fluoroquinolones were the most frequently used antibiotics by Lactobacillus users. They were mainly CDI cases, used …

The Evaluation Of Pain Experienced By Children Undergoing Simple Extraction Using 2% Lidocaine Versus Oraqix Topical Anesthetic Gel, John Haffner

Theses and Dissertations

Purpose: The purpose of this study is to examine the pain response experienced by children undergoing simple tooth extractions using 2% Lidocaine injection versus Oraqix topical anesthetic gel. Methods: This study is being conducted at VCU pediatric dentistry clinic. The sample size will consist of 15 children ages 7-12 undergoing a simple extraction procedure. Each participant is randomly assigned to one of two groups, the lidocaine injection group or the Oraqix topical group. The pain level will be measured at four key events during the procedure. The first event will evaluate the pain at baseline. The second event will measure …

Functional Health Literacy And The Use Of Dental Services In Young Children, Melissa Fries

Theses and Dissertations

Purpose: The purpose of this study is to examine parental Functional Health Literacy and their child’s subsequent utilization of dental services. Methods: This was a prospective cohort study of children (n=1175) enrolled in the Child Health Investment Partnership of Virginia (CHIP). Descriptive statistics and separate multivariate logistic regressions were used to determine the relationship between functional health literacy measures; 1) Health Care Literacy (HCL), 2) Personal Health Literacy (PHL), and 3) LSP 22 scale, with utilization as measured as number of dental visit/s. Results: Descriptive analysis of the cohort reveals: 45% black, 40% white, 10% Hispanic, 5% other, 41% of …

Meta-Analysis: Racial Disparities In Prostate Cancer Survival And Case-Control Study: Association Between Family History Of Cancers, Obesity And Prostate Cancer, Gayathri Sridhar

Theses and Dissertations

This is a compilation of 3 abstracts for the three manuscripts included in this dissertation. I. Meta-Analysis: Racial Disparities in Prostate Cancer Survival: Prostate cancer is the second leading cause of cancer-related mortality in men. Previous studies have drawn inconsistent conclusions on racial differences in prostate cancer survival. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of published articles from 1968 to 2007 assessing survival from prostate cancer among African American and White men was conducted. The search yielded 20 eligible published manuscripts. Analysis of unadjusted studies showed African American …

The Economic Impact Of Antimicrobial Resistance In Patients With Nosocomial Staphylococcus Aureus Bacteremia, Suzanne Phillips

Theses and Dissertations

Background: The proportion of nosocomial Staphylococcus infections caused by methicillin-resistant Staphylococcus aureus (MRSA) has increased from 22% in 1995 to 63% in 2004. Blood stream infections, more commonly referred to as bacteremias, represented the majority (75.5%) of hospital-onset MRSA cases. The economic impact of Staphylococcus aureus bacteremia merits investigation. Methods: This was a retrospective cohort analysis within Cerner HealthFacts data warehouse. Eligible patients were those who had Staphylococcus aureus bacteremia and were discharged between January 1, 2000, and December 31, 2006. Inclusion criteria include age > 18 years old and onset of infection > 48 hours post admission. The crude association was …

Obesity, Adiposity, And Satiety In Mouse Models Of Smith-Magenis Syndrome And Dup(17)(P11.2) Syndrome, Brooke Burns

Theses and Dissertations

Smith-Magenis syndrome (SMS) is a complex disorder caused by haploinsufficiency of RAI1 and characterized by sleep disturbances, behavioral abnormalities, mental retardation, and obesity in teens and adults. Rai1+/- mice are obese after 20 weeks. Dup(17)(p11.2) syndrome is a complex disorder associated with overexpression of RAI1. A transgenic mouse model of dup(17)(p11.2) syndrome overexpresses Rai1 and results in a mouse that is growth delayed. In order to characterize the obese phenotypes of mouse models of SMS and the role of RAI1 in obesity, daily food intake and serum levels of insulin, glucose, PPY, and leptin were measured; adiposity was studied by …

Salvinorin A: Fragment Synthesis And Modeling Studies, Donna Mcgovern

Theses and Dissertations

Salvinorin A is a non-nitrogenous, selective kappa opioid receptor agonist with potent hallucinogenic properties. Because Salvinorin A has no basic nitrogen, it does not readily adhere to the “message-address” concept of selectivity for the opioid receptors. Therefore, a better understanding of how salvinorin A and its analogs interact with the kappa opioid receptor may shed some light on how salvinorin A obtains its potency and selectivity. The structure-affinity relationships (SAFIR) of salvinorin A and its analogs along with a discussion of the selectivity of the opioid receptors, is presented. A fragment of salvinorin A, methyl-3-acetoxy-4-oxocyclohexanecarboxylate, was synthesized to determine if …

