Medicine and Health Sciences Commons^™

Cost-Effectiveness Analysis Of Alternative Infant And Neonatal Rotavirus Vaccination Schedules In Malawi, Catherine Wenger

Public Health Theses

Rotavirus is the leading cause of cases and deaths related to diarrhea-related hospitalizations among children under five worldwide, especially in low- and middle- income countries. Although vaccination is proven to be the best strategy for preventing rotavirus, its impact has been suboptimal in LMICs.

The primary aim of this study was to evaluate the impact of and cost- effectiveness of the current Rotarix rotavirus vaccine, two alternative vaccine delivery schedules, and the next-generation vaccine (RV3-BB) in Malawi.

The cost-effectiveness of rotavirus vaccine strategies in Malawi was evaluated using moderate-to-severe and non-severe rotavirus cases derived from a mathematical model ofrotavirus transmission …

Randomized Trial Of Exercise Vs. Usual Care On Inflammatory And Metabolic Biomarkers In Women With Breast Cancer Taking Aromatase Inhibitors, Lingxiao Zhang

Public Health Theses

ABSTRACT

Background: The Hormones and Physical Exercise (HOPE) study demonstrated efficacy of exercise in reducing AI-associated arthralgia in breast cancer survivors. Yet, the underlying mechanism for this relationship remains unclear. Prior research among breast cancer survivors highlights improvements in metabolic and inflammatory biomarkers related to exercise. This secondary analysis of HOPE examined the potential role of metabolic and inflammatory biomarkers in mediating the effect of exercise vs. usual care on AI-associated arthralgia.

Methods: Our analysis included 80 participants (42 exercise arm, 38 usual care) enrolled in the HOPE study. The intervention was a year-long exercise program that included both supervised …

Do Rental Assistance Programs Relieve Overcrowding In U.S. Children?, Frank Zhu

Public Health Theses

Introduction: Crowded living conditions are associated with many negative health outcomes, with significant implications for children, as they are particularly shaped by their home environment and more likely to live in crowded conditions, given their larger household size. How rental assistance programs may shape and improve household crowding has not been previously explored. Methods: This study leveraged data from NHANES linked with HUD administrative rental assistance records. We examined changes in crowding measures in U.S. children using linear and logistic regression models stratified by different rental assistance program types. Results: There was a statistically significant 40 percentage point reduction in …

The Menstrual Cycle In Psychotherapy: Interventions, Therapist Engagement, And Blind Spots, Rozita Alaluf

Dissertations and Theses

There is a dearth of literature on psychotherapy and menstruation, except for the treatment and diagnosis of issues associated with premenstrual distress. This study aimed to bridge this gap by investigating the frequency and context of discussions about the menstrual cycle, the factors influencing therapists’ engagement with this topic, and the therapeutic approaches utilized to address the menstrual cycle within psychotherapy.

In phase 1, 118 psychotherapists from various theoretical backgrounds completed a survey on menstruation in clinical practice. The data was analyzed using descriptive statistics. In phase 2, semi-structured interviews were conducted with 7 psychotherapists, primarily identifying their theoretical orientation …

The Shadow Of Grief: Understanding Grief Among Ethnoracially Diverse Young Adults, Rona R. Tarazi

Dissertations and Theses

Background: Complicated grief, characterized by prolonged and intense mourning, presents unique challenges for individuals grappling with loss, as it is shaped by a multitude of factors influencing the grieving and mourning processes. While the literature has identified several factors that significantly impact complicated grief, such as post-loss symptom severity, stigmatization, the quality of the relationship to the deceased, and grief-related avoidance, this two-part study aimed to expand on existing findings by shedding light on the landscape of grief among a sample of ethnoracially diverse young adults. Part 1 of the study examined whether previously identified factors remain significant in this …

The Sewage Microbiome Dynamics Of Different Serving Neighborhoods In Charleston, Illinois, Sandra Chiamaka Okoye

