Digital Commons Network^™

Effects Of An Osteoporosis Educational Intervention: Knowledge And Self-Efficacy Of Prevention In Young Adult Collegiate Females, Valerie A. Bollenbacher

Evidence-Based Practice Project Reports

Osteoporosis is a silent and potentially debilitating chronic illness. In 2012, the CDC reported that 4.5 million women over the age of 50 were diagnosed with osteoporosis in the United States. Within the next 20 years, 41 million women worldwide are projected to have osteoporosis. The annual financial burden of osteoporosis is estimated to be 19 billion dollars. The objective of this evidence-based practice project was to answer the clinical question: In young adult collegiate females, how does an osteoporosis educational intervention compared to current education effect osteoporosis knowledge and self-efficacy of osteoporosis prevention over a one-month time period? The …

The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

The Effects Of Education On Cardiovascular Disease Knowledge, Lauren A. Ostrowski-Winkler

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. The three main risk factors for the development of CVD include hypertension, high cholesterol, and tobacco use; these factors are largely prevented or reduced through lifestyle modifications. Researchers indicate that knowledge of CVD mortality has been linked with individual action to reduce one’s CVD risk. Researchers have also indicated that segments of our underserved society, particularly those with the highest CVD mortality rates, are also the least knowledgeable about CVD and their own personal risk. These risk factors were a concern within the …

Screening Asymptomatic Women For Cardiovascular Risk, Kathryn Nelson-Murphy

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) has long been recognized as a significant health problem in the U.S., and is the leading cause of preventable death in women, collectively causing about one death per minute (Caboral, 2013). A myriad of modifiable risk factors including dyslipidemia, hypertension, smoking, obesity, and type II diabetes are associated with 80-90% of CVD morbidity and mortality. Despite sobering statistics, valid risk prediction screening tools, and national preventive guidelines, adequate screening in clinical practice settings is sadly deficient. An evidence-based practice project was designed and implemented at a large OB/GYN practice in southern Ohio to address this identified gap …

The Role Of Amp-Activated Protein Kinase (Ampk) In Regulating The Early Stages Of Acute Pancreatitis, Mohamed Shitia

Honors Scholar Theses

Acute pancreatitis is an inflammatory disease that is initiated by the activation and retention of digestive zymogens inside pancreatic acinar cells (acini). It is proposed that adenosine monophosphate-activated protein kinase (AMPK) regulates early responses of acute pancreatitis in acini. A recent study shows that induction of experimental pancreatitis in isolated rat acini with supraphysiologic cerulein (orthologue of cholecystokinin) increases intracellular zymogen activation, but decreases AMPK levels. Furthermore, in vitro pharmacologic stimulation of AMPK reduces zymogen activation, having a protective effect. In this study, the effectiveness of two AMPK activators was examined in two separate in vivo pancreatitis models. In the …

Comparative Differences Between Traditional Chinese Medicine And Western Medicine In Treating Type Two Diabetes Mellitus, Neley Morales

HIM 1990-2015

In the United States alone, there were 25.8 million people suffering from diabetes in 2010. The prevalence of diabetes is expected to markedly increase worldwide over the next 30 years, an estimated 2.8% in 2000 and 4.4% in 2030. For individuals diagnosed with type 2 diabetes mellitus (T2DM), treatment is essential to control adverse effects such as hypertension and diabetic neuropathy. The focus of this study is to examine various approaches to maintain and improve the lifestyle of individuals suffering from T2DM. A comparative approach has been used to evaluate the differences in the treatment of T2DM with the use …

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …

Lean Body Mass May Explain Apparent Racial Differences In Carotid Intima-Media Thickness In Obese Children., Shahryar M. Chowdhury, Melissa H. Henshaw, Brad Friedman, J Philip Saul, Girish S. Shirali, Janet Carter, Bryana M. Levitan, Tom Hulsey

Manuscripts, Articles, Book Chapters and Other Papers

Background: Racial differences in carotid intima-media thickness (cIMT) have been suggested to be associated with the disproportionally high prevalence of cardiovascular disease in black adults. The objective of this study was to evaluate the effects of cardiovascular risk factors on the racial differences seen in cIMT in obese children.

