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Nutrition And Health Status Of Hemodialysis Patients In Dhaka, Bangladesh, Tanjina Rahman

Wayne State University Dissertations

Methods to identify patients at risk for End stage renal disease (ESRD) are a high priority in Bangladesh, where kidney transplants/dialysis options are limited and costly. Every year, 35,000 to 40,000 people reach ESRD in Bangladesh, but currently available facilities can hardly accommodate only 9000 to 10,000 new patients with twice weekly dialysis and the remaining 66% have no access to any kind of renal replacement therapy (RRT) in the form of dialysis or transplantation. Nutrition is an important factor in maintaining good health of hemodialysis patients. However, data on nutritional status of Bangladeshi dialysis patients is limited and is …

Characterizing Novel Radiologic And Pathologic Tissue-Based Risk Factors For Breast Cancer In African American Women With Benign Breast Disease, Asra N. Shaik

Wayne State University Dissertations

African American women (AAW) suffer a higher breast cancer mortality burden than women of other ethnicities in the US. More likely to be diagnosed with aggressive subtypes resistant to therapy and with rapidly fatal course than European American women (EAW), AAW may benefit greatly from earlier detection of breast cancers. However, it remains difficult to predict with a high degree of accuracy which women will develop breast cancer. Current risk assessment is especially poor for AAW, where models consistently underestimate risk in the subset of women with a prior biopsy. Risk assessment can be improved with the inclusion of new …

Arab American Adolescents’ Bullying Experiences And Effects On Their Perceived Stress And Health, Maha Albdour

Wayne State University Dissertations

This study is intended to examine the bullying experience among Arab American adolescents and effects on their perceived stress and health. Adolescents who are vulnerable or marginalized might be at higher risk for bullying. Arab American adolescents have not been included in research studies examining bullying and described as the invisible population.

The Neuman System Model, which focuses on wellness of adolescents in relation to environmental stress, guided this study. Bullying is a tension producing stressor, operationally defined as repeated attacks or intimidation that cause fear, distress or harm and perceived power imbalance between bully and victim. Perceived stress is …

Clinicopathology And Molecular Determinants Underlying Benign Breast And Breast Cancer Lesions, Andreana Holowatyj Holowatyj

Wayne State University Dissertations

Despite converging incidence rates for breast cancers by race, disparities in mortality persist where black women suffer from poorer prognosis compared to white counterparts. To understand the clinical, demographic, and molecular characteristics underlying these disparities, we examined differences among patients with breast cancer to understand the role of human epidermal growth factor receptor 2 (HER2) status, age, and race/ethnicity among women diagnosed with hormone receptor-positive breast cancer, and disparities in surgical therapy among female patients with early stage young-onset breast cancer. Benign breast disease, another known risk factor for breast cancer, includes a histological spectrum of lesions, could contribute to …

Child Maltreatment, Problem Alcohol Use And Physical Revictimization: Examining Longitudinal Trajectories In A Nationally Representative Sample, Kathryn Mariah Zumberg Smith

Wayne State University Dissertations

Past investigations examining the relationships between child maltreatment, alcohol use and physical revictimization have been limited by their use of cross-sectional designs and their focus on childhood sexual abuse and sexual revictimization. In addition, there is a paucity of epidemiological studies examining child maltreatment, alcohol use, and physical revictimization. The present study sought to address these limitations by examining relationships between child maltreatment, problem alcohol use, and physical revictimization in a nationally representative sample. Data were analyzed from the public-use data set of the National Longitudinal Study of Adolescent to Adult Health (Add health; Harris & Udry, 2014), waves I-IV. …

Youth-Led School Health Initiatives: Perceptions And Processes, Lila Murphy Gutuskey

Wayne State University Dissertations

Disparities in obesity prevalence, based on a child’s race and income, establish that health interventions should prioritize these target populations. Additionally, children who are from low-income families in urban neighborhoods and of ethnic minorities have unequal access to environmental determinants of healthy eating (HE) and physical activity (PA). Schools might be the best setting for health interventions, given the understanding that a school’s mission should be to educate the whole child and the substantial amount of time that a child spends in school. The purpose of this study was to examine student-led, school-health interventions in four elementary schools. The Fuel …

Management Safety Climate And Violence Prevention Climate: A Mediational Model For Healthcare Employee Outcomes, Lydia Hamblin Hamblin

Wayne State University Dissertations

Workplace violence is defined as aggressive acts against employees ranging from verbal abuse, threats, and bullying, to physical assault (OSHA, 2002; Jackson, Clare, & Mannix, 2002). The two purposes of this study were (1) to differentiate two specific forms of psychological climate related to workplace violence on a work unit: Violence Prevention Climate (VPC) and Management Safety Climate (MSC), and (2) to test a causal model focusing on the relationship between these climates and their effects on relevant outcomes for at-risk employees in the healthcare industry. MSC was expected to partially mediate the effects of VPC on four outcomes: work …

Toward Enhancing Treatment For Pregnant Smokers: Laying The Groundwork For The Use Of Complementary And Alternative Medicine Approaches, Amy Michele Loree

Wayne State University Dissertations

Tobacco is the most widely used drug of abuse during pregnancy. Despite efforts to reduce perinatal tobacco use, its prevalence has remained steady over at least the past decade, suggesting that efforts to reduce smoking prevalence before and during pregnancy have not been effective. Although a range of effective treatments exist, most pregnant smokers neither seek nor receive any kind of treatment. Complementary and alternative medicine (CAM) treatments may be ideal as alternative, low-cost approaches capable of reaching and assisting a greater proportion of pregnant women with smoking cessation. This study examined characteristics and treatment utilization practices of pregnant smokers …

Metabolic Syndrome In Obese African American Adolescents, Yulyu Yeh

Wayne State University Dissertations

Limited research regarding metabolic syndrome (MetS) has been conducted in obese African American adolescents (OAAA) using the International Diabetes Federation IDF criteria. MetS is a constellation of risk factors that increase the risk for chronic diseases and is defined as presence of any 3 or more of the 5 criteria: fasting glucose 100mg/dl, waist circumference 90th percentile, triglycerides 150 mg/dl, blood pressure (BP) 130/85 mmHg and HDL < 40mg/dl. The aim of this study was to assess the incidence of MetS in OAAA by using the IDF criteria and the relationship with diet, fast food consumption, nutrition knowledge, home food environment (HFE), and serum calcium, leptin, 1,25-dihydroxy vitamin D (1, 25 D3) levels. One hundred and fifty one OAAA (mean age: 14.3 ± 1.4 years, 65.6% girls, mean BMI: 37.4±7.2 kg/m2) in a metropolitan area took part in this study. Anthropometric data and fasting blood samples were collected. Participants completed a set of questionnaires regarding diet, fast food consumption, and nutrition knowledge. HFE was completed by the care givers. The MetS rate for OAAA was 61.6% and boys had higher MetS than girls (73.1%, 55.6% respectively). OAAA without MetS had higher serum calcium and 1,25 D3 level but no significant difference were found in food consumption, nutrition knowledge, and HFE. Total cholesterol /HDL ratio and Insulin resistance increased the odds of MetS by 55% and 10% and 1,25 D3 decrease the odds of MetS by 2%. Even though high fast food consumption, lack of nutrition knowledge and poor food environment were negatively associated with obesity, they didn't contribute to MetS. Increase serum vitamin D and calcium level might be beneficial to reduce MetS in OAAA population.

Proximate And Evolutionary Insights Into The Epigenetics Of Posttraumatic Stress Disorder, Levent Sipahi

Wayne State University Dissertations

Posttraumatic stress disorder (PTSD) is an important medical and social condition. Although the vast majority of individuals are exposed to traumatic events within their lifetime, a minority subsequently develop diagnosable PTSD. What underlies differential risk and resiliency in the face of trauma is an ongoing research and clinical question with implications for prevention and treatment. Recent work has revealed a putative role of epigenetic variation and modification - most notably DNA methylation - in the etiology of PTSD. That DNA methylation is stable, yet modifiable in response to lived experiences, makes it a strong candidate to mechanistically explain the ontogeny …

Characterization Of Antimicrobial-Resistant Staphylococcus Spp. In Food Animals And Retail Meat, Kanika Bhargava

Wayne State University Dissertations

Antimicrobial resistance in Staphylococcus spp. is a worldwide epidemic concern in hospital and community settings. Food animals and retail meat are important reservoirs of these pathogens that can pose potential threat to humans. In this dissertation, we aimed to investigate the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Coagulase-negative Staphylococci (MRCoNS) in food animals and retail meat to provide insight into the role of agricultural environment in transmitting bacteria of human clinical significance. Furthermore, the potential application of phytochemicals as antimicrobials and antimicrobial adjuvants to control MRSA infections was explored.

CoNS recovered from food animals were characterized by …

Using The Protection Motivation Theory To Examine The Effects Of Obesity Fear Arousal On The Physical Activity Of Young Adult Female College Students, Bibia Renee Redd

Wayne State University Dissertations

The national rate of physical activity has been consistently declining while obesity and obesity-related illnesses are on the rise (French, Story, & Jeffrey, 2001; James, Leach, Kalamara, & Shayeghi, 2001; Malnick & Knobler, 2006). The current study employed a 2 (severity) x 2 (susceptibility) x 2 (intention implementation plan) x 3 (time) longitudinal within subject design examining the effects of the Protection Motivation Theory (Rogers, 1975, 1983) on the physical activity among 87 overweight young adult college females. A main effect was hypothesized for short-term severity, personal susceptibility, and the development of an intention implementation plan messages and an interaction …

Examining The Relationship Among Physical And Psychological Health, Parent And Peer Attachment, And Cyberbullying In Adolescents In Urban And Suburban Environments, Jemica Monique Carter

Wayne State University Dissertations

Cyberbullying is a new phenomenon that has received substantial attention via media. An extensive review of the literature revealed limited nursing research on this topic. The purpose of this study was to examine the impact of cyberbullying on adolescents' physical (e.g., headache, stomachache, etc.) and psychosocial (e.g., self-esteem, depression, post traumatic stress syndrome, etc.) outcomes. Individuals who experience repeated traditional bullying are at increased risk for experiencing repeated incidents of cyberbullying. Research has shown that effects of cyberbullying may be more traumatic than traditional bullying because victims can be bullied 24 hours and 7 days a week, on and off …

The Effects Of Racially-Motivated Emotional Arousal On The Eating Behaviors Of African American Women, Lenwood W. Hayman

Wayne State University Dissertations

Disparities between African Americans and Caucasians remain vast across a wide variety of health indicators. Chronic stress has been identified as a risk factor for a variety of chronic illnesses and poor health outcomes. One type of chronic stress that has been linked to health disparities is the stress associated with experiences of racial discrimination. The stress African Americans encounter as a result of their racist experiences contributes to a chronic elevation of their physiological stress response. In addition to stress, a major risk factor for coronary heart disease and diabetes is obesity, which has been established as a major …

A Study Of The Associations Between Childhood Obesity And Three Forms Of Social Capital, Cynthia Bala-Brusilow

Wayne State University Dissertations

Purpose: The purpose of the study was to expand the understanding of childhood obesity in American children by examining the associations between obesity in children and measures of social capital.

Context: Persons between 2 and 20 years of age are categorized as "obese" if their BMI is in 95th percentile or above for their age and sex using the Center for Disease Control and Prevention (CDC) BMI-for-age growth charts. Obesity prevalence has more than quadrupled in the last 40 years in the United States for children. Social capital, in the study of health, can be defined as resources accrued and/or …

Adaptive Radiation Therapy Of Prostate Cancer, Ning Wen

Wayne State University Dissertations

ART is a close-loop feedback algorithm which evaluates the organ deformation and motion right before the treatment and takes into account dose delivery variation daily to compensate for the difference between planned and delivered dose. It also has potential to allow further dose escalation and margin reduction to improve the clinical outcome. This retrospective study evaluated ART for prostate cancer treatment and radiobiological consequences. An IRB approved protocol has been used to evaluate actual dose delivery of patients with prostate cancer undergoing treatment with daily CBCT.

The dose from CBCT was measured in phantom using TLD and ion chamber techniques …

2001 Michigan Hospital Cqi/Tqm Study, Colleen L. Croxall

Wayne State University Dissertations

In recent years, there has been significant interest in the application of total quality management/continuous quality improvement (TQM/CQI) within health care organizations. The health care industry, in its quest to improve outcomes with fewer resources, began to look at CQI/TQM as a possible solution. To date, the most comprehensive and enthusiastic response to efforts to improve quality while containing or lowering costs is reflected in hospitals' commitment to continuous quality improvement/total quality management (CQI/TQM). The health care industry, particularly hospitals, has embraced the concepts of CQI/TQM with the belief that adoption will lead to an improvement in both the quality …