Masters Theses

The complex microbial ecosystem within sewage systems holds significant implications for environmental and public health. Unlike studies on wastewater treatment plant microbiomes, upstream sewage systems have not been studied widely. This research investigated the dynamic sewage microbiome across diverse serving neighborhoods in Charleston, Illinois, encompassing residential, hospital, industrial, and university areas. Drawing upon recent advancements in microbiome research, the study aimed to unravel the spatial and temporal variations in microbial structures. Three times between June to December 2023 sewage samples were collected from manholes in the areas mentioned above. Community DNA was extracted and sequenced for the V4-V5 region of …

The Investigation Of The Effects Of Adolescent Substance Use On Socioeconomic Outcomes During Adulthood, Bedis Elkamel

Honors Undergraduate Theses

Background: Adolescence is a crucial point in life where choices, behaviors, and environmental influences can significantly shape future outcomes. This research investigates the increasing concerns surrounding adolescent substance use and examines its long-term effects on socioeconomic status (SES) in adulthood. Substance use during adolescence has been shown to have significant long-term physiological impacts, as the brain is still developing at this age. Additionally, many short- and long-term effects are associated with substance use, such as impacts on academics, physical and emotional well-being, and social life. Several studies have been conducted to explore the relationship between substance use and SES, however, …

Contributing Factors And Interventions For Increased Central Line-Associated Bloodstream Infection (Clabsi) Rates During The Covid-19 Pandemic: A Literature Review, Brittney Perry

Honors Undergraduate Theses

The purpose of this literature review is to determine the contributing factors of CLABSI rate increases during the COVID-19 pandemic and identify interventions which restored CLABSI rates to pre-pandemic levels to guide healthcare professionals’ actions during the next pandemic. Background: In the first two decades of the 21^st century, CLABSI rates were reduced in United States hospitals by innovating safer patient care practices. However, there was a significant increase in the annual CLABSI rate in 2020 and 2021, increasing the average length of stay, mortality rate, and cost to the U.S. healthcare system. Methods: An extensive search of CINAHL …

Financial Issues And Trends Among Testicular Cancer Patients: A Review Of Patient-Reported Outcomes, Treatments, And Employment, Staphana Valery Edouard

Honors Undergraduate Theses

The present study reviewed existing literature on the effects of treatment and recovery costs on the multidimensional wellness of testicular cancer (TC) survivors. Peer-reviewed and scholarly articles were systematically searched and analyzed to determine the extent and impact of the overall financial effects of a TC diagnosis. This study aimed to uncover evidence indicating the possible decline in overall health-related quality of life (HRQoL) due to the potential deleterious effects on TC survivors’ financial well-being.

We found that TC survivors’ HRQoL is affected due to the damages of high out-of-pocket treatment costs, possible loss of employment, disability, and any other …

Recognizing Risk Factors Of Bronchopulmonary Dysplasia In Neonates ≥ 24 And ≤ 32 Weeks Of Gestational Age, Hannah Tatro

Honors Undergraduate Theses

Background: Bronchopulmonary dysplasia (BPD) is a chronic lung condition that is diagnosed among neonates who are on oxygen therapy for longer than 28 days. BPD causes insufficient gas exchange due to prematurely developed lungs and is the most common condition that causes morbidity of prematurity. Many risk factors contribute to the development of this condition and relate to care from the delivery room to the first few days of life.

Purpose: The purpose of this literature review is to examine risk factors related to the development of BPD in neonates from the gestational ages of 24 to 32 weeks.

Methods: …

Sars-Cov-2 Infection History Is Positively Correlated With Frequency Of Psychotic Symptoms In Schizophrenia, Jackson D. Beecher

Honors Undergraduate Theses

Previous work in human and animal studies has implicated aberrant insular cortex (IC) activity in the pathophysiology of hallucinations. Of note, the IC overlaps with the olfactory cortex (OC), a region of the brain that receives extensive projections from sensory neurons of the olfactory epithelium. SARS-CoV-2 (COVID-19) is a highly infectious coronavirus with a demonstrated ability to cause anosmia; the virus does this by colocalizing with and damaging support cells in the olfactory epithelium, ultimately leading to alterations in olfactory receptor cell signaling to the OC. Given the overlap between OC and IC, we asked the question of whether COVID-19 …