Multisensory Input To The Lateral Rostral Suprasylvian Sulcus (Lrss) In Ferret, Elizabeth Hagood

Theses and Dissertations

For the brain to construct a comprehensive percept of the sensory world, information from the different senses must converge onto individual neurons within the central nervous system. As a consequence, how these neurons convert convergent sensory input into multisensory information is an important question facing neuroscience today. Recent physiological studies have demonstrated the presence of a robust population of multisensory neurons in the lateral bank of the rostral suprasylvian sulcus (LRSS) in adult ferret (Keniston et al, 2008). The LRSS is a region situated between somatosensory and auditory cortices, where bimodal (somatosensory-auditory) neurons occupy the greatest percentage of the sensory-responsive …

Comparative Analysis Of Torsional Strength Between Profile® Gt® And Gt® Series X(Tm) Nickel Titanium Rotary Instruments, Jake Reynolds

Theses and Dissertations

The purpose of this study was to compare the resistance to fracture by the twisting of two nickel titanium (NiTi) rotary file systems. The Profile® GT® (GT) and the GT® Series X(TM) (GTX) files were tested to analyze the maximum torsional strength and the maximum angular deflection at the time of separation of the files. For each system, ten new files were tested at each of the following eight taper/size designations for a total of 160 files: 20/0.04, 20/0.06, 30/0.04, 30/0.06, 30/0.08, 40/0.04, 40/0.06, and 40/0.08. The American National Standards Institute / American Dental Association Specification No. 28 was implemented …

Comparing Cyclic Fatigue Of The New Gt® Series X(Tm) Files To The Endo Sequence™ Rotary Instruments, Nathan Wayment

Theses and Dissertations

The purpose of this study was to examine the number of rotations to failure of two different rotary file systems, EndoSquence Brassler USA (Savannah, GA) and GT(TM) series X(TM). Files sizes 20,30,40 with 0.04, 0.06 tapers of GT series X and Endo Sequence files size and taper used were 20, 30, 40 with 0.04 and 0.06 taper. Like tip and tapers were compared between systems. All files tested were 25mm in length. Files were allocated into 12 groups of 10 files each, and mounted to a universal testing machine. Each file was rotated at 300 rpms until fractured occurred. The …

Comparing Cyclic Fatigue Of The New Gt® Series Xtm Files To The Original Profile® Gt® Rotary Instruments, Steven Osmond

Theses and Dissertations

The purpose of this study was to test the number of rotations to fracture of the M-Wire GT® Series X(TM) rotary files compared to the original ProFile® GT® rotary files in a simulated curved canal. Eighty GT® Series X(TM) files of 25mm length were divided into eight groups of ten, one for each of the new GT® Series X(TM) files. Eighty original ProFile® GT® files of 25mm length were divided into eight groups of the same tip and taper sizes consistent with the GT® Series X(TM) file groups. Files were rotated at 300 rpm. While the angle may have slightly …

The Role Of Acanthamoeba Culbertsoni Serine Proteases In Abating Microglial-Like Cell Cytokines And Chemokines, Jenica Harrison

Theses and Dissertations

Acanthamoeba culbertsoni is an opportunistic free-living amoeba that is causative of granulomatous amoebic encephalitis (GAE), a chronic and often fatal central nervous system (CNS) disease that is most prevalent in immune compromised individuals. One hallmark of this disease is the formation of granulomas within the CNS, which are commonly absent in immune compromised individuals. Granulomas are usually composed of amoebae, microglia (CNS macrophages), macrophages, T cells, B cells, and neutrophils. Previous studies have demonstrated that microglia respond to Acanthamoeba by producing pro-inflammatory cytokines such as tumor necrosis factor alpha (TNF)-α, interleukin (IL)-1α, and IL-1β. In addition, activated microglia and macrophages …

Therapeutic Drugs In Cancer, Teneille Walker

Theses and Dissertations

The first study examined the interaction between low doses of the multi-kinase inhibitor sorafenib and the histone deacetylase inhibitor vorinostat in colon cancer cells. Sorafenib and vorinostat synergized to kill HCT116 and SW480 cells. In SW480 cells, sorafenib+vorinostat toxicity correlated with CD95 activation and CD95-stimulated autophagy. Drug lethality in SW480 cells was blocked by knock down of CD95. In SW620 cells that are patient matched to SW480 cells, sorafenib+vorinostat toxicity was significantly reduced that correlated with a lack of CD95 activation and lower expression of ceramide synthase 6 (LASS6). Overexpression of LASS6 in SW620 cells enhanced drug-induced CD95 activation and …

The Effects Of Motivational Interviewing In Pregnancy On Infant Oral Health Knowledge And Behavior, Patricia Arteaga

Theses and Dissertations

Purpose: The purpose of this study is to examine infant oral health knowledge and readiness of expectant mothers to incorporate preventive oral health behaviors for their infants. Methods: The study used a prospective cohort design to examine the effect of prenatal education and motivational counseling with expectant mothers about infant oral health care readiness. Participants were all enrolled in a prenatal care program called Centering Pregnancy offered by VCU’s Department of Obstetrics and Gynecology. They all completed a pre-survey questionnaire, followed by a motivational counseling intervention, and then completed a post-survey questionnaire. Results: A sample of 30 pregnant women completed …

Preventive Dental Services For Infants And Subsequent Utilization Of Dental Services, Elizabeth Berry

Theses and Dissertations

The purpose of this study was to examine the use of dental services for young children following a preventive oral health intervention in a pediatric medical clinic. Over a 3 year period (2005-2008), children 0-36 months of age, enrolled in Medicaid, were provided preventive oral health services in a medical setting. Descriptive statistics and multivariate logistic regression were used to determine the effect receiving the preventive oral health services in a medical setting with the outcomes of dental utilization. 15% were determined to have dental caries at the intervention and 42% found to have a dental visit post-intervention. Children determined …

Genetic Variations Of Cyp2b6 Enzyme And The Response To Meperidine In Oral Sedation, Sally Hua

Theses and Dissertations

Purpose: The purpose of this study was to determine the relationship of CYP2B6 genotype to the clinical response to meperidine in pediatric dental patients. Methods: Twenty-five patients, ASA I/ II, 45–92 months old, received an oral sedative regimen containing meperidine for dental treatment. The North Carolina Behavior Rating Scale (NCBRS) and Overall Effectiveness of Sedation Scale (OESS) were used to assess their behavior and sedation outcome. Saliva DNA samples were genotyped by PCR-RFLP. Results: We found the following genotype distributions: homozygous wild-type 1*1 (n = 8, 32%), heterozygous 1*6 (n = 13, 52%), and homozygous variant 6*6 (n = 4, …

The Role Of Myeloid-Derived Suppressor Cells In The Immunotherapy Of Breast Carcinomas, Johanna Morales

Theses and Dissertations

Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of immature cells at various stages of differentiation. These cells are broadly characterized by the simultaneous expression of the surface markers CD11b and Gr1 and have been found to accumulate in large numbers in response to many different tumors in both mice and humans, including HER2/neu+ breast cancers. The adoptive immunotherapy of cancers has been a promising field, yet the clinical efficacy of adoptive immunotherapies targeted against human breast cancers and many other cancers has been extremely limited. Given the influx of MDSC in tumor-bearing individuals, we hypothesized that these cells were …

Cannabinoid Effects On Nfkappab Function In Microglial-Like Cells: Dual Mode Of Action, Latoya Griffin-Thomas

Theses and Dissertations

Cannabinoids have been shown to modulate the immune system in vitro and in animal models. A major area of interest is how cannabinoids impact the brain. A whole variety of neuropathies or brain disorders, such as AIDS dementia, Parkinson’s disease, Multiple Sclerosis and Alzheimer’s disease, are associated with a hyperinflammatory response within the brain. Microglia, the resident macrophages of the brain, are the major cell type responsible for the persistent elicitation of pro-inflammatory cytokines (IL-1a, IL-1b, IL-6, TNFa) and other mediators. In vitro experiments have demonstrated that the partial exogenous cannabinoid agonist delta-9-tetrahydrocannabinol (D9-THC) and the potent synthetic exogenous cannabinoid …