Methods: Obese subjects aged 4 to 21 years were recruited prospectively. Height, weight, blood pressure, fasting insulin, glucose, lipid panel, high-sensitivity C-reactive protein, and body composition by dual-energy x-ray absorptiometry were obtained. B-mode carotid imaging was analyzed by a single blinded physician.

Results: A total of 120 subjects (46 white, 74 …

The Health-Related Quality Of Life Of Adults With Down Syndrome, Rebecca Jermyn Graves

Theses and Dissertations (ETD)

Purpose. The purpose of this study was to examine the health-related quality of life (HRQOL) and factors associated with the HRQOL of adults with Down syndrome (DS) as reported by adults with DS and their caregivers. The study was designed to compare measures of HRQOL, health problems, health risks, and health-care utilization of adults with DS based on self-report with those from caregiver-report and to explore associations between HRQOL and health problems, health risks, health-care utilization, adaptive behavior, and demographic characteristics. Background. The life expectancy of individuals with DS has lengthened from approximately 30 years around 1960 to over 50 …

Inborn Error Of Metabolism Is A Disease Of Any Age; Carniting Palmitoyltransferase Ii Deficiency And Its Manifestations, Mira Mitry Md, James Ross Md, Facp

Department of Medicine

No abstract provided.

Methylation Of Leukocyte Dna And Ovarian Cancer: Relationships With Disease Status And Outcome, Brooke L. Fridley, Sebastian M. Armasu, Mine S. Cicek, Melissa C. Larson, Chen Wang, Stacey J. Winham, Kimberly R. Kalli, Devin C. Koestler

Dartmouth Scholarship

Genome-wide interrogation of DNA methylation (DNAm) in blood-derived leukocytes has become feasible with the advent of CpG genotyping arrays. In epithelial ovarian cancer (EOC), one report found substantial DNAm differences between cases and controls; however, many of these disease-associated CpGs were attributed to differences in white blood cell type distributions. We examined blood-based DNAm in 336 EOC cases and 398 controls; we included only high-quality CpG loci that did not show evidence of association with white blood cell type distributions to evaluate association with case status and overall survival.

Childhood Obesity And Familial Hypercholesterolemia: Genetic Diseases That Contribute To Cardiovascular Disease, Alyssa Caudle

Senior Honors Theses

Childhood obesity occurs as the result of an imbalance between caloric intake and energy expenditure. Genetic risk factors for obesity have become an area of research due to its permanency. Mutated genes such as Fat Mass and Obesity Associated (FTO), Leptin (LEP), Leptin Receptor (LEPR), Melanocortin 4 Receptor (MC4R), Adiponectin C1Q and Collagen Domain Containing (ADIPOQ), Proprotein Convertase Subtilisin/Kexin Type 1 (PCSK1), and Peroxisome Proliferator-Activated Receptor Gamma (PPARG) all contribute to the development of childhood obesity. In the presence of high cholesterol caused by obesity, the genetic condition known as familial hypercholesterolemia is exacerbated. Familial hypercholesterolemia is caused by a …

Galactose-1-Phosphate Uridyl Transferase (Galt) And Galactosemia A Review Of Galt Function And Current Theories On Galactosemia Pathogenesis, Lydia R. Rehrer

Senior Honors Theses

All living organisms depend on the metabolism of carbohydrates for energy and the biosynthesis of necessary glycoconjugates. One of these carbohydrates is the monosaccharide galactose. Galactose is metabolized by humans through the Leloir pathway of galactose metabolism, which contains three enzymes to modify galactose so that it can be incorporated into glycolysis for the production of cellular energy. The middle enzyme of this pathway, galactose-1-phosphate uridyltransferase, produces uridine diphosphogalactose (UDP-gal) from galactose-1-phosphate (gal-1P), and a deficiency of this enzyme results in the human disease galactosemia. Galactosemia is diagnosed soon after an infant begins feeding, and although a galactose-restricted diet eliminates …

Prepregnancy Low-Carbohydrate Dietary Pattern And Risk Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Katherine Bowers, Deirdre K. Tobias, Sjurdur F. Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.

Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.

Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal …

The Gut Reaction: How The Intestinal Microbiota Respond To Citrobacter Rodentium Colonization, Cassandra Black

Senior Honors Theses

The human intestine hosts a diverse community of bacteria known as the intestinal microbiota. The intestinal microbiota have a symbiotic relationship with the host organism. Current research does not clearly define the effect these commensal microorganisms have on the overall maintenance of gastrointestinal health, including protection from the invasion and pathogenesis of foreign bacteria known as pathogens. EHEC O157:H7 causes severe sickness and can be life-threatening, but is difficult to study in vivo. One challenge is that EHEC does not colonize the preferred animal model for human GI studies: the murine intestine. However, the murine pathogen Citrobacter rodentium has …

The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng

ETSU Faculty Works

In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among …

Celiac Disease As A Model For The Evolution Of Multifactorial Disease In Humans, Aaron Sams, John Hawks

Human Biology Open Access Pre-Prints

Celiac disease (CD) is a multifactorial chronic inflammatory condition that results in injury of the mucosal lining of the small intestine upon ingestion of wheat gluten and related proteins from barley and rye. Although the exact mechanisms leading to CD are not fully understood, the genetic basis of CD has been relatively well characterized. In this review we briefly review the history of discovery, clinical presentation, pathophysiology, and current understanding of the genetics underlying CD risk. Then, we discuss what is known about the current distribution and evolutionary history of genes underlying CD risk in light of other evolutionary models …

Tobacco Use Among Adults Initiating Treatment For Hiv Infection In Rural Uganda, Gina R. Kruse, David Bangsberg, Judith A. Hahn, Jessica E. Haberer, Peter Hunt, Conrad Muzoora, John P. Bennett, Jeffrey N. Martin, Nancy A, Rigotti

OHSU-PSU School of Public Health Faculty Publications and Presentations

We conducted a longitudinal study of tobacco use among adults initiating antiretroviral therapy (ART) in Mbarara, Uganda where 11% of men and 3% of women use tobacco according to the 2011 Demographic and Health Survey. In a prospective cohort, self-reported tobacco use was assessed before starting ART and reassessed every 3–4 months. Plasma cotinine, a nicotine metabolite, was measured in a subset of adults pre-ART to verify self-report. Among 496 subjects, 50 (10%) reported current tobacco use (20% of men, 6% of women). Most (53%) adults with elevated cotinine levels (>15 ng/mL) reported no tobacco use. By 6 months …

Acculturation And Cardiovascular Behaviors Among Adult Asian-Americans, Monideepa Bhattacharya Becerra

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The World Health Organization recommends the promotion of positive cardiovascular behaviors (healthy diet and physical activity), while reducing negative ones (tobacco and alcohol abuse) as critical steps in reducing the burden of cardiovascular diseases. Researchers have highlighted the role of acculturation in predicting such behaviors among immigrants, though similar studies among Asian-American subgroups are lacking. This study examines the putative relationship between acculturation and aforementioned cardiovascular behaviors among six Asian-American subgroups.

Methods: A secondary analysis of the California Health Interview Survey 2007, 2009, and 2011 public access data was conducted. Acculturation was assessed utilizing proxy measures of language spoken …

To Take, Or Not To Take, Unproven Supplements In The Fight Against Huntington's Disease, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Trans Fatty Acids – A Risk Factor For Cardiovascular Disease, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

Trans fatty acids (TFA) are produced either by hydrogenation of unsaturated oils or by biohydrogenation in the stomach of ruminant animals. Vanaspati ghee and margarine have high contents of TFA. A number of studies have shown an association of TFA consumption and increased risk of cardiovascular disease (CVD). This increased risk is because TFA increase the ratio of LDL cholesterol to HDL cholesterol. Food and Agriculture Organization of the United Nations and World Health Organization have come up with the recommendation that the contents of TFA in human dietary fat should be reduced to less than 4%. There is high …

Variation In Feeding Practices Following The Norwood Procedure., Linda M. Lambert, Nancy A. Pike, Barbara Medoff-Cooper, Victor Zak, Victoria L. Pemberton, Lisa Young-Borkowski, Martha L. Clabby, Kathryn N. Nelson, Richard G. Ohye, Bethany Trainor, Karen Uzark, Nancy Rudd, Louise Bannister, Rosalind Korsin, David S. Cooper, Christian Pizarro, Sinai C. Zyblewski, Bronwyn H. Bartle, Richard V. Williams, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To assess variation in feeding practice at hospital discharge after the Norwood procedure, factors associated with tube feeding, and associations among site, feeding mode, and growth before stage II.

STUDY DESIGN: From May 2005 to July 2008, 555 subjects from 15 centers were enrolled in the Pediatric Heart Network Single Ventricle Reconstruction Trial; 432 survivors with feeding data at hospital discharge after the Norwood procedure were analyzed.

RESULTS: Demographic and clinical variables were compared among 4 feeding modes: oral only (n = 140), oral/tube (n = 195), nasogastric tube (N-tube) only (n = 40), and gastrostomy tube (G-tube) only …

Metabolic Reprogramming Induced By Ketone Bodies Diminishes Pancreatic Cancer Cachexia, Surendra K. Shukla, Teklab Gebregiworgis, Vinee Purohit, Nina V. Chaika, Venugopal Gunda, Prakash Radhakrishnan, Kamiya Mehla, Iraklis I. Pipinos, Robert Powers, Fang Yu, Pankaj K. Singh

Robert Powers Publications

Background: Aberrant energy metabolism is a hallmark of cancer. To fulfill the increased energy requirements, tumor cells secrete cytokines/factors inducing muscle and fat degradation in cancer patients, a condition known as cancer cachexia. It accounts for nearly 20% of all cancer-related deaths. However, the mechanistic basis of cancer cachexia and therapies targeting cancer cachexia thus far remain elusive. A ketogenic diet, a high-fat and low-carbohydrate diet that elevates circulating levels of ketone bodies (i.e., acetoacetate, β-hydroxybutyrate, and acetone), serves as an alternative energy source. It has also been proposed that a ketogenic diet leads to systemic metabolic changes. Keeping in …

Phages Of Non-Diary Lactococci: Isolation And Characterization Of Phi L47, A Phage Infecting The Grass Isolate Lactococcus Lactis Ssp Cremoris Dpc6860, Daniel Cavanagh, Caitríona M. Guinane, Horst Neve, Aidan Coffey, R. Paul Ross, Gerald F. Fitzgerald, Olivia Mcauliffe

Department of Biological Sciences Publications

Lactococci isolated from non-dairy sources have been found to possess enhanced metabolic activity when compared to dairy strains. These capabilities may be harnessed through the use of these strains as starter or adjunct cultures to produce more diverse flavor profiles in cheese and other dairy products. To understand the interactions between these organisms and the phages that infect them, a number of phages were isolated against lactococcal strains of non-dairy origin. One such phage, ΦL47, was isolated from a sewage sample using the grass isolate L. lactis ssp. cremoris DPC6860 as a host. Visualization of phage virions by transmission electron …

Milk Consumption And Cardiovascular Risk Factors In Older Chinese: The Guangzhou Biobank Cohort Study, Yangbo Sun, Chaoqiang Jiang, Kar Keung Cheng, Weisen Zhang, Gabriel M. Leung, Tai Hing Lam, Mary Schooling

Publications and Research

Background
Dairy products consumption is increasingly common globally. Most of the evidence concerning dairy products comes from observational studies in western populations which are inevitably open to confounding. To triangulate the evidence concerning dairy products, we examined the associations of whole cow’s milk consumption with cardiovascular risk factors in a non-Western setting with a different pattern of milk consumption and cardiovascular diseases from Western populations.

Methods
We used multivariable censored linear or logistic regression to examine cross-sectionally the adjusted associations of whole cow’s milk consumption (none (n = 14892), 1–3/week (n = 2689) and 3+/week (n = 2754)) with cardiovascular …

Cognitive Impairment In Patients With Type 2 Diabetes Mellitus: Perspectives And Challenges, Okezie I. Aruoma, Darshini Narrain, Joseph Indelicato, Emmanuel Bourdon, Fatima Murad, Theeshan Bahorun

The School of Health Sciences Publications and Research

Type 2 Diabetes Mellitus is associated with elevated blood glucose level, abnormal abdominal fat deposition, insulin resistance and a number of complications including embryopathy, cardiovascular diseases, nephropathy, neuropathy, microangiopathy and retinopathy. Complications extending to the central nervous system may have a deteriorating effect on mental health including a decline in cognitive functioning. This could be a reason for depression, lack of compliance towards medication/treatment, and the inability of patients to meet the day-to-day management demands of the disease. Due to the high metabolic demand for energy in the brain, perturbations in glucose metabolism can noticeably impact cognitive performance. This review …

The Interplay Of Diabetes, And Health Self Efficacy, Cognition And Compliance, Joseph Indelicato, Vanessa Gilchriest

The School of Health Sciences Publications and Research

The authors argue that screening tools for health self efficacy and cognitive impairment in patients with diabetes should be created to help implement interventions which would be most useful to those patients.

Metabolic Factor: A New Clinical Tool In Obesity Diagnosis And Weight Management, Brandon Davis, Joseph Indelicato, Nicholas Kuiper

The School of Health Sciences Publications and Research

Obtaining resting metabolic rates (RMR) via indirect calorimetry is a critical component of weight management that is used to calculate a new concept, metabolic factor. This calculation allows for the standardized expression of RMR to make it possible to compare metabolism between people and over time. This study found an inverse relationship between weight and metabolic factor, statistically significant, r = -­‐.63, p < 0.001, effect size = .46, suggesting that people who weigh more tend to have lower metabolic factors. Furthermore, statistically significant differences were found in the metabolic factors between people who were normal weight, overweight, and obese, p < 0.001. There was also an inverse relationship between metabolic factor and age, r = -­‐0.21, p < .05, effect size = .03, suggesting that age has a small but significant effect of metabolic factor. This variable has the potential to play a key role in treatment planning as it can be used to set realistic weight goals, determine caloric needs for a given weight, and to make decisions as to surgical intervention. More importantly, metabolic factor can be a key instrument in clinical work used to educate people regarding unique differences in metabolism to lower prejudice against the obese and to reduce the devastating shame that often accompanies weight issues.

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

School of Public Health Faculty Research

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …

Influence Of Diet And Obesity On Copd Development And Outcomes, Corrine K. Hanson, Erica P. Rutten, Emiel F.M. Wouters, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

The global increase in the prevalence and incidence of obesity has called serious attention to this issue as a major public health concern. Obesity is associated with many chronic diseases, including cardiovascular disease and diabetes, and recently the role of overweight and obesity in lung disease has received new interest. Independently of obesity, diet also plays a role as a risk factor for many chronic diseases, and evidence is accumulating to support a role for diet in the prevention and management of several lung diseases. Chronic obstructive lung disease is the third-leading cause of death globally, and both obesity and …