The Retrospective Diagnosis Of Attention-Deficit/Hyperactivity Disorder In Adolescents: Family Physicians' Challenges, Adam M. Pechmann

Masters Theses

The primary purpose of the study was to identify current retrospective practices used by family physicians in the diagnosis of Attention-Deficit-Hyperactivity Disorder (ADHD) in adolescents and young adults. In other words, do physicians adhere to best practices and examine information from childhood in order to diagnose ADHD in adolescents and young adults? In addition, this study aimed to examine the information physicians request for ADHD diagnosis, types of treatments they recommend, the type of information they use to assess treatment outcomes, and professional attitudes regarding the nature of ADHD. Participants completed a questionnaire designed to answer the research questions. Participants …

Assessing The Impact Of Pre-Meal To-Go Containers On Consumption And Satiety, Claudia Bueno

Masters Theses

Lack of portion control is one of the main causes of obesity. Restaurants offer portions larger than recommended by the USDA. This can lead to portion distortion among consumers and increased consumption. The purpose of this study was to evaluate the effect of offering a to-go box before a meal on reducing consumption.

In this quasi-experimentally designed study, a convenience sample of diners (N=35) served as subjects. The experimental group (n=18) was offered a to-go box before the meal, and the control group (n=17) was offered a to-go box after the meal. The food was …

Deconstructing Anesthesia Handoffs During Simulated Intraoperative Anesthesia Care, Jason S. Lowe

Theses and Dissertations

Anesthesia patient handoffs are a vulnerable time for patient care and handoffs occur frequently during anesthesia care. Communication failures contribute to patient harm during anesthesia patient handoffs. The Joint Commission has recognized the potential for communication failure during patient handoffs and has recommended processes to improve handoff safety. Handoffs are made more difficult by latent conditions such as time constraints, pressure and distractions, which often result in incomplete or inaccurate handoff reports. This nonexperimental, correlation study identified the latent conditions that occur during the handoff process and their relationship to the quality of the handoff. This research shows an inverse …

Elucidation Of A Novel Pathway In Staphylococcus Aureus: The Essential Site-Specific Processing Of Ribosomal Protein L27, Erin A. Wall

Theses and Dissertations

Ribosomal protein L27 is a component of the eubacterial large ribosomal subunit that has been shown to play a critical role in substrate stabilization during protein synthesis. This function is mediated by the L27 N-terminus, which protrudes into the peptidyl transferase center where it interacts with both A-site and P-site tRNAs as well as with 23S rRNA. We observed that L27 in S. aureus and other Firmicutes is encoded with a short N-terminal extension that is not present in most Gram-negative organisms, and is absent from mature ribosomes. The extension contains a conserved cleavage motif; nine N-terminal amino acids are …

High School Teacher And Administrator Perceptions Of Student Health Promotion: An Exploratory Study, Sarah B. Conklin

Theses and Dissertations

The current study explored the high school health promotion environment with regards to physical activity, nutrition, and sedentary behaviors from the perspective of high school health and physical education teachers and administrators. Specifically, potential strategies for a prevention program to promote student physical activity participation and healthy eating, and decrease student sedentary time were explored.

Individual semi-structured interviews were conducted with physical education teachers to explore potential strategies to promote student health behaviors. Next, interviews were conducted with high school administrators to determine the feasibility of recommended strategies. Teachers and administrators in the current study expressed a need for strategies …

The Slc22 Transporter Family: Novel Insights To Roles In Drug Efficacy, Drug-Drug Interactions And Mood Disorders, Xiaolei Pan

Theses and Dissertations

Numerous studies have demonstrated the impact of organic cation (OCTs; SLC22 family) and anion transporters (OATs; SLC22 family) on the efficacy and safety of clinically important therapeutics. To be specific, OCTs and OATs have been identified as determinants for uptake into and secretion from enterocytes, hepatocytes and renal proximal tubular cells, and are frequent sites of drug-drug interaction (DDI). In addition, OCTs expressed in brain are components of the low-affinity, high capacity clearance pathway (uptake-2) for biogenic monoamine neurotransmitters. As a result, OCTs may represent novel targets for mood disorders.

