Medicine and Health Sciences Commons^™

The Joint Effects Of Cognitive Function And Sedentary Time On Mortality Risk In Older Adults: 2011-2014 Nhanes, Sarah A. Wilson

UNF Graduate Theses and Dissertations

Background: Examining the joint effects of cognitive function (CF) and sedentary time (ST) may provide insight into the complex mechanisms underlying mortality risk within older adults. This study examines the joint effects of CF and ST on mortality risk in older adults.

Methods: Sample included 2,230 older adults (≥ 60 years of age) participants in the 2011-2014 National Health and Nutrition Examination Survey. The Digit Symbol Substitution Test (DSST), Consortium to Establish a Registry for Alzheimer's Disease (CERAD) subtests, and Animal Fluency (AF) were used to assess CF. Average daily sitting and television time represented ST. Quartiles of CF and …

Sleep, Sedentary Time, And Physical Activity In Heart Failure Subtypes: Multi-Ethnic Study Of Atherosclerosis (Mesa), Demi M. Nott

UNF Graduate Theses and Dissertations

INTRODUCTION: Previous studies have examined the associations between physical activity (PA), sedentary time (ST), and sleep on the risk of heart failure (HF). The primary aim of this study was to examine PA, ST, and sleep quality (SQ) in those diagnosed with preserved ejection fraction HF (HFpEF) and reduced ejection fraction HF (HFrEF). The secondary aim of this study was to examine these relationships in those with and without HF, independent of sub-type.

METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) collected data from 6,814 adults from a diversified cohort who range in age from 45 to 84. Subjects were classified …

Examining Potential Causal Associations Of Sedentary Time And Physical Activity With Heart Failure Using Subjective And Objective Measures: A Mendelian Randomization Analysis, Jessica Geller

UNF Graduate Theses and Dissertations

Purpose: The objective of this study was to assess the causal relationship between both subjectively and objectively measured sedentary time (ST) and physical activity (PA) with heart failure (HF) risk, utilizing Mendelian Randomization (MR) approach.

Methods: The present MR used genetic instruments identified for self-reported ST and PA extracted from 51 genome wide association studies (GWAS), encompassing data from 703,901 individuals. The GWAS identified 89 independent single nucleotide polymorphisms (SNPs) associated with leisure screen time. Eleven loci were reported to be associated with moderate to vigorous physical activity (MVPA). From another GWAS examining accelerometer-based activities, three loci were found to …

Nutrition Care For The Transgender Population: A Retrospective Study To Investigate Relationships Between The Nutrition Care Process Model And Patient Outcomes, Alana Minnee Marrero Gonzalez

UNF Graduate Theses and Dissertations

One of the most important roles of the registered dietitian nutritionist is to provide medical nutrition therapy that is fitting to an individual’s culture, reality, ethnicity, and dietary preferences. A review of existing literature exposes the lack of information available on LGBTQ (lesbian, gay, bisexual, transgender, queer) health, for transgender communities. The purpose of this research was to generate knowledge of the nutrition-related problems and barriers to adequate nutrition and health, and their impact in nutrition assessment in a sample of Hispanic transgender adult patients living in San Juan, Puerto Rico. A retrospective observational study was conducted, data from 114 …

The Experiences Of Transgender And Gender Diverse Individuals Seeking Mental Health Treatment, Brice T. Marks

UNF Graduate Theses and Dissertations

Transgender and Gender Diverse (TGD) individuals are underserved in communities despite experiencing disproportionately higher rates of mental health distress. The cisheteronomativity of society creates chronic stressors that impact the mental health outcomes of TGD individuals. TGD individuals face the highest rates of discrimination in healthcare settings. Yet, little is known about the population's specific experiences seeking mental health care. Using a phenomenological approach, this study interviewed eight TGD individuals to understand the experience of seeking mental health care. There were six themes: facilitation of seeking behaviors, barriers, type of care, characteristics of providers, identity disclosure, and burden of advocacy and …

Association Between Objectively-Measured Sedentary Time And Self-Reported Prescription Medication Use Among Adults: A Pilot Study, Ciarra Ashley Boyne

UNF Graduate Theses and Dissertations

BACKGROUND: Prescription medication use and extended sedentary time are independently related to poor health outcomes (e.g., diabetes, metabolic syndrome, mortality). Historically, survey methods have been used to obtain estimates of total sedentary time (ST), however, recent use of accelerometers avoids self-report bias and affords more characteristics of ST that may be factors in health outcomes (e.g., frequency and duration of sedentary bouts). The aims of this pilot study were to 1) examine the association between objectively measured ST via accelerometers and self-reported prescription medication use in adults and 2) examine the independent association of sedentary bout length and frequency with …

Illness Stigma, Social Connectedness, And Health In People Living With Chronic Illness: A Structural Equation Model, Abigail Brooke Crawford

UNF Graduate Theses and Dissertations

The complexity of chronic or unexplained conditions may lead to potential stigma for those suffering long-term symptoms as they do not follow the expected pattern of recovery following diagnosis and treatment. Experiencing such illness-related stigma has potential for leading to a belongingness identity of detachment with implications for health across physical, social, and psychological dimensions. This study aimed to examine the relationship between stigma, social connection, mental health, physical health, and social functioning in a group of 231 participants with ongoing symptoms of chronic illness through structural equation modeling. The fit indices all suggest that the model reasonably fits the …

Walking The Talk: A Qualitative Exploration Of Gatekeeping Staff Perceptions Surrounding Implementation Of Nutrition Policy In Florida Food Banks, Rachel Lynn Mccandless

UNF Graduate Theses and Dissertations

Food insecurity is an independent risk factor for adverse health outcomes; providing nutrient-dense food through the emergency food system to individuals who regularly seek assistance can impact population-level health disparities. This research explored the extrinsic and intrinsic barriers and facilitators surrounding formal nutrition policy implementation as seen by the logistical gatekeepers in a sample of Feeding Florida food banks. A secondary aim of this research was to explore the change readiness of these same logistical decision-makers in nutrition policy implementation. Research Questions included the following: What are the critical gatekeeping staff perceptions of the barriers and facilitators to implementing formal …

Physiological Responses Regarding Stress And Trauma: The Freeze Response, Emma Arie Von Holten

UNF Graduate Theses and Dissertations

Fight-or-flight is a commonly known response to threatening situations, but the freeze response is another defensive mechanism that might arise in such situations. There is also evidence that exposure to trauma can impact physiological reactions when defensive mechanisms are not required, such as freezing in response to non-threatening situations. The current study aimed to replicate and expand upon a limited number of previous studies on the human freeze response by implementing measurements of postural sway, heart rate, and infrared thermography while valenced images were shown to participants. Ninety-two participants were recruited from the University of North Florida and participants were …

Implementation Of A Transitions Of Care Nutrition Intervention For Malnourished Patients, Nina Rocca

UNF Graduate Theses and Dissertations

The topic of Transitions of Care (TOC) has been investigated by physician and nursing professions for years, while only more recently by nutrition professionals. Registered Dietitians are not always involved in TOC planning. RDs can play an important role in TOC by communicating patients’ nutrition information across health care settings, especially for patients with malnutrition. The primary aim was to use a CDC based process evaluation to evaluate if a case management, nursing focused care transitions framework, adapted for a TOC nutrition intervention, can result in a successful intervention implementation. The secondary aim was to use a CDC outcomes evaluation, …

Interprofessional Education Activities And New Practitioner Competence: Implications For Practice In Nutrition And Dietetics Education, Stephanie N. Petrosky

UNF Graduate Theses and Dissertations

Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) are associated with improved perception, values, attitudes towards collaborative practice, and therefore benefits patients, practitioners, and health care systems. Notable organizations have long promoted standardized guidelines for best practices in interdisciplinary team-based learning to improve patient safety and health outcomes. The state of IPE in nutrition and dietetics practice was recently addressed by the Nutrition and Dietetic Educators and Preceptors (NDEP) practice group of the Academy of Nutrition and Dietetics. The authors generated a call to action to engage in IPCP while pushing the boundaries of leadership in teaching, research, and practice. …

Estimation Of 24-Hour Urinary Creatinine Excretion Through The Development Of A Model And Its Relationship To Outcomes In Hospitalized Critically Ill Veterans, Lynn Diane Hiller

UNF Graduate Theses and Dissertations

Background: Muscle mass is highly correlated with patient outcomes. Techniques to identify patients with low muscularity include computed tomography (CT) and bioelectrical impendence analysis (BIA) however disadvantages of cost, exposure to radiation and access make these measurements unavailable to the average dietitian. Urinary creatinine excretion (UCE) and estimation of creatinine height index (CHI) are strongly associated with muscularity and outcomes, however, require a 24-hour urine collection. The postulation that UCE may be predicted from patient variables, through mathematical modeling, would avoid the need for a 24-hour urine collection and may be clinically useful.

