Medicine and Health Sciences Commons^™

A Paradigm Shift In The Diagnosis And Treatment Of Polycystic Ovarian Syndrome: A Practice Change In Primary Care, Patricia L. Sullivan

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Patricia Lynn Sullivan

The purpose of this Doctor of Nursing Practice (DNP) Scholarly Project was to determine whether participants’ knowledge of the updated guidelines on the diagnosis and treatment of the obese patient with polycystic ovarian syndrome (PCOS) is increased following a continuing education presentation. The increase in the knowledge of PCOS guidelines for an obese patient is documented using a pretest/ posttest method following the continuing education program which utilizes a PowerPoint presentation. PCOS is the most common endocrine disorder in women. This DNP capstone project was designed to provide a literature …

Angiogenic Roles Of Vegfb And Vegfr1 In Vitro And In Vivo, Jacob Cecil

Chancellor’s Honors Program Projects

No abstract provided.

Examining The Associations Between Depressive Symptoms, Body Mass Index, And Physical Activity Self-Efficacy In African American Mother-Child Dyads, Y'Esha Vonyae Williams

Theses and Dissertations (ETD)

In recent decades the prevalence of childhood and adult depression and obesity has increased worldwide. Multiple factors influence the onset of both depression and obesity. Individual manifestations of depressive symptomatology and health-related problems associated with obesity vary; however, genetics and environmental and psychological factors have been implicated as correlates. Consequently, both disorders can ultimately interfere with individuals’ activities of daily living and decrease their quality of life. African American women are known to have a higher prevalence of obesity and more severe depressive symptoms in comparison to Caucasian women. Likewise, African American children are more obese and experience many factors …

Elucidating The Effects Of Metabolic State On Nanoparticle Distribution In Mice And In Vitro Uptake, Kevin James Quigley

Doctoral Dissertations

Since almost 70% of the U.S. population over 20 years old is overweight and 30% is obese, with much of the western world following suit, many patients that will potentially be administered circulating nanoparticles designed to localize to tumors and avoid non-target areas will have significant amounts of white adipose tissue (WAT), enlarged livers, and additional metabolic complications such as type 2 diabetes. However, studies on nanoparticle biodistribution and efficacy take place almost without exception in lean rodents with healthy metabolic states. In this work, I determined the biodistribution of model nanoparticles – neutral filomicelles and polystyrene spheres both carrying …

Panx1 And Panx3 Regulate Adipocyte Development And Fat Accumulation In Vivo, Vanessa R. Lee

Electronic Thesis and Dissertation Repository

The obesity epidemic is a growing concern due to its various comorbidities and associated risk factors. Pannexins 1 and 3 (Panx1 and Panx3), are members of a family of channel-forming glycoproteins that have been reported to be important in paracrine signaling and development. Panx1 and Panx3 are homologous and are regulated in many different cell types, mediating cell proliferation and differentiation. We have shown that Panx1 and Panx3 are expressed in adipocytes and adipose-derived stromal cells (ASCs) throughout the process of differentiation. Mice globally lacking Panx1 (Panx1 KO) have significantly greater total fat mass compared to wildtype (WT) mice under …

The Information-Motivation-Behavioral Skills Model: An Examination Of Obesity Prevention Behavioral Change In Children Who Participated In The Afterschool Program Virginia Beach Let’S Move, Marilyn Miroshlava Bartholmae

Health Services Research Dissertations

The purpose of this study was to examine the utility of the Information-Motivation-Behavioral Skills Model (IMB) as a foundation to design childhood obesity prevention afterschool programs. This study employed a secondary analysis of pre (n=172), post (n=170), and 1-year follow-up (n=32) evaluations of the obesity prevention afterschool program Virginia Beach Let’s Move for children ages 5-11 years. Independent variables included demographic characteristics for the participating children and their parents. Dependent variables used in this study were the IMB constructs information and motivation. Motivation was measured by the attitudes of the children and information was measured by the children’s knowledge.

The …

Piloting A Screening Tool For Eating And Eating-Related Behavior, Michael N. Reynolds

Dissertations

Obesity is a common medical condition associated with negative health and social outcomes. Obesity has a primary malleable behavioral cause, eating more calories than are metabolized. While metabolic rate is malleable with exercise, eating can more quickly add calories than exercising can subtract them. In the past, behavioral weight-loss treatment studies relied on multi-component package interventions that have shown reliable patterns of participant weight-loss during treatment and weight-regain in follow-up. Those findings could be conceptualized as an ABA withdrawal design, eating behavior returns to baseline after the prosthetic contingencies of the treatment study are withdrawn. We must develop ways to …

Implementing The 5as Framework For Obesity Management, Jennifer C. Sassman

Doctor of Nursing Practice Final Manuscripts

This Doctor of Nursing Practice (DNP) pilot project strives to improve management of obesity by increasing provider knowledge and utilization of the 5As Framework which is an effective evidence-based intervention and a behavioral counseling tool. Pre-data including BMI and waist circumference were collected over one month. An educational in-service on the 5As was held for one primary care nurse practitioner. Post data was gathered over five months. Provider knowledge on the 5As was increased however, there was not an increase in identifying obesity. The 5As was used about 10% of time with obese patients. This pilot project can be expanded …

Effective Communication Of School Health Screening Information: A Pilot Study Evaluating The Effect Of Electronic Communication Of Bmi Screening Information In Elementary Schools, Kara Elizabeth Carter

Senior Honors Projects, 2010-2019

Obesity is a growing concern surrounding today’s youth. School-based health screenings are promoted as a public health strategy to identify obese children and those at high risk for becoming obese. Despite numerous programs, data is lacking in effective school to parent communication of health related information. The purpose of this research is to determine the effect of electronic communication of health screening outcomes, including parents’ understanding of screening information, utilization of informational resources, and decision to seek physician follow-up. Screenings for body mass index, acanthosis nigricans and blood pressure were conducted during school hours among children in kindergarten and third …

A Link Between Paediatric Asthma And Obesity: Are They Caused By The Same Environmental Conditions?, Phylicia Gonsalves

Electronic Thesis and Dissertation Repository

The highly associated paediatric conditions of asthma and overweight have seen dramatic increases over the past few decades. This thesis explored air pollution exposure as a potential underlying mechanism of co-morbid asthma and overweight among adolescents aged 12 to 18 years. Data from the Canadian Community Health Survey were merged with a database containing estimates of air pollution as assessed by particulate matter ≤ 2.5 microns (PM_2.5) concentrations at the postal code centroid in southwestern Ontario. Logistic regression was used to conduct the analysis. Adolescents were more likely to be overweight as PM_2.5 concentrations increased. There was …

Effectiveness And Feasibility Of In-Office Versus Smartphone Text-Delivered Nutrition Education In The College Setting: A Mixed-Methods Pilot Study, Jordan Rose, Deepika Goyal, Mary Ellen Wilkosz, Anita Catlin

Doctoral Projects

Often, being away from home for the first time, coupled with limited knowledge regarding healthy eating behaviors, leads to poor food choices and an increased risk of obesity among college-aged young adults. These college students are prone to high-calorie diets and limited physical activity, putting them at risk for obesity, a physiologically, psychologically, and financially costly epidemic in the United States. College students use their cellular phones over eight and a half hours a day and cell phones are their primary means of information consumption outside of the classroom, suggesting that the phones would be a useful tool to provide …

Body Image And Anthropometric Measurements In Bariatric Surgery Patients, Julie Ann Varns

Dissertations

Purpose: The purpose of this study was to explore body image and anthropometric (body mass index) measurements in bariatric surgery patients over three months. Conceptual framework: The dimensions of body image are body attitude, Appearance Evaluation, body checking, body space, body size, and Appearance Orientation. Body attitude is affective distress related to one’s weight, shape, size, and fatness. Appearance Evaluation is feelings of satisfaction or dissatisfaction with one’s looks. Body checking is the repeated scrutiny of one’s body size, shape, and weight. Perceived body space is the amount of space individuals perceive their bodies to occupy. Perceived body size is …

Anti-Fat Attitudes And Weight Bias Internalization: An Investigation Of How Bmi Impacts Perceptions, Opinions And Attitudes, Laurie Schrider

USF Tampa Graduate Theses and Dissertations

Americans hold negative and judgmental attitudes towards obese and overweight individuals and these anti-fat attitudes and weight stigma have become a damaging form of discrimination. The internalization of weight bias and anti-fat attitudes contributes to negative health outcomes including: feelings of devalue, self-hate, anxiety, depression, body dissatisfaction and eating disturbances. The purpose of this study was to investigate weight bias internalization in individuals who perceive themselves as overweight as well as to examine differences in anti-fat attitudes among normal and overweight individuals. A sample of 202 male and females completed an online survey that assessed anti-fat attitudes via the Anti-Fat …

Comparison Of Quick Methods For Determining Body Composition In Female Collegiate Athletes And Obese Females, Mandee E. Martin

Theses and Dissertations--Nutrition and Food Systems

The Body Mass Index (BMI) is a tool used broadly by public health agencies to assess weight in populations. However, when differentiating between fat mass and fat free mass the formula (BMI = weight in kilograms/height in meters2) is not applicable. Research suggests that evaluating body fat percentage and adipose tissue deposition may provide a nuanced indication of overall health, making it more accurate on an individual basis. This study evaluated four methods (Body Mass Index, waist circumference, A Body Shape Index, and Waist to Stature Index) that assess body composition and their ability to predict body fat percentage in …

Promoting Healthy Eating And Physical Activity: A Qualitative Examination Of Community-Based Obesity Interventions In Rural Kentucky, Brooke F. Butterworth

Theses and Dissertations--Nutrition and Food Systems

Rural Americans are medically underserved groups and are at greater risk of becoming obese than urban Americans. The purpose of this qualitative study was to determine the perceived causes of obesity in six counties of rural Kentucky and to determine how to customize strategies to reduce obesity in these areas. University of Kentucky Cooperative Extension Service Agents formed coalitions in each of the six counties to assess their communities’ needs and assets to inform plans for implementing evidence-based obesity interventions. Between February and August of 2015, the coalitions were convened for a total of 11 meetings. Each of the coalition …

Uncovering New Roles For The Aryl Hydrocarbon Receptor (Ahr) In Breast Cancer, Justin Kirk Tomblin

Theses, Dissertations and Capstones

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor that is responsive to many exogenous and endogenous ligands. AHR is of particular interest in cancer, and has been shown to play roles in tumor progression. As such, it has received growing attention as a possible chemotherapeutic target. Obesity increases the risk of breast cancer, complicates treatment of breast cancer, and stimulates the growth of larger, more aggressive mammary tumors. Many breast tumors in obese women are estrogen receptor (ER)-positive and, while targeting hormone receptors like ER is beneficial, many obese women see a recurrence of their cancer after standard …

Effects Of Obesity On United States Farmers: A Pilot Study, Sharon C. Hunsucker

Theses and Dissertations--Nursing

Previous research described the value farmers place on their ability to work. The impact of obesity on workers is an increasing concern in occupational health research; yet, knowledge regarding the impact of obesity on the performance of farm work is limited. Identifying the impact of obesity on farmer’s work ability can guide healthcare workers in promoting and motivating farmers to implement lifestyle changes to improve health and sustain longevity in their ability to work.

The purpose of this dissertation was to examine the impact of obesity on the work ability of U.S. farmers. Specific aims were to 1) examine the …

Central And Peripheral Weight Gain Affect Trunk Kinematics And Lower-Extremity Muscle Activation Differently During Sit-To-Stand, Michelle Christine Walaszek

Theses and Dissertations--Kinesiology and Health Promotion

Background: Obesity-induced alterations in biomechanics and muscle recruitment during activities of daily living, such as sit-to-stand (STS) are often attributed to increases in adipose tissue (AT) mass. Central or peripheral distribution of AT may differently affect biomechanics and muscle recruitment.

Methods: Fifteen healthy, normal weight (BMI 22.4 ± 1.9 kg/m², 24.1 ± 4.2 years) subjects volunteered. External loads equivalent to a 5 kg/m² BMI increase were applied in three conditions: unloaded (UN), centrally loaded (CL), and peripherally loaded (PL). Subjects completed three successful STS movements in a backless chair under each load condition in random order. Motion …

A Comparison Of The 2013 Aha/Acc/Tos Guideline For The Management Of Overweight And Obesity In Adults To Clinical Outcomes Of A Plmm Intervention Among Hispanics, Silvia Salinas-Lopez

Open Access Theses & Dissertations

Obesity is a serious and costly condition, causing a higher prevalence of chronic diseases and having an average medical cost of $1,430 higher than non-overweight patients (Finkelstein, Trogdon, Cohen, & Dietz, 2009). With more than two thirds of U.S. adults suffering from overweight or obesity, health organizations have recognized the disease as a threat to the well-being of the nation. In 2013, the American Health Association (AHA) and the American College of Cardiology (ACC) among other stakeholders developed a set of guidelines and recommendations for primary health providers in order to reduce overweight, obesity and concomitant conditions (Jensen et al., …

Factors Affecting Body Mass Index Levels In African American Women Living In North Carolina, Padmini Shanti Kirpalani

Walden Dissertations and Doctoral Studies

The prevalence of obesity has doubled over the past 25 years in the United States, particularly in North Carolina. Obesity is influenced by biological, social, and environmental factors; its prevalence has been found to be higher among African American women and other racial ethnic minorities. Guided by the social ecological model, the purpose of this cross sectional study was to examine the relationship of the psycho-social, psycho-behavioral factors, and body mass index levels (BMI) in African American women living in North Carolina versus their Hispanic American and European American counterparts. A logistic regression model using secondary data from the Behavioral …

An Obesity Needs Assessment With African American Adults In Central Virginia, Nicole Michelle Brown

Walden Dissertations and Doctoral Studies

The risk for obesity is especially prevalent among African American adults in Central Virginia, who have one of the highest rates of obesity in the nation. Efforts to address obesity in African American adults through diet, weight reduction, and increased physical activity in settings such as schools, worksites, healthcare organizations, churches, and communities, are among the initiatives of Healthy People 2020. The objective of this project, conducted with 91 African American adults (33 females and 58 males) in central Virginia, was to complete a community needs assessment that related to obesity among members of an African American church. The needs …

Determinants Of Obesity Among Deaf And Hard Of Hearing Adults, Lindsay Buchko

Walden Dissertations and Doctoral Studies

Trends of obesity increased over the last 3 decades with the obesity rate doubling from 1980 to 2010. People with disability are more likely to experience health disparities including obesity compared to the general population. Yet research on the determinants of obesity such as self-efficacy, hearing levels, and deaf acculturation styles among those who are deaf or hard of hearing (HoH) is limited. This cross-sectional study, using the social cognitive theory framework, examined BMI and self-efficacy differences between deaf/HoH adults and hearing adults, aged 20 years and older. This study also examined the associations between BMI or self-efficacy and factors …

The Effect Of Dietary Fruits & Vegetable Consumption And Physical Activity On Obesity In African American Adolescent Females., Tanisha Brooks

Walden Dissertations and Doctoral Studies

Obesity is epidemic among Black adolescent females, and adolescent obesity often leads to adult obesity. Previous research suggests that there may be an interaction between physical activity and dietary fruit and vegetable intake on body mass index (BMI) in obese adolescent females in general, but it was unclear whether the same pattern is evident in Black adolescent females, who, on average, tend to have low levels of physical activity and fruit and vegetable intake. Bandura's social learning theory implies the possibility that adolescent females might model their behaviors on the behavior of others in their high school years, including physical …

Environmental Factors Associated With Body Mass Index Among Long Haul Truck Drivers, Charlotte Hughes Huntley

Walden Dissertations and Doctoral Studies

In 2009–2010, the prevalence of obesity among U.S. adults was 40%, and the prevalence was 69% among long haul truck drivers. Researchers have not established a clear relationship between working environment and weight among truck drivers. This quantitative cross-sectional study, using an ecological framework, evaluated the relationship between the working environment (sleep performance, food choices, driving environment, and activity level) and weight severity (e.g., body mass index [BMI]) among long haul truck drivers. One hundred and twenty six adults (46 + 10, years of age), including both genders (male = 97 and females = 29) completed an online questionnaire evaluating …

The Role Of Fat Grafting And Adipose-Derived Stem Cells In Breast Reconstruction, Krishna S. Vyas

Theses and Dissertations--Clinical and Translational Science

Fat grafting is a common surgical procedure that involves the transfer of fat from one area of the body to another in order to improve contour deformities, such as in breast reconstruction. Advantages of the technique include using autologous tissue rather than a foreign body and the added benefit of having liposuction to remove fat from an undesirable location. Although adipose tissue could be the ideal soft tissue filler, fat grafting is plagued by tremendous variability in long-term retention, with volume survival rates of 20-80%, resulting in suboptimal outcomes and repetitive procedures.

The mechanisms contributing to long-term fat graft survival …

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

Relationships Of Chronotype, Social Jetlag, Sleep, Physical Activity And Diet With Mood, Perceived Stress, Obesity, Blood Pressure And Prostate Cancer, Daria M. Mcmahon

Theses and Dissertations

Background: Chronotype, social jetlag, poor sleep, proinflammatory diet, and low physical activity have been associated with increased risk of chronic diseases: obesity, diabetes, cardiovascular disease, depression and cancer. Yet the relationships between these factors have not been extensively investigated in prospective studies.

Methods: Two studies were conducted. The first study followed 390 healthy men and women ages 21-35 for two years. Social jetlag [SJL] and sleep measures (total sleep time [TST], sleep onset latency [SOL], wake after sleep onset [WASO]), sleep efficiency [SE]), were derived from physical activity personal (armband) monitoring. The participants wore the armband for 4-10 …

Obesity And Asthma: Adiponectin Receptor 1 (Adipo R1) And Adiponectin Receptor 2 (Adipo R2) Are Expressed By Normal Human Bronchial Epithelial (Nhbe) Cells At Air-Liquid Interface (Ali) And Expression Changes With Il-13 Stimulation, Jennifer L. Bradley

Theses and Dissertations

Obesity is recognized as an important risk factor for the development of many chronic diseases such as hypertension, Type 2 diabetes mellitus (T2DM) cardiovascular disease, cancer, renal disease, neurologic dysfunction, metabolic syndrome and asthma (3, 4). Circulating serum adiponectin levels in obese asthmatics have been reported to be low. Therefore, we aimed to investigate the role of adiponectin in a mucus hypersecretion model and hypothesized that adiponectin would decrease IL-13 induced MUC5AC expression from differentiated NHBE cells and that increasing concentrations of IL-13 would cause a decrease in Adipo R1 and Adipo R2 expression. MUC5AC expression with exposure to adiponectin …

Retrospective Analysis Of Body Mass Index Screening And Obesity Counseling In A Primary Care Setting: Comparative Analysis Of Demographic Variables And Co-Morbidities, Christina Fisher Higdon

DNP Projects

Study Purpose: To assess obesity screening and counseling in patients at annual wellness exams in an urban primary care clinic. Specific aims of the study: determine percentage of patients with documented body mass index (BMI), ICD-9/ICD-10 diagnosis of overweight or obesity, documentation of education or a follow-up plan for weight management, follow-up visit for weight loss and documentation by provider, and comparative analysis of co-morbidities and demographic variables during well-exam visits.

Target Population and Measures: Adults over the age of 18 in an urban primary care clinic with a BMI greater than 25 kilograms (kg)/meters squared (m2). BMI screening and …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …