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Item 2D layout of bead based thioaptamer/aptamer selection platform for therapeutics and diagnostics(2007-07-20) Xu Zhao; Bruce A. Luxon; William D. Willis; L.Lilian ChanNucleic acid research has expanded the way we can intervene with biological systems. Especially, oligonucleotide agents (ODN or aptamers) are believed to affect cell function via complementary recognition or binding to specific proteins by forming tertiary structure. This opens new ways in therapeutics and diagnostics. The phosphoro- mono-/di- thioate substitutions in the backbone (termed “thioaptamer”) grants ODN nuclease resistance and higher binding affinity. \r\nA bead-based combinatorial library, in which every bead contains a unique species of aptamers, provides a promising platform for selection of aptamers and thioaptamers. To successfully screen the bead-based library, 2D layout of beads in gel and on bead screening model is proposed. To develop the 2D layout of beads and its corresponding functional assays, a model system is first established: NF-kappa B proteins were expressed, purified and characterized. Thioaptamer XBY6, which specifically targets NF-kappa B protein, and its natural origin, I-kappa B were synthesized and verified. Thioaptamer purification using FPLC and HPLC was also investigated, and several 5’-funtionalized thioaptamers were successfully purified. Electrophoretic mobility shifting assay (EMSA) has been used to verify XBY6 binding, and ELISA assay has been used to verify I-kappa B binding towards human recombinant NF-kappa B protein. Preliminary study of bead in 2D gel showed applicability of bead-based selection and thus on bead functional assays were developed. Both double strand one species library with I-kappa B sequence and a 212=4096 different species beads library were constructed and verified. The library was then tested using on-bead EMSA like assay and ELISA assay. Both assays showed encouraging results for 2D layout selection and further enhancement of visualization (signal/noise improvement) is discussed. \r\nThe project suggested that 2D layout of beads in gel (PAGE) is well suited for parallel high-throughput selection of thioaptamers and aptamers, thus paving a new way for drug discovery and future therapeutics and diagnostics.\r\nItem A 4-month randomized controlled clinical trial of adjuvant exenatide or pramlintide versus insulin alone in pediatric type 1 diabetes mellitus: Effect on glycemic control(2010-07-29) Sarah Elizabeth Withycombe; Elena Volpi; Melinda Sheffield-Moore; Antonella CasolaThis study investigates the effects of 16 weeks of treatment with adjuvant Exenatide or Pramlintide versus insulin alone on glycemic control, as measured by glycated hemoglobin (HbA1C) and 1,5-Anhydroglucitol (1,5-AG), or GlycoMark, in pediatric Type 1 Diabetes Mellitus (T1DM). We present here the preliminary results (n=24) of a Phase III randomized clinical trial designed to compare the glycemic effects of using adjuvant Pramlintide or Exenatide versus insulin alone in pediatric T1DM. Sample size calculations estimated 21 patients per treatment arm (63 total) are needed. So far, 24 patients have been recruited from Texas Children’s Hospital’s main Diabetes Care Center or its outlying clinics in the Houston, TX area. Recruited patients were randomized to one of 3 treatment arms (Pramlintide + insulin, Exenatide + insulin, or insulin alone) and completed 16 weeks of treatment. HbA1C and 1,5-AG levels were the primary endpoints analyzed as measures of glycemic control. All statistical analyses were\r\ndone using two-sample t-tests assuming equal variance and paired two-sample t-tests performed in Excel. No statistical differences in ΔHbA1C or Δ1,5-AG were observed between each treatment arm and the insulin control arm. Similarly, no statistical differences in HbA1C or 1,5-AG were reported within each group from baseline to 16 weeks. These preliminary data suggest that addition of Pramlintide or Exenatide to insulin regimen of pediatric T1DM does not improve glycemic control. However, reevaluation of the results upon study completion is warranted.Item A Comparison Of Traditional Face-To-Face And Hybrid Pediatrics and Obstetrical Nursing CoursesJammer, Veronica M.; Bishop, Sheryl L.; Hill, Alice S.; Richard, Patricia L.; Nieburh, Bruce R.; Fowler, Debra L.Distance learning is rapidly spreading across various institutions as a main methodology in the delivery of curriculum. As schools of nursing are faced with mandates to increase enrollment to meet the demands of the nursing shortage with limited resources (financial and human capital) some institutions are offering complete programs online while others are gradually integrating this methodology through hybrid instruction (51% face-to-face and 49% online). Such a shift in educational modality brings with it a commensurate concern with equivalency of educational content. Is student performance equivalent or, perhaps even superior, in one modality versus another? Does content make a difference in the effectiveness of a particular modality? This study compared four groups of students who were enrolled in the Associate Degree in Nursing program at a community college in southeast Texas. Two courses, pediatrics and obstetrics (OB), were taught in the fall 2010 semester. Each had a section delivering course content in the traditional face-to-face lecture and a second via hybrid delivery. This was the students’ first experience with distance learning nursing courses. Historically, students have higher performance outcomes (grades) in pediatric courses compared to obstetric courses. Thus, an evaluation of modality across differing content was also important. The study was a descriptive comparative design of Content (2) x Modality (2) that examined student performance outcomes on unit exams, final exams, and the Health Education Systems, Inc. (HESI), a specialty test for pediatrics and OB. This design allowed an examination of the equivalence of the delivery methodologies across different nursing content and provided for the assessment of both content and modality contribution to educational performance outcomes. Results indicated clear equivalences across modalities for both content areas. Improvement across time was seen in the hybrid groups but not observed in the face-to-face classes within content areas, which essentially offset initial lower performance in hybrid courses. This finding suggests that the newer and more unfamiliar format of hybrid courses may pose an initial challenge for students, but students quickly adapt and perform at equivalent levels as their face-to-face counterparts by mid-semester with no significant differences in end-point or HESI performance.Item A Correlational Study of the Relationship between Human Caring and Nursing Home Administrator TurnoverNorton, Lakeesha Patricia; Verklan, Terese; Rounds, Linda; Wiggs, Carol; Grumbles, Loretta; Jones, JacquelineMany nursing homes in the United States are experiencing a significant state of fluctuation in nursing home staff which is believed to have contributed to a “dysfunctional” crisis. There are reports of substantial nursing staff and administrator turnover rates in numerous nursing homes around the country. This is of significant concern as it is predicted that the U.S. will soon experience an explosion in its’ Baby Boomer population. This projected growth of the older population is expected to substantially impact American healthcare providers, especially those providing services for the elderly residing in nursing homes. Many nursing homes are in need of strong, reliable, and caring administrators to lead and deliver high quality healthcare services. There is a significant amount of nursing literature addressing how important human caring is to the development of transpersonal relationships, which is essential to the development of caring and healing environments. However, the nursing home administrator is not specially addressed. The purpose of this study was to develop an understanding of the relationship between human caring and nursing home administrator turnover. A correlational research design using a purposive sample of 144 licensed nursing facility administrators (LNFAs) in the state of Texas was used in this study. The data were collected from Caring Dimension Inventory (CDI) questionnaires mailed to subjects. The resulting dataset from the CDIs was analyzed by use of Pearson’s correlation and other statistical tests to examine associations, relationships, and differences between LNFA’s caring scores, turnover rates, and selected LNFA demographics. Additional analyses were conducted to determine caring scores and turnover rates of LNFAs who participated in this study. Findings revealed no significant association between human caring levels and turnover rates of LNFAs in this study. There was also no evidence indicating that higher level of human caring increases LNFA retention. However, all LNFAs in this study exhibited high levels of human caring. The overall mean caring level of LNFA’s was 4.39 and average LNFA turnover rate was 28%. Additionally, none of the statistical analyses detected any significant associations, relationships, or differences between LNFA’s caring levels, turnover rates, and selected demographics.Item A cross-national comparison of the effect of diabetes on the cognitive function of older adults- The case of Mexico and the United States(August 2020) Contrera Avila, JaquelineOlder adults in Mexico and the U.S. have aged under different socioeconomic and epidemiologic contexts. Poorer aging conditions in Mexico impact cognitive function and chronic disease burden. In Mexico, diabetes prevalence is similar to that in the U.S., but the diabetes-related mortality is higher. As diabetes impacts cognitive function, the greater diabetes burden in Mexico may negatively impact the cognitive function of older adults to a greater extent compared to the U.S. Thus, the objective of this dissertation is to measure the effect of diabetes on the cognitive trajectory of older adults in Mexico and the U.S at one cross-section and over time. Two nationally representative cohorts of older adults 50 years and older were used to study Mexico and the U.S., the Mexican Health and Aging Study (MHAS) and the Health and Retirement Study (HRS), respectively. The outcome of interest was cognitive function, measured with a total cognitive score, by cognitive domain, and categorized