Medicine and Health Sciences Commons^™

Current Trends In The Management Of Invasive Cervical Resorption, Erik J. Foisy

Theses and Dissertations

Purpose: To determine how endodontic practitioners are currently managing cases of invasive cervical resorption. Also, to analyze how invasive cervical resorption (ICR) has been managed at Virginia Commonwealth University (VCU) over the past ten years.

Methods: Both domestic and international endodontists were invited to participate in a 14-question survey developed and administered via REDCap. Survey invitations were sent via email to currently practicing endodontists. Electronic dental records were queried for patients diagnosed with ICR at VCU in the preceding ten years. Results of both were summarized using descriptive statistics (counts and percentages). Fisher’s exact test was used to compare survey …

The Correlation Between Maternal Postpartum Depression And Child Psychopathology, T'Keyah I. Vaughan

Theses and Dissertations

Background: Postpartum depression (PPD) is a phenomenon that affects nearly 10-15% of pregnancies in the US. It is characterized by depressed mood or anhedonia and lasting for more than 2 weeks. PPD changes how moms interact with family members and child-rearing behavior. Depression is a phenomenon that is also known to affect the psychopathology of children. However, the specifics of how postpartum depression impacts children remains controversial. Many studies do not control for major depressive disorder which makes it difficult to disentangle the impact depression has within the first year of life. Furthermore, other PPD risk factors may be confounding …

The Intersection Of Social Stress, Mental Well-Being, And Sexual Health Among Black Women In Emerging Adulthood, Brandi Galloway

Theses and Dissertations

With an estimated 37,000 new HIV infections each year, HIV continues to be a major public health concern. HIV affects some populations more than others. Young Black women, in particular, are disproportionately affected by HIV. While being a woman does not typically increase a person’s HIV risk, being Black and being a woman does.

Data indicate that individual-level factors do not fully address the differences in HIV and STIs between Black emerging adult women and their White counterparts. Thus, it is critical to better understand contextual factors such as social stress and mental-wellbeing which might better account for these disparities. …

Biopsychosocial Variables Associated With The Development Of Chronic Low Back Pain In Healthcare Workers, Jena Pauli

Theses and Dissertations

ABSTRACT

Purpose: Worldwide the incidence and prevalence of acute low back injury with pain (ALBIP) is increasing in healthcare workers (HCW). Approximately 27% of ALBIP result in chronic low back pain (CLBP). The primary aim of this study was to identify biopsychosocial factors that contribute to the development of CLBP. A secondary aim was to examine the predictive value of reliable and valid screening instruments to identify individuals at highest risk for CLBP.

Significance: Low back pain is the second most commonly reported pain condition in the United States, one of the leading causes of sick leave and …

“It’S Supposed To Be Super Easy And It’S Not”: Black And Latinx Student Experiences In The Doctor Of Physical Therapy Admissions Process, Melissa Yeung

Theses and Dissertations

Data provided by the Physical Therapy Central Application System (PTCAS) suggests that despite the large numbers of applicants to Doctor of Physical Therapy (DPT) programs on an annual basis, a gap remains between the number of White and Black and Latinx applicants who are offered admission to DPT programs. Efforts made by DPT programs to increase the diversity of their incoming cohorts include the use of holistic review processes and enrichment programs to recruit more diverse classes. However, research suggests that the undergraduate experiences of students of color have an impact on their aspirations to graduate and professional schools, and …

The Role Of Manganese In Streptococcus Sanguinis, Tanya M. Puccio

Theses and Dissertations

Streptococcus sanguinis is primarily associated with oral health as a commensal bacterium. As an opportunistic pathogen, S. sanguinis is capable of colonizing heart valve vegetations, leading to the disease infective endocarditis. Previous studies from our lab have identified the high-affinity manganese transporter SsaACB as important for endocarditis virulence. The impact that manganese depletion has on S. sanguinis had never been evaluated and a secondary manganese transporter has not been identified. Thus, we employed the use of a fermentor to control large-scale growth over time and depleted manganese in an ΔssaACB mutant using a metal chelator, EDTA. The changes in …

Changing Landscapes: Perspectives Of Young African American Women Of Population-Wide Testing For Hereditary Breast Cancer Mutations, Alesha Henderson

Theses and Dissertations

Young African American women continue to die from breast cancer at higher rates than White women. In an effort to promote breast cancer prevention, population-wide testing (PWT) for all women in the U.S. starting at age 30 is a potential future initiative that is garnering a lot of attention. However, African American women currently utilize genetic testing for hereditary breast cancer at lower rates than White women. Therefore, if young African American women are not prioritized in a future roll out of PWT, then existing breast cancer and genetic testing disparities will likely continue to widen. The purpose of this …

A Review Of Factors, Seating Design, And Shape Capture Methods For Reducing Pressure Injury Risk, John A. Damiao

Theses and Dissertations

This dissertation in the form of three papers ready for submission to peer-reviewed journals is submitted toward the requirements of the PhD in Health Related Sciences program at Virginia Commonwealth University. Chapter One provides an introductory overview of the project, including: (a) an overview of pressure injuries, (b) the impact of seating as an intervention, and (c) aims of the three-paper dissertation in addressing various aspects of pressure injury prevention. Each paper is unique and singular in its focus, yet all share the overlying aim of addressing pressure injury risk associated with wheelchair seating. Paper One describes the unique facilitators …

Swipe Right For Condoms And Testing: Differences In High-Risk Sexual Behavior And Sexual Health Beliefs Among Dating App Users Compared To Non-App Users, Shelby A. Smout

Theses and Dissertations

Millions of Americans are currently using smartphone dating applications (apps) to socialize and meet with others. In some cases, app-based conversations lead to sexual interactions. Previous research examining the relationship between the use of dating apps and sexual behaviors has found that individuals who use dating apps and meet with partners from the app are more likely to engage in high-risk sexual behaviors such as having multiple partners and inconsistent condom use. Individuals between the ages of 18 and 24 are the group most likely to be using dating apps compared to other age groups and are a high-risk group …

Ndrg1 And Myelin-Related Disease: Alcoholism And Chemotherapy-Induced Neuropathy, Guy Harris

Theses and Dissertations

Alcohol use disorder (AUD) is a prevalent neuropsychiatric disease with profound health, social, and economic consequences. With an estimated 50% heritability, identifying genes that engender risk and contribute to the underlying neurobiological mechanisms represents an important first step in developing effective treatments. Gene expression studies are an important source of candidate genes for studying AUD, providing windows into the molecular machinery engaged by the brain in response to ethanol. Our laboratory has implicated N-myc down-regulated gene 1 (Ndrg1) as a potential candidate gene that modulates ethanol-induced changes in myelin-related gene expression and acute sensitivity to ethanol. Analysis of …

Transcriptomic Profiling Of Postmortem Prefrontal Cortex And Nucleus Accumbens From Chronic Alcohol Abusers., Eric S. Vornholt

Theses and Dissertations

Alcohol use disorder (AUD) is a debilitating psychiatric illness that develops from a combination of genetic and environmental factors. While it is well documented that AUD is heritable, the shift from recreational alcohol use to abuse/dependence is poorly understood. In this dissertation, using postmortem brain tissue from individuals with alcohol dependence (AD), we profiled the genome-wide expression of circular RNA (circRNA), microRNA (miRNA), and messenger RNA (mRNA) to better understand the impact of gene expression on the development of AUD. To achieve this, we performed two independent studies that explore transcriptome differences between AD cases and controls. The first of …

In Vivo Effects Of The Cb1 Allosteric Modulator Ldk1258, A Structural Analog Of Org-27569, Mohammed A. Mustafa

Theses and Dissertations

CB1 receptor allosteric modulators are an area of growing interest for their potential novel therapeutic actions. In the present study, we examined LDK1258 in a series of pharmacological in vivo tests sensitive to CB1 receptor stimulation. In the tetrad assay, LDK1258 produced significant decreases in locomotor activity and body temperature measures but did not produce either antinociception as measured in the tail-withdrawal assay or catalepsy as assessed in the bar test. These same effects were observed in both CB1 (-/-) and (+/+) mice. Moreover, LDK1258 failed to shift the dose-response curves of two orthosteric CB1 receptor agonists in the triad …

