Medicine and Health Sciences Commons^™

Associations Between The Use Of Ssri Medication In Older Adults And Cognitive Decline And Impairment, Paige Jones

Theses and Dissertations

Previous research has indicated that depression is a risk factor for dementia. Since SSRI medication is the most common treatment for depression, it is important to determine if SSRIs are associated with reduced dementia and better cognitive outcomes. Using longitudinal data from the 2004-2014 waves of the Health and Retirement Study merged with the 2005 Prescription Drug Study, we examined potential associations between SSRI and TCA medication and cognitive impairment and cognitive decline. The study population consisted of 1,775 older adults who participated in the PDS in 2005. We found that SSRIs were associated with significantly higher odds of cognitive …

Internalizing Mental Health Symptoms And Nicotine Use Among Adolescents In Canada, England, And The Us From 2020-2022, Emily E. Hackworth

Theses and Dissertations

Background: There is a well-established bi-directional relationship between cigarette smoking and internalizing mental health (IMH) symptoms (e.g., symptoms of depression, symptoms of anxiety). However, it is unclear whether IMH symptoms are associated with using different types of nicotine products among adolescents, as adolescents are using a variety of nicotine products, including combustible products (cigarettes), non-combustible products (e-cigarettes), or combinations of both types of products. This dissertation examines associations between IMH symptoms and current use of various types of nicotine products across three countries from 2020-2022.

Methods: Data come from the 2020-2022 waves of the International Tobacco Control (ITC) Adolescents Tobacco …

The Role Of Telehealth And Obstetrics Capacity On Maternal Health Care: A Mixed Methods Approach, Shanikque L. Barksdale

Theses and Dissertations

Background: The United States (US) is experiencing a maternal health crisis, with rising severe maternal morbidity and mortality rates and persistent racial, ethnic, and geographic disparities. While telehealth can address access challenges, there is limited evidence of its impact on access to maternity care and outcomes among rural and minoritized communities. The overall objective of this study was to analyze the disparities in maternal outcomes and user satisfaction by hospital-based telehealth and obstetric care availability.

Methods: A convergent parallel mixed methods approach was used. A multinomial logistic regression was used to analyze whether the changes in the proportions of hospitals …

What Is The Economic Benefit Of Annual Covid-19 Vaccination From The Adult Individual Perspective?, Sarah M Bartsch, Kelly J O'Shea, Colleen Weatherwax, Ulrich Strych, Kavya Velmurugan, Danielle C John, Maria Elena Bottazzi, Mustafa Hussein, Marie F Martinez, Kevin L Chin, Allan Ciciriello, Jessie Heneghan, Alexis Dibbs, Sheryl A Scannell, Peter J Hotez, Bruce Y Lee

Center for Medical Ethics and Health Policy Staff Publications

Background: With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward.

Methods: We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine.

Results: For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe …

Inhalational Drug Devices: Revisiting The Linchpin Of Asthma Management, Damini Saxena, Neveda Murugesan, Uyioghosa D Evbayiro, Marina K Ngassa, Muhammad Adrish

Faculty, Staff and Students Publications

Asthma remains a prevalent condition among all age groups globally. First-line treatment requires the delivery of medications into the distal respiratory tract via inhalers. Using appropriate inhaler techniques is a significant challenge in achieving disease control. A variety of inhalers are available for treating asthma, and selecting the appropriate inhaler type for any given patient is crucial to achieving and maintaining symptomatic control. This review will discuss the anatomy and physiology behind drug delivery via inhalers, the types of inhalers currently available for use, nebulizers, and future directions in the delivery of inhaled medications for asthma.

The Experience Of Homelessness And Its Effects On Gut Eubiosis, Kamerin Villagomez

University Honors Theses

Microorganisms which populate the human gastrointestinal tract (GIT) have a profound effect on overall human health. The relationship between host health and eubiosis, or balance, of the GIT microbiome is symbiotic and can have reciprocal relationships with quality of sleep, quality of diet, stress and mental health, and the experience of pain. These specific aspects of health are unique in populations experiencing homelessness due to the multi-dimensional and complex nature of their lived experience. Very few studies explore populations experiencing homelessness, with even fewer investigating the intersection between this population and the human GIT microbiome. It is important to do …

Redoma: Bayesian Random-Effects Dose-Optimization Meta-Analysis Using Spike-And-Slab Priors, Cheng-Han Yang, Evan Kwiatkowski, J Jack Lee, Ruitao Lin

Faculty, Staff and Student Publications

The rise of cutting-edge precision cancer treatments has led to a growing significance of the optimal biological dose (OBD) in modern oncology trials. These trials now prioritize the consideration of both toxicity and efficacy simultaneously when determining the most desirable dosage for treatment. Traditional approaches in early-phase oncology trials have conventionally relied on the assumption of a monotone relationship between treatment efficacy and dosage. However, this assumption may not hold valid for novel oncology therapies. In reality, the dose-efficacy curve of such treatments may reach a plateau at a specific dose, posing challenges for conventional methods in accurately identifying the …

Factors Associated With Elevated Sars-Cov-2 Immune Response In Children And Adolescents, Sarah E Messiah, Rhiana Abbas, Emma Bergqvist, Harold W Kohl, Michael D Swartz, Yashar Talebi, Rachit Sabharwal, Haoting Han, Melissa A Valerio-Shewmaker, Stacia M Desantis, Ashraf Yaseen, Henal A Gandhi, Ximena Flandes Amavisca, Jessica A Ross, Lindsay N Padilla, Michael O Gonzalez, Leqing Wu, Mark A Silberman, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

BACKGROUND: Understanding the distinct immunologic responses to SARS-CoV-2 infection among pediatric populations is pivotal in navigating the COVID-19 pandemic and informing future public health strategies. This study aimed to identify factors associated with heightened antibody responses in children and adolescents to identify potential unique immune dynamics in this population.

METHODS: Data collected between July and December 2023 from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a statewide prospective population-based antibody survey among 1-to-19-year-old participants, were analyzed. Each participant had the following data available for analysis: (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for Nucleocapsid protein antibodies (Roche N-test), (2) qualitative and …

Genetics And Genomics Of Pulmonary Fibrosis: Charting The Molecular Landscape And Shaping Precision Medicine, Ayodeji Adegunsoye, Jonathan A Kropski, Juergen Behr, Timothy S Blackwell, Tamera J Corte, Vincent Cottin, Allan R Glanville, Marilyn K Glassberg, Matthias Griese, Gary M Hunninghake, Kerri A Johannson, Michael P Keane, John S Kim, Martin Kolb, Toby M Maher, Justin M Oldham, Anna J Podolanczuk, Ivan O Rosas, Fernando J Martinez, Imre Noth, David A Schwartz

Faculty, Staff and Students Publications

Recent genetic and genomic advancements have elucidated the complex etiology of idiopathic pulmonary fibrosis (IPF) and other progressive fibrotic interstitial lung diseases (ILDs), emphasizing the contribution of heritable factors. This state-of-the-art review synthesizes evidence on significant genetic contributors to pulmonary fibrosis (PF), including rare genetic variants and common SNPs. The MUC5B promoter variant is unusual, a common SNP that markedly elevates the risk of early and established PF. We address the utility of genetic variation in enhancing understanding of disease pathogenesis and clinical phenotypes, improving disease definitions, and informing prognosis and treatment response. Critical research gaps are highlighted, particularly the …

Recruitment And Retention Of Physician Assistants In Rural Medicine: A Novel Approach, Sean Grabbe

Theses and Graduate Projects

Improving the health of patients requires having access to well trained medical providers. This is one of the main goals of the physician assistant profession. For many years research has documented how to recruit and retain physician assistants in the rural areas of the United States. Although created to fill the gaps in primary care medicine physician assistants have moved as all of medicine has into specialization. This gap in primary care has not closed and is most significant in rural areas. This paper reviews the plethora of research and elaborates on the known and best methods for recruitment and …

Personalized Nutrition: Tailoring Dietary Recommendations Through Genetic Insights, Saiful Singar, Ravinder Nagpal, Bahram H. Arjmandi, Neda S. Akhavan

Kinesiology and Nutrition Sciences Faculty Research

Personalized nutrition (PN) represents a transformative approach in dietary science, where individual genetic profiles guide tailored dietary recommendations, thereby optimizing health outcomes and managing chronic diseases more effectively. This review synthesizes key aspects of PN, emphasizing the genetic basis of dietary responses, contemporary research, and practical applications. We explore how individual genetic differences influence dietary metabolisms, thus underscoring the importance of nutrigenomics in developing personalized dietary guidelines. Current research in PN highlights significant gene–diet interactions that affect various conditions, including obesity and diabetes, suggesting that dietary interventions could be more precise and beneficial if they are customized to genetic profiles. …

The Worry Of Food Insecurity And The Manifestation Of Generalized Anxiety In Relation To Perceived Health Status, Ramona Lynnette Taylor

Walden Dissertations and Doctoral Studies

This study examined the association between the worry of food insecurity and the manifestation of generalized anxiety, and how these factors related to perceived health status among adults aged 18 years and older in the U.S. The study controlled demographic factors such as gender, age, race, and education. Utilizing data from the 2019 National Health Interview Survey (NHIS), a binomial logistic regression analysis was employed. The findings indicated a significant association between those persons who often worry about food insecurity, severe (OR = 7.324, p < .001) and frequent generalized anxiety (OR = 5.185, p < .001) suggesting that individuals who worry about food insecurity have higher odds of experiencing severe and frequent (more than 3 times per week) generalized anxiety. Furthermore, both the worry of food insecurity in persons not sure (OR = 0.120, p = 0.004) and generalized anxiety (OR = 0.623 for severe anxiety, p = 0.009) were found to be significantly associated with lower perceived health status. These results suggest a potential association between worry about food insecurity and negative impacts on mental health and perceived overall well-being. Overall, these findings underscore the significant impact of food insecurity on mental health. Further research, including experimental and longitudinal studies, is necessary to elucidate the causal relationship between food insecurity and the manifestation of generalized anxiety in order to impact positive social change.

Writing For The Journal: A Guide For Community-Based Organizations, Randy Wykoff, Rachel E. Dixon

Journal of Appalachian Health

The Journal of Appalachian Health welcomes submissions from a variety of stakeholders interested in and contributing to improvement of health across the Appalachian Region. This editorial provides basic guidelines for those working in community settings who may with to make JAH (or any other journal) their publication home.

Association Between High Health Literacy, Doctor's Recommendation, And Prostate Cancer Screening Among Men In The United States, Felicia Njideka Akunna

Walden Dissertations and Doctoral Studies

To efficiently identify and prevent the advancement of prostate cancer and decrease mortality rates, it is crucial to examine the impact of health literacy. Despite potential advantages associated with enhanced health literacy and early detection, the United States continues to witness a significant rise in both new prostate cancer cases and mortality rates, emphasizing the severity of the condition. However, it is unclear if those with high health literacy are discouraged from participating in prostate cancer screening due to the risks associated with screening. Based on the stimulus organism response model, 2016 Behavioral Risk Factor Surveillance System data were analyzed …

Secondary Trauma Amongst Emergency Shelter Volunteers: An Intervention To Identify, Assess, And Respond To Secondary Trauma Exposure, Ashlyn K. Yokom

Master's Projects and Capstones

Purpose: Emergency shelter volunteers are experiencing secondary traumatic stress (STS) symptoms during their deployments. The purpose of this paper is to create an intervention that protects the volunteers from developing STS.

Design: Questionnaires were distributed to current and previous emergency shelter volunteers along with conducting interviews. This design allowed important information to be collected that was used to determine the level of STS symptoms experienced by the volunteers.

Trends: Three STS symptoms were focused upon, intrusion, avoidance, and arousal. It was determined that intrusion symptoms were experienced more frequently than avoidance and arousal symptoms.

Summary: It was determined that emergency …

Empowering The Biomedical Research Community: Innovative Sas Deployment On The All Of Us Researcher Workbench, Izabelle Humes, Cathy Shyr, Moira Dillon, Zhongjie Liu, Jennifer Peterson, Chris St Jeor, Jacqueline Malkes, Hiral Master, Brandy Mapes, Bassent Abdelbary

Physician Assistant Studies Faculty Publications

Objectives: The All of Us Research Program is a precision medicine initiative aimed at establishing a vast, diverse biomedical database accessible through a cloud-based data analysis platform, the Researcher Workbench (RW). Our goal was to empower the research community by co-designing the implementation of SAS in the RW alongside researchers to enable broader use of All of Us data.

Materials and methods: Researchers from various fields and with different SAS experience levels participated in co-designing the SAS implementation through user experience interviews.

Results: Feedback and lessons learned from user testing informed the final design of the SAS application.

Discussion: The …

Molecular Detection Of Pathogenic Bacteria In American Dog Ticks (Dermacentor Variabilis) In Brown County, Nebraska, Nicole Messbarger, Darby Carlson, Keith Geluso, Julie Shaffer

Transactions of the Nebraska Academy of Sciences and Affiliated Societies

Ticks carry and transmit disease pathogens that cause many human illnesses. Many of these diseases in humans are accompanied by a wide variety of symptoms making tick-borne illnesses often difficult to diagnose. The rate of reported tick-borne illnesses in humans has increased during the past decades in the United States, alongside a rise in concern for public health and safety. In northern Nebraska, the American dog tick (Dermacentor variabilis) is the primary tick encountered by humans and domestic animals in the region. This species is a known vector for spotted fever group (SFG) rickettsioses and tularemia (Francisella …

Cluster Effect For Snp-Snp Interaction Pairs For Predicting Complex Traits, Hui Yi Lin, Harun Mazumder, Indrani Sarkar, Po Yu Huang, Rosalind A. Eeles, Zsofia Kote-Jarai, Kenneth R. Muir, Johanna Schleutker, Nora Pashayan, Jyotsna Batra, David E. Neal, Sune F. Nielsen, Børge G. Nordestgaard, Henrik Grönberg, Fredrik Wiklund, Robert J. Macinnis, Christopher A. Haiman, Ruth C. Travis, Janet L. Stanford, Adam S. Kibel, Cezary Cybulski, Kay Tee Khaw, Christiane Maier, Stephen N. Thibodeau, Manuel R. Teixeira, Lisa Cannon-Albright, Hermann Brenner, Radka Kaneva, Hardev Pandha, Et Al

School of Public Health Faculty Publications

Single nucleotide polymorphism (SNP) interactions are the key to improving polygenic risk scores. Previous studies reported several significant SNP-SNP interaction pairs that shared a common SNP to form a cluster, but some identified pairs might be false positives. This study aims to identify factors associated with the cluster effect of false positivity and develop strategies to enhance the accuracy of SNP-SNP interactions. The results showed the cluster effect is a major cause of false-positive findings of SNP-SNP interactions. This cluster effect is due to high correlations between a causal pair and null pairs in a cluster. The clusters with a …

Recruiting Transgender Men In The Southeastern United States For Genital Microbiome Research: Lessons Learned, Olivia Van Gerwen, Z. Alex Sherman, Emma Sophia Kay, Jay Wall, Joy Lewis, Isaac Eastlund, Keonte J. Graves, Saralyn Richter, Angela Pontius, Kristal J. Aaron, Krishmita Siwakoti, Ben Rogers, Evelyn Toh, Jacob H. Elnaggar, Christopher M. Taylor, Nicholas J. Van Wagoner, Christina A. Muzny

School of Medicine Faculty Publications

Background Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study. Methods Inclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 …

Socioeconomic Determinants And Maternal Mortality In Liberia, Monee Sherman

Walden Dissertations and Doctoral Studies

High rates of pregnancies and childbirth contribute to a heightened risk of maternal mortality among women between 15 and 49 in Liberia. Most women are uninformed about their maternal risk behaviors, symptom severity, and delayed care-seeking. The mortality rate for women between 25 and 34 during pregnancy and childbirth is unacceptably high. The highest increase in maternal mortality rates is seen among women between 40 and 44 who choose to delay motherhood. In Liberia, the deaths of 4.5 women a day are caused by complications during pregnancy and childbirth. We examined the influence of participant background characteristics, socioeconomic factors, and …

Pressing Issues For Oral Care Quality Improvement: Findings From The Eu Deliver Project, Paulo Melo, Leonor Frey-Furtado, Daniela Correia, Stefan Listl, Michael Lorenz, Nagihan Bostanci, Álvaro Azevedo, Maria Lurdes Pereira

Faculty, Staff and Student Publications

BACKGROUND: While oral health often takes a backseat to other health domains, it silently affects nearly half of the Worldwide population. The DELIVER project, funded by the EU's Horizon Europe program, seeks to develop a blueprint model for improving the quality of oral health care for everyone.

METHODS: Applying the Nominal Group Technique (NGT), 17 stakeholders from various backgrounds participated in identifying pressing issues for oral care quality improvement across practice, community, and policy levels.

RESULTS: The results revealed significant differences at the different levels, with accessibility emerging as a prominent issue, encompassing affordability, availability, and acceptability of oral healthcare …

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

How Is Diagnostic Uncertainty Communicated And Managed In Real World Primary Care Settings?, Jessica Russell, Laura Boswell, Athena Ip, Jenny Harris, Hardeep Singh, Ashley N D Meyer, Traber D Giardina, Afsana Bhuiya, Katriina L Whitaker, Georgia B Black

Faculty, Staff and Students Publications

Background: Managing diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during a period of investigative uncertainty, whilst minimising scope for diagnostic error is a challenge. Mismanagement can lead to diagnostic errors, treatment delays, and suboptimal patient outcomes.

Objective: Our aim was to explore how UK primary care physicians (GPs) address and communicate diagnostic uncertainty in practice.

Design: This qualitative study used video and audio-recordings. Verbatim transcripts were coded with a modified, validated tool to capture GPs' actions and communication in …

Clathrin Light Chains Negatively Regulate Plant Immunity By Hijacking The Autophagy Pathway, Hu-Jiao Lan, Jie Ran, Wen-Xu Wang, Lei Zhang, Ni-Ni Wu, Ya-Ting Zhao, Min-Jun Huang, Min Ni, Fen Liu, Ninghui Cheng, Paul A Nakata, Jianwei Pan, Steven A Whitham, Barbara J Baker, Jian-Zhong Liu

Faculty, Staff and Students Publications

The crosstalk between clathrin-mediated endocytosis (CME) and the autophagy pathway has been reported in mammals; however, the interconnection of CME with autophagy has not been established in plants. Here, we report that the Arabidopsis CLATHRIN LIGHT CHAIN (CLC) subunit 2 and 3 double mutant, clc2-1 clc3-1, phenocopies Arabidopsis AUTOPHAGY-RELATED GENE (ATG) mutants in both autoimmunity and nutrient sensitivity. Accordingly, the autophagy pathway is significantly compromised in the clc2-1 clc3-1 mutant. Interestingly, multiple assays demonstrate that CLC2 directly interacts with ATG8h/ATG8i in a domain-specific manner. As expected, both GFP-ATG8h/GFP-ATG8i and CLC2-GFP are subjected to autophagic degradation, and degradation of GFP-ATG8h is …

The Status Of Abortion Care Training For Medical Providers Amidst The Current Abortion Access Crisis: A Literature Review, Leah Johnson

Theses and Graduate Projects

Background: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, …

Relationship Between Driving While Impaired And Riding With An Impaired Driver Among Adolescents In The United States, Michael S. Dunn

Public Health

Background: Alcohol, tobacco, and other drug use (ATOD) and sexual risk-taking are contributors to the health and welfare of adolescents and a significant percentage engage in these behaviors. These behaviors may contribute to other risk-taking such as driving while impaired (DWI) or riding with an impaired driver (RWI). The purpose of this study was to assess the relationship between DWI and RWI and ATOD use, sexual risk-taking, and physical fighting among adolescents. Methods: Date for this study were derived from the 2017, 2019, 2021 Youth Risk Behavior Survey (YRBS) (n = 45,132). Logistic regression models were used to estimate the …

A Systematic Review: Longevity And Quality Of Life In Blue Zones, Salmaan Mulla

Theses and Graduate Projects

Ikaria, Loma Linda, Sardinia, Okinawa, and Nikoya. These 5 cities around the world are famed for their increased longevity and quality of life and are termed “Blue Zones”. Blue zones are areas around the world noted for their population of centenarians, overall long life expectancy and high quality of life compared to the average population. Studying these communities offer insights into the commonalities they share to better understand the unique aspects of living a healthy, fulfilling and long life. A comprehensive literature review was conducted using Google Scholar, with the search terms “Ikaria, Greece longevity; Loma Linda, California longevity; Sardinia, …

The Role Of Aarp Mississippi In Healthy Aging, Kimberly Campbell, Melinda Bertucci

Journal of Public Health in the Deep South

No abstract provided.

Integrated Delivery Of Health Care And Continuity Of Care For Older Mississippians With Mental And Behavioral Health Concerns, Tockie V. Hemphill

Journal of Public Health in the Deep South

The mental health of older adults is of national concern. There is some uncertainty regarding access to care and whether mental and behavioral health care will be readily available in primary care settings. This paper explores the concepts of integrated delivery of care and continuity of care for older adults. The definitions of the two concepts vary in detail, but are similar in purpose. There is an array of strategies presented that outline a continuity of care that involves an integrated delivery system. Relationship development is the core of this system, as well as older adults’ ability and willingness to …

Aging Redefined: Moving Past The Deficit Model, Aaron Guest

Journal of Public Health in the Deep South

The remarkable increase in longevity is the pivotal triumph of public health over the last two centuries. Yet, even as we experience the benefits of increased longevity, we continue to face rampant ageism – or the prejudice and discrimination directed at individuals perceived as 'old.' Worst of all, we know that ageism is associated with increased medical costs, poorer health outcomes, and increased mortality. Efforts to combat ageism have been insufficient. The triumvirate of ageism, gerontological illiteracy, and gerontophobia have resulted in a deficit model of aging. Far from being a liability, the rapid increase in the aging population presents …