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Knowing the Signs: Implementing the Agitated Behavior Scale to Assess Early Signs of Agitation in Traumatic Brain Injury Patients in the Inpatient Rehabilitation Setting
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ADHD AS A PREDICTOR OF SCHOOL ENGAGEMENT: IS RACE A MODERATOR?
Get PDFPrevious research indicates that there are racial disparities in diagnosing Attention Deficit and Hyperactivity Disorder (ADHD) and ADHD treatment. Specifically, Black children are diagnosed with ADHD less frequently than their white peers despite exhibiting more symptoms. Further, Black children receive fewer evidence-based treatments when compared to their white peers. Many studies are addressing ADHD racial disparities. However, only a few discuss the implications of these disparities on school engagement. Considering the symptoms of ADHD are particularly troubling in the school setting, the current research utilized data from the 2019 National Survey of Children's Health (NSCH) to determine if school engagement differed by race among children diagnosed with ADHD. The researchers conducted the current study to determine if there are disparities in ADHD diagnosis based on race and level of school engagement within this population. Data from the current study indicates no significant association between racial identity and frequency of ADHD diagnosis. Additionally, there is no difference in the level of school engagement for Black and white children diagnosed with ADHD. There was no interaction between race and ADHD diagnosis. Further, there was no predicted compounding impact on school engagement for students who were nonwhite and had ADHD. There are discrepancies between the current study and previous research findings. Thus, more studies analyzing ADHD and social determinants of health, such as social environment or income, may contribute to what researchers know about ADHD disparities
WEIGHT STIGMA, INTERNALIZED WEIGHT BIAS, AND PHYSICAL ACTIVITY: EXAMINING BEHAVIORS, MOTIVATIONS, AND GENDER DYNAMICS
No full textWeight stigma is a well-documented social determinant that negatively affects physical and psychological health outcomes. Internalized weight bias (IWB) and experienced weight stigma (EWS) have been associated with maladaptive behaviors, including physical inactivity and exercise avoidance, however, few studies have examined how these forms of stigma relate to different types of physical activity (PA), extrinsic motivations for exercise, and social contextual experiences during PA. This study explores the influence of EWS and IWB on PA behaviors, motivations, and avoidance, with specific attention to gender differences and the moderating role of gender. Social contextual variables (e.g., activity type, social media use, interpersonal experiences, and location of PA) were also examined to provide a broader understanding of how stigma operates in PA settings.
A nationally representative sample of U.S. adults (N = 435) completed a cross-sectional online survey assessing demographic characteristics, IWB (using the WBIS-M), EWS (using the SSI-B), PA frequency (using the Godin Leisure-Time Exercise Questionnaire), weight-related exercise avoidance, and extrinsic exercise motivations (from the EMI-2). Participants also provided open-ended responses to questions assessing social contextual factors involved in their PA. Qualitative data were coded thematically to classify patterns in PA settings and behaviors. Mixed-method data were analyzed using multiple linear regressions, ANCOVAs, MANCOVAs, chi-square tests, and moderation analyses via PROCESS in SPSS.
Results indicated that IWB was a strong and consistent predictor of lower PA frequency, greater exercise avoidance, and higher extrinsic motivations for weight management and appearance. EWS was a significant predictor of exercise avoidance and social recognition motivation, though it did not significantly predict PA frequency. Social contextual analyses revealed that individuals who reported no or unclear forms of PA engagement or settings were more likely to experience higher levels of EWS, suggesting disengagement from structured PA may signal perceived stigma. Women reported higher levels of IWB, exercise avoidance, and extrinsic motivations (particularly weight management and appearance), while men were more likely to report public PA settings and social recognition motives. A significant interaction between gender and EWS emerged for appearance motivation, such that EWS was more strongly associated with appearance-driven exercise motives among women.