Relationship Of Demographic Characteristics Of Occupational And Physical Therapists Towards Their Knowledge And Attitude On Person-Centered Care In Skilled Nursing Facilities, Sadashiv R. Aggarwal

Theses and Dissertations

The study aimed to assess the relationship of specific demographic characteristics of occupational (OTs) and physical therapists (PTs) with their knowledge and attitudes towards principles of Person-Centered Care (PCC) in skilled nursing facilities (SNFs). The study further examined if knowledge and/or attitudinal differences exist between OTs and PTs towards PCC. The proposed descriptive study used the Person-Centered Care theory, which is a holistic (bio-psychosocial-spiritual) health care delivery approach. PCC delivers services that are respectful and individualized, allowing negotiation of care, and offering choice through a therapeutic relationship where persons receiving care are empowered to be involved in health decisions at …

Feasibility And Acceptability Of Focused Breathing For Management Of Anxiety In Parkinson’S Disease, Susan K. Chandler

Theses and Dissertations

ABSTRACT

Anxiety is recognized as a predominant nonmotor symptom of Parkinson’s disease (PD) which greatly diminishes quality of life. Current treatment is largely pharmacologic and is recognized as rife with undesirable and unsafe side effects. Reviews commissioned by The Movement Disorder Society Task Force on Evidence-Based Medicine and the American Academy of Neurology revealed there was insufficient evidence to make recommendations for the treatment of anxiety. A review of the literature confirmed anxiety in PD is underdiagnosed, undertreated, and under studied. A common element in many of the non-pharmacologic self-managed interventions used by the studies included in the review was …

The Effects Of An Inflammasome Inhibitor Olt1177 On The Development Of Ischemic Heart Failure, Joseph S. Aliaga

Theses and Dissertations

Thesis Abstract

THE EFFECTS OF AN INFLAMMASOME INHIBITOR OLT1177 ON THE DEVELOPMENT OF ISCHEMIC HEART FAILURE

By Joseph S. Aliaga, BS

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University.

Virginia Commonwealth University, 2020

Background: Evidence suggests that prolonged and enhanced pro-inflammatory signaling, modulated by the NLRP3 inflammasome, plays a crucial role in the pathophysiology of several different types of cardiovascular diseases such as acute myocardial infarction (AMI), adverse ventricular remodeling, and heart failure (HF). Consequently, we hypothesize that attenuating the enhanced inflammatory response using a pharmacological NLRP3 …

Novel Strategies To Overcome Carboplatin Resistance In Triple Negative Breast Cancer Using Patient Derived Xenografts, Mohammad A. Al Zubi

Theses and Dissertations

Triple-negative breast cancer (TNBC) patients have a poor prognosis and rely on chemotherapeutic treatment as standard of care. Often, they develop chemotherapy resistance, which leaves them without more therapeutic options, like targeted therapy. New models have been developed to test targeted inhibitors in human tumors, and they are known as patient-derived xenografts (PDX). These tumors are obtained from patients, then established and maintained in mice where they areused for tumor studies. In this work, we characterized 14 PDXs for their primary tumor growth rate and investigated metastatic propensity using spontaneous and experiment metastasis models. We utilized RNA-sequencing to characterize contributions …

Quality Of Medical Care For Adults With Intellectual/Developmental Disabilities, Priya Chandan

Theses and Dissertations

QUALITY OF MEDICAL CARE FOR ADULTS WITH INTELLECTUAL/DEVELOPMENTAL DISABILITIES

By Priya Chandan, M.D., M.P.H.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of

Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020.

Director: Director: Gloria J. Bazzoli, Ph.D.

