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Ashtanga For Addiction: A Qualitative Web-Based Open-Ended Survey To Assess Outcomes From Ashtanga Yoga Practice In Individuals In Long-Term Recovery From Substance Abuse Disorder, Shaun M. Jones

Dissertations and Theses (Open Access)

Over 72,000 people die from overdose or secondary health issues related to substance use disorder (SUD) annually. Studies support mind-body interventions in reducing stress, anxiety, depression, and craving symptoms. There is a growing body of literature supporting yoga as a mind-body intervention for individuals recovering from SUD. These interventions promote improved physical awareness, greater awareness of mental states, non-reactivity, and reduced perception of pain, allows for more successful coping with cravings. Ashtanga yoga (AY) is a tradition of yoga wherein students work on a one-on-one basis with highly qualified teachers following an invariant sequence of yoga postures. AY is characterized …

Implementation Of A Multi-Phase, Trauma-Focused Intervention Model Post-Hurricane Maria In Puerto Rico: Lessons Learned From The Field Using A Community Based Participatory Approach, Rosaura Orengo-Aguayo, Regan W. Stewart, Michael A. De Arellano, Freddie A. Pastrana, Bianca T. Villalobos, Karen G. Martínez-González, Joy Lynn Suárez-Kindy, Melissa Brymer

Journal of Family Strengths

Hurricane Maria made landfall in Puerto Rico on September 20, 2017, becoming the most devastating storm to impact the island in almost a century. Natural disasters have been shown to adversely impact children’s emotional, behavioral, and academic functioning and schools provide an ideal setting in which to implement wide-reaching interventions that can bolster resiliency and promote psychological recovery. Yet there is limited-to-non existent literature describing the actual implementation process of an evidence-based, trauma-informed intervention model within a school system after a natural disaster. This paper describes the process by which our team established a partnership with the Puerto Rico Department …

The Louisiana Spirit Hurricane Recovery Program: Addressing The Needs Of Children And Adolescents After Catastrophic Hurricanes, Melissa J. Brymer, Tonya Hansel, Alan M. Steinberg, Anthony Speier, Joy Osofsky, Howard Osofsky

Journal of Family Strengths

Aims: The Louisiana Spirit Hurricane Recovery Program was a statewide disaster mental health initiative implemented in response to the 2005 Hurricanes Katrina and Rita. Major components of the program included community-based culturally appropriate outreach strategies, risk screening and triage, and provision of Specialized Crisis Counseling Services (SCCS). The goal was to identify children and families at risk, and deliver services to address current needs and ongoing distress to prevent longer-term mental health problems. Methods: As the behavioral health needs of special populations, including minorities, and children and adolescents often go unmet, the Louisiana Spirit Program addressed this by …

Exposure Outliers: Children, Mothers, And Cumulative Disaster Exposure In Louisiana, Lubna Mohammad, Lori Peek

Journal of Family Strengths

Only a limited number of studies have explored the effects of cumulative disaster exposure—defined here as multiple, acute onset, large-scale collective events that cause disruption for individuals, families, and entire communities. Research that is available indicates that children and adults who experience these potentially traumatic community-level events are at greater risk of a variety of negative health outcomes and ongoing secondary stressors throughout their life course. The present study draws on in-depth interviews with a qualitative subsample of nine mother-child pairs who were identified as both statistical and theoretical outliers in terms of their levels of disaster exposure through …

The Hurricane Exposure, Adversity, And Recovery Tool (Heart): Developing And Validating A Risk Screening Instrument For Youth Exposed To Hurricane Harvey, Cody G. Dodd Ph.D., Ryan M. Hill Ph.D., Benjamin Oosterhoff Ph.D., Christopher M. Layne Ph.D., Julie B. Kaplow Ph.D., A.B.P.P.