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …

From Suicidal Ideation To Suicide Attempt: Clarifying The Role Of Painful And Provocative Events, Mallory Stephenson

Theses and Dissertations

The Interpersonal-Psychological Theory of Suicide hypothesizes that capability for suicide is acquired in part through exposure to physically painful and/or fear-inducing experiences, referred to as painful and provocative events (PPEs). Studies of PPE exposure offer an opportunity to characterize potential targets for suicide prevention and inform efforts to identify individuals at elevated suicide risk. However, the literature on PPE exposure and risk for suicidality has been limited by a reliance on cross-sectional designs, lack of genetically informed research, inclusion of risk-taking behaviors as potential PPEs, and focus on risk over resilience. In this dissertation, we aimed to address these knowledge …

A Radiographic Analysis Of Teeth With Carrier-Based Obturation Requiring Retreatment, Robert W. Rudnicki

Theses and Dissertations

Objective: The purpose of this study was to determine observer accuracy and agreement in detecting carriers using preoperative radiographs, as well as to identify potential radiographic indicators for the presence of carriers.

Methods: A chart review was conducted for patients seen at the VCU graduate endodontic clinic. Eligible cases included previously treated teeth that were nonsurgically retreated, with and without identified carriers. 100 cases were identified, including 61 carrier and 39 non-carrier cases. Preoperative radiographs were randomized, and evaluators assessed each case for the presence of carrier-based obturation. Evaluators included three endodontists, one general dentist, and four endodontic residents. Statistical …

Characteristics Of Permanent Teeth Diagnosed With Pulpal Necrosis: A Retrospective Study, William Lee

Theses and Dissertations

Objective: To determine associations of pulpally necrotic teeth with demographics, clinical findings, radiographic presentation, and periapical status.

Methods: Virginia Commonwealth University uses AxiUm software to record dental treatment and treatment notes. The current study involves a keyword search using the term “pulpal necrosis”. Factors compiled and evaluated included but not limited to patient demographics, location in the dental arch, clinical findings, radiographic presentation, and periapical status.

Results: Data has revealed that teeth with pulpal necrosis can present with a variety of different clinical findings. All of the following were observations of teeth with pulpal necrosis. A total of 325 teeth …

Investigating Black Emerging Adult Health And Model Of Care Choices, Alexandra Wynn

Theses and Dissertations

This mixed methods study aimed to analyze the health profiles of Black emerging adults (who do not seek medical care for chronic condition management) college students to identify factors influencing their use of preventive services and their choices in healthcare plans. The study revealed distinct profiles of Black emerging adults based on patterns of factors related to their engagement with healthcare, such as barriers to care, insurance access, usual source of care, self-rated health, intention to seek care, discrimination, trust in physician, medical mistrust, and sex-assigned at birth. Interviews were conducted to investigate the similarities and differences among all participants …

Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado

Theses and Dissertations

Tobacco dependence has posed a significant public health challenge in the United States and disproportionately affects Latine adults' risk of developing a variety of adverse health conditions. Childhood trauma is a recognized risk factor for dependence, overall health, and mental health concerns. Still, the influence of compassion for self or compassion for others in this context remains unclear. This cross-sectional study investigated the moderating effects of self-compassion and compassion for others on the relationship between childhood trauma and cigarette dependence among Latine adults. Data was collected through questionnaires assessing childhood trauma, self-compassion, cultural values and factors, compassion for others, and …

Age Of First Dental Visit And Early Childhood Oral Health Quality Of Life, Richard Greene

Theses and Dissertations

Objective: This project aims to examine the association between the age of a child's first dental visit and their Early Childhood Oral Health Impact Scale (ECOHIS) score.

Methods: A 22-item cross-sectional survey was distributed to caregivers of healthy children aged 5 years and younger with an American Society of Anesthesiology (ASA) I and II status who presented for new patient exams.

Results: In total, 117 caregivers participated in the survey. The ECOHIS was assessed on a 5-point Likert scale and scores ranged from 0-52; higher values indicate poor oral health having a greater impact on the child and family. Those …

Assessment Of Maxillary Sinus Pneumatization In Dentate And Edentulous Areas Using Cone Beam Computed Tomography, Catherine Ramundo

Theses and Dissertations

Objectives: The primary goal of this retrospective analysis is to analyze the morphologic changes that occur following extraction in regards to sinus pneumatization.

Methods: The patient population was selected from the VCU School of Dentistry Graduate Periodontics Department. Cone Beam Computed Tomography scans (CBCT) was obtained from patients that had a posterior tooth extracted. A horizontal tangent line was drawn to the inferior border of the nasal cavity, acting as a constant reference point for measuring the extent of maxillary sinus pneumatization. Radiographic measurements were performed from a horizontal line at this fixed anatomical marker to the deepest level of …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Darlene W. Jean

Theses and Dissertations

Purpose: To investigate the benefit of educating teachers, coaches, and athletic trainers about dental trauma to prevent incidents and improve the management of students/athletes with dental trauma.

Methods: Teachers, coaches, and athletic trainers throughout the greater Richmond metro area were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they have experienced dental trauma with their students/athletes previously. The participants were given the option to attend an in-person or virtual seminar educating them on the basic management of traumatic dental injuries and how to guide affected students/athletes and their families to obtain optimal …

Clinical Outcomes Of Primary Anterior Esthetic Crowns In Pediatric Dentistry, Jenan Alahmad

Theses and Dissertations

Clinical Outcomes of Primary Anterior Esthetic Crowns in Pediatric Dentistry - A Prospective Cohort Study

By: Jenan Alahmad, BDS

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

Virginia Commonwealth University, 2024

Thesis Advisor: Parthasarathy Madurantakam, DDS, MDS, PhD

Department of Pediatric Dentistry

BODY

Purpose: This prospective cohort study aimed to compare the effectiveness of restoring maxillary anterior teeth in children (aged 3-6 years) with three different materials: Zirconia Crowns (ZC), Resin Composite Crowns (RC), and Pre-veneered Stainless-Steel Crowns (PVSSC). The study aims to assess the Oral …

A Preliminary Report Of A Randomized Controlled Clinical Trial Comparing Ferric Sulfate With Zin Oxide Eugenol And Non-Eugenol Based Material For Pulpotomy In Primary Molar Teeth, Sarah Balal

Theses and Dissertations

Purpose: This study aimed to evaluate the effect of eugenol and non-eugenol-based Zinc Oxide Eugenol (ZOE) cements on primary tooth pulpotomies where Ferric Sulfate (FS) is used as a medicament.

Methods: Children aged 3-7 years with dental caries in their primary molars that have clinical and radiographic diagnosis of reversible pulpitis and undergoing dental treatment under Oral Conscious Sedation (OCS) or General Anesthesia (GA) were recruited. Children were randomly assigned to receive either FS and ZOE (IRM) or FS and non-eugenol based (CAVIT). The outcomes were assessed based on failure rates of the materials separately for clinical or radiographic evidence …

Established Colonization Of Sneathia Vaginalis In A Mouse Model, Kailyn E. Turcios-Gonzalez

Theses and Dissertations

Sneathia vaginalis (Sv) is a gram-negative anaerobic bacterium associated with adverse reproductive outcomes. Sv can traverse the fetal membrane and damage epithelial cells in vitro by producing a pore-forming cytotoxin, cytopathogenic toxin A (CptA). To further understand the transition of Sv from normal flora to a pathogen, an animal in vivo model needs to be created to observe the preliminary ascending infection before we begin to study the effects on pregnancy. Experimentation was conducted to optimize mouse breed, bacteria administration methods, and other variables that arise when working in vivo. The C57BL/6 mouse strain displayed the most consistent …

Mental Health Help-Seeking Behaviors And Service Utilization Of Black College Students, Troy J. Keys

