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Articles 901 - 930 of 2525

Full-Text Articles in Medicine and Health Sciences

The Eye As A Window To The Alzheimer’S Disease Brain, Fred Souza Jan 2017

The Eye As A Window To The Alzheimer’S Disease Brain, Fred Souza

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Alzheimer’s disease (AD) is a debilitating, and the most prevalent, type of dementia that is manifested by cognitive deficits, anomalous protein metabolism, cell loss, and pathological alterations in several neurotransmitter systems, particularly the cholinergic and glutamatergic systems. Moreover, AD is associated with visual deficits that have been reported to occur even in the early stages of the disease and may precede conspicuous cognitive impairment. To date, the underlying causes of the visual deficits and whether they stem from retinal or cortical abnormalities remain poorly understood. The following studies aimed at establishing whether the pathological changes observed in the cerebrum are …

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The Dietary Context Of Nut Intake Among Overweight And Obese African-American Women Living In The Rural South: An Exploratory Study, Samara Sterling Jan 2017

The Dietary Context Of Nut Intake Among Overweight And Obese African-American Women Living In The Rural South: An Exploratory Study, Samara Sterling

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Obesity has become a national epidemic over the last few decades, and lays its heaviest burden on certain populations (eg, rural residents, African-Americans, and African-American women in the Southeast). Obesity increases medical costs substantially, and is a significant risk factor for various chronic conditions, including certain cancers. There is a need to identify specific dietary behaviors that may contribute to obesity and obesity-related cancers among African-American women in the rural South, and to recommend dietary modifications that may alleviate those risks. Previous research has shown that nuts offer numerous health benefits, including weight loss and cancer protection. More research is …

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A Novel Role For T-Bet And Ifng In Directing B Cell Differentiation, Sara Stone Stone Jan 2017

A Novel Role For T-Bet And Ifng In Directing B Cell Differentiation, Sara Stone Stone

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The transcription factor T-bet regulates the epigenetic programming and differentiation of cytotoxic and helper T (Th) cells. Several studies recently identified T-bet expression in B cells after stimulation with TLR7 or interferon alpha or gamma. T-bet controls isotype switching to IgG2a in B cells; however, the mechanism by which T-bet exerts this effect and whether T-bet regulates fate decision beyond isotype choice is not clear. When activated by interferon gamma-producing Th cells, B cells rapidly upregulate T-bet and undergo T-bet dependent changes in chromatin accessibility and wide-scale transcriptional reprogramming. T-bet controls expression of the core transcription factors required for antibody …

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The Military Nursing Practice Environment's Association With Patient Outcomes, Pauline Arminda Swiger Jan 2017

The Military Nursing Practice Environment's Association With Patient Outcomes, Pauline Arminda Swiger

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In the United States, preventable medical errors account for many avoidable patient deaths per year. A favorable nursing practice environment, characterized by factors that improve or enhance a nurse’s ability to practice professional nursing, is a potential mechanism for promoting a culture of safety and enhancing the quality of care in hospitals. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is the national standard for measuring the nursing practice environment, and its importance has been validated repeatedly in civilian nurse populations around the world. For the last several years, the scores on the PES-NWI in military facilities have …

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Modeling Depression Treatment Strategies For Human Immunodeficiency Virus (Hiv) Positive Patients, Rongbing Xie Jan 2017

Modeling Depression Treatment Strategies For Human Immunodeficiency Virus (Hiv) Positive Patients, Rongbing Xie

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This dissertation empirically examines the associations between depression and HIV-related outcomes, simulates both care and outcomes under different depression care strategies, and compares the cost effectiveness of various depression care strategies to the current care strategy. The empirical investigations reveal the negative associations between depression and HIV-related outcomes using two longitudinal patient-level databases. Furthermore, the patterns and outcomes of depression care are identified and simulated using agent-based modeling. Finally, simulated costs and effectiveness are used to evaluate different depression care strategies for reducing new HIV infections and improving quality of life. The current standard of care for depression among patients …

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Statistical Methods In Cancer Survival Prediction And Microbiome Data Analysis, Xinyan Zhang Jan 2017

Statistical Methods In Cancer Survival Prediction And Microbiome Data Analysis, Xinyan Zhang

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This dissertation focused on developing statistical methods in two areas, cancer survival prediction and microbiome data analysis. Heterogeneity in terms of tumor characteristics, prognosis, and survival has been a persistent problem in cancer prediction and prognosis for many decades. One of the main shortcomings of past studies is the failure to incorporate prior biological information into the predictive model, given strong evidence of pathway-based genetic nature of cancer. In paper 1, to address this problem, we propose a two-stage approach to incorporate pathway information into the prognostic modeling using large-scale gene expression data. In the first stage, we fit all …

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Quality Of Care And Racial Disparities In Head And Neck Cancer Treatment, Siddharth Jain Jan 2017

Quality Of Care And Racial Disparities In Head And Neck Cancer Treatment, Siddharth Jain

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PURPOSE: Intensity-modulated radiotherapy (IMRT) is a development of conventional radiotherapy in the treatment for most Head and Neck Cancers (HNC). There is no sufficient evidence to suggest that some physicians are associated with better outcomes in HNC patients. Also, there is limited data that showed that African Americans have poor outcomes compared to other races among HNC patients. We conducted a cross-sectional analysis to evaluate the effect of radiation oncologist characteristics on outcomes in HNC patients treated with IMRT, and factors associated with racial disparities in the treatment outcomes. METHODS: The study used Surveillance Epidemiology and End Results (SEER)-Medicare linked …

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Comparative Performance And Clinical Utility Of Indirect Treatment Comparison Estimators, William Hillegass Jan 2017

Comparative Performance And Clinical Utility Of Indirect Treatment Comparison Estimators, William Hillegass

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In the clinical decision between two or more discrete competing diagnostic or therapeutic patient care strategies, the main consideration is typically the expected difference in the primary outcome of interest. When head-to-head randomized trial results are unavailable or insufficient, this expected difference in outcome can be estimated with an indirect comparison in some settings. Publication of formalized indirect comparisons and proposed statistical methods in the medical literature began in 1993. Despite growing acceptance of indirect treatment comparisons as credible evidence, the statistical underpinnings, properties, and performance of these methods both individually and comparatively remain incompletely explored and defined. This dissertation …

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Motor Abilities And Social Participation In Young Children With Autism Spectrum Disorder, Jamie M. Holloway Jan 2017

Motor Abilities And Social Participation In Young Children With Autism Spectrum Disorder, Jamie M. Holloway

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder that primarily affects social communication and behavior, however, a number of motor impairments have been identified in children with ASD. In children who are typically developing, the development of social, communication, and cognitive skills is thought to be influenced by motor development. However, the impact of these motor skill deficits on overall development in children with ASD is not yet known. The purpose of this dissertation was to explore the relationship between gross motor ability and social function and participation in young children with ASD. The first study described changes in peer …

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Oxygen Permeability (Dk) Of Silicone-Hydrogel Materials: Relationship With Water, Silicon, And Fluorine Contents, Terin E. Dupre Jan 2017

Oxygen Permeability (Dk) Of Silicone-Hydrogel Materials: Relationship With Water, Silicon, And Fluorine Contents, Terin E. Dupre

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To more precisely determine the fundamental relationships between oxygen permeability (Dk), water content (WC), silicon (Si) content, and fluorine (F) content of clinically prescribed silicone-hydrogel (SiHy) materials, identical methodologies for 16 commercially available brands of SiHy materials were performed. Dk and WC were determined according to the ANSI and ISO standards and, with Si and F contents, on the same lot numbers of samples across a common range of available refractive powers. A negative linear relationship was found between Si content and water content. Lotrafilcon A, Lotrafilcon B, and the bulk polymer of Delefilcon A initially deviated from this relationship. …

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The Role Of Rig-I And Mda5 In Alphavirus Replication, Ivan Viachaslavavich Akhrymuk Jan 2017

The Role Of Rig-I And Mda5 In Alphavirus Replication, Ivan Viachaslavavich Akhrymuk

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Evolution of vertebrates has resulted in the development of a wide range of cellular pattern recognition receptors (PRRs), which detect the presence of virus-specific molecules termed pathogen-associated molecular patterns (PAMPs). Sensing of the incoming viruses and/or their replication by PRRs activates the cascade of cellular pathways that ultimately result in activation of antiviral response. Such response is determined by hundreds of cellular genes, whose products either directly interfere with virus replication or are released from the cells and activate antiviral state in yet uninfected cells. Consequently, the latter cell signaling prevents development of the next rounds of infection both in …

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African American Child And Adolescent Obesity: The Parents Perspective, Alice Marie Austin Jan 2017

African American Child And Adolescent Obesity: The Parents Perspective, Alice Marie Austin

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Nearly 36% of African American children ages 2 to 19 are overweight or obese. Childhood obesity results in children with social and psychological disorders, chronic disease, and an increase in morbidity and mortality. Solutions have been offered but none have made a significant impact on African American children living in the Southern United States. Studies that implement life style change produce short-term reductions in African American children but few show life-long change. Parents are responsible for making lifestyle choices for children, it is imperative to understand parental perceptions of child and adolescent obesity and its relationship to lifestyle change. The …

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Individual And Institutional Level Factors That Influence Hiv Testing And Counseling Utilization During Antenatal Care In Nigeria, Modupeoluwa O. Durojaiye Jan 2017

Individual And Institutional Level Factors That Influence Hiv Testing And Counseling Utilization During Antenatal Care In Nigeria, Modupeoluwa O. Durojaiye

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Of the estimated 150,000 new HIV infections in children in 2015, 122,000 occurred in sub-Saharan Africa (SSA), with Nigeria accounting for a third of all cases. Most of these infections were acquired via mother-to-child transmission (MTCT). HIV testing and counseling, a critical first step in the prevention of MTCT (PMTCT), can ensure that HIV-positive women access services that can reduce HIV transmission risk. Incorporating HIV testing and counseling into antenatal care (ANC) is an integral component of the World Health Organization (WHO) strategies. This dissertation aims to understand factors that influence HIV testing and counseling during ANC. It is comprised …

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Publc Hospital Conversions: A Question Of Social Capital?, Antionette Smith Epps Jan 2017

Publc Hospital Conversions: A Question Of Social Capital?, Antionette Smith Epps

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ABSTRACT Between 1975 and 2015, the number of public hospitals decreased by 43%, from 1761 to 1003. Public hospitals have undergone changes in ownership status, structural and/or governance conversions and closures. Reasons for these changes are varied and numerous, however, many studies identify financial difficulties as a major reason that decision-makers consider an ownership change. Some public hospitals persist despite exhibiting financial issues. Therefore, there may be other factors contributing to the persistence of some public hospitals. This paper examines the potential role of social capital or community engagement and cohesion as a factor in determining if a public hospital …

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Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans Jan 2017

Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans

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This three-paper dissertation sought to examine the existence of strategic groups in the home health industry, the application of Porter’s generic strategies (cost leader, differentiator, “stuck-in-the-middle” and both cost leader/differentiator) in identifying these groups, and the association of group membership with agency performance. The findings of this study will provide researchers and managers with a highlight of the current strategic makeup of the home health industry and its relationship with quality and financial performance. The results of this dissertation provide some evidence that strategic groups do exist in the home health industry and can be described along the basis of …

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The Effectiveness Of Clinical Integration: The Relationship Between Evidence-Based Clinical Processes, In-Network Utilization And Clinical, Service And Efficiency Outcomes, Patrick D. Falvey Jan 2017

The Effectiveness Of Clinical Integration: The Relationship Between Evidence-Based Clinical Processes, In-Network Utilization And Clinical, Service And Efficiency Outcomes, Patrick D. Falvey

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THE EFFECTIVENESS OF CLINICAL INTEGRATION: THE RELATIONSHIP BETWEEN EVIDENCE-BASED CLINICAL PROCESSES, IN-NETWORK UTILIZATION AND CLINICAL, SERVICE AND EFFICIENCY OUTCOMES PATRICK D. FALVEY EXECUTIVE DOCTORAL PROGRAM – SCHOOL OF HEALTH PROFESSIONS ABSTRACT The evolving U.S. health care system continues to steer healthcare organizations and integrated healthcare delivery networks (IDNs) to function as population health networks and ACOs. Policymakers, payers, health care leaders and consumer groups are advocating that IDNs clinically integrate processes and structures under the assumption that they will improve the clinical outcomes for a population, reduce the health care spend, and enhance the patient experience. Relatively little research has …

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Identification And Exploration Of The Information Needs And Information-Seeking Behaviors Of Medical-Surgical Nurses During Patient Care, Carrie Lee Gardner Jan 2017

Identification And Exploration Of The Information Needs And Information-Seeking Behaviors Of Medical-Surgical Nurses During Patient Care, Carrie Lee Gardner

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Errors during the course of clinical practice are common and can lead to adverse events in hospitalized patients. Insufficient information and lack of clinician knowledge can serve as major contributing factors to the incidence of errors that occur during patient care. Nurses at the bedside need immediate access to patient specific information, at the point of care, and in an easily accessible format. There is a need for better understanding of the information needs and information-seeking behaviors of medical-surgical nurses. The purpose of this mixed-methods study was to explore the information-seeking behaviors of nurses when delivering patient care on medical-surgical …

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Immunoregulation During Acute And Chronic Exposure To Aspergillus Fumigatus, Jaleesa M. Garth Jan 2017

Immunoregulation During Acute And Chronic Exposure To Aspergillus Fumigatus, Jaleesa M. Garth

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A. fumigatus is one of the most common fungal isolates with clinical disorders ranging from mild to severe. The development of Aspergillus-induced allergic and invasive fungal infections is a major health concern in several patient populations. IL-1 family members have been shown to play critical roles in host defense against A. fumigatus. IL-33, an IL-1 family member widely study in allergic and inflammatory diseases, was induced upon acute exposure to A. fumigatus. IL-33 receptor knockout mice, (Il1rl1-/-), demonstrated lower lung fungal burden in the presence of enhanced IL-1α, IL-1β, IL-6, IL-17A, IL-22, and PGE2 production. Administration of IL-33 to normal …

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Reducing Acute Cardiovascular Hospitalizations With A Weight Management Program (Reach), Laura A. Graham Jan 2017

Reducing Acute Cardiovascular Hospitalizations With A Weight Management Program (Reach), Laura A. Graham

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Reducing cardiovascular (CVD) risk factors such as obesity through lifestyle and behavioral interventions like weight management programs should result in better cardiovascular health. However, there is conflicting evidence on the effectiveness of these interventions in reducing long-term CVD outcomes such as acute myocardial infarction or stroke. This reflects an important gap in our understanding about factors affecting recruitment and engagement in these programs and how these factors relate to improvement in long-term cardiovascular health. To address this gap, we will use a retrospective study with up to 11 years of follow up data from the nation’s largest health care system-associated …

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Evaluating The Genotype Phenotype Correlations In Cleidocranial Dysplasia, Stephen Lamar Greene Jan 2017

Evaluating The Genotype Phenotype Correlations In Cleidocranial Dysplasia, Stephen Lamar Greene

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Cleidocranial dysplasia (CCD, OMIM 119600) is a rare (1 in 1,000,000) human autosomal dominant skeletal disorder with unique craniofacial and dental features caused by mutations the gene coding for transcription factor RUNX2. RUNX2 is a key master regulator of osteoblast differentiation, chondrocyte maturation and tooth formation. CCD is commonly diagnosed based on bone defects with ~90% of cases presenting with supernumerary teeth or a “third dentition”. Mouse Runx2 null models (Runx2+/-), although having similar CCD skeletal defects, do not mimic the human dental phenotype of supernumerary teeth. Instead, Runx2-/- mouse have arrested tooth formation at the cap stage. Furthermore, based …

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Transcriptional Dysregulation In Interneurons Causes Altered Modulation Of Hippocampal Synaptic Transmission And Circuit Function By The Dopamine System, Lillian J. Brady Jan 2017

Transcriptional Dysregulation In Interneurons Causes Altered Modulation Of Hippocampal Synaptic Transmission And Circuit Function By The Dopamine System, Lillian J. Brady

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Genetic deletion of the transcriptional coactivator PGC-1α leads to transcriptional dysregulation in interneurons, and transcriptional dysregulation in interneurons lead to changes in hippocampal synaptic transmission and circuit function. Hippocampal circuit activity and synaptic transmission alterations have implications for symptoms of cognitive impairment in neurological disorders like schizophrenia. Modulation of dopamine receptor activity through pharmacologic application of haloperidol and the specific dopamine D4 receptor antagonist L-745,870 in PGC-1α-/- mice leads to altered effects on inhibitory/excitatory synaptic transmission balance, circuit function, and innate hippocampal dependent nesting behavior. These are key aspects underlying hippocampus dependent cognitive impairment. Specifically, bath application of haloperidol restores …

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Autism Spectrum Disorders And Social-Ecological Models: Understanding How Context Drives Prevalence, Anne Elizabeth Brisendine Jan 2017

Autism Spectrum Disorders And Social-Ecological Models: Understanding How Context Drives Prevalence, Anne Elizabeth Brisendine

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Background: While there has been significant work done to explore disparities in autism spectrum disorder (ASD) diagnoses with respect to individual characteristics, little work has been done to examine the overall system and structure of the environment in which ASD identification is made and how it is related to diagnosis and services. The purpose of this study is to better understand the social-ecological factors that impact ASD diagnoses at the population level. Methods: In the first aim of this dissertation, a tailored social ecological model was developed and examined across variables in the 2011/12 National Survey of Children’s Health. In …

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Immunobiology Of The Mucosal Response To Helicobacter Pylori In Children, Kyle Brawner Jan 2017

Immunobiology Of The Mucosal Response To Helicobacter Pylori In Children, Kyle Brawner

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Helicobacter pylori colonizes the stomach of approximately one half of the world’s population. However, the vast majority of infected persons remain asymptomatic. The degree of H. pylori-induced gastric inflammation depends on a complex interaction of several factors. In this dissertation, we focus on age as a determinant of gastritis severity. Children are known to respond to H. pylori infection with a stronger T regulatory cell profile compared with infected adults, yet the reason remains unknown. The influence of the microbiota on, and the communication among, cells of the innate immune system shape the nature of the adaptive immune response to …

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Nadph Oxidase-Derived Superoxide Production During Coxsackie B Virus Infection Fuels Macrophage Activation To Accelerate Type 1 Diabetes, Ashley R. Burg Jan 2017

Nadph Oxidase-Derived Superoxide Production During Coxsackie B Virus Infection Fuels Macrophage Activation To Accelerate Type 1 Diabetes, Ashley R. Burg

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Type 1 diabetes (T1D) is a chronic inflammatory autoimmune disease in which autoreactive T cells selectively destroy insulin-producing pancreatic β-cells. While genetic predisposition underlies susceptibility, environmental factors are proposed to play the important role of triggering the activation of autoimmunity in T1D individuals. Viral infections, particularly by Coxsackie B viruses, are highly suspected as a precipitating event. However, the exact molecular mechanism for how viral infections elicit β-cell-specific autoimmunity remains unclear. Rodent models of virus-induced T1D suggest it is through bystander activation, during which innate antiviral responses to pancreas-tropic viral infections create an inflammatory milieu that breaks the peripheral tolerance …

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A Comparison Between Number And Letter Acuities Among Patients, Sarah Berry Jan 2017

A Comparison Between Number And Letter Acuities Among Patients, Sarah Berry

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ABSTRACT Purpose: Previous studies have shown that there is an association between visual acuity and Alzheimers’ disease. Untreated visual problems may contribute to cognitive impairment and more progressive cognitive decline. This study investigates the association of chart design, specifically comparing charts using letters versus numbers, to accuracy and repeatability among patients with dementia. Methods: 23 English-speaking subjects diagnosed with moderate to advanced levels of dementia were recruited from two local Birmingham nursing homes. Visual acuities were measured in a randomly selected eye and timed from six different charts: Back-illuminated ETDRS chart with letters, Back-illuminated ETDRS chart with numbers, HOTV cards …

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Interplay Of The Circadian Clock And Growth Hormone Signaling In The Heart, Ryan Darrell Berry Jan 2017

Interplay Of The Circadian Clock And Growth Hormone Signaling In The Heart, Ryan Darrell Berry

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Growth hormone (GH) signaling plays a critical role in postnatal development and the details of its release, regulation, and influence on the development of a number of organs has been well studied. GH is released from the anterior pituitary in a pulsatile fashion with pulse amplitude being greater at night than during the day in a number of species, including humans. Once in circulation, GH binds to the GH receptor (GHR) on target tissues throughout the body altering gene expression and stimulating the local production of insulin-like growth factor 1 (IGF-1). IGF-1 primarily acts in an autocrine and paracrine fashion. …

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Increasing The Accessibility Of A Falls Prevention Intervention For Community-Dwelling Older Adults With Low Vision, Sarah Blaylock Jan 2017

Increasing The Accessibility Of A Falls Prevention Intervention For Community-Dwelling Older Adults With Low Vision, Sarah Blaylock

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Falls remain a costly problem as a leading cause of injuries and fatalities for individuals over the age of 65. Older adults with low vision, or non-correctable visual impairment, are estimated to be two times more likely to fall than those without vision loss. There appear to be limited falls prevention interventions available for older adults that have been tested on or designed specifically for individuals with visual impairment. The goals of this dissertation were to learn more about the availability of visually accessible falls prevention interventions and to develop an intervention that can be used with veterans receiving services …

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Contribution Of Distinct Interneuron Subclasses To Cortical Network Activity, Andrew Scott Bohannon Jan 2017

Contribution Of Distinct Interneuron Subclasses To Cortical Network Activity, Andrew Scott Bohannon

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The excitatory glutamatergic output of the cerebral neocortex is tightly regulated by the release of the inhibitory neurotransmitter GABA from cortical interneurons (INs). Once viewed as a largely homogenous population, recent studies have revealed that cortical INs display a diverse range of biochemical, anatomical and physiological properties. In this work we sought to determine if differences in the physiology and connectivity patterns of identified cortical IN populations enable them to differentially contribute to network activity. Specifically, we investigated the contribution of discrete L2/3 IN groups to the generation of aberrant cortical synchrony, and the influence of HCN channels on information …

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Racial Disparities In The Maintenance Of Healthy Lifestyles And Their Effect On Cumulative Blood Pressure Burden And Left Ventricular Mass In African Americans And Whites: Data From The Coronary Artery Risk Development In Young Adults (Cardia) Study, John N. Booth Jan 2017

Racial Disparities In The Maintenance Of Healthy Lifestyles And Their Effect On Cumulative Blood Pressure Burden And Left Ventricular Mass In African Americans And Whites: Data From The Coronary Artery Risk Development In Young Adults (Cardia) Study, John N. Booth

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The prevalence of healthy behaviors associated with optimal blood pressure (BP) levels and reduced risk for target-organ damage and cardiovascular disease (CVD) is lower in blacks compared with whites. Randomized controlled trials provide evidence that if healthy behaviors are maintained over the lifespan, including normal body weight, moderate physical activity, limited alcohol intake, limited sodium intake, adequate potassium intake and a rich diet of fruits and vegetables and low in high-fat dairy and saturated and total fat, then high BP may be preventable. The goal of this dissertation was to assess racial differences in the maintenance of healthy behaviors and …

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Optimizing The Non-Ablative Conditioning Regimen For Bone Marrow Transplantation Using A Murine Model Of Sickle Cell Disease, Divya Devadasan Jan 2017

Optimizing The Non-Ablative Conditioning Regimen For Bone Marrow Transplantation Using A Murine Model Of Sickle Cell Disease, Divya Devadasan

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In this dissertation, we sought to determine if a sub-myeloablative conditioning regimen followed by bone marrow transplantation/hematopoietic stem cell transplantation (HSCT) using syngeneic donor cells could facilitate donor chimerism using a clinically relevant mouse model of sickle cell disease (SCD). This pre-clinical study determined the feasibility of using sub-myeloablative conditioning in the context of autologous HSCT. The prospect of using less-intense conditioning is particularly appealing in the era of modern gene-editing technologies since its extension to use in humans will allow for HSCT to be less toxic and hence be applicable in all patients. We showed that using a sub-myeloablative …

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