Journal of Family Strengths

Given the increasing regularity with which severe (named) hurricanes arise, there is a need for valid, practically useful measures that facilitate child-centered post-hurricane situation analysis and needs assessment. Measures that accurately assess the most potent hurricane-related risk factors are essential to identifying youth at risk for developing posttraumatic stress reactions and providing them with effective post-disaster support. With feedback from community stakeholders (e.g., school personnel, physicians and hospital staff, community clinicians), we developed the Hurricane Exposure, Adversity, and Recovery Tool (HEART), a 29-item self-report measure of hurricane risk factors. Test development procedures included: (1) Reviewing the literature regarding hurricane exposure-related …

Project Reach: Implementation Of Evidence-Based Psychotherapy Within Integrated Healthcare For Hurricane Harvey Affected Individuals, Lynn M. Hana B.S., Sandra L. Cepeda B.S., Catherine C. Christian B.E., Sophie C. Schneider Ph.D., Ashley M. Shaw Ph.D., Jill Ehrenreich-May Ph.D., Alison Salloum Ph.D., Laurel Williams D.O., Asim A. Shah M.D., Eric A. Storch Ph.D.

Journal of Family Strengths

Project Reach was established to deliver evidence-based mental healthcare services to children and adults affected by Hurricane Harvey and its aftermath. Through Project Reach, an innovative multi-component assessment and treatment service is utilized to identify and treat in integrated healthcare settings both children and adults exhibiting significant behavioral health concerns in Houston. The aim is to provide sustainable, integrated mental health services through primary care and school-based settings to post-Harvey affected individuals whose emotional needs remain unmet. This paper describes the design and implementation of Project Reach as well as special considerations for implementation. The overall goal of Project Reach …

Repeated Disasters And Chronic Environmental Changes Impede Generational Transmission Of Indigenous Knowledge, Shanondora Billiot, Soonhyung Kwon, Catherine E. Burnette

Journal of Family Strengths

Indigenous coastal communities are interdependent with the environment and families are vulnerable to the environmental changes that disrupt culture, continuity, and livelihood. The purpose of this study was to elucidate meaning from shared cultural perceptions of experiencing repeated disasters and other environmental changes among a United States Indigenous coastal community. This study is part of a larger community- engaged study and reports results from phenomological semi-structured in-depth qualitative interviews (n=19). Participants were enrolled tribal members with a strong ethnic identity and earned a majority of their income from subsistence activities. The results highlight that discrimination, which is part of the …

Social And Emotional Support For Children And Their Caregivers Post-Disasters, Anjana Dayal De Prewitt, Tony Jose Richards

Journal of Family Strengths

The purpose of this paper is to share Save the Children’s responses to Hurricane Harvey in Texas, Hurricane Maria in Puerto Rico, and Hurricane Irma in Florida in 2017. Save the Children’s response and recovery efforts in the aftermath of these disasters consisted of a wide range of services for the affected children and their caregivers, including assistance to childcare centers and organizations, and providing child-focused services, such as psychosocial support. This paper will particularly focus on the psychosocial support element of the responses.

Mhealth Childhood Obesity Prevention: A Look Into The Hispanic Mother’S Perspective, Veronica Isabel Gonzalez

Dissertations and Theses (Open Access)

Along with increasing physical activity, improving nutrition is an important behavior to target to reduce the risk of obesity in children and adolescents. To date, a nutrition-focused mHealth intervention used to promote obesity prevention and healthy living among Hispanic children and adolescents has not been specifically developed for Hispanic mothers. The purpose of this study was to provide information on feasibility and acceptability of a mHealth child nutrition intervention among Hispanic mothers. The data was collected from an online survey and telephone interviews from 30 mothers of 8-12-year-old Hispanic girls. Most mothers were 40 years old or younger (70%), identified …

Climate Change And Chagas Disease In The Americas: A Qualitative Systematic Review, Brittany N. Graves

Dissertations and Theses (Open Access)

While many studies have found associations between climate change and factors affecting Chagas disease transmission, the future impact of climate change on the global spread of Chagas disease remains debatable. A qualitative, systematic review was conducted to assess the impact of climate change on Chagas disease transmission in the Americas (Central America, South America, and North America). The literature search was performed in January 2019 using the keywords climate, Chagas, and “trypanosoma cruzi” and the electronic databases PubMed, Scopus, and Ovid. Searches retrieved records from 1982 through 2019. The initial electronic database search identified a total of 191 record documents …

Perceived Discrimination From Providers On Latina Mothers’ Decision-Making On Hpv Vaccination Initiation And Completion In Houston, Tx, Fatima Frausto

Dissertations and Theses (Open Access)

Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) in the United States (US). Certain HPV strains have the potential to develop into cervical, anal, penile, vulvar, and throat cancers. Latinos in the U.S. have the highest rates of cervical and penile cancers compared to non-Hispanic Whites. Despite the availability of HPV9v, uptake of the vaccine is suboptimal in the Latino community. Previous research has found factors such as provider recommendation and communication are important in HPV vaccine series initiation and completion. Discrimination in the medical setting is linked to poorer health outcomes and delayed …

“He’S Not Too Young”: Empowering Parents In Child Language Development Through Upwords, A Parenting Education Program, Lynda Chima Aririguzo

Dissertations and Theses (Open Access)

Community-based early literacy intervention programs show promise in improving the home language environment, particularly for children at increased risk of language delays and poor school readiness. However, the literature on parents’ perspective of these programs is limited. This study investigated the perspectives and language scores of participants in upWORDS, a community-based literacy intervention program in Houston, TX. Through mixed-methods, this study aimed to describe the program’s impact on parents’ views on child development, changes in child behaviors, and continued application of information from the program. It also aimed to identify patterns in parent-reported measurements of children’s language skills over time. …

Uses Of Continuous-Time Markov Chain To Describe Longitudinal Patient-Reported Outcomes For Survival Prediction And Dimension Reduction, Ting-Yu Chen

Dissertations and Theses (Open Access)

A patient-reported outcome (PRO) is a type of outcome reported directly from patients, and it has been widely used in medical research and clinical trials to measure a patient’s symptoms, health-related quality of life, physical functioning, and health status. Previous studies have linked PROs to survival outcomes, but most of them only used the PRO information at baseline or at a specific clinical time point [1, 2]. Even though some of these studies collected longitudinal PROs, only few of them evaluated the association between the longitudinal PROs and a survival outcome. One of the major challenges in longitudinal PRO studies …

Hepatitis C Infection In Men Who Have Sex With Men, Jing Zhao

Dissertations and Theses (Open Access)

Hepatitis C virus (HCV) infection is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. Current treatment rates and efficacy are inadequate to manage the disease burden caused by HCV; thus, efforts are needed to control HCV transmission. Besides the well-known transmission routes, which are health-care-associated transmission and transmission through injecting drugs, HCV could also be transmitted by sexual contact, especially among men having sex with men (MSM). MSM also have higher drug use prevalence than the general population, which may contribute to HCV infection by sexual disinhibition and other risky behavior. Since 2000, there have been emerging reports …

Utilization Of Mind-Body Practices For Adults With Fibromyalgia: 2017 National Health Interview Survey, Jennifer Contreras

Dissertations and Theses (Open Access)

Fibromyalgia (FM) is a medical condition characterized by chronic pain and tenderness. Individuals with FM may experience burdensome symptoms, which impact their health-related quality of life. Treatment for FM includes pharmacological and non pharmacological practices. Non-pharmacological treatments for FM include dietary management, routine exercise, and physical and mind-body therapies. There is growing evidence that the utilization of mind-body practices is increasing in the United States, but there have been limited investigations done to observe the use of mind-body practices in the FM population. The purpose of this study is to identify predictors of the use of meditation and/or meditative movement …

The Impact Of Food Security Status On The Food Shopping Behavior And Patterns Of 2018 Brighter Bites Participants At Baseline, Sarah A. Crulcich

Dissertations and Theses (Open Access)

Households with children continue to have a greater prevalence of food insecurity compared to the national average. While the national food security rates have improved in recent years, it remains stagnant among children. The purpose of this study was to conduct a cross-sectional regression analysis on food shopping patterns and behavior among Brighter Bites participants stratified by food security status to offer more insight into how these households obtain fresh produce. We used baseline survey data from Brighter Bites participants completed during fall 2018. The results indicate that food insecure Brighter Bites households shop more frequently for produce at locations …

Novel Propensity Score Methods For Multiple And Continuous Treatments: Applications To Ehr Data, Derek W. Brown

Dissertations and Theses (Open Access)

Propensity scoring is often utilized to overcome the challenges posed by covariate imbalance to make causal inferences within observational studies. While methods for utilizing propensity scoring in a binary treatment case are well studied and established, generalizations to multiple unordered (multinomial) and continuous treatments are more complicated. In Aim 1, we developed and tested a novel multinomial treatment propensity score method, the GPS-CDF method, which derives a single scalar balancing score that can match and stratify subjects. Simulation results showed superior performance of the new methodology compared to standard multinomial propensity score methods. The proposed GPS-CDF method was also applied …

Tuberculosis Among Dairy Workers In Bailey County, Texas, Anabel Rodriguez

Dissertations and Theses (Open Access)

On January 2016, Texas State Department of Health Services (DSHS) Public Health Region 1 (PHR 1) conducted T-SPOT.TB tests in response to two requests to screen dairy workers potentially exposed to cattle infected with Mycobacterium bovis or bovine tuberculosis (bTB) in Bailey County, Texas. Out of 140 workers tested, 14 had confirmed latent tuberculosis infection (LTBI)—prevalence of 10.0%. This first study gave rise to questions concerning tuberculosis (TB) knowledge and exposure history among dairy workers in this same county. The second study focused on determining TB knowledge among dairy workers through a series of questions administered by research personnel on …

Assessing The Readiness Of Relatives To Undergo Cascade Genetic Testing For Inherited Predispositions To Cancer Using The Transtheoretical Model Stages Of Change, Erica M. Bednar

Dissertations and Theses (Open Access)

National guidelines recommend cascade genetic testing (CGT) for blood relatives after a cancer predisposition gene mutation is identified in an individual. Despite recommendations for CGT, only 30-60% of first-degree relatives (FDRs) complete CGT. The proportion of untested relatives who are planning to have CGT is unknown. We used the Transtheoretical Model to assess the readiness (stage of change) for CGT among living, untested FDRs at-risk for a hereditary predisposition to cancer. An anonymous, online survey was open to U.S. adults with an autosomal dominant, adult-onset, hereditary predisposition to cancer. Participants reported demographic information, their genetic testing information, and information on …

The Effect Of Hospital Engagement Network Participation On Central Line-Associated Bloodstream Infections And Readmission Rates, Tyler Wallace

Dissertations and Theses (Open Access)

In 2012, the Centers for Medicare and Medicaid Services (CMS) launched the Hospital Engagement Network (HEN) program to decrease patient harm events in United States’ (US) hospitals. The HEN program became the nation’s largest quality improvement collaborative (QIC) focusing on improving patient care. Results from the program’s formal evaluation were inconclusive on whether the HEN program was effective. There have been no other known studies on this program’s effectiveness. Even with the evidence lacking, the CMS continues to fund programs similar to the HEN program. This study’s research aim was to compare patient outcomes for HEN participants to nonparticipants to …

Evaluation Of Food Journal Application Validity In Comparison With Dhq Iii, Michael Roa

Dissertations and Theses (Open Access)

As chronic conditions associated with the high prevalence of obesity/overweight in the United States continue to rise, research focusing on nutrition has grown in recent years. The gold standard for collecting detailed nutritional information on individuals is food journals, mostly via pen and paper. Alternatively, smartphone food journal applications have become more popular and widely accessible in recent years. These applications allow the user to quickly make meal entries, often taking advantage of the application’s food and servings database.

This study compared the results of the third iteration of the Diet History Questionnaire (DHQ III) with a dietary journal data …

Commissioning Of Micro-Cube Thermoluminescent Dosimeters For Small Field Dosimetry Quality Assurance In Radiotherapy, Brandon Luckett

Dissertations and Theses (Open Access)

Small field dosimetry presents complications and uncertainties that could be circumvented by using detectors which are smaller than the radiation field. This study evaluates the reproducibility and accuracy of TLD micro-cubes for use in stereotactic radiosurgery (SRS) remote auditing quality assurance (QA) for treatment centers participating in clinical trials. This study tested the hypothesis that TLD micro-cubes could be commissioned to evaluate small field dosimetry, and provide reproducibility within 3%, as well as assure agreement between measured dose and calculated doses to within 5%.

The aims of this thesis were to characterize and commission TLD micro-cubes as well as to …

Inhibition Of Urothelial Carcinoma By Type I Interferon Activation Of The Innate And Adaptive Immune Response, Devin Plote

Dissertations and Theses (Open Access)

Bacillus Calmette-Guerin (BCG) is the first line therapy for bladder cancer patients with non-invasive disease. However, roughly 40% of patients exhibit no response, tumor recurrence or tumor progression following BCG treatment. Type I interferon (IFN-I) has potent anti-tumor effects against urothelial carcinoma (UC) and may be an alternative treatment option for patients who do not respond to BCG standard of care. However, the mechanisms that mediate the IFN-I-stimulated immune responses against UC are not fully elucidated. Herein, we evaluated the anti-tumor mechanisms of IFN-I in UC by use of adenoviral interferon-α (Ad-IFNα/Syn3) in human patients, and poly(I:C) or lentiviral IFNa …

The Gsk-3Β-Fbxl21 Axis Regulates Tcap Via Ubiquitin-Mediated Proteasomal Pathway In The Cytoplasm, Jiah Yang

Dissertations and Theses (Open Access)

Protein turnover is one of the most essential mechanisms controlling circadian rhythms. F-Box and Leucine Rich Repeat Protein21 (FBXL21) is a circadian E3 ligase which shows oscillatory mRNA transcripts and protein levels. It was previously found to perform subcellular compartment-specific E3 ligase activities targeting the core clock proteins CRYPTOCHROME(CRY)1/2. Here we identified a new sarcomeric target substrate, Telethonin(TCAP), which also shows circadian oscillation in its mRNA transcript and protein expression and, importantly, interaction with FBXL21 in an anti-phasic manner. Via computational and pharmacological tests, we identified Glycogen Synthase Kinase-3β(GSK-3β) as a regulator of FBXL21. Biochemical and molecular characterizations demonstrated that …

Evaluating The Therapeutic Efficacy Of Grb2 Inhibition In Ovarian Malignancies, Olivia Lara

Dissertations and Theses (Open Access)

Purpose: Adaptor proteins such as growth factor receptor-bound protein-2 (Grb2) play important roles in cancer cell signaling. In the present study, we examined the biological effects of liposomal antisense oligodeoxynucleotide that blocks Grb2 expression (L-Grb2) in ovarian cancer models.

Experimental Design: Murine orthotopic models of ovarian cancer (OVCAR5 and SKOV3ip1) were used to study the biological effects of L-Grb2 on tumor growth. In vitro experiments (cell viability assay, Western blot analysis, siRNA transfection, and reverse phase protein array) were carried out to elucidate the mechanism and potential predictors of tumor response to L-Grb2.

Results: Treatment with L-Grb2 decreased tumor growth …

Identifying And Targeting Adaptive Changes To Bet Inhibition In Ovarian Cancer, Christopher Lafargue

Dissertations and Theses (Open Access)

Purpose: To identify combination strategies using Bromodomain and Extra-Terminal Domain (BET) inhibitors in a mechanism driven fashion to maximize anti-tumor activity, and to determine the efficacy of BET inhibitor combinations in pre-clinical ovarian cancer mouse models.