Bon Secours Professor, Department of Health Administration

People with intellectual/developmental disabilities (IDD) are difficult to identify in administrative data, limiting the ability to study the quality of health care provided to this population. This study utilized clinical diagnoses to define a sample of hospitalized patients with IDD in the largest publicly available all-payer inpatient care database—the …

The Role Of Interleukin-18 In Myocardial Ischemia/Reperfusion, Yogesh Dhakal

Theses and Dissertations

Acute Myocardial Infarction (AMI) is one of the leading causes of morbidity for cardiovascular diseases (CVDs) in the western world. While mortality rates for AMI has reduced in the last 20 years due to advancements in clinical interventions, patients who have an AMI are significantly more likely to develop heart failure (HF) in the following years. Reperfusion of the ischemic tissue is a necessary procedure to restore blood delivery to cardiomyocytes, minimize myocardial dysfunction, and reduce infarct size. Still, the step of reperfusion itself induces myocardial damage in a phenomenon known as reperfusion injury. Considering that the degree of myocardial …

Can School Be A Source Of Trauma? Assessing Academic Traumatic Stress As A Mechanism Underlying The Health Outcomes Of Black Undergraduate Students, Ebony A. Lambert

Theses and Dissertations

Research examining Black students’ school experiences demonstrates that exposure to oppressive power dynamics in schools may lead to adverse physiological and psychological consequences. Recent conceptualizations in public discourse further posit that traumatic educational experiences, operationalized here as academic trauma or the cumulative toll of adverse and oppressive experiences in academic settings, may influence Black students’ wellbeing even after they have graduated. However, academic trauma has yet to be investigated empirically, and the health contributions of such educational harm remain unstudied. Moreover, little is known about how culturally-relevant personal characteristics (e.g., emotion regulation strategies) influence Black students’ reactivity to academic trauma. …

Impact Of Performance-Based Budgeting On Quality Outcomes In U.S. Military Healthcare Facilities, Kimberly L. Decker Virginia Commonwealth University

Theses and Dissertations

Performance-based budgeting (PBB) is a variation of pay for performance that is applicable to government programs. It works by increasing or decreasing funding based on pre-established performance thresholds, which incentivizes organizations to improve performance. In late 2006, the U.S. Army implemented a PBB program in all of its healthcare facilities due to rising concerns over costs and quality in its facilities. The U.S. Army’s PBB program tied hospital-level funding decisions to performance on key cost and quality-related metrics. This study examined the impact of this program and a subsequent PBB program on quality improvement in U.S. Army healthcare facilities. Drawing …

Hospital Investment In Urgent Care: Impacts On Emergent, Outpatient, And Ambulatory Surgery Volumes, Hillary A. Linhart

Theses and Dissertations

As the popularity of urgent care centers (UCCs) has grown, hospitals have increasingly chosen to invest in this care model. Hospital interest in UCCs is largely driven by two key factors. First, hospitals aim to use UCCs to generate referrals, which generate additional patient volume for downstream hospital services. Secondly, hospital UCC investment presents an opportunity to ease the demand for non-urgent care in the emergency department (ED) by diverting low-acuity ED patients to the more appropriate UCC setting. No study to date has evaluated the impact of hospital UCC investment on referrals or downstream service volumes. A few studies …

An Exploration In Accountable Care Organization Structure, Contingency And Performance, 2015-2017, Siriporn P. Satjapot

Theses and Dissertations

The Patient Protection and Affordable Care Act of 2010 enacted one of the most significant reforms seen in the United States healthcare landscape. The Center for Medicare and Medicaid (CMS) led transformation efforts in regulatory reform and coverage expansion across the U.S. population. Since 2010, care delivery systems have been shifting from episodic, decentralized and fee-for-service models to value-based population health models, like accountable care organizations (ACO). ACOs have been specifically primed for local response to improve the health of their communities. ACO research has traditionally focused on performance measures like mortality, readmissions, quality outcomes and savings. ACO organizational characteristics …

Spag17 Is Important For Protein Trafficking In Mammalian Spermiogenesis, Virali Bhagat

Theses and Dissertations

Spermiogenesis is the process through which undifferentiated germ cells develop into mature spermatozoa. While spermiogenesis is a very well-regulated process, the protein-protein interactions regulating it remain poorly understood. A knockout (KO) mouse for the ciliary protein SPAG17 was generated by our lab. Loss of SPAG17 has been shown to disrupt the transport of proteins important for acrosome biogenesis and manchette functions. With this information, we hypothesized that SPAG17 plays an essential role in protein trafficking during mammalian spermiogenesis. To further investigate this, immunofluorescence (IF) studies were performed in germ cells collected from both WT and SPAG17 KO mice to visualize …

Prediction Of The Vaginal Microbiome Using Urine Samples, Christopher R. Diachok

Theses and Dissertations

The vaginal microbiome is associated with women’s health, including but not limited to the pathogenesis of bacterial vaginosis, adverse pregnancy outcomes including preterm birth and sexually transmitted infections. However, there has been very limited research on the urinary microbiome and its relationship to the vaginal microbiome. We sought to predict the vaginal microbiome profile using clean catch urine samples from the same person. Here, paired vaginal and urine samples were collected and sequenced by 16S ribosomal RNA sequencing. Alpha and beta diversity analysis showed that there was no significant difference between the paired vaginal and urine microbiomes. In fact, a …

Anticholinergic Burden And Risk Of Cognitive Impairment In Older Adults, Syeda Hashimi

Theses and Dissertations

Studies reveal that 10-27% of older adults chronically use anticholinergic medications. Increased cumulative anticholinergic burden scores are associated with increased risks of dementia. The mechanisms by which anticholinergic drugs negatively impact cognition remain elusive. However, researchers speculate that the drug’s impairment of cholinergic neurons promotes neuroinflammation.

We hypothesize that drugs with anticholinergic properties will induce inflammation in the brain. MCP1 and IL 6 are chemokines that contribute to neuroinflammation. We investigated the influence of diphenhydramine (Benadryl) on the production of MCP1 and IL-6 in Normal Human Astrocytes and Paroxetine on the production of MCP1 in Normal Human Astrocytes and Normal …

The Substantiality Of The Neuroplasticity Hypothesis Of Major Depressive Disorder: The Prospective Use Of Ketamine-Like Drugs As Antidepressants, Roma Kankaria

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Abstract

Major depressive disorder (MDD) affects approximately 17.3 million adults in the United States each year. For more than 50 years, the serotonin hypothesis of MDD, which hypothesizes that a deficiency of monoaminergic neurotransmitters results in depression, has been the foundation for neuropsychological research. However, studies reveal that only an estimated 50% of MDD patients respond to traditional, biogenic-amine-based antidepressants (ADs), like selective serotonin reuptake inhibitors (SSRIs). Research has noted that the neuroplasticity hypothesis, which posits that weakened excitatory synaptic transmission results in depression, offers an alternative mechanism by which ketamine-like drugs lacking the abuse liability and psychoactive effects of …

Applications Of Cloud-Based Quantum Computers With Cognitive Computing Algorithms In Automated, Evidence-Based Virginia Geriatric Healthcare, Henry Childs

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Quantum computers have recently headlined IBM’s next generation of products promoting computational evolution. After the successful release of the cloud-streaming quantum computer IBM Watson Q, the company has released projections for future development of quantum devices. Because of the incredible processing power of these machines and the expected integration into everyday life in the near future, what implications can this have in the healthcare field?

I am studying cloud-based quantum computers with natural language processing (NLP) algorithms and patient health record data because I want to understand automated, evidenced-based co-optimized treatment of home-bound geriatric patients in order to help my …

College Students’ Perceptions Of Popular Diets And Orthorexia Nervosa, Madison W. Weinstock

Theses and Dissertations

Data suggest that individuals’ purported dietary patterns influence others’ perceptions of them. However, few studies have investigated how adherence to specific popular diets might influence these perceptions. This study investigated female undergraduates’ (n = 463) perceptions of vignette characters described as adhering to specific dietary practices perceptions of a vignette character in a sample of 463 female undergraduates. Characters described as adhering to a Clean Eating diet were viewed most positively, followed by individuals on the Ketogenic diet or nondieters. Characters following an Intermittent Fasting diet, and those with Orthorexia Nervosa were viewed most negatively. These findings support the …

Virginia Dental Journal (Vol. 97, No. 2, 2020)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 97, No. 4, 2020)

Virginia Dental Journal

No abstract provided.