Therapeutic Drugs In Cancer And Resistance., Aditi Pandya Martin

Theses and Dissertations

We investigated the mechanism of toxicity and resistance development of small molecule tyrosine kinase inhibitor lapatinib in HCT 116 colon cancer cells. Lapatinib mediated cell death in HCT 116 cells was caspase independent and involved cytosolic release of apoptosis inducing factor. Treatment of HCT 116 cells with 10µM Lapatinib lead to the outgrowth of lapatinib resistant HCT 116 cells. Our studies show that alterations in the expression and activation of Bcl-2 family proteins allow lapatinib resistant HCT 116 cells to resist cytotoxic effects of lapatinib as well as of other commonly used chemotherapeutic agents. In hepatoma and pancreatic cancer cells, …

Bonding Orthodontic Brackets To Stainless Steel Crowns, Daniel Stewart

Theses and Dissertations

The purpose of this study was to compare shear bond strengths of brackets bonded to stainless steel crowns using various orthodontic adhesives and surface conditioning techniques. One hundred and twenty mandibular first molar stainless steel crowns were randomly divided into groups: (1): Aluminablasting + Metal Primer + Assure; (2): Aluminablasting + Silane Coupling Agent + Transbond; (3): Diamond Bur Abrasion + Metal Primer + Assure; (4): Diamond Bur Abrasion + Silane Coupling Agent + Transbond; (5: control): Acid Etching + Metal Primer + Assure; (6: control): Acid Etching + Silane Coupling Agent + Transbond. Bond strength was tested using a …

In Silico Whole Genome Association Scan For Murine Prepulse Inhibition, Bradley Todd Webb, Joseph L. Mcclay, Cristina Vargas-Irwin, Timothy P. York, Edwin J. C. G. Van Den Oord

Biomarker Research and Personalized Medicine Publications

Background

The complex trait of prepulse inhibition (PPI) is a sensory gating measure related to schizophrenia and can be measured in mice. Large-scale public repositories of inbred mouse strain genotypes and phenotypes such as PPI can be used to detect Quantitative Trait Loci (QTLs) in silico. However, the method has been criticized for issues including insufficient number of strains, not controlling for false discoveries, the complex haplotype structure of inbred mice, and failing to account for genotypic and phenotypic subgroups.

Methodology/Principal Findings

We have implemented a method that addresses these issues by incorporating phylogenetic analyses, multilevel regression with mixed …

Dental Anatomy Carving Computer-Assisted Instruction Program: An Assessment Of Student Performance And Perceptions, Elizabeth T. Nance, Sharon K. Lanning, John C. Gunsolley

Periodontics Publications

The purpose of this study was to compare the performance of students exposed to two different instructional modalities for dental anatomy wax carving: CAI (computer-assisted instruction) using DVD technology, or traditional laboratory instruction. Students’ self-assessment scores were also compared to faculty scores, and students’ perceptions of their teaching modality were analyzed. Seventy-three first-year dental students (response rate 81 percent) participated in this randomized single blind trial, in which faculty graders were blinded to student group assignment. There were no statistical differences, as determined by the Wilcoxon non-parametric test and a t-test, between the faculty grades on the wax carving from …

Peginterferon Alfa-2b Or Alfa-2a With Ribavirin For Treatment Of Hepatitis C Infection, John G. Mchutchison, Eric J. Lawitz, Mitchell L. Shiffman, Andrew J. Muir, Greg W. Galler, Jonathan Mccone, Lisa M. Nyberg, William M. Lee, Reem H. Ghalib, Eugene R. Schiff, Joseph S. Galati M.D., Bruce R. Bacon, Mitchell N. Davis, Pabak Mukhopadhyay, Kenneth Koury, Stephanie Noviello, Lisa D. Pedicone, Clifford A. Bass, Janice K. Albrecht, Mark S. Sulkowski

Internal Medicine Publications

Background

Treatment guidelines recommend the use of peginterferon alfa-2b or peginterferon alfa-2a in combination with ribavirin for chronic hepatitis C virus (HCV) infection. However, these regimens have not been adequately compared.

Methods

At 118 sites, patients who had HCV genotype 1 infection and who had not previously been treated were randomly assigned to undergo 48 weeks of treatment with one of three regimens: peginterferon alfa-2b at a standard dose of 1.5 μg per kilogram of body weight per week or a low dose of 1.0 μg per kilogram per week, plus ribavirin at a dose of 800 to 1400 mg …