Experimental Design: We used a novel, previously uncharacterized pan-BET inhibitor, CN210, for all in vitro (MTT, apoptosis, protein expression, reverse phase protein array (RPPA) analysis and in vivo (orthotopic mouse model)) experiments. The poly (ADP-ribose) polymerase (PARP) inhibitor olaparib, as well as the mechanistic target of rapamycin (mTOR) inhibitors rapamycin and INK-128 were also used. Statistical analyses of in vitro and in vivo experiments …

An Information Theory Model For Optimizing Quantitative Magnetic Resonance Imaging Acquisitions, Drew Mitchell

Dissertations and Theses (Open Access)

Quantitative magnetic resonance imaging (qMRI) is a powerful group of imaging techniques with a growing number of clinical applications, including synthetic image generation in post-processing, automatic segmentation, and diagnosis of disease from quantitative parameter values. Currently, acquisition parameter selection is performed empirically for quantitative MRI. Tuning parameters for different scan times, tissues, and resolutions requires some measure of trial and error. There is an opportunity to quantitatively optimize these acquisition parameters in order to maximize image quality and the reliability of the previously mentioned methods which follow image acquisition.

The objective of this work is to introduce and evaluate a …

Modeling Proton Relative Biological Effectiveness Using Monte Carlo Simulations Of Microdosimetry, Mark A. Newpower

Dissertations and Theses (Open Access)

Proton therapy is a radiotherapy modality that can offer a better physical dose distribution when compared to photon radiotherapy by taking advantage of the Bragg peak, a narrow region of rapid energy loss. Proton therapy is also known to offer an enhanced relative biological effectiveness (RBE) compared to photons. In the current clinical standard, RBE is fixed at 1.1 at all points along the proton beam, meaning protons are assumed to require 10% less dose than photons to achieve target coverage and organ at risk (OAR) sparing. However, there is mounting clinical evidence, and a significant number of in vitro …

Role Of C-Met And Egfr In Acquired Resistance To Parp Inhibitors In Triple-Negative Breast Cancer, Clinton Yam

Dissertations and Theses (Open Access)

Triple-negative breast cancer is associated with a poor prognosis and treatment options are limited. The Poly (ADP-ribose) polymerase (PARP) inhibitors, olaparib and talazoparib, were recently approved for metastatic breast cancer (including triple-negative breast cancer) in patients with a germline BRCA1/2 mutation. Despite impressive response rates of ~60%, the prolongation in median progression-free survival with PARP inhibitors is modest, suggesting the emergence of resistance. We previously demonstrated that c-MET contributes to intrinsic resistance to PARP inhibitors in triple-negative breast cancer. However, whether c-MET plays a role in acquired resistance to PARP inhibitors in triple-negative breast cancer remains unclear. Here, we show …

Oxidative Phosphorylation: A Critical Feature And Novel Therapeutic Target In Melanoma Brain Metastases, Grant Fischer

Dissertations and Theses (Open Access)

We recently showed via RNA-sequencing (RNA-seq) analysis of clinical samples that melanoma brain metastases (MBMs) have higher expression of oxidative phosphorylation (OXPHOS) genes (including PPARGC1A or PGC1α) than patient-matched extracranial metastases (ECMs). Thus, the central hypothesis of this dissertation is that OXPHOS plays a critical role in the pathogenesis of MBMs.

RNA-seq analysis identified increased expression of OXPHOS genes in intracranial (ICr) vs. subcutaneous (SQ) xenografts of 4 different human melanoma cell lines. Increased OXPHOS in the ICr xenografts was confirmed by direct metabolite analysis and [U-¹³C]-glucose tracing analysis. Together, these studies indicate that the brain TME …