Digital Commons Network^™

Taking What We Have And Making What We Need: Utilizing Natural Helping Support Networks To Decrease Self Directed Violence Among Adolescents Of Color., Ladrea Ingram, Vanessa Drew-Branch

Journal of Family Strengths

Previous research has linked family and community connectedness with decreased risk of self-directed violence among adolescents. Despite the strong correlation between social connectedness and lowered risk of self-directed violence, very few interventions use social connections as mediators. This article identifies the risk and protective factors associated with self-directed violence among adolescents of color. In alignment with Healthy People 2020, this paper highlights the social determinants of self-directed violence including factors associated with individual’s social and physical environments. The authors provide an interdisciplinary review of current trends and historical data on self-directed violence in adolescents of color. The researchers suggest, the …

Predictors Of Obesity In African American College Students, Christiana Chinenye Osuagwu

Journal of Family Strengths

Abstract

Introduction: Obesity is the second highest cause of death in the United States due to its numerous co-morbidities, and data reveal that African Americans are at greatest risk for this disease. The study explored the multiple factors that predict obesity in the African American college students.

Method: Using a hybrid of the PRECEDE-PROCEED and the vital renewal models, a mixed methods study design that included 142 male and female African American college students was conducted. A Likert-scaled survey for the quantitative phase and a focus group interview for the qualitative arm were utilized. Constructs of attitude, culture, environment, …

Injustice And Inequality In Healthcare: Trends And Progress, Angelo Giardino, Robert Sanborn

Journal of Family Strengths

Angelo P. Giardino and Robert Sanborn discuss the latest issue of the Journal of Family Strengths.

Addressing Nutritional Literacy In Preschool Learning Environments, Cynthia Warren

Journal of Family Strengths

INTRODUCTION: Obesity among preschool children is more common among lower-income families. Prevalence of type 2 diabetes in U.S. Mexican and African American populations has steadily increased and is associated with modifiable risk factors, such as poor dietary habits.

AIM: The purpose of this study was to conduct an assessment of the preschool Bienestar/NEEMA Health Program, focusing on: students’ knowledge increase, teacher input on the classroom materials used, parental feedback on take-home activities, and input on the program's food service training by the school district's nutrition coordinator.

SAMPLE: Curriculum was implemented and assessed in one Head Start school over …

Use Of Short Assessment Of Health Literacy For Spanish Adults (Sahlsa-50) To Determine The Health Literacy Rate Of The Spanish-Speaking Population In An Urban Emergency Department, Dick Kuo M.D., Sheetal Thaker, Martin Duncan, Michael Puente, Sonia Parra, Ashley Rider, Kelsey Horter, Malford T. Pillow

Journal of Family Strengths

Background: The Hispanic population presents a great opportunity in terms of potential improvements in clinical outcomes and cost reduction for interventions through assessing and improving health literacy. While there are various tools to assess health literacy, many do not assess comprehensive Spanish health literacy.

Objectives: We sought to determine the health literacy rate of our Spanish-speaking population in the ED using the SAHLSA-50 tool.

Methods: We surveyed a convenience sample of 300 patients from October to November 2012 that presented to our busy, high volume, urban ED. All subjects completed the SAHLSA-50 tool and demographic form with Spanish-speaking research assistants. …

A Novel Bioinformatic Approach To Understanding Addiction, Latifa F. Jackson

Journal of Family Strengths

Finding the genetic markers that influence complex, multigenic substance addiction phenotypes has been an area of significant medical study. Understanding complex disease traits like addiction has been hampered by the lack of functional insights into novel variants to the human genome. We hypothesized that gene location plays a role in functional genomic neighborhoods.

To test whether there is a relationship between opiate, dopamine, and GABA disease and population allele frequencies, we used genes obtained from addiction literature curated by the National Center for Biotechnology Information (NCBI). These addiction and metabolism focused search terms generated opiate, dopamine, and GABA addiction results …

Illness Severity Among Non-English, Non-Spanish Speaking Patients In A Public Emergency Department, Malford T. Pillow M.D., M.Ed., Thomas Ence M.D., Tyler Dirvonas M.D., William F. Peacock M.D., Dick Kuo M.D.

Journal of Family Strengths

Background: Patients with limited English proficiency (LEP) have poor health outcomes compared to English proficient patients. Most studies on language proficiency and health disparities focus on Spanish.

Objective: This study examines whether non-Spanish speaking LEP patients experience greater disparities than Spanish speaking LEP patients by comparing disease acuity and language proficiency in an emergency department.

Design: This is a retrospective case-control study from November 2010 to February 2012 comparing differences between non-English non-Spanish (NENS) speaking patients to English speaking patients with differences between Spanish speaking and English speaking patients.

Main outcomes: Primary endpoints include the emergency severity index …

Geospatial Distribution And Population Substructure Of Subgroups Of Us Ethnic Minorities: Implications For Perpetuation Of Health Disparities And Paucity Of Precision Medicine, Hasan Jackson, Fatimah L.C. Jackson

Journal of Family Strengths

Substructure due to familial-associated divisions exists in all large populations. Geographical heterogeneity in US ethnic minorities is a function of historical, social, political, and economic factors overlaying regional geographical biodiversity. Using geospatial, historical, demographic, genetic, and epidemiological databases, we identify 40 US microethnic isolates across the US, the “minorities within ethnic minorities” and locate their geospatial distributions within the US. Key components of the environment relevant to health disparities are identified and elaborated in terms of their impact on genomics. US ethnic minority microethnic isolates often have distinct genetic and social histories from the US ethnic majority that put these …

Stigma And The Reluctance To Address Mental Health Issues In Minority Communities, Gary L. Kreps

Journal of Family Strengths

Health disparities are a serious problem for members of minority communities in the United States. Disparities do not only lead to negative influences and inequities in the outcomes from serious physical health problems (such as cancer, heart disease, HIV/AIDS, and diabetes) for members of minority communities, but also lead to significant problems with outcomes from serious mental health conditions (including stress-related, manic-depressive, and psychotic disorders, as well as suicidal tendencies) for ethnic and racial minority group members in the US. While current epidemiological evidence suggests that the actual rates of incidence of mental health problems is not significantly different across …

Preferred Health Information Sources: An Examination Of Vulnerable Middle-Aged And Older Women, Caroline D. Bergeron, Marcia Ory, Heather H. Goltz, Samuel D. Towne Jr, Sangnam Ahn, Nelda Mier, Matthew Lee Smith

Journal of Family Strengths

Background. Women are the greatest consumers of health information. Despite this fact, little is known about middle-aged and older women’s preferred sources for health information.

Objectives. This study aims to: (1) identify preferred sources of health-related information among middle-aged and older women; and (2) examine sociodemographics, family/household characteristics, health status, and health-related behaviors associated with their preferred sources for health information.

Methods. Data were collected from 3,946 middle-age and older women using a randomized multimodal survey of households in an eight-county region of Texas. Frequencies, Pearson’s chi-squares and one-way ANOVA were used to examine relationships to the respondent’s preferred sources …

Molecular Determinants Of Residual Disease In Ovarian Cancer, Kshipra M. Gharpure

Dissertations and Theses (Open Access)

The standard treatment for high grade serous ovarian cancer is primary cytoreductive surgery followed by adjuvant chemotherapy. Residual disease followed by surgery is associated with adverse overall and progression-free survival as well as poor response to adjuvant chemotherapy. Accurate identification of patients at high risk of residual disease will help avoid unnecessary surgeries and help in triaging these patients to neoadjuvant chemotherapy prior to interval surgical debulking. In this study, we address this clinical issue by identifying and validating molecular biomarkers that can predict the likelihood of residual disease in ovarian cancer patients. Using publically available databases and microarray datasets, …

Phopsphorylation And Ubiquitin Modification At Dna Damage Sites In Response To Double-Strand Breaks, Atanu Paul

Dissertations and Theses (Open Access)

Genomes of all organisms are continuously damaged by numerous exogenous and endogenous sources leading to different kinds of DNA lesions, which if not repaired efficiently may trigger wide-scale genomic instability, a hallmark of cancer development. To overcome this, cells have evolved a sophisticated sensory network called the DNA damage response (DDR) comprised of a large number of distinct protein complexes categorized as sensor, mediator, transducer and effector proteins that amplify the DNA damage signal and activate cell cycle checkpoint to initiate DNA repair or trigger apoptosis where the defect is beyond repair. This intricate signaling pathway is tightly regulated by …

Visualizing The Dynamics Of Immune Surveillance In Brain Tumors By Intravital Multiphoton Microscopy, Felix Nwajei

Dissertations and Theses (Open Access)

Visualizing the dynamics of immune surveillance in brain tumors by intravital multiphoton microscopy

By

Felix I. Nwajei, MD

Supervisory Professor: Tomasz Zal, Ph.D.

Brain tumors (BTs) generally have a bad prognosis despite conventional treatment strategies. Immunotherapy is a relatively novel treatment approach that has shown benefit for durable treatment of melanoma, and is a promising candidate for different tumor types including BTs. Immunotherapeutic strategies work by exploiting and/or enhancing natural anti-tumor immune response, a process that is critically dependent on adaptive immunity, T cell infiltration and surveillance of tumor. However, little is known about the dynamics and regulation of T …

Role And Regulation Of Sphingosine 1-Phosphate In Erythrocyte, Kaiqi Sun

Dissertations and Theses (Open Access)

Sphingosine 1-phosphate (S1P) is a bioactive signaling sphingolipid produced in every mammalian cell. It plays a variety of important roles both in and outside of cells. S1P is highly enriched in mature erythrocytes because of the high enzymatic activity of the S1P-generating enzyme Sphingosine Kinase 1 (Sphk1) and the absence of S1P degrading enzymes. Erythrocytes are considered only a major reservoir for S1P because they supply S1P to the circulation for the regulation of various physiological processes which include but are not limited to immune cell trafficking, endothelial integrity and hematopoietic stem cell mobilization. However, if S1P plays a role …

Integrative Analysis Of Omics Data In Adult Glioma And Other Tcga Cancers To Guide Precision Medicine, Xin Hu, Xin Hu

Dissertations and Theses (Open Access)

Transcriptomic profiling and gene expression signatures have been widely applied as effective approaches for enhancing the molecular classification, diagnosis, prognosis or prediction of therapeutic response towards personalized therapy for cancer patients. Thanks to modern genome-wide profiling technology, scientists are able to build engines leveraging massive genomic variations and integrating with clinical data to identify “at risk” individuals for the sake of prevention, diagnosis and therapeutic interventions. In my graduate work for my Ph.D. thesis, I have investigated genomic sequencing data mining to comprehensively characterise molecular classifications and aberrant genomic events associated with clinical prognosis and treatment response, through applying high-dimensional …

Tumor-Cell Derived Inhibin, Beta A Is Essential For Adrenergic Effects On Fibroblast Activation, Archana Sidalaghatta Nagaraja

Dissertations and Theses (Open Access)

Objectives: Catecholamine-mediated effects driven by elevated adrenergic signaling are known to increase tumor growth and metastasis by direct effects on tumor cells. However, knowledge of effects of adrenergic signaling on other cells such as cancer-associated fibroblasts (CAFs) within the tumor microenvironment is limited. We hypothesize that adrenergic signaling and norepinephrine can accelerate the induction of CAF-phenotype to promote inflammation and metastasis.

Methods: Ingenuity Pathway Analysis and NetWalker were used to assess gene expression data from patients with known CESD (Center for Epidemiological Studies-Depression)-score alongside microdissected CAFs from primary ovarian cancer. Tumor samples from mice exposed to daily restraint-stress or non-stressed …

Non-Coding Rnas Identify The Intrinsic Molecular Subtypes Of Muscle-Invasive Bladder Cancer, Andrea E. Ochoa

Dissertations and Theses (Open Access)

NON-CODING RNAS IDENTIFY THE INTRINSIC MOLECULAR SUBTYPES OF MUSCLE-INVASIVE BLADDER CANCER

Andrea Elizabeth Ochoa, B.S.

Advisory Professors: David J. McConkey, Ph.D. and Joya Chandra, Ph.D.

There has been a recent explosion of genomics data in muscle-invasive bladder cancer (MIBC) to better understand the underlying biology of the disease that leads to the high amount of heterogeneity that is seen clinically. These studies have identified relatively stable intrinsic molecular subtypes of MIBC that show similarities to the basal and luminal subtypes of breast cancer. However, previous studies have primarily focused on protein-coding genes or DNA mutations/alterations.

There is emerging evidence implicating …

Managing Variant Discrepancy In Hereditary Cancer: Clinical Practice, Barriers, And Desired Resources, Ellen Zirkelbach

Dissertations and Theses (Open Access)

Variants are changes in the DNA whose phenotypic effects may or may not be definitively understood. Because variant interpretation is a complex process, sources sometimes disagree on the classification of a variant, which is called a variant discrepancy. This study aimed to determine the practice of genetic counselors regarding variant discrepancies and to identify the barriers to counseling a variant discrepancy in hereditary cancer genetic testing. This investigation was unique because it was the first to address variant discrepancies from a clinical point of view. An electronic survey was sent to genetic counselors in the NSGC Cancer Special Interest Group. …

Genesurance Counseling: Patient Perspectives, Chelsea Wagner

Dissertations and Theses (Open Access)

Genetic counselors (GCs) have recently reported an increase in the discussion of insurance-related, or “genesurance,” topics during genetic counseling sessions. Despite increasing frequency, little knowledge exists about genesurance conversations and patient expectations. This study aimed to assess patient expectations of GCs in genesurance discussions and evaluate if health insurance literacy impacted these expectations. A 38-item survey, including a validated tool to assess health insurance literacy (HIL) was administered prior to patients receiving prenatal or cancer genetic counseling at three participating institutions. A total of 360 responses were analyzed. Key variables were compared using chi-square analysis and multivariable logistic regression was …

The Utilization Of Prenatal Microarray: A Survey Of Current Genetic Counseling Practices And Barriers, Leslie N. Durham, Leslie Durham

Dissertations and Theses (Open Access)

Chromosomal microarray (CMA) assesses chromosome copy number variants (CNVs) missed by standard karyotyping. The American College of Obstetricians and Gynecologists (ACOG) recommends CMA for all patients with fetuses with an ultrasound anomaly and suggests that it be made available to all women undergoing invasive testing. In order to assess prenatal genetic counselors’ (GCs) practices regarding the utilization of CMA we conducted a survey of their current practices, attitudes, and perceived barriers. Of the 192 respondents, 183 (95%) have incorporated CMA into clinical practice with the majority (64%) believing that the benefits of CMA outweigh the harms. However, only half (52%) …

Statistical Methods For Assessing Structural Change In Human & Microbial Genomes, Xuan Zhu

Dissertations and Theses (Open Access)

Genetic sequencing has been recognized as an effective approach to accurately address biological problems, such as clinical detection of disease, mutation discovery, and targeting specific biomarkers associated with complex diseases. Compared with conventional Sanger sequencing, next-generation sequencing costs much less due to massively parallel high-throughput sequencing. However, due to large numbers of short read sequences, the accuracy of high-throughput sequencing data remains a challenge in that the data obtained from next-generation sequencing often has higher error rates, which may impact downstream genomic analysis. Even if the downstream genomic analysis performs well, the quality of the result will still be impacted …

Characterizing The Source Of Neutrophil Elastase And Proteinase 3 Cross-Presentation In B-Cell Acute Lymphoblastic Leukemia, Selena Carmona

Dissertations and Theses (Open Access)

Discovery of tumor-associated antigens is an important step in designing effective antigen-targeting immunotherapies. PR1 is a nonameric human leukocyte antigen (HLA)-A2 restricted leukemia-associated antigen derived from serine proteases neutrophil elastase (NE) and proteinase 3 (P3). NE and P3 are primarily expressed in cells of myeloid lineage including granulocytes, bone marrow progenitors and myeloid leukemia. Our lab reported that NE and P3 are cross-presented by antigen presenting cells (APCs) and solid tumors, a mechanism whereby exogenous antigens are endocytosed and presented on HLA class I molecules, inducing a cytotoxic T lymphocyte (CTL)-mediated immune response. Therefore, identifying non-myeloid tumors capable of PR1 …

Undergraduate Student Perceptions And Awareness Of Genetic Counseling, Amanda Gerard

Dissertations and Theses (Open Access)

Genetic counseling (GC) is a rapidly expanding field, and the supply of certified genetic counselors is currently unable to keep up with job demand. Research is fairly limited regarding the awareness and perceptions potential genetic counseling program applicants have of the field and what factors most influence their interest in the field. This study aimed to examine some of these topics. The current study includes data collected from 1,389 undergraduate students in the sciences at 23 universities across the United States who were surveyed regarding information related to their awareness, perceptions, knowledge, and interest in GC. Data analysis was performed …

Analysis Of The Biochemical And Cellular Activities Of Substrate Binding By The Molecular Chaperone Hsp110/Sse1, Veronica M. Garcia

Dissertations and Theses (Open Access)

Molecular chaperones ensure protein quality during protein synthesis, delivery, damage repair, and degradation. The ubiquitous and highly conserved molecular chaperone 70-kDa heat-shock proteins (Hsp70s) are essential in maintaining protein homeostasis by cycling through high and low affinity binding of unfolded protein clients to facilitate folding. The Hsp110 class of chaperones are divergent relatives of Hsp70 that are extremely effective in preventing protein aggregation but lack the hallmark folding activity seen in Hsp70s. Hsp110s serve as Hsp70 nucleotide exchange factors (NEF) that facilitate the Hsp70 folding cycle by inducing release of protein substrate from Hsp70, thus recycling the chaperone for a …

Understanding The Mechanism Of Genomic Instability During Replicative Aging In Budding Yeast, Sangita Pal

Dissertations and Theses (Open Access)

Aging brings a gradual decline in molecular fidelity and biological functionality, resulting in age related phenotypes and diseases. Despite continued efforts to uncover the conserved aging pathways among eukaryotes, exact molecular causes of aging are still poorly understood. One of the most important hallmarks of aging is increased genomic instability. However, there remains much ambiguity as to the cause. I am studying the replicative life span (RLS) of the genetically tractable model organism Saccharomyces cerevisiae, or budding yeast using the innovative “mother enrichment program” as the method to isolate unparalleled numbers of aged yeast cells to investigate the molecular changes …

Characterization Of The Role Of The Pkm101-Encoded T4ss Outer Membrane Core Complex In Substrate Transfer, Pilus Biogenesis, And Recipient Cell Contact, Jay E. Gordon

Dissertations and Theses (Open Access)

The bacterial type IV secretion systems (T4SS) encoded on the Escherichia coli pKM101 and R388 conjugative plasmids and the Agrobacterium tumefaciens virB operon are composed of 12 subunits arranged in an architecturally similar fashion. Structural studies of the T4SS from R388 (Trw_R388) highlighted the presence of a distinct outer membrane core complex (OMCC) and inner membrane complex (IMC) joined together by a central stalk. This thesis is focused on the development of the pKM101 model system and the role of an OMCC cap region formed by alpha helical antenna projections (AP) found in VirB10 and TraF_pKM101. …

Detecting And Evaluating Therapy Induced Changes In Radiomics Features Measured From Non-Small Cell Lung Cancer To Predict Patient Outcomes, Xenia J. Fave

Dissertations and Theses (Open Access)

The purpose of this study was to investigate whether radiomics features measured from weekly 4-dimensional computed tomography (4DCT) images of non-small cell lung cancers (NSCLC) change during treatment and if those changes are prognostic for patient outcomes or dependent on treatment modality. Radiomics features are quantitative metrics designed to evaluate tumor heterogeneity from routine medical imaging. Features that are prognostic for patient outcome could be used to monitor tumor response and identify high-risk patients for adaptive treatment. This would be especially valuable for NSCLC due to the high prevalence and mortality of this disease.

A novel process was designed to …

Ms171: Interview With Margaret Carter Mcneese, Margaret Carter Mcneese M.D., Houston Academy Of Medicine-Texas Medical Center Library

Texas Medical Center - Women's History Project

An oral history interview with Margaret Carter McNeese about her career in the Department of Pediatrics at the Univeristy of Texas Health Science Center at Houston Medical School.

Dr. McNeese’s undergraduate years were spent at Mary Baldwin College in Staunton, Virginia. She went to medical school at The University of Texas Medical Branch at Galveston, where she began her career as a physician and pediatrician. She has been a recipient of many awards, among them the UT Health Science Center at Houston’s President’s Award for Mentoring Women; the Catholic Charity Guild Award for service at the San Jose Clinic, the …

Ms171: Interview With Kathryn Peek, Kathryn Elaine Peek Ph.D., Houston Academy Of Medicine-Texas Medical Center Library

Texas Medical Center - Women's History Project

An oral history interview with Kathryn Elaine Hickman Peek about her career as a biomedical administrator and educator at many institutions in the Texas Medical Center.

Kathryn Elaine Peek, Ph.D. completed her bachelor’s degree in English and embarked on a first career as a public school teacher. She obtained master’s degrees in biology and behavioral sciences at the University of Houston and UH Clear Lake during two stays in the Houston area. She entered the University of Texas Graduate School of Biomedical Sciences at what is now the McGovern Medical School at the age of 39. She graduated with a …

Understanding Patient Safety Reports Via Multi-Label Text Classification And Semantic Representation, Chen Liang

Dissertations and Theses (Open Access)

Medical errors are the results of problems in health care delivery. One of the key steps to eliminate errors and improve patient safety is through patient safety event reporting. A patient safety report may record a number of critical factors that are involved in the health care when incidents, near misses, and unsafe conditions occur. Therefore, clinicians and risk management can generate actionable knowledge by harnessing useful information from reports. To date, efforts have been made to establish a nationwide reporting and error analysis mechanism. The increasing volume of reports has been driving improvement in quantity measures of patient safety. …