into dementia vs. normal cognition. The main independent variable was self-reported diabetes status. A cross-sectional analysis was conducted to assess how diabetes impacts cognitive function in the 2012 waves of the MHAS and HRS. Two longitudinal analyses were conducted using the 2001, 2003, 2012, and 2015 MHAS waves, and the 2000, 2002, 2012, and 2014 HRS waves. First, mixed-effect linear models were used to test the impact of diabetes on the cognitive trajectory in both countries. Second, GEE models were used to test if the risk of dementia associated with diabetes differed between countries. Compared to those without diabetes, the results showed that those with diabetes had lower cognitive scores in the 2012 cross-section in both countries. Diabetes also predicted greater cognitive decline over time in both countries, for both memory and non-memory domains. Further, having diabetes increased the risk of dementia at age 65, but the dementia risk did not differ by diabetes status after age 80 in both countries. Independent of diabetes status, the probability of dementia over time was greater in Mexico compared to the U.S. However, the risk of dementia associated with diabetes was similar between the two countries.Item A descriptive epidemiological review of hospital admissions for UTI from long term care facilities and a systematic review of strategies to reduce the risk of catheter associated UTI in long term care facilities in order to reduce these admissions.Han, Wei; Eschbach, Karl; Arcari, Christine; Kramer, GeorgeUrinary tract infection (UTI) is a significant source of morbidity and mortality in the elderly. Urinary catheter use greatly increases the risk of contracting a UTI. Use of a urinary catheter has been shown to increase the risk of contracting a UTI-accounting for up to 40% of nosocomial infections in one (older) study. A number of studies and reviews of studies have been done to assess strategies for reducing the risk of such catheter associated UTI (CA-UTI) in the acute setting. However, there has been less work done in long term care facilities (LCTF), a setting where UTI incidence is already high and urinary catheter use is increasing. LTCF have a number of issues that increase the difficulty in applying strategies developed for more acute care settings, including higher percentage of comorbid conditions and reduced staffing and funding. This Capstone project has two aims. It will first examine the Texas Health Care Information Collection (THCIC) database to find the number and attributes of hospital admissions from LTCF for UTI in order to describe the epidemiology of the problem. Second, it aims to do a systematic review of the literature and assess strategies for reducing risk of CA-UTI in LTCF, especially in terms of feasibility and economic impact. The author will be initially using the PubMed database and concentrating on English language articles. Keywords include Long-Term-Care-Facility, UTI, and Urinary Catheter. Expansion into other databases will be done as needed.Item A Naturalistic Inquiry into the Experiences of Emergency Medical Technicians and Paramedics Who Become Registered NursesFord, Shiela RThe United States has been faced with a nursing shortage for many decades (ANA, 2017). The increasing age of nursing faculty, the aging population, and retirement of bedside nurses further diminish the nursing workforce in the United States (ANA). One potential nursing recruitment source is Emergency Medical Technicians and Paramedics (EMT-P). EMT-Ps can bring important skills and knowledge to nursing. Concern about attrition of EMT-Ps from pre-licensure nursing programs and the dearth of literature about EMT-Ps who are interested in becoming registered nurses led to this Naturalistic Inquiry study (Lincoln & Guba, 1985; Erlandson et al., 1993) that explored the experiences of EMT-Ps who become registered nurses. Twelve EMT-Ps who were registered nurses at the time of data collection participated in the study. Data consisted of demographic and interview data as well as the researcher’s observations. Study findings highlighted EMT-Ps’ motivations for becoming a nurse, the challenge of adapting to a nurse mindset, and the process of coming to terms with being a nurse. The study findings also provided information about how the EMT-P who became nurses identified themselves and some of the ethical dilemmas they face being EMT-Ps who are practicing as nurses.Item A Naturalistic Inquiry Into the Lived Experience of Nurse Practitioners Who Have Full Practice Authority(2023-05-01T05:00:00.000Z) Jenkins, Kimberly N 1979-; Dr. Linda Rounds; Dr. Mary O'Keefe; Dr. Carol Wiggs; Dr. Kathleen Pitts; Dr. Judith Aronson; Dr. Mary O'KeefeFull Practice Authority (FPA) is one of three types of practice authority that a nurse practitioner (NP) can obtain through state licensure, depending on the state where the NP plans to practice. The American Academy of Nurse Practitioners (AANP) explains that FPA entails “…the authorization of nurse practitioners to evaluate patients, diagnose, order, and interpret diagnostic tests, initiate, and manage treatments - including prescribing medications – under the exclusive licensure authority of the state board of nursing” (AANP, 2022, Policy Briefs section). To date, there are 29 FPA states and territories, 16 reduced practice states, and 11 restricted practice states. The purpose of the study, “A Naturalistic Inquiry Into the Lived Experiences of Nurse Practitioners with Full Practice Authority,” was to explore the everyday experience of the FPA NP using Naturalistic Inquiry (NI). NPs were recruited through electronic mail (e-mail) requests using e-mail addresses obtained from the state Board of Nursing in FPA states. Eleven NPs were interviewed, and data collection followed a semi-structured interview format, with analysis resulting in the emergence of the following themes: (a) autonomy, (b) confidence, (c) collaboration/support system (d) standard credentialing/licensure process, (e) legislation, (f) accessibility and flexibility in patient care, (g) new FPA NP education and research, (h) limitations, (i) reimbursement. The participants indicated FPA is a positive experience in their practices, but limitations to practice and inconsistencies in regulation still exist as the United States, including the District of Columbia and U.S. territories. This study can offer information and insights about the experience of practicing with FPA to the NP who has yet to obtain FPA as all states progress towards FPA for NPs.Item A Naturalistic Inquiry of Nigerian Immigrant Nursing Students’ Experiences in United States (U.S.) Baccalaureate Nursing Programs(2020-05-01T05:00:00.000Z) King, Shatoi TNigerian immigrant nursing students have been identified in the literature as having difficulty in making a transition to the teaching methods used in nursing programs in the U.S. Among the problems they experience are understanding the vocabulary and terminology of the Western culture. Previous research suggests Nigerian students remain silent in seeking help regarding the challenges of their learning in part due to the isolation they face from peers and faculty (Sanner, Wilson and Samson, 2002). There is a paucity of research associated with Nigerian immigrant nursing students and how they acclimate to U.S. nursing programs. This study utilized Naturalistic Inquiry (Erlandson et al., 1993; Lincoln & Guba, 1985) to explore the perceptions and experiences of ten Nigerian immigrant nursing students. Study participants were Nigerian immigrant nursing students and the researcher recruited students enrolled in baccalaureate nursing programs in Texas. Interviews, face-to-face or by telephone, for the ten participants were conducted in a private, agreed upon place. Data were collected until reaching saturation, indicating data redundancy, and with no new themes evolving. Analyzed data used procedures described by Lincoln and Guba (1985) and Erlandson et al. (1993) to seek emerging patterns. Guided by Lincoln and Guba (1985) procedures, the five emergent themes included Stepping into America, Navigating the Rough Waters, Unexpected Changes, Searching for Consistency, and Hopes of Finding Clarity. Lincoln and Guba’s (1985) criteria were used to evaluate trustworthiness of the data. Study findings revealed that Nigerian immigrant nursing students experience positive and negative encounters with faculty and classmates, challenges and obstacles related to the American English language, their Nigerian accent, family expectations, and work obligations. The study findings may aid U.S. nursing schools and faculty to incorporate strategies in the learning environment to assist Nigerian immigrants and other international nursing students, to better acclimate to Western programs to achieve success.Item A Naturalistic Inquiry of the Experiences of Women Diagnosed with Gestational Diabetes(December 2023) Mandia, Diana; Dr. Adrian Juarez (axjuarez@utmb.edu); Dr. Carolyn Phillips (Retired); Dr. Patricia Blair; Dr. Monique Pappadis; Dr. Sandra LeeGestational diabetes, hyperglycemia that develops in pregnant women with no prior history of diabetes, affects 2% to 10% of all pregnancies in the United States (Centers for Disease Control and Prevention [CDC], 2022). About 50% of women with GDM go on to develop T2DM, and babies of women diagnosed with GDM also are at increased risk of developing T2DM later in life (CDC, 2022). Effective management of GDM requires women to change their health behaviors related to diet, exercise, and medication adherence. Although some studies have examined the experiences of women who have been diagnosed with GDM in other parts of the world, there is a need for research that explores the experiences of women with GDM living in the United States. The current study utilized Naturalistic Inquiry [NI] (Erlandson et al., 1993; Lincoln & Guba, 1985) to explore and describe the experiences of women diagnosed with gestational diabetes [GDM] in a previous pregnancy and were living in the United States. Data collection took place in the form of one-on-one interviews via Zoom Video Conference with women diagnosed with GDM in a previous pregnancy currently living in the United States. Study data consisted of interview data and participants’ demographic data. Interview data was analyzed using Erlandson et al.’s (1993) interpretation of Lincoln and Guba’s (1985) approach to inductive data analysis. Data analysis revealed three major categories: 1) Finding Out About the Gestational Diabetes Diagnosis, 2) Mastering GDM, and 3) Life After GDM. The implications of the study’s findings pertain to nurses and other healthcare providers who help care for pregnant women diagnosed with GDM. Women with GDM need more information about GDM risk factors, how to incorporate GDM recommendations into their daily lives, mental health resources, and whether having had GDM posed long-term risks for themselves and their children.Item A novel GC-MS/MS assay for the measurement of 2-hg enantiomers and the utility of 2-hg enantiomer levels as a biomarker for IDH mutant gliomas(May 2021) Strain, Shinji KennethThe isocitrate dehydrogenase (IDH) gene has recently been identified to be mutated in gliomas, a malignant brain tumor. Mutant IDH (IDHmut) produces the oncometabolite, (R)-2-hydroxyglutarate (R-2-hg), resulting in a significant increase of intracellular concentrations above physiological levels. However, a lack of correlation between circulating 2-hg levels and IDH status has been observed. This is likely due to the lack of discrimination from the enantiomer of R-2-hg and (S)-2-hydroxyglutarate (S-2-hg). S-2-hg is also normally made in the body but can increase to levels comparable to R-2-hg during hypoxic and acidic conditions. Thus, it is important to differentiate between R-2-hg and S-2-hg to determine the utility of R-2-hg as a biomarker. Furthermore, the current mass spectrometry (MS) methods available for the separation and detection are lacking. Current assays use laborious methods that can result in interconversion of enantiomers during sample preparation, and since low-resolution mass spectrometry instruments have been utilized, incorrect characterization of 2-hg MS data has occurred. A novel chiral gas chromatography-tandem mass spectrometry (GC-MS/MS) assay was developed which improves upon current methods. The assay utilizes a simplified ethyl acetate extraction, separates 2-hg enantiomers using a chiral column which avoids racemization, and quantifies 2-hg enantiomers using stable-isotope dilution MS. Using 2-hg isotopologues, unique EI fragmentation pathways for both 2-hg and the 2-hg lactone have also been described resulting in the ability to simultaneously detect both 2-hg and 2-hg lactone enantiomers. The assay was then validated and serum 2-hg levels from healthy patients were measured, establishing a new, comprehensive reference range for normal levels of each enantiomer. Differences in basal levels of 2-hg enantiomers were observed between races but not sex. Finally, serum levels of 2hg enantiomers were measured in patients with and without IDHmut gliomas. An increase in R-2hg levels was observed for a number of patients with growing IDHmut gliomas, however, not all patients with IDHmut gliomas had an increase in R-2-hg levels. Increased S-2-hg levels were also observed in patients who received prior chemotherapy/radiotherapy. Further work is needed to fully understand circulating 2-hg enantiomer biology, but the work presented herein takes a significant first step in providing the tools and framework for understanding the clinical utility of R-2-hg as a biomarker for IDHmut gliomas.Item A Recombinant Vesicular Stomatitis Virus Expressing the Junin Virus Glycoprotein for Arenavirus Countermeasure Development(2019-12-01T06:00:00.000Z) Sorvillo, Teresa EirenaArenaviruses are pathogens of biodefense importance due to their potential for aerosol transmission and mortality rates reaching 30%. Here, we evaluated the use of a recombinant vesicular stomatitis virus expressing the Junin virus glycoprotein (rVSVΔG-JUNVGP) for the development of countermeasures against arenaviruses. First, we evaluated rVSVΔG-JUNVGP as a vaccine against lethal Junin virus (JUNV) challenge in a guinea pig model. Currently, there are no JUNV vaccines licensed by the United States Food and Drug Administration (FDA) for at-risk individuals. We demonstrated that rVSVΔG-JUNVGP generated 100% protective efficacy against lethal JUNV challenge using a single vaccine injection. We also showed that rVSVΔG-JUNVGP induced robust, high avidity IgG antibody titers as well as detectable neutralizing antibodies. We next evaluated the use of rVSVΔG-JUNVGP as a tool for the detection of JUNV neutralizing antibodies. Conventional methodologies for the detection and quantification of JUNV neutralizing antibodies have several limitations, including the length of time necessary to obtain results (6-8 days) and the requirement of a high containment (BSL-3/4) laboratory. In this study, we showed that rVSVΔG-JUNVGP could overcome these limitations, detecting neutralizing antibodies with the same sensitivity as currently available methods, but more rapidly (within 48 hours) and without the need for a high containment laboratory. Lastly, for biodefense and public health purposes the development of a cross protective arenavirus vaccine may be an important long-term research objective. We therefore developed a panel of chimeric glycoproteins which simultaneously express immunogenic epitopes from multiple arenavirus pathogens. We demonstrated that all chimeric GPs were adequately processed intracellularly, packaged into a rVSVΔG-GFP virion from the plasma membrane, and capable