These findings offer insight into how internal and external forms of weight stigma impact motivation, behavior, and exercise engagement. The results highlight the need for stigma-informed interventions and exercise environments that promote autonomy, self-compassion, and intrinsic motivation, particularly for women and individuals higher in IWB. Health promotion efforts should shift away from weight-centric messaging and instead foster inclusive spaces that emphasize function, enjoyment, and psychological well-being. Future research should engage in longitudinal and further mixed-method approaches to further investigate how weight stigma impacts long-term exercise adherence and to develop targeted strategies for mitigating its harmful effects across diverse populations
CRNAs’ Perceptions of a Quick Reference Guide For Aspiration Pneumonitis: A Quality Improvement Project
No full textPerioperative aspiration pneumonitis continues to be a relevant complication in anesthesia as it is one of the leading causes of morbidity and mortality. The purpose of this Doctor of Nursing Practice quality improvement project is to assess the perceptions of CRNAs working at a partnering facility regarding the adequacy of a Quick Reference Guide (QRG) designed to aid in the prompt identification of at-risk patients and provide prevention strategies and treatment options for perioperative aspiration pneumonitis. A newly designed aspiration QRG was distributed to CRNAs working at an outpatient surgery center for use during a two-week implementation period. A pre- and post-implementation survey was used to collect data. By comparing survey results, CRNAs showed an increased awareness of fasting guidelines, GLP-1 agonist recommendations, and the use of gastric ultrasound to assess aspiration risk. Post-implementation survey results showed mixed reviews on the usefulness of the QRG and CRNAs’ likelihood of using it again. However, the post-implementation survey did indicate a desire for more hands-on training in the use of gastric ultrasound as a tool to assess aspiration risk
Efficacy of water- and oil-based mosquito control formulated products evaluated against mosquitoes in a novel compact wind tunnel
No full textInsecticides are important tools in an integrated mosquito management program to protect public health from vector-borne disease. Mosquito control programs (MCP) often use adulticides for targeted control. However, mosquitoes can develop resistance to active ingredients (AI) in formulated products (FP), thereby reducing efficacy. Biomist® 3+15 (hereafter, Biomist®) is widely used throughout North Carolina, though previous insecticide resistance (IR) testing identified resistance in some mosquito populations. Some FP are offered with either oil- or water-based options to offer greater flexibility and suit different operational needs. Duet® (oil-based) and AquaDuet® (water-based) contain the same dual action AI (sumithrin and prallethrin). Further testing is needed to identify potential differences in efficacy for FP with different diluents. Laboratory and wild Aedes albopictus, Culex quinquefasciatus, and Culex pipiens/quinquefasciatus were exposed to aerosolized Biomist® (AI: permethrin), Duet® (AI: prallethrin, sumithrin), AquaDuet® (AI: prallethrin, sumithrin), or air (control) for 10 s in a novel compact wind tunnel. Knockdown was measured at 2 h post-exposure and mortality was measured at 24 h and 48 h post-exposure. Resistance or susceptibility status was determined based on mortality at the final time point. Chi square tests (P<0.001) showed significant differences in efficacy of oil- and water-based FP and FP resistance between Culex populations. In lab Culex, Duet® caused significantly higher mortality than AquaDuet®, though Biomist® caused significantly higher mortality than Duet®. In wild Culex, Duet® caused significantly higher mortality than AquaDuet®, while Biomist® caused significantly higher mortality than both Duet® and AquaDuet®. Wild Culex exhibited significantly higher rates of resistance to all three FP compared to lab Culex. No significant differences in mortality between FP were identified when lab and wild Aedes were compared. Different FP may be useful for different MCP needs. However, efficacy of oil- and water-based FP may vary between different mosquito populations, and this should be evaluated before widespread use. These results highlight the importance of mosquito surveillance efforts and ongoing IR testing to guide FP selection to maximize efficacy of targeted control
Beta Cyclodextrin Modifications as Organocatalysts and Cyclodextrin-Halo Protein Complex for Targeted Drug Delivery
No full textCyclodextrin (CD) is a type of cyclic oligosaccharide that commonly contains 6 to 8 glucopyranose units, forming a hollow truncated cone-like structure with a hydrophilic outer surface and a hydrophobic inner cavity. Due to its unique structure and easy complexation with many biomolecules, it has played a critical role in water solubility improvement, slow release, and transportation of hydrophobic molecules like dyes and drugs. Historically, raw beta cyclodextrin has been used as a catalyst for some organic reaction under aqueous conditions and as water solubility booster for drugs. Many current drug formulations often include cyclodextrin to increase the solubility and bioavailability of the active ingredients. However, natural beta-cyclodextrin has its limitations in water solubility and target cell specificity. To address these limitations, many derivatives of cyclodextrin have been synthesized for specific applications. However, each modification of cyclodextrin requires a different synthesis method to install the exact functional group required for performance improvement of modified cyclodextrin. To create more diverse modifications of beta cyclodextrin with consistent reaction, Cu1 azide-alkyne Huisgen cycloaddition (click) reaction was explored with 6A-Azido-6A-deoxy-beta-cyclodextrin which can be an intermediate clickable beta cyclodextrin for click reaction. Click chemistry provides a highly specific and regioselectivity method of modification for cyclodextrin, as it requires an azido and an alkyne group which are rare functional groups in natural organic molecules. Many more modifications of beta cyclodextrin can become possible through simple click chemistry. To investigate the feasibility of this method of beta-cyclodextrin modification, beta-cyclodextrin derivatives with small molecules connected by click chemistry were used to examine the potential of organic catalytic activity and improved delivery potential of beta cyclodextrin. For organic catalytic activity screening, the clickable beta cyclodextrin was attached with some amino acid derivatives to observe the effects of cyclodextrin-amino acid conjugate. Cyclodextrin-amino acid (CD-AA) complex conjugates were tested with a Wieland–Miescher ketone synthesis reaction (WMK) for the organocatalytic potential of clicked beta-cyclodextrin derivative. Beta-cyclodextrins clicked with halogen containing small molecules were investigated for a potential direct connection to HaloTag protein at the surface of cell membrane which could open the door for many new utilities of CD-peptide complexes including targeted delivery of drug molecules
Exploring the Copper (I) and Iron (III) Binding to Recombinant Wild-type FtrB from Brucella abortus: Role of Cu-ion in the FtrABCD Iron Transport System in Gram-Negative Pathogens
No full textFtrABCD is a four-component Fe²⁺ active transporter found in several Gram-negative pathogens, including Brucella and Bordetella spp. Co-expression of these proteins is essential for the survival of these organisms inside the host where these pathogens encounter iron-restricted environment due to host immune response. Based on protein homology and evolutionary data for FtrC, it is hypothesized that this permease uses the free energy (ΔG) derived from Fe²⁺ oxidation to perform the active transport of its cargo. A similar permease, Ftr1p, is found in yeast, and experiments have confirmed that Fe2+ oxidation is required for iron utilization by Ftr1p. In this yeast system, Fe2+ oxidation is done by a co-expressed multicopper oxidase (MCO), Fet3p. The proteins co-expressed with FtrC (FtrA, FtrB, and FtrD) are not MCOs and the soluble components, periplasmic FtrA and FtrB do not belong to any known families of redox proteins. Phylogenetic studies on FtrB and known single and multidomain copper redox proteins have shown that FtrB is evolutionarily related to Fet3p. Based on this, it was proposed that Brucella abortus FtrB is a novel and uncharacterized copper redox protein
and can perform the following reaction—
Cu2+-FtrB + Fe2+ Cu2+-FtrB-Fe2+ (aq) Cu+-FtrB-Fe3+ (aq)
For FtrB to be an effective redox protein and perform the above reaction, it must bind Cu2+, Cu+, Fe2+, as loss of Cu+ from FtrB will terminate its redox activity. As free Fe3+ is toxic and insoluble, it is also predicted that Fe3+ produced by Cu2+-FtrB must stay bound to reduced FtrB until it gets recognized by the permease, FtrC, and is translocated. The ability of recombinant wild-type FtrB to bind Cu2+ and a Fe2+ mimic were determined by another undergraduate researcher from my lab. This thesis describes experiments performed by me and were performed to establish if FtrB can stay bound to Cu⁺ and Fe3+. To investigate if Cu⁺ and Fe³⁺ bind to FtrB, we used Ag⁺ and Ga³⁺ as mimics for Cu⁺ and Fe³⁺, respectively. These mimics were chosen because Cu⁺ and Fe³⁺ are unstable and can oxidize quickly, making them difficult to work with directly. Ag⁺ and Ga³⁺ provide similar coordination chemistry and binding properties, allowing for accurate modeling of the interactions without these complications. Isothermal titration calorimetry (ITC) was performed by titrating Ag⁺ into apo-FtrB in water at neutral pH, showing strong binding (Kd ~ 3 µM, N ~1). Further ITC experiments with Ga³⁺ and Ag⁺-FtrB revealed two distinct binding sites for Ga³⁺. The first site showed a stoichiometry (n) of 2.844, a dissociation constant (Kd) of (1.208 ×10-5) M, a positive change in enthalpy (ΔH) of 28.94 kcal/mol, and a substantial increase in entropy (ΔS) of (1.196 × 102) cal/mol·K. The second site exhibited a stoichiometry (n) of 10, a dissociation constant (Kd) of (1 ×10-3) M, a negative change in enthalpy (ΔH) of -8.378 kcal/mol, and a decrease in entropy (ΔS) of -14.37 cal/mol·K. These findings enhance our understanding of the metal-binding properties of FtrB and its role in ion homeostasis, emphasizing the importance of these interactions for the protein's biological function.
To determine if recombinant wild-type FtrB can bind Cu²⁺ specifically, I performed circular dichroism (CD) spectroscopy on as isolated wild-type FtrB as it is exposed to other divalent transition metal ions during its expression and purification. I used the signature Cu²⁺-His CD peaks to establish the presence of Cu²⁺ in as isolated wild-type FtrB
Impact of Health Literacy and Social Support on the Survival of Hispanic Chronic Kidney Disease Patients
No full textABSTRACT
Background:
Chