Medicine and Health Sciences Commons^™

What Parents Value Matters: Examining The Association Between Cultural Values, Parenting Styles/Practices, And Child Outcomes, Chen-Yun Wang

Theses and Dissertations

Researchers have identified significant relationships between parenting styles and child outcomes. However, these associations might vary in different cultures because parenting behaviors could link to cultural values. Additionally, understanding the cultural values of parents would help researchers better understand the reasons of parents’ behaviors. Therefore, the purpose of this study was to examine the relationships between parental Asian values, parenting styles, parenting practices, and child outcomes. Parents of preschool-age children (N = 273) from Taiwan completed a series of parenting values and parenting behaviors questionnaires. Teachers rated child prosocial behaviors, modesty, sociability, and impulse control. Results revealed that some domains …

The Plant-Based And Soul-Full Study (Pass): Examining How Owners Of Local Vegan Soul Food Restaurants Promote The Consumption Of Vegan Foods In The African American Community, Anthony Crimarco

Theses and Dissertations

Background: Obesity remains a prevalent public health epidemic and African American (AA) adults are disproportionately affected by obesity more than any other ethnic group. There are also disparities in obesity by location, with the South having the highest rates compared to other geographic regions in the United States. Addressing poor dietary habits is important for improving obesity rates among AAs, but there has been limited research that has focused on specifically developing culturally-tailored interventions. With a recent number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to AAs and others interested in eating …

The Effect Of Spectral Shaping On Perceptual, Acoustic, And Listening Effort Measurements In Young Normal Hearing Adults, Rachel Madorskiy

Theses and Dissertations

Amplification is necessary to restore audibility to individuals with hearing impairment. However, frequency-specific amplification alters the spectral shape and level of speech. Previous research has demonstrated that amplification is associated with better speech recognition outcomes as compared to unaided listening (e.g. Humes, 2013). However, many hearing aid listeners report a lack of perceived benefit associated with hearing aids, and adherence is low (McCormack and Fortnum, 2013). This may, in part, be reflected by a common complaint of hearing aid users that speech is audible, but additional effort is required to understand speech. As amplification alters the spectral shape and overall …

Role Of Epigenome And Microbiome In Cannabinoid And Aryl Hydrocarbon Receptor-Mediated Regulation Of Inflammatory And Autoimmune Diseases, Zinah Zamil Al-Ghezi

Theses and Dissertations

Inflammation is considered to be the underlying cause of a majority of clinical disorders. Thus, studies aimed at understanding the signaling pathways that trigger inflammation could have significant translational impact. In the current study, we investigated the effect of activation of cannabinoid (CB) and Aryl hydrocarbon hydroxylase (AhR) receptors on the inflammatory response. To that end, we used cannabinoids such as Δ (9)-Tetrahydrocannabinol (THC) and cannabidiol (CBD), and a well-established AhR agonist namely 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD). These were tested against two inflammatory disease models: 1) Experimental autoimmune encephalomyelitis (EAE), an animal model for human multiple sclerosis (MS), and 2) Exposure to …

Effects Of Human Dopamine Transporter (Dat) Mutations And Novel Allosteric Modulatory Compounds In Disrupting Hiv-1 Tat-Dat Protein Interaction, Pamela Marie P. Quizon

Theses and Dissertations

More than 37 million people are living with HIV worldwide. Despite the widespread use of antiretroviral therapy (ART), up to 70% of HIV-positive individuals suffer from cognitive and behavioral deficits collectively known as HIV-associated neurocognitive disorders (HAND). HIV-mediated damage to the dopaminergic system is a mediating factor in HAND. Dopamine (DA) transporter (DAT)-mediated reuptake is essential for maintaining DA homeostasis. Because most ART cannot efficiently cross the blood-brain barrier (BBB), the brain serves as a viral reservoir that facilitates the spread of infection to microglia and astrocytes. Infected cells shed viral proteins such as Tat, which plays a critical role …

Behavioral And Neural Correlates Of Aging Effects On Temporal Predictive Mechanisms During Speech Production And Limb Movement, Karim Joharikhatoonabad

Theses and Dissertations

Existing evidence suggests that the brain facilitates motor responses to temporally predictable sensory inputs by generating more robust predictions about the timing of incoming stimuli to better estimate the next state of movement. In this context, previous studies have shown that motor responses are generated with faster reaction time in response to sensory stimuli with predictable compared to those with unpredictable temporal dynamics. However, our understanding of the underlying behavioral and neural mechanisms of temporal predictive mechanisms during movement production has remained limited by several factors. First, studies regarding temporal predictive mechanisms have mainly examined limb movement as a target …

Association Between Snps In The Vitamin D Binding Protein, Vitamin D Status, And Aggressive Prostate Cancer By Race, Diana Diaz

Theses and Dissertations

Prostate cancer incidence and mortality have been decreasing in recent years, but it remains the most commonly diagnosed cancer among men. Racial disparities exist in prostate cancer with African Americans (AAs) having notably higher rates of incidence and mortality, lower survival rates, and are more likely to be diagnosed with a highergrade cancer compared to European Americans (EAs). Genome-wide association studies have revealed several single nucleotide polymorphisms (SNPs) within the vitamin Drelated GC gene that may be associated with prostate cancer aggressiveness. In addition to SNPs, previous research has suggested that low levels of 25-hydroxyvitamin D (25(OH)D) may be related …

The Association Of Rural Hospital Closures With In-Hospital And 30-Day Post Hospital Discharge Mortality From Emergency Care Sensitive Conditions, Melinda A. Merrell

Theses and Dissertations

Purpose

Over 100 rural hospitals have closed in the U.S. since 2010. Continuous pressures on the rural health care delivery system suggest that the trajectory of closures will continue in at least the short-term. While the causes of rural hospital closures have been described in the literature, the effects on the health outcomes of populations that experience these closures are still poorly understood. The purpose of this study was to determine associations between rural hospital closures and in-hospital and 30-day post hospital discharge mortality rates for affected residents experiencing time-sensitive emergencies in two U.S. states.

Methods

Rural hospital closures were …

Role Of Epigenetic, Molecular And Cellular Pathways In The Regulation Of Inflammation, William James Becker

Theses and Dissertations

Dysregulated inflammation is at the heart of countless human diseases. Graft rejection is the process by which an organ from an incompatible donor is rejected by the recipient whose immune cells attack the foreign tissue. Colitis is an inflammatory disorder caused by undue chronic inflammation in the colon and rectum that can progress to cancer. Colitis incidence is on the rise, especially in developing nations and Asia; and the list of patients who need organ transplants grow by the day. Therapies for both graft rejection and colitis are limited to immunosuppressive drugs that leaves patients vulnerable to infection, heart disease, …

Pre-Exposure Prophylaxis (Prep) For Hiv Prevention: A Mixed-Methods Study Of Sexual Risks And Knowledge, Perceptions, And Willingness Of Prep Use Among African American Women In The South, Jamie Troutman

Theses and Dissertations

There are approximately 1.1 million people living with HIV in United States, with nearly 40,000 new diagnoses annually. Significant regional and racial disparities are associated with HIV diagnoses — with the South experiencing the greatest burden of HIV and African American women accounting for 60% of new diagnoses among women. Pre-exposure prophylaxis (PrEP) has been designated as an effective tool to prevent HIV transmission among individuals who may be at risk of HIV infection. Earlier PrEP research has focused mainly on at-risk groups such as men who have sex with men (MSM). Previous PrEP research involving African American women included …

Astrocyte Sensitivity To Dopamine In Culture And Ex Vivo, Ashley L. Galloway

Theses and Dissertations

Dopamine is critical for processing of reward and etiology of drug addiction. Astrocytes throughout the brain express dopamine receptors, but consequences of astrocytic dopamine receptor signaling are not well established. This thesis illustrates effects of dopamine on cultured astrocytes and astrocytes in brain slices (ex vivo). In striatal cultures, extracellular dopamine triggered changes in astrocytic Ca²⁺ signaling and rapid concentration-dependent stellation of astrocytic processes that was not a result of dopamine oxidation, but instead relied on both cAMP-dependent and cAMP-independent dopamine receptor signaling. To isolate possible mechanisms underlying these structural and functional changes, whole-genome RNA sequencing was …

Effect Of Tcdd, An Environmental Contaminant, On Activation Of Ahr Leading To Induction Of Myeloid Derived Suppressor Cells (Mdscs) And The Ability Of Resveratrol, A Botanical, To Neutralize This Effect, Wurood Hantoosh Neamah

Theses and Dissertations

Aryl hydrocarbon receptor (AhR), is a ligand-activated transcription factor that integrates environmental, dietary, microbial and metabolic cues to control various cellular processes, such as the cell cycle, epithelial barrier function, cell migration and immune function. AhR was discovered as the receptor that binds with high affinity to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and leads to numerous of toxicological outcomes. In the current study, we discovered a critical role played by AhR, following activation by TCDD, in modulating a variety of immunological functions through regulation of epigenetic and microbial pathways. Our data demonstrated that AhR activation triggers MDSC mobilization from bone marrow to peritoneal …

Disparities In Non-Small Cell Lung Cancer In The United States: An Examination Of Treatment, Survival, And Access To Care, Cassie Lewis Odahowski

Theses and Dissertations

Lung cancer is the leading cause of cancer-related deaths in the United States with a 5-year survival rate of only 18%. Differences in access to care and treatment utilization may play a role in observed survival disparities among rural patient populations. This dissertation aimed to examine rural disparities in all-cause and lung-cancer specific survival, time to treatment initiation, and utilization of surgical treatment among non-small cell lung cancer cases.

We utilized comprehensive cancer registry data from the Surveillance, Epidemiology, and End Results program linked with Medicare billing claims (SEER-Medicare) for non-small cell lung cancer (NSCLC) patients diagnosed between 2003-2011. We …

Interdependent Mechanisms Of Stress Susceptibility, Julie Elaine Finnell

Theses and Dissertations

Social stress is a significant risk factor for the emergence of psychiatric disorders including depression and anxiety. While there are a number of commercially available therapeutic options for the treatment of these disorders, these treatments require weeks of continuous use to produce behavioral efficacy. It has also been suggested that these traditional therapies are only marginally effective in producing complete remission, suggesting that our understanding as it pertains to the mechanisms underlying stressinduced behavioral dysfunction is still in its infancy. In the last few years, inflammation has become a major focus in the field of stress and depression as clinical …

Family Behaviors As Unchanging Obstacles In End-Of-Life Care: 16-Year Comparative Data, Jasmine Burson Jenkins

Theses and Dissertations

Background: Critical care nurses (CCNs) provide end-of-life (EOL) care for critically ill patients. CCNs face many obstacles while trying to provide quality EOL care. Some research has been published focusing on obstacles CCNs face while trying to provide quality EOL care; however, research focusing on family behavior obstacles is limited.Objective: To determine if magnitude scores (obstacle item size x obstacle item frequency of occurrence) have changed since previous magnitude score data were first gathered in 1999.Methods: A random geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses (AACN) was surveyed. Responses from quantitative Likert- type items …

The Mother Domain: A Mediated Model Of Maternal Gatekeepers And Depressed Fathers Among Newlyweds With Children, Clare R. Thomas

Theses and Dissertations

Paternal depression is an understudied topic and research connecting it to maternal gatekeeping is still in its infancy. Research has found that the marriage relationship can be associated with both depression and maternal gatekeeping. This study focuses on how these three areas are related. A subsample of the CREATE project was used including 216 couples, or 432 married parents. Two separate SEM mediational models were tested to examine father depression as a predictor of maternal gatekeeping, with marital instability as the mediator in one model and partner connectedness as the mediator in the other model. Both parent reports were used …

Effect Of Heart Rate Variability Biofeedback On Sleep, Joshua Mercadel

Theses and Dissertations

Healthy amounts of sleep is vital for normal human functions such as daily learning, memory, emotional state and cardiovascular function. Studies conducted previously have shown sleep deprivation to be associated with increases in sympathetic activity contributing to autonomic nervous system (ANS) dysregulation. HRV biofeedback (HRVB) training induces HRV coherence, a condition that maximizes HRV and facilitates autonomic and cardiorespiratory homeostasis. This randomized, controlled, intervention trial will test the hypothesis that HRVB can improve HRV coherence and increase overall sleep quality. Patients are randomized to previously established HRVB or sham protocols (n=40 each, total planned enrollment N=80). Each participant completes a …

Investigating The Neural Correlates Of Nicotine Withdrawal Phenotypes In Mice: Involvement Of Creb-Dependent Nrg3-Erbb4 Signaling In Mediating Anxiety-Like Behavior, Miranda Fisher

Theses and Dissertations

Addiction to nicotine and the ability to quit smoking are influenced by genetic factors. Therefore, it is important to understand how genes and drugs of abuse mechanistically impact each other. One well-characterized protein responsible for regulating both response to drugs and gene expression is the transcription factor cAMP response element-binding protein (CREB). Work from our lab indicates that hippocampal specific alterations in CREB signaling and synaptic plasticity underlie certain nicotine withdrawal (WD) phenotypes in a region-specific manner. We found that CREB deletion in the ventral hippocampus (VH), a region known for regulation of mood and emotion, results in amelioration of …

Glia Responsivity In Nicotine Dependence, Adewale Oluwamuyiwa Adeluyi

Theses and Dissertations

Neurons are the primary research target in the exploration and development of novel smoking cessation pharmacotherapies over the years. These research efforts have led to the discovery and development of three FDA-approved smoking cessation aids – nicotine replacement therapy, varenicline, and bupropion, each of which have quantifiable success as smoking cessation aids. However, relapse is still very common and smoking cessation is successful in less than 5% of quit attempts, making paramount the development of novel therapeutics. One untapped therapeutic target are glia, particularly, astrocytes and microglia, which are active participants in the neuroplastic events underlying drug addiction.

First, we …

Experience Of Persistent Pain Among Military Service Members Participating In An Interdisciplinary Intensive Outpatient Program, Barbara Katarzyna Bujak

Theses and Dissertations

Persistent pain is one of today’s most complex issues in healthcare. In the U.S. military, persistent pain affects close to half of the service members who have deployed overseas and up to 73.2% of service members and veterans experiencing persistent pain. Interdisciplinary pain management, considered one of the most effective ways to manage persistent pain, utilizes the biopsychosocial model that illustrates the dynamic interaction between the physiological, psychological and social factors involved in the experience of persistent pain. Effective interdisciplinary programs address all components of the model and result in better coping skills to self-manage persistent pain, decreased fear of …

The Contribution Of Adipose Tissue From Ovariectomized Mice To Colon Cancer, Meredith Smith Carson

Theses and Dissertations

Obesity is considered a major public health concern worldwide due to the increased incidences of metabolic dysfunction and cancer risk. The obese state is, in part, attributable to the overconsumption of calorie-dense foods commonly seen in a standard Western diet, which aids in the progression of chronic, lowgrade inflammation. The role of estrogen varies depending on menopausal status, where estrogen deficiency coupled with increased visceral fat associated with post-menopause leads to increased secretions of pro-inflammatory adipokines and cytokines. However, the presence of estrogen in a premenopausal state has been shown to attenuate the pro-inflammatory response, which has been demonstrated when …

Coding Rupture Indicators In Couple Therapy (Crict): An Observational Coding Scheme, Annalisa Ward Carr

Theses and Dissertations

The therapeutic alliance, a construct representing agreement and collaboration on therapy goals, therapy tasks, and the emotional bond between client(s) and therapist, is a robust predictor of therapy outcomes in individual, couple, and family therapy. One way to track the therapeutic alliance is through ruptures and repairs. Ruptures are breaks, tensions, or tears in the therapeutic alliance. Ruptures and repairs influence the therapeutic alliance and consequently therapeutic outcomes. Currently, there is a lack of research addressing ruptures and repairs in couple therapy. The first step in researching alliance ruptures is to have a reliable way to assess alliance ruptures. This …

Macrophages And Associated Inflammation Differentially Impact Obesity, Colorectal Cancer And Obesity-Enhanced Colorectal Cancer, Jackie Bader

Theses and Dissertations

Colorectal Cancer (CRC) is the third-most common malignancy for men or women, with chronic inflammation considered as a primary risk factor. Obesity is also considered a chronic inflammatory disease and is associated with increased CRC incidence. Further, obesity and CRC occur in men and women differently with the highest incidence of either disease found in men, suggesting that female sex hormones may play a protective role in inflammatory diseases. Macrophages can promote inflammation and are a driving force in obesity-associated metabolic dysfunction. Conversely, macrophages also contribute to pro-tumoral responses including, proliferation, angiogenesis and tissue remodeling. This heterogeneity of macrophage behavior …

The Association Of Cardiorespiratory Fitness With Advancing Age Among Those With And Without Type Ii Diabetes, Amber Kathlyn Watson

Theses and Dissertations

OBJECTIVE: This study examined the relationship between cardiorespiratory fitness (CRF) and age to determine if the decrease in CRF associated with advancing age is greater among those with type 2 diabetes mellitus (T2DM) as compared to those without T2DM. This study also assessed if differences in CRF between persons with T2DM and those without are consistent across CRF percentiles.

METHODS: Data from the Aerobics Center Longitudinal Study (ACLS, Dallas, Texas, 1970-2006) were utilized in the current study. CRF was measured by maximal treadmill exercise testing using the Balke protocol and T2DM status was determined by self-report of previous diagnosis by …

Disparities In Colorectal Cancer: Measuring Spatial Accessibility, Screening, And Surveillance Outcomes In South Carolina, Michele J. Josey

Theses and Dissertations

The purpose of this dissertation project is to add to the growing literature about the multi-faceted aspects of colorectal cancer (CRC) prevention and related disparities. We focused on the spatial distribution of facilities performing screening services to identify areas that underutilize colonoscopy screening. Next, we examined how the food and physical activity environment affects precursors of CRC by considering plausible pathways. Finally, we explored if access to health insurance reduced the racial disparity of receiving a timely surveillance colonoscopy after a CRC diagnosis.

We utilized the SC Ambulatory Surgery Discharge Database, an all-payer, population-based outpatient dataset with colonoscopy records from …

Social Networks, Social Support, And Contextual Factors That Affect Blood Glucose Control Among Individuals With Type 2 Diabetes Mellitus In Urban Ghana, Marian O. Botchway

Theses and Dissertations

This study used primary data from Kumasi, Ghana, to examine whether social networks, social support, diabetes-related stigma, religion, and traditional medicine affected blood glucose (HbA1c) control among adults with type 2 diabetes mellitus (T2DM). First, the study evaluated whether three social network characteristics (kin composition, household composition, and network density) were directly or indirectly (via social support) associated with HbA1c. Kin composition and household composition were significantly associated with social support. Neither network characteristics nor social support were associated with HbA1c, which suggests that social network characteristics may operate through mechanisms other than social support to affect HbA1c among study …

Role Of Epigenome And Microbiome In Endocannabinoid-Mediated Regulation Of Inflammation During Diet-Induced Obesity, Kathryn Miranda

Theses and Dissertations

Obesity is an inflammatory disease involving accumulation of adipose tissue, gut microbiota dysbiosis, and over-activation of the endocannabinoid system (ECS). Mechanisms involved in ECS regulation of obesity-induced inflammation are not well understood. Presented here are three chapters involving microRNA (miR) regulation of inflammatory adipose tissue macrophages (ATM) during high-fat diet (HFD)-induced obesity and cannabinoid receptor-mediated regulation of gut microbiota dysbiosis.

ATMs are innate immune cells that drive chronic low-grade inflammation during obesity. Polarization between pro-(M1) and anti-(M2-like) inflammatory phenotypes influence insulin sensitivity and energy expenditure; however, the mechanisms involved are unclear. In study one, we characterized miRs involved in ATM …

Role Of Heart Rate Variability Biofeedback In Cognitive Performance, Chronic Pain, And Related Symptoms, James P. Winstead

Theses and Dissertations

Over-modulation of the sympathetic nervous system and reduced heart rate variability (HRV) are commonly overlooked components of pain, poor cognition (decreased attention, recall, and cognitive processing), depression, stress, and fatigue. HRV Biofeedback (HRVB) training induces HRV coherence to balance the autonomic system. Paced breathing (~6 breaths/minute) increases HRV coherence. This randomized, controlled intervention trial tested the hypothesis that HRVB would improve HRV coherence, pain (severity, interference, and catastrophizing), cognitive performance, and reduce depressive, stress, and fatigue symptoms and pain medication use in veterans. Participants were randomized to previously established HRVB or control protocols. Each participant completed a Baseline Assessment, 6 …

Developing A School-Age Language Screening For Sli, Logan Douglass

Theses and Dissertations

Purpose: This study explored past tense marking in oral reading as a clinical marker of specific language impairment (SLI). A School-Age Language Screening Assessment (SALSA) was evaluated to determine whether it can be used to improve the identification of school-age children with SLI. The first aim was to calculate overall accuracy with children with TL and SLI on reading regular and irregular past tense verbs in oral reading of connected text. The second aim was to determine the overall diagnostic accuracy of SALSA.

Method: 96 children with TL and 3 children with SLI (N = 99) in grades 2-4 were …

Sociocultural Factors Influencing Cervical Cancer Prevention And Control Behaviors In Cusco, Peru, Venice Elizabeth Haynes

Theses and Dissertations

Cervical cancer is one of the most preventable types of cancer; however, it continues to pose significant health challenges for women in low and middle-income countries (LMICs), particularly in Peru. Studies previously conducted in Peru have examined factors associated with cervical cancer screening, screening access, availability, and geographical determinants on cervical cancer incidence and mortality. These studies have suggested the need to explore sociocultural factors and the roles of men and women in screening decisions associated with excessive cervical cancer burden and low rates of screening among Peruvian women. The goal of the dissertation research was to explore influences of …