Theses and Dissertations

Black college students are less likely to seek mental health services compared to other students. While previous research has identified barriers and facilitators contributing to Black college students’ help-seeking behaviors, the current political and social climate and pandemic have negatively impacted their mental health thus warranting the exploration of these factors again. This study aimed to identify the mental health help-seeking behaviors and attitudes of Black college students, the barriers and supports for help-seeking behaviors, their preferred service utilization providers, and their thoughts about promoting mental health help-seeking among their peers. Black college students (n = 21) enrolled at an …

Continuous Flow As A Process Intensification Tool For The Preparation Of Pharmaceutically Relevant N-Heterocycles, John W. Tomlin Jr

Theses and Dissertations

Continuous flow as a process intensification tool for the preparation of pharmaceutically relevant N-heterocycles

John W. Tomlin

Thesis Defense: 17 January 2024

Committee: B. Frank Gupton, Ph.D. (Advisor), Suzanne M. Ruder, Ph.D. (Chair), Heather R. Lucas, Ph.D., James K. Ferri, Ph.D., Matthew C.T. Hartman, Ph.D.

A dissertation submitted in partial fulfillment of the requirements of Doctor of Philosophy at Virginia Commonwealth University

© 2024 John W. Tomlin Jr All Rights Reserved

Abstract

Essential medicines must be produced in large quantities to accommodate large global demand. The preparation of these active pharmaceutical ingredients (API) must therefore strive to be both cost-effective …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …

Feasibility Of Using Somatosensory Input On Pediatric Patients Receiving Dental Treatment, Liara D. Vinson

Theses and Dissertations

Purpose: The aim of this randomized, cross-over designed feasibility study is to evaluate patient anxiety, patient cooperation, and patient acceptance of a vibrating weighted vest used during the restorative treatment compared to when no device is used.

Methods: Children aged 5 to 15 years, needing at least two appointments for restorative treatment requiring local anesthesia under basic behavior guidance techniques were recruited. Patients were randomly allocated to wearing a vibrating weighted vest at one of the appointments. At both appointments, behavior was evaluated using Frankl scores and anxiety was evaluated at the beginning and at the end of …

Inhaling The Unseen: Exploring The Presence Of Microplastics In The Human Respiratory Tract, Kara Coffman-Rea

Graduate Research Theses & Dissertations

Microplastics (plastic pieces less than 5 mm) have emerged as a pervasive form of pollution acknowledged as a universal threat to both environmental and human health. Their small size and widespread distribution pose significant risks to marine life, terrestrial ecosystems, and ultimately human health. Microplastics have been reported in food and drink items designated for human consumption, in cosmetics and consumer goods designed for human use, and within the air we breathe, each providing an entry route for microplastics to enter the human body. Recently, microplastic particles have been detected in a variety of human tissue samples (e.g., lung tissue). …

Promoting Cultural Competence Through Clinical Education, Katie Coakley

Graduate Research Theses & Dissertations

Purpose: The purpose of this dissertation was to explore how clinical education can be leveraged to promote the cultural competence of aspiring clinicians. Cultural competence training is important in addressing health disparities and recommended in health professions education, but barriers exist to its implementation. This dissertation seeks to explore and appraise the literature on cultural competence instruction in rehabilitation education, evaluate the impact of a clinical education experience for speech language pathology (SLP) students on their perceived cultural competence, and assess the outcomes for clients receiving feeding therapy services from supervised SLP students, including the client perceptions of cultural competence …

An Exploration Of The Sense Of Belonging For African American Women Licensed Clinicians In A Voluntary Professional Counseling Organization, Raushanah Jackson

Graduate Research Theses & Dissertations

Due to historical oppression in academe, the voices of African American women have been excluded, or unjustifiably limited, in academic research and from mainstream psychological thought. This study was one aim at understanding the experiences of belonging of women of African American ancestry who were clinically licensed professional members in a volunteer member counseling organization. Centering African American women’s voices was used through a lens of critical race theory and Black Feminist Thought to illuminate the structural, representational, and sociopolitical barriers that African American women face. An Interpretive Phenomenological Analysis approach was used to center the voices of five licensed …