Medicine and Health Sciences Commons^™

Cognitive Decline And Polypharmacy In An Elderly Population., Ximena A. Oyarzun Gonzalez

Electronic Theses and Dissertations

Aging is associated with increased risk of chronic disease, comorbidities, and greater medication use. Polypharmacy, the concomitant use of 5 or more medications, has been associated with adverse health effects, and potentially cognitive decline. The proposed hypothesis is that polypharmacy increases the risk of cognitive decline in elderly people. Using longitudinal data from 572 participants from the New Mexico Aging Process Study cohort, the impact of polypharmacy on the Mini Mental State Examination (MMSE) scores and Mild Cognitive Impairment (MCI) was studied. The statistical analyses were performed using mixed linear regression multivariable models and generalized estimating equations, adjusting for important …

Neurodegeneration-Associated Instability Of Ribosomal Dna., Justin Lauren Hallgren 1981-

Electronic Theses and Dissertations

Homologous recombination-mediated instability of the repetitively organized ribosomal DNA has been proposed as a mediator of cell senescence in yeast triggering the DNA damage response. High individual variability in the content of human ribosomal DNA suggests that this genomic region remained relatively unstable throughout evolution. Therefore, quantitative real time PCR was used to determine the genomic content of ribosomal DNA in post mortem samples of parietal cortex from 14 young and 9 elderly individuals with no diagnosis of a chronic neurodegenerative/neurological disease. In addition, ribosomal DNA content in that brain region was compared between 10 age-matched control individuals and 10 …

Markers And Mechanisms Of Metabolic Aging., Peter Dziewornu Ahiawodzi

Electronic Theses and Dissertations

Oxidative stress has been implicated in aging and age-related diseases. Using three distinct studies, this dissertation examines associations between lifestyle factors and oxidative stress, and their effects on advanced glycation end products, telomere length, and type II diabetes. Carboxymethyl-lysine (CML), an advanced glycation end-product, has been linked to oxidative stress, cardiovascular and other age-related diseases. The first study investigates the association between sleep disordered breathing (SDB), a source of oxidative stress, and CML. 1002 participants with sleep data from the Cardiovascular Health Study (CHS) were analyzed. SDB was not significantly associated with CML, but after stratification by gender and hemoglobin …

Quality Of Primary Care From The Patient Perspective In Saudi Arabia : A Multi-Level Study., Khalid Awad Alahmary

Electronic Theses and Dissertations

Objectives: To assess primary care performance for measures of patients’ experience in Community-based Primary Care (CPC) and Employer-based Primary Care (EPC) systems in Saudi Arabia, to examine variations in performance across the two systems, and to explore factors at both the individual-level and the organizational-level that explain variations in primary care performance. Design and Methods: This is an observational and cross-sectional study, using comparative design and survey research methods. The newly revised and re-translated Arabic version of the Primary Care Assessment Survey (PCAS) was used to measure patients’ experience of primary care. PCAS operationalizes the IOM definition of primary care, …

The Role Of Pesticides In Non-Alcoholic Fatty Liver Disease (Nafld)., Laila Al-Eryani 1986-

Electronic Theses and Dissertations

NAFLD, the most common form of liver disease worldwide, is caused by various factors including industrial chemicals and pesticides exposure. Annually, 5.2 billion pounds of pesticides are used worldwide and can contribute to liver disease, but their role is modestly studied. We hypothesize that pesticides contaminating food supply can worsen diet-induced steatosis via xenobiotic receptor activation. Two human and two rodent databases were utilized and 85% of the 330 chemicals identified associated with NAFLD were pesticides. Eight were selected for evaluating hepatic receptor activation in vitro. The majority including DDT activated hPXR/CAR and mPXR. DDT (100 mg/kg) was studied in …

Effect Of Metallic Restoration Artifacts On Maxillofacial Cone Beam Computed Tomography Images., Mitali Binani 1987-

Electronic Theses and Dissertations

Artifacts due to high-density objects (HDO) such as metallic dental restorations on maxillofacial cone beam computed tomographic (CBCT) images can render certain areas unsuitable for diagnosis. It was hypothesized that image quality due to HDO artifacts was affected by CBCT acquisition parameters and the number and configuration of HDO. Simulated complete maxillary and mandibular dental arches were constructed using dental stone and extracted teeth. Conservative coronal dental amalgam (MOD) restorations on premolar and molar teeth were used as HDOs. Gray values (GV) measured on uniform dental stone test cylinders at specific levels from the occlusal plane at three tooth locations …

Neutrophils Alter Epithelial Response To Porphyromonas Gingivalis In A Gingival Crevice Model., Jessica Lynn Bondy-Carey 1987-

Electronic Theses and Dissertations

A gingival crevice model (epithelial cell-Porphyromonas gingivalis-neutrophil) was established and used to profile gingipain, matrix metalloproteinase (MMP), MMP mediators [neutrophil gelatinase-associated lipocalin (NGAL) and tissue inhibitor of metalloproteinases 1 (TIMP-1)] and cytokine networks. Smoking is the primary environmental risk factor for periodontitis. Therefore, the influence of cigarette smoke extract (CSE) was also monitored in the same model. Porphyromonas gingivalis alone induced low levels of interleukin-1b and interleukin-8 from epithelial cells, but high levels of both cytokines were produced on the addition of neutrophils. Exposure to CSE (100 and 1000 ng mL1 nicotine equivalency) significantly compromised P. gingivalis-induced cytokine secretion (both …

Clinical Efficacy Of Cross-Sectional Imaging Compared With Panoramic Imaging And Virtual 3d Models For The Assessment Of Dental Implant Placement., Moiz Ahmad Khan 1987-

Electronic Theses and Dissertations

Introduction: This study compared the clinical efficacy of panoramic imaging and Cone Beam Computed Tomography (CBCT) in the optimal placement of virtual dental implants in the posterior edentulous bounded regions of the jaws. Material and methods: From a retrospective audit of patient records, fifty-two subjects were recruited with sixty-one dental implant sites in the maxilla and mandible. Physical measurements of the residual alveolar ridge were performed and consensus decisions of optimal implant length and bone graft necessity were obtained using reformatted panoramic alone (RP) or cross-sectional imaging (XS). Results: Horizontal restorative space measurements greater for RP (p=0.001). Shorter implants were …

Functional Implications Of Demyelination And The Molecular Control Of Remyelination In The Adult Mouse., Nicholas John Kuypers

Electronic Theses and Dissertations

Oligodendrocyte (OL) loss contributes to the functional deficits underlying diseases with a demyelinating component (Gajjar et al., 1997; Miller et al., 2002). Remyelination can restore these deficits (Duncan et al., 2009). Chapter 1 is an introduction to de- and re-myelination thus providing the necessary background information for consideration in subsequent chapters. Ethidium bromide (EB) has been extensively used in the rat and cat as a model of spinal cord demyelination. However, this lesion has not been addressed in the adult mouse. Therefore, Chapters 2 and 3 characterize a model of chronic EB-induced spinal cord demyelination in the mouse which can …

The Performance Of The K6 Scale In A Large Adolescent Sample., Nicholas Chalmer Peiper 1982-

Electronic Theses and Dissertations

This dissertation is an applied research study to examine the performance of the K6 scale that measures serious emotional disturbance (SED) among adolescents. As the K6 was included in the 2012 administration of the Kentucky Incentives for Prevention Survey (KIP), three specific aims are included: 1) confirm the unidimensional structure of the K6 among adolescents using factor analysis; 2) define the prevalence and correlates of adolescent SED among Kentucky students; and 3) utilize latent class analysis (LCA) to empirically derive clinically relevant subtypes of adolescents with SED. Of the 122,718 students who completed the KIP in 2012, approximately 89% provided …

Coal Ash And Children's Sleep : A Community-Based Study., Clara G. Sears

Electronic Theses and Dissertations

Kentucky is the fifth largest producer of coal ash, a by-product of coal combustion. The small spherical coal ash particles contain heavy metals like arsenic, lead, mercury, and cadmium. Coal ash is currently classified as nonhazardous by the EPA, which allows it to be stored in open-air impoundments near low-income communities. The primary object of the study is to determine the prevalence of sleep disruptive behaviors in children exposed to coal ash, compared to a group of demographically similar non-exposed children. Parents or guardians from five neighborhoods surrounding a coal ash storage facility, and one non-exposed community, participated in a …

Preventive Effect Of Non-Mitogenic Acidic Fibroblast Growth Factor On Diabetes-Induced Testicular Cell Death., Melissa Skibba 1990-

Electronic Theses and Dissertations

Fibroblast growth factor (FGF)-1 was found to protect the heart from oxidative damage, but clinically its long-term use was restricted for its undesirable proliferating activity on cells. Thus a cluster of amino acids responsible for the proliferation were deleted in the native FGF-1 to create a non-mitogenic FGF-1 (nmFGF-1). To assess whether nmFGF-1 protects male germ cells from diabetes-induced apoptotic death, the study employed a murine model of diabetes using multiple low-doses of streptozotocin, followed by nmFGF-1 treatment for 6 months. Diabetic mice showed a decrease in testicular weight and an increase in apoptotic cell death. Treatment with nmFGF-1 alleviated …

Factors Influencing The Relationship Between Socioeconomic Status And Prenatal Smoking., Irene Yang

Electronic Theses and Dissertations

The prevalence of prenatal smoking is highest among women from low socioeconomic status (SES) backgrounds. The adverse effects of smoking on pregnancy outcomes are widely known and current intervention efforts appear to have reached their maximum effectiveness. Improving interventions, particularly for those who are most vulnerable to this behavior demands a deeper and more contextualized understanding of contributing factors. The purpose of this dissertation was to explore factors that influence the relationship between SES and prenatal smoking. This was done in three ways: a critical review of literature on prenatal smoking in low SES women; an examination of the state …

Implementation Of An Oral Health Intervention For Adults With Intellectual And Developmental Disabilities., Brigit Rene Zaksek

Electronic Theses and Dissertations

Often oral care is overlooked during the daily care of adults with intellectual and developmental disabilities (IDD). Due to the integration of adults with IDD from institutions into group homes and private homes, caregivers need to be taught to implement daily oral hygiene protocols. The purpose of this pilot study, conducted by the University of Louisville and the Pacific Institute for Research and Evaluation, was to develop an oral hygiene plan for adults with IDD residing in group homes in the Louisville, Kentucky area that would ultimately improve their oral health and quality of life. This thesis focuses on the …

Management Of Suicidal Behavior: Is The World Upside Down?, Paula Artieda-Urrutia, Isabel Parra Uribe, Gema Garcia-Pares, Diego Palao, Jose De Leon, Hilario Blasco-Fontecilla

Psychiatry Faculty Publications

No abstract provided.

Clinically Relevant Interactions Between Newer Antidepressants And Second-Generation Antipsychotics, Edoardo Spina, Jose De Leon

Psychiatry Faculty Publications

INTRODUCTION: Combinations of newer antidepressants and second-generation antipsychotics (SGAs) are frequently used by clinicians. Pharmacokinetic drug interaction (PK DI) and poorly understood pharmacodynamic (PD) drug interaction (PD DI) can occur between them.

AREAS COVERED: This paper comprehensively reviews PD DI and PK DI studies.

EXPERT OPINION: More PK DI studies are needed to better establish dose correction factors after adding fluoxetine and paroxetine to aripiprazole, iloperidone and risperidone. Further PK DI studies and case reports are also needed to better establish the need for dose correction factors after adding i) fluoxetine to clozapine, lurasidone, quetiapine and olanzapine; ii) paroxetine to …

Eye-Tracking Measures Of Attentional Bias In Cocaine Dependent Subjects, Nadeeka Dias

Dissertations & Theses (Open Access)

Cocaine-dependent (CD) subjects show evidence of attentional bias toward cocaine-related cues, and this measure of cue-reactivity is predictive of craving and relapse. In previous work, cue-reactivity and attentional bias have been assessed by models that present drug-relevant stimuli (e.g., cocaine-specific Stroop task) and measure physiological and behavioral reactivity (e.g., heart rate, reaction times). Studies have indicated competition between the higher-order cortical processes (frontal eye-fields, DLPFC) in voluntary eye control (i.e., anti-saccades) and more reflexive saccades driven by involuntary midbrain (superior colliculus) perceptual input (i.e., pro-saccades). In addition, neuroimaging studies in patients with cocaine dependence have shown activation in frontal regions …

Anti-Insulin Resistance Treatments Suppress Her2+ Breast Cancer Growth Via Altering Metabolism, Ping-Chieh Chou

Dissertations & Theses (Open Access)

Epidemiological studies have identified that type 2 diabetes mellitus (DM2) is a significant risk factor for carcinogenesis and cancer death, including breast cancer. Our previous finding in patients showed that anti-insulin resistance treatments are associated with improved HER2⁺ breast cancer survival of diabetic women. However, there were no transgenic mouse models to study the correlation and explain the detailed mechanism. We generated a mouse model of HER2⁺ breast cancer with DM2 by crossing leptin receptor point mutation (Lepr ^db/+) and MMTV-ErbB2 (neu) mice. The MMTV-ErbB2/Lepr ^db/db mice had a poor survival rate compared …

Toxoplasmosis Gondii: An Atypical Presentation Of Optic Neuritis, Nicky R. Holdeman, Steven Burnham, Roberto A. Cruz, Rosa A. Tang

School of Medicine Publications and Presentations

Toxoplasmosis gondii is a parasite whose natural host is the cat. Ocular toxoplasmosis can be categorized into two forms of infections: congenital, where an infant is infected in utero; and acquired, where an individual is typically infected by ingesting food contaminated with T. Gondii oocytes. Although acquired infections are rare in the United States, they can occur and toxoplasmosis should be in the differential diagnosis of an infectious optic neuritis.

The typical manifestation of toxoplasmosis is a retinochoroiditis, with a “headlight in the fog” appearance, due to dense inflammation of the vitreous; consequently, the diagnosis is often made clinically. This …

Survey Of Dental Hygienists’ Attitudes And Support Of The Proposed Dually Accredited Advanced Dental Therapist, Deborah S. Mcbride

Electronic Theses and Dissertations

The proposed dually licensed advanced dental therapy program, a graduate level curriculum created by the American Dental Hygienists’ Association (ADHA) encompassing both dental hygiene and basic restorative procedures, creates an innovative career path in dental hygiene and increases the standing of the dental hygienist from an auxiliary role to an independent midlevel dental practitioner. Data were gathered via an online anonymous survey tool from Massachusetts registered dental hygienists to assess support of this proposed curriculum by practicing hygienists. Eighty-seven percent of survey respondents are in agreement that the scope of dental hygiene responsibilities should increase with level of education, and …

Posttraumatic Stress And Posttraumatic Growth And Their Relationship To Coping And Self-Efficacy In Northwest Australian Cyclone Communities, Julie Ann Pooley, Lynne Cohen, Moira O'Conner, Myra Taylor

Myra F Taylor

The main focus of disaster research conducted to date has been on providing insights into the negative consequences of experiencing a serious threat or adversity. The present study extends this research endeavor by investigating the positive posttrauma resiliency experiences of 512 survey respondents living in four cyclone-prone communities in Northwest Australia. The findings reveal that disaster stress is often accompanied by disaster growth and, thus, provides an alternative resilience-based way of viewing postdisaster interventions.