Methods: Input variables of age, …

Childhood Food Insecurity: A Program Impact And Evaluation Study Of The Meals On Wheels For Kids Program, Claudia Rivero

UNF Graduate Theses and Dissertations

In America, millions of families and children face hunger and food insecurity every day. According to the United States Department of Agriculture, more than thirty-eight million people experienced hunger in 2020. As many as 13 million children in the United States live in food-insecure homes. Many households that experience food insecurity do not qualify for federal nutrition programs. While valuable, barriers to these programs can block food-insecure households with children and prevent access to healthy food. The impact of adverse health and nutritional consequences, of a food-insecure household, will continue to plague our communities until efficient programming connects to those …

Identification And Characterization Of The Tssk6 Activating Co-Chaperone (Tsacc) Gene In Skeletal Muscle, Tala Shourbagi Tello

UNF Graduate Theses and Dissertations

Skeletal muscle atrophy is defined as a decrease in muscle size and occurs due to disparate physiological conditions, including aging, immobilization, and corticosteroid exposure. TSSK6 activating co-chaperone (TSACC) was identified as a gene that is significantly upregulated in skeletal muscle in response to denervation. To confirm Tsacc expression in skeletal muscle, the Tsacc cDNA was cloned from cultured myoblast cells leading to the discovery of a novel alternative splice-variant that is 49 amino acids shorter than the known full-length transcript. Quantitative PCR (qPCR) confirmed that Tsacc is expressed in skeletal muscle with expression increasing as muscle cells undergo differentiation. Characterization …

Exploring The Health Outcomes And Patient’S Viewpoint Of Pediatric Patients Receiving Medical Nutrition Therapy Visits With In-Person, Telephonic, And Tele-Video Modalities At A Rural Community Health Center, Valerie L. Muehleman

UNF Graduate Theses and Dissertations

The Covid-19 pandemic advanced telephonic (TP) and tele-video (TV) visits for medical nutrition therapy (MNT). This study explored the health outcomes and patient’s viewpoints of MNT by modalities in a community health center (CHC). Participants ranged in age from 1-18 years, diagnosed with overweight/obesity, and received MNT from a registered dietitian nutritionist (RDN) from January 1, 2019 to August 31, 2021. Health outcomes measured were health goal achievement, BMI percentile, pre/post lipid panel, and A1C%. Show/no-show rates and demographic characteristics of gender, age, race, insurance, county, language, and ethnicity were also compared by the visit modality. Ten interviews in the …

The Associations Between Homa-Ir And Muscular Strengthening Activity In Euglycemic U.S. Adults, William Robert Boyer Ii

UNF Graduate Theses and Dissertations

Background: Muscular strengthening activity (MSA) has been shown to be inversely associated with insulin resistance (IR). The associations between quartiles of the homeostatic model assessment of insulin resistance (HOMA-IR) and self-reported MSA in a nationally representative sample of euglycemic U.S. adults were examined.

Methods: Sample included adult participants (≥20 years of age [n=2,543]) from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). HOMA-IR was categorized into quartiles based on every 25^th percentile. No MSA was the dependent variable.

Results: Following adjustment for covariates, those with HOMA-IR values in third (p

Conclusions: Having a higher HOMA-IR value is associated …

Effects Of The Use Of A Heart Failure Diary On Self-Care And Quality Of Life, Claudette Walker

UNF Graduate Theses and Dissertations

Heart Failure is a growing and costly problem in the United States. There have been advancements in medical therapy, but unfortunately patients continue to have frequent exacerbations and hospital readmissions. The reason for this may be inadequate Heart Failure self-care, which is the most important aspect of disease management. Literature strongly encourages self-care, but there is minimal research focusing on the use of a Heart Failure diary. The study was a one group pretest/posttest design. The intervention included individualized education, provision of the Heart Failure Diary, and weekly follow-up for a total of four weeks. The Heart Failure Diary was …

Nursing And Health Care In Jacksonville, Florida, 1900-1930, Linda Emerson Sabin

UNF Graduate Theses and Dissertations

This study examines the development of nursing as a vocation, in the early twentieth century, within the context of a growing southern city and an evolving health care system. Nursing advanced from a domestic service to a recognized vocation during this era. An extensive survey of historical and nursing literature revealed few studies which focus on nursing and health care in an urban context. Those studies identified gave only brief glimpses of nurses and focus on northern cities. This investigation aims to add a southern chapter to the history of nursing and health care in urban settings.

A community systems …