of cellular entry. Our findings suggest that these chimeric GPs may be good candidates to move forward into a rVSV vaccine vector for evaluation of protective efficacy in-vivo. Overall, the findings in these studies demonstrate that a rVSV vector system can be utilized to successfully advance arenavirus and JUNV-specific countermeasure development.Item A Review of Associations Between Traumatic Brain Injury & Addiction and Therapeutic Interventions for Addiction in the Brain Injured PopulationWynne, Karon; Arcari, Christine; Seale, Gary; Baillargeon, JacquesThe research linking drug and alcohol use with increased risk of sustaining a traumatic brain injury (TBI) has been well established. There is some evidence suggesting that the inverse relationship exists; that sustaining a TBI increases the likelihood for developing a drug or alcohol abuse problem. However much less is known about the impact of TBI on substance use disorders (SUD) and many barriers exist in determining these links. Research also suggests that for individuals with previously existing drug or alcohol problems, sustaining a TBI increases the likelihood of relapse. SUD greatly impact recovery after injury and because this association between TBI and SUD is not well understood there is a need to address how to treat addiction in this population. This work reviews the body of literature about the links between TBI and addiction and strategies for improving SUD treatment in individuals with cognitive impairments. Using the existing body of literature we identified strategies for how SUD treatment can be modified to address the specific needs of individuals with a TBI.Item A Review of the Government Sponsored Offensive Biological Programs, Weaponized Biological Pathogens and their CountermeasuresPatterson, Michael James; de Boer, Melanie A; Arcari, Christine; LeDuc, JamesSince the beginning of the 20th century humanity’s capacity for warfare and death has evolved at an ever increasing rate. The horse was quickly replaced by the automobile and the rifle by the machine gun. The use of biological weapons (bioweapons) took the same leap forward from medics fighting battlefield illness to strategic weapons of mass destruction. The two largest research programs, the Soviet and United States of America (US), operated for decades at the height of their scientific fields developing and stockpiling biological weapons with the capability to kill thousands more cost-efficiently than any weapon previously designed. All of these weapons were developed from naturally occurring human pathogens and most of the research is still classified. Many of these pathogens account for only a minimal number, if any, of disease cases each year within the US. The rarity of many of these diseases makes it difficult for medical personnel to diagnosis. The delay in diagnosis and treatment can affect the outcome for the patient and drastically increase the risk of an outbreak. This capstone covered a selection of the bioweapons produced by these two programs, their historical importance, clinical symptoms, and the available countermeasures in the case of exposure. It then opened a discussion on the selection criteria modern bioweapons programs may utilize in the 21st century and the role many of these pathogens play as public health risks. Finally it addressed many of the new developments and policies implemented by the US to tackle and minimize these risks.Item A Rhapsody on the Aryl Hydrocarbon Receptor: Molecular and Environmental Health Insights Through Novel and Canonical Signaling PathwaysJackson, Daniel P; Sowers, Lawrence; Elferink, Cornelis; Kyumycu-Martinez, Neshilan M; Elferink, Lisa; Becnel, LaurenThe Aryl Hydrocarbon Receptor is a ubiquitously expressed, cytosolic transcription factor, which is activated by myriad structurally-diverse xenobiotic compounds, most notably 2,3,7,8-tetrechlorodibenzo-p-dioxin. In this role, the AhR is known to play a fundamental role in several physiological process, for example cell division. Pathologically, the AhR has been identified as a fundamental driver of the toxic effects of numerous persistent, potent, and commonly encountered environmental contaminants. As such, we have investigated the specific role of the AhR in cellular replication during liver regeneration. Based on our findings, we then set out to assess transcriptional targets of the AhR in the mouse liver following exposure to 2,3,7,8-tetrechlorodibenzo-p-dioxin. Finally, given the toxicities with which the AhR is associated, we undertook studies to quantify PAH contamination in Gulf of Mexico seafood as a result of two recent oil spills in an effort to assess safe seafood consumption levels, given the well-known link between the AhR and its toxic xenobiotic PAH ligands.Item A Secondary Analysis of County Health Statistics for the Galveston County of Texas ReportRobbins, Esther Raney; Prochaska, John; Arcari, Christine M; Mutambudzi, MiriamThe health of Galveston County communities (as is common with many areas outside large urban cities) is not fully summarized in a single report; however, a descriptive analysis would benefit community partners such as the Research Education and Community Health coalition who are interested in developing community health plans and for setting goals aimed at improving community health. The objective of this analysis is to compare reported health measures for Galveston County to Texas and the United States to see the most pressing health problems and their determinants of health such as race, gender, age, education and income. The methods included collecting secondary data from the Texas Behavioral Risk Factor Surveillance System for 2010, the County Health Rankings and Roadmaps, the 2013 American Community Survey 5-Year Estimates, and mortality data through the CDC Wonder Query system for Galveston County, Public Health Administration region 6/5S, Texas and the United States. Differences were calculated for each indicator between PHA 6/5S, Galveston County and Texas and/or the nation (for certain measures). To focus on greatest health concerns, only the highest differences were presented. Results revealed that Galveston County’s leading cause of death is cancer compared to Texas and the US with cardiovascular disease as the leading cause. The greatest differences seen for health risks were in the health topics of Prostate Cancer Screening, Colon Cancer Screening, Immunizations, Tobacco Use, Alcohol Use, Mental & Physical Health, and Health Access. 25% of these differences were associated with black race and 20% were associated with no high school education. County Health Rankings differences showed that Galveston County’s premature death rate was higher than the state of Texas. For clinical care, the proportions of primary care providers and mental health providers are fewer patients per one provider compared to Texas. The conclusions of this report reinforce known health disparities such as minority status and lack of education. Cancer deaths as well and access to cancer screenings seem to be the greatest health problems in Galveston County; however, sub-county level data needs to be elucidated to understand more specific population health status.Item A study of two interventions to increase adherence with oral contraceptives and condom use among adolescents and young adultsBerenson, Abbey; Freeman, Jean; Freeman, Dan; Wilkinson, Gregg; Barrett, Alan; Jamieson, DeniseA randomized, controlled trial was conducted to examine the effectiveness of two different interventions on adherence with oral contraception (OC) and their effect on dual use (oral contraception and condoms). A total of 1,155 women 16-24 years of age who requested oral contraception at one of five reproductive health clinics were recruited to participate and randomized to receive either (1) face-to-face behavioral counseling and education at their baseline clinic visit (C group); (2) this same intervention followed by monthly phone calls for 6 months (C+P group); or (3) standard care (S group). Phone interviews at 3, 6, and 12 months after the initial visit assessed whether women developed a cue (defined as use of an object or action to help them remember to take their medication), duration and correctness of contraceptive use, method satisfaction, clinic follow up, condom use with and without hormonal contraceptive use (dual use), and rates of pregnancy and sexually transmitted infections (STIs). Bivariate analysis demonstrated that women in the C+P group were more likely to use their pills correctly in only one out of the 12 months of follow up. Analysis using General Estimating Equations showed that those in the C group were actually more likely to switch brands of OC and less likely to recommend their method to a friend. Those randomized to C+P were more likely to report condom use at last intercourse, but not more likely to use condoms while taking OC. Furthermore, use of a cue was associated with a longer period of correct OC use, regardless of the intervention. No differences were observed between those in either intervention group and standard care in contraceptive discontinuation, satisfaction rates, correct use of their method, or STI rates. Finally, the Mantel Haenszel test revealed no differences in pregnancy rates between groups during the 12 months of follow up. In conclusion, this study demonstrated that clinic based education with or without phone follow up is not effective in helping young women use OC for a longer duration or more accurately. Furthermore, it does not increase rates of dual use.Item A Systematic Review of the Psychological Effects of Heat Stress on Subjects in Uncooled, Sealed, Environment SuitsLevin, Dana ReedThis review was performed to determine if current literature is sufficient to understand the cognitive effects of heat stress for individuals in uncooled pressure suits and the timeline when these effects would occur. Recent growth in the commercial spaceflight industry has led to renewed interest in environment suits to protect against decompression events. Such suits impair the body’s thermoregulatory mechanisms leading to heat stress.22 Because of this, space suits incorporate cooling mechanisms to offload stored heat.22,32,44 However, coolant system failures have been a recurrent problem for spacecraft, particularly those affecting the systems in pressure suits.3,4 Events that force crew members to stay in suits for extended periods of time, such as off nominal landings with a delayed rescue, or coolant failures on orbit could expose crew members to significant heat stress. While the physiological effects are well documented, the cognitive effects of heat stress, which could impair one’s ability to perform critical spaceflight tasks, are less well understood. A systematic review was performed via Ovid, Pubmed, the Defense Technical Information Center, the Institute for Scientific Information Web Of Science, and Google Scholar. The aim was to identify English language studies measuring performance ability, body temperature, and time in individuals wearing uncooled, sealed environment suits and performing limited physical activity under hot environmental conditions. These criteria were used to ensure both space suit based and analogue based studies were detected. Twenty-eight studies representing data from five hundred fifteen individuals met inclusion criteria. The studies tested multiple variables across a range of conditions. The results show evidence for increased fatigue, increased depression, increased hostility, decreased cognitive capacity, decreased vigilance, worsened task performance, decreased psychomotor abilities, increased anxiety, decreased perception, and decreased memory. Application of the results from this review to the spacefaring population are limited because most of the reviewed studies are in analogue populations that do not match current astronauts or expected commercial spaceflight participants. Many factors, such as demographics, suit type, health status of individuals, environmental exposures and activities differ between the conditions in these studies and those expected to be experienced in spaceflight.Item A Tale of Two States: Texas v. California Firearm Mortality, Legislation, and Policies to Reduce Firearm-Related Violence in the United StatesEscobar, BetsyNinety Americans die every day due to gun violence. This violence is a public health burden resulting in thousands of injuries and deaths every year. The age-adjusted firearm mortality rate per 100,000 from 2000-2015 ranges from 10.14-11.01 and is trending up. States address gun violence differently, either by strengthening or deregulating existing firearm legislation. In Texas, the legislature passed an open carry law, enacted on January 1, 2016. Conversely, California has stricter firearm legislation and no open carry. These differences prompted the comparison of Texas and California gun laws following the methods of Kalesan et al. I reviewed the literature and evaluated firearm legislation comparing gun laws and firearm-related mortality rates. The goal was to propose evidence-based recommendations aimed at reducing gun-related mortality. There was an association between stronger gun legislation and lower firearm-related mortality. The most supported and effective legislation for reducing gun-related deaths is expanding universal background checks to private sales to keep guns away from criminals, domestic abusers, and severely mentally ill people. This paper is focusing on three impact areas to address gun violence: research, legislation, and public health campaigns. First, removing Dickey restrictions on CDC and NIH budgets to fund gun violence research. Second, legislating universal background checks to stop unauthorized people from buying guns. Finally, creating public health campaigns targeting the gun culture, social and mental health issues to address gun violence.Item Acculturation and disability in Mexican American older adults(2008-11-19) Mary Ellen E. Kuhlmann; Kenneth Ottenbacher, Ph.D.; Ronald Angel, Ph.D.; M. Kristen Peek, Ph.D.; Laura Ray, M.P.A.; Judith Drew, Ph.D., R.N.; Gayle Weaver, Ph.D.; Elbert Whorton, M.S., Ph.D.Abstract: The purpose of this study is to examine acculturation and disability in Mexican American older adults living independently in the southwestern United States. Design: A prospective cohort study (1993-2005). Setting: Texas, New Mexico, Colorado, Arizona, and California. Participants: Participants in the Hispanic Established Population for Epidemiologic Studies of the Elderly (H-EPESE), a population-based sample of 3050 non-institutionalized Mexican-American men and women aged 65 and over. Measures: Variables included three measures of acculturation (English proficiency, English usage, and Mainstream contact), risk factors (age, gender, education, marital status, and BMI), disablement process factors (chronic pathology, cognitive status, and physical performance), and activities of daily living disability (ADLs), and instrumental activities of daily living disability (IADLs). Chi-Square, Chi-Square test for trends, ordinary least squares regression and discrete hazard analyses were used to identify associations of measures of acculturation with incidence of ADL and IADL disability. Results: There was a significant association between one measure of acculturation (English proficiency) and incidence of IADL disability, which remained after adding risk factors and Disablement process variables to the model. Conclusion: The findings support the importance of acculturation when examining ADL and IADL disability. Interventions that consider acculturation may be useful in reducing ADL and IADL disability in Mexican American older adults.