The inhibitory effects of several therapeutic agents, designed drugs and …

The Effect Of Optogenetic Manipulation Of Ss Interneurons Within Malformed, Epileptogenic Cortex, Nicole Ekanem

Theses and Dissertations

A large percentage of individuals with intractable epilepsies have an accompanying cortical malformation, the underlying cellular mechanisms of which are poorly understood. It is known however that in an animal model for one such malformation, polymicrogyria, epileptogenesis occurs most easily from an adjacent area termed the paramicrogyral region (PMR). Previous studies implicate SS interneurons as a potential contributor to this pathology, which lead to our hypothesis: in PMR, SS interneurons exert a higher modulatory influence on excitatory pyramidal cells, as compared to the same by SS interneurons within homologous control cortex.

Using a freeze-lesion model for polymicrogyria in transgenic mice …

Reproductive Health And Behavior: The Role Of Abuse And Couple Pregnancy Intent, Susan Cha

Theses and Dissertations

Background: Rapid repeat pregnancy (RRP), a pregnancy occurring less than 24 months from a prior birth, and unintended pregnancy-related induced abortions can be prevented with family planning. However, few studies have adequately addressed the role of male partners in reproductive decision-making. Objectives: The goal of this research is to understand the interrelationships between couple pregnancy intention, intimate partner violence (IPV), reproductive health and behaviors. Specifically, this project aims to: (1) examine the extent to which couple pregnancy intentions are associated with RRP and (2) induced abortions among women in the U.S., and (3) examine the extent to which …

Experimental Evolution Of An Rna Virus In Wild Birds: Evidence For Host-Dependent Impacts On Population Structure And Competitive Fitness, Nathan D. Grubaugh, Darci R. Smith, Doug E. Brackney, Angela M. Bosco-Lauth, Joseph R. Fauver, Corey L. Campbell, Todd A. Felix, Hannah Romo, Nisha K. Duggal, Elizabeth A. Dietrich, Tyler Eike, Jennifer E. Beane, Richard A. Bowen, William C. Black, Aaron C. Brault, Gregory D. Ebel

Journal Articles: Epidemiology

Within hosts, RNA viruses form populations that are genetically and phenotypically complex. Heterogeneity in RNA virus genomes arises due to error-prone replication and is reduced by stochastic and selective mechanisms that are incompletely understood. Defining how natural selection shapes RNA virus populations is critical because it can inform treatment paradigms and enhance control efforts. We allowed West Nile virus (WNV) to replicate in wild-caught American crows, house sparrows and American robins to assess how natural selection shapes RNA virus populations in ecologically relevant hosts that differ in susceptibility to virus-induced mortality. After five sequential passages in each bird species, we …

Does Human Papillomavirus Affect Pregnancy Outcomes? An Analysis Of Hospital Data 2012-2014, Harpriya Kaur, Delf Schmidt-Grimminger, Steven W. Remmenga, Baojiang Chen, K.M. M. Islam, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Objective: To estimate the rate of Human Papillomavirus among pregnant women and its impact on the pregnancy outcomes.

Study design: This was a retrospective cohort study of women who sought prenatal care and later delivered at the Nebraska Medical Center from 2012-2014. Human Papillomavirus infection was based on a cytological cervicovaginal diagnosis (Pap test) report. Bivariate and multivariable analyzes were performed using SAS 9.3.

Results: Of the total sample size of 4824 women, 221 (4.4%) were HPV-positive. Women with Human Papillomavirus infection had increased risk of preeclampsia (adjusted OR: 2.83 95% CI: 1.28-6.26) and were also 1.8 times more likely …

Risperidone And Its Deconstructed Analogs: Functional Effects On The 5ht2ar, Sneha Shah

Theses and Dissertations

G protein-coupled receptors (GPCRs) are seven-transmembrane domain receptors that sense extracellular signal and activate intracellular signaling pathways. The serotonin 5HT2A receptor (or 2AR) is one of the GPCRs coupled to Gq proteins, activating PLC and hydrolyzing PIP2. This hydrolysis causes a diffusion of bound PIP2 away from the channel binding site resulting in G protein-gated inwardly rectifying K⁺ channel (GIRK) inhibition and a downstream stimulation of Ca²⁺ release from endoplasmic reticulum stores. Previous experiments have demonstrated that the serotonin 5HTA receptor is a target of serotonergic psychedelic drugs, such as LSD, and partially mediates the action of many …

Mitochondrial Biogenesis And Electrical Properties Of Hpsc-Derived Motor Neurons, Laura O'Brien

Theses and Dissertations

Human pluripotent stem cells (hPSCs), including human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) hold great promise in the fields of drug development and regenerative medicine. If iPSCs reprogrammed from patient cells replicate what is seen in vivo they may be used as a model of disease. A process that is disrupted in many neurodegenerative diseases is mitochondrial biogenesis. One of these diseases is amyotrophic lateral sclerosis (ALS), which is characterized by loss of motor neurons in the brain and spinal cord. Differentiation of hPSCs into motor neurons offers a way to study a previous unavailable cell …

Development Of Non-Traditional Platinum Anticancer Agents: Trans-Platinum Planar Amine Compounds And Polynuclear Platinum Compounds, Daniel E. Lee

Theses and Dissertations

Development of Non-Traditional Platinum Anticancer Agents: trans-Platinum Planar Amine Compounds and Polynuclear Platinum Compounds

By Daniel E. Lee, Ph.D.

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

Virginia Commonwealth University, 2015

Major Director: Nicholas P Farrell, Ph.D., Professor, Department of Chemistry

Platinum anticancer compounds with cis geometry, similar to cisplatin, have been explored to circumvent the cisplatin resistance; however, they were not considered broadly active in cisplatin cells due to exhibiting similar or same cell death mechanism as cisplatin. Platinum compounds with trans geometry were less studied …

A Justification For The Trend Towards Indirect Pulp Therapy, Marissa Kuhnen

Theses and Dissertations

Purpose: The purpose of this retrospective chart review was to determine how primary molars needing vital pulp therapy have been treated in the past four years at Virginia Commonwealth University (VCU) and to determine which treatments: indirect pulp therapy (IPT), formocresol pulpotomy, and ferric sulfate pulpotomy have been successful. Methods: AxiUm records that contained the procedure codes D3120 (Pulp Cap – Indirect) or D3220 (Therapeutic Pulpotomy) were totaled by year. Visit records were queried again to identify treatment failures i.e. extractions or pulpectomy. Results: In 2010, 52% of vital pulp therapies were ferric sulfate pulpotomies and in …

Identifying Problems During Transitions Of Care And Reasons For Emergency Department Utilization In Community-Dwelling Older Adults, Antoinette B. Coe

Theses and Dissertations

A mixed methods approach was used for this study. The setting was a low-income, subsidized housing apartment building for community-dwelling older and younger disabled adults identified as a health care hot spot due to high rates of ambulance use. The study purpose was to identify reasons for ED use and problems during transition from ED to home, predictors of zip code 23220 (health care hot spot) in emergent and non-emergent ED visits, and predictors of total ED costs in community-dwelling older adults living in a health care hot spot. Semi-structured interviews with residents who used the ED, an existing database …

Axon Initial Segment Stability In Multiple Sclerosis, Suneel K. Thummala

Theses and Dissertations

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system characterized by inflammation and demyelination. In addition to these hallmark features, MS also presents with axonal pathology, which is likely responsible for the signs and symptoms of the disease. Although prominent in MS, axonal pathology is frequently considered a consequence of demyelination and not a primary event. This conclusion is consistent with demyelination inducing the loss of specific axonal domains, known as the nodes of Ranvier that are responsible for the propagation of action potentials along the axon. In contrast, we propose that axonal pathology associated with MS …

Workplace Discrimination And Visual Impairment: An Analysis Of Eeoc Charges And Resolutions, Jane Mcneil

Theses and Dissertations

Workplace discrimination for individuals with visual impairments in the U.S. is an ongoing issue dating before the founding of the EEOC and the enactment of the ADA. Despite laws enacted to protect against unequal treatment in the workplace, the EEOC continues to receive submissions of formal discrimination charges from individuals with visual impairments.

The workplace is experiencing changes with increasing amounts of older adults, women, minorities, and the use of technology and the Internet. By examining characteristics of the discrimination charges and the resulting outcomes, the knowledge gained can describe the current situation and the historical progression of workplace discrimination …

Relieving Post-Stroke Fatigue Using A Group-Based Educational Training Approach, Catherine E. Emery

Theses and Dissertations

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale …

Crown Size Comparisons In Patients With Unilateral Palatally Displaced Canines, Joseph Eliason, Steven J. Lindauer

Theses and Dissertations

Abstract

CROWN SIZE COMPARISONS IN PATIENTS WITH PALATALLY DISPLACED CANINES

By Joseph L. Eliason, D.D.S.

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, 2015

Thesis Director: Steven J. Lindauer, D.M.D., M.Dent.Sc.

Professor and Chair, Department of Orthodontics

There has been significant debate over the past decades regarding the etiology of palatally displaced canines. Theorized risk factors include agenesis or malformation of the lateral incisors, incisor retroclination, transverse deficiency, or genetic predisposition. The purpose of this study is to compare the linear and volumetric …

Understanding The Function Of Dyrk1a Through Characterization Of Its Interacting Proteins, Varsha Ananthapadmanabhan

Theses and Dissertations

DYRK1A is a protein kinase encoded by a gene implicated in Down syndrome pathogenesis. Loss of DYRK1A could promote oncogenic transformation. However, the regulation and substrates of DYRK1A are not fully understood. MudPIT proteomic analysis revealed novel DYRK1A interacting proteins with poorly characterized or even unknown functions. Therefore, the aim of this thesis was to understand the function of DYRK1A through the characterization of its interacting proteins. To achieve this aim, we established stable cell lines expressing these proteins and confirmed the interactions between DYRK1A and seven candidate binding partners. Furthermore, we found that all novel DYRK1A-interacting proteins also bind …

Development And Validation Of A Discrete Event Simulation Model To Evaluate The Long Term Use Of Electronic Cigarettes In Us Population, Kunal Saxena

Theses and Dissertations

Introduction: Cigarette smoking is associated with lung cancer, cardiovascular disease, and chronic respiratory conditions. It is responsible for high mortality and morbidity risk in the US population. Smokers find sudden quitting difficult and it is reported that a large number of unassisted quitting attempts are eventually unsuccessful. Electronic cigarette or e-cig is a novel battery-driven, nicotine delivery product, currently being used as a smoking cessation tool by current and former smokers. Since its resemblance to a conventional cigarette, and its non-combustible nature, e-cig use has risen exponentially in the last few years. To address such public health issues, the US …

Characterization Of A Novel Protease In Staphylococcus Aureus, Adam L. Johnson

Theses and Dissertations

A newly discovered cysteine protease, Prp, has been shown to perform an essential, site-specific cleavage of ribosomal protein L27 in Staphylococcus aureus. In Firmicutes and related bacteria, ribosomal protein L27 is encoded with a conserved N-terminal extension that must be removed to expose residues critical for ribosome function. Uncleavable and pre-cleaved variants were unable to complement an L27 deletion in S. aureus, indicating that this N-terminal processing event is essential and likely plays an important regulatory role. The gene encoding the responsible protease (prp) has been shown to be essential, and is found in all organisms …

High-Throughput Data Analysis: Application To Micronuclei Frequency And T-Cell Receptor Sequencing, Mateusz Makowski

Theses and Dissertations

The advent of high-throughput sequencing has brought about the creation of an unprecedented amount of research data. Analytical methodology has not been able to keep pace with the plethora of data being produced. Two assays, ImmunoSEQ and the cytokinesisblock micronucleus (CBMN), that both produce count data and have few methods available to analyze them are considered.

ImmunoSEQ is a sequencing assay that measures the beta T-cell receptor (TCR) repertoire. The ImmunoSEQ assay was used to describe the TCR repertoires of patients that have undergone hematopoietic stem cell transplantation (HSCT). Several different methods for spectratype analysis were extended to the TCR …

An Association Study Between Adult Blood Pressure And Time To First Cardiovascular Disease, Yongjia Pu

Theses and Dissertations

BACKGROUND: Several studies have demonstrated the association between the time to hypertension event and multiple baseline measurements for adults, yet other survival cardiovascular disease (CVD) outcomes such as high cholesterol and heart attack have been somewhat less considered. The Fels Longitudinal Study (FLS) provides us an opportunity to connect adult blood pressure (BP) at certain ages to the time to first CVD outcomes. The availability of long-term serial BP measurements from FLS also potentially allows us to evaluate if the trend of the measured BP biomarkers over time predicts survival outcomes in adulthood through statistical modeling.

METHODS: When the reference …

Cost Effectiveness Of Warfarin In Anticoagulant Clinic After Introduction Of Dabigatran For Stroke Prevention In Atrial Fibrillation Patients In The United States, Mai Alhazami

Theses and Dissertations

OBJECTIVES: To assess cost effectiveness of anticoagulant clinics after FDA approval of New Oral Anticoagulants (NOACs) for preventing ischemic stroke in Atrial Fibrillation (AF) patients in the United States. METHODS: A decision tree was built to compare cost and effectiveness of 150mg dabigatran twice a day to adjusted dose of warfarin within anticoagulation clinic. The analysis was for one year using a societal perspective. The population in this analysis was a cohort of AF patients, ≥ 65 years old, with a CHADS₂ score>2, and no contraindication to anticoagulation. RESULTS: The base case analysis showed that changing from warfarin …

Elaboration And Design Of Α7 Nachr Negative Allosteric Modulators, Osama I. Alwassil

Theses and Dissertations

α7 Neuronal nicotinic acetylcholine receptors are one of two major classes of receptors responsible for cholinergic neurotransmission in the central nervous system. The existence of α7 neuronal nAChRs in different regions of the nervous system suggests their involvement in certain essential physiological functions as well as in disorders such as Alzheimer’s disease (AD), drug dependence, and depression. This project was aimed toward the discovery and development of small–molecule arylguanidines that modulate α7 nAChR function with improved subtype-selectivity through an allosteric approach. Identifying the required structural features of these small molecules allowed optimization of their negative allosteric modulator (NAM) actions at …

A Comparison Of Vitamin D Levels In Children With Early Childhood Caries, Vanessa O. Hofilena

Theses and Dissertations

Purpose: To determine if there is an association between early childhood caries (ECC) and vitamin D deficiency, as measured via a serum sample. An exploratory goal was to investigate the possibility of measuring vitamin D with a salivary assay. Methods: Serum samples of patients who were scheduled for a dental or otolaryngology procedure under general anesthesia were assessed for 25-hydroxyvitamin D (25(OH)D), parathyroid hormone and calcium. Results: Our analysis indicates that the vitamin D levels of the controls and ECC group were significantly different. There were significant inverse correlations between: 1) PTH levels and vitamin D and 2) decayed, missing, …

Motivational Factors For Treating Patients With Special Health Care Needs, Arpi Patel

Theses and Dissertations

Purpose: The purpose of this study is to assess what training and motivational factors dental providers report in providing dental care to PSHCN (patients with special healthcare needs. Materials and Methods: An electronic questionnaire was sent to n=104 fourth year dental students, n=147 general dentists with a specific continuing education course pertaining to PSCHN, and n=140 pediatric dentists in Virginia. The questionnaire consisted of four sections including Demographics, Professional Attitudes, Special Needs Patients and Motivational Factors, and PSCHN Cases. Results: The overall response rate for our study was 21%. The response rates of dental students, general dentists, …

The Scoop, Vol. 1 Issue 10, January 2015, Health Sciences Library

Volume 1

Latest news and events from the Health Sciences Library in our monthly newsletter for January 2015.

At What Age Should Screening Mammography Be Recommended For Asian Women?, Junko Tsuchida, Masayuki Nagahashi, Omar M. Rashid, Kazuaki Takabe, Toshifumi Wakai

Surgery Publications

Although regular screening mammography has been suggested to be associated with improvements in the relative survival of breast cancer in recent years, the appropriate age to start screening mammography remains controversial. In November 2009, the United States Preventive Service Task Force published updated guidelines for breast cancer, which no longer support routine screening mammography for women aged 40–49 years, but instead, defer the choice of screening in that age group to the patient and physician. The age to begin screening differs between guidelines, including those from the Task Force, the American Cancer Society and the World Health Organization. It remains …