Is Their Foundation Solid Enough To Build On: An Investigation Into The Information-Seeking Skills And Self-Efficacy Levels Of New Nursing Students, Kimberly Whalen, Patricia Mileham

Kimberly J. Whalen

Researchers at a mid-sized, Midwest, faith-based university used a quasi-experimental non-equivalent control group pretest posttest design to gather data from newly enrolled nursing students in a baccalaureate, masters and doctorate in nursing practice program. Literature regarding confidence levels, self-efficacy and information literacy skills was reviewed. Specific tools to assess confidence and self-efficacy of information literacy skills were explored. The 28-item Information Literacy Self-Efficacy Scale (ILSES) developed in 2006 by Serap Kurbanoglu was used in fall 2012, spring 2013 and fall 2013 to gather data from over 200 newly enrolled nursing students. Analysis of self-reported information literacy skills and self-efficacy levels …

Nips: Post Circumcision Policy, Elizabeth Bufink

Elizabeth Bufink

No abstract provided.

Poor Nutrition Status And Associated Feeding Practices Among Hiv-Positive Children In A Food Secure Region In Tanzania: A Call For Tailored Nutrition Training, Bruno F. Sunguya, Krishna C. Poudel, Linda B. Mlunde, David P. Urassa, Junko Yasuoka, Masamine Jimba

Krishna C. Poudel

Finding The Perfect Golf Swing, Christopher Joyce

Christopher Joyce

No abstract provided.

Core Resources Of International Health Researchers: An Analysis Of Citations In Major International Health Journals, Young-Joo Lee

Young-Joo Lee

Is Their Foundation Solid Enough To Build On: An Investigation Into The Information-Seeking Skills And Self-Efficacy Levels Of New Nursing Students, Patricia J. Mileham, Kimberly J. Whalen

Patricia Mileham

Researchers at a mid-sized, Midwest, faith-based university used a quasi-experimental non-equivalent control group pretest posttest design to gather data from newly enrolled nursing students in a baccalaureate, masters and doctorate in nursing practice program. Literature regarding confidence levels, self-efficacy and information literacy skills was reviewed. Specific tools to assess confidence and self-efficacy of information literacy skills were explored. The 28-item Information Literacy Self-Efficacy Scale (ILSES) developed in 2006 by Serap Kurbanoglu was used in fall 2012, spring 2013 and fall 2013 to gather data from over 200 newly enrolled nursing students. Analysis of self-reported information literacy skills and self-efficacy levels …

Electronic Health Records And Change Management, Wm. Marty Martin, Sergey Voynov

William Marty Martin

Abstract— Electronic health records (EHRs) offer many potential opportunities for patients, payers, physicians, and other healthcare providers. These opportunities are only realized if healthcare organizations commit to investing in EHRs and providers adopt the new technology for the benefit of patient care, higher quality, fewer errors, and greater efficiency. This paper focuses on increasing the probability those healthcare organizations in general but physicians and providers in particular adopt EHRs as a valuable tool to prevent and manage disease and illness. The adoption of EHRs often has less to do with the technology and more to do with the underlying changes …

Emg Activity Of Leg Musculature During The Back Squat With Weightlifting And Running Shoes: 3007 Board #293 May 30, 2, George K. Beckham, Kimitake Sato, Jacob P. Reed, William A. Sands, David H. Land

George Beckham

Asthma And Adaptive Functioning Among Homeless Kindergarten-Aged Children In Emergency Housing, J. J. Cutuli, Janette E. Herbers, Theresa L. Lafavor, Sandra M. Ahumada, Ann S. Masten, Charles N. Oberg

J. J. Cutuli

Background. Children who experience homelessness have elevated rates of asthma, a risk factor for other problems. Purpose. Examine rates of asthma and its relation to health care use and adaptive functioning among young children staying in family emergency shelters. Methods. Children and caregivers (N = 138) completed assessments in shelters, including measurement of child cognitive functioning, parent report of child health care service utilization and asthma diagnosis, and teacher report of child school functioning. Results. Asthma diagnosis was reported for 21% of 4‑to‑6‑year‑ old children, about twice the national and state prevalences. Children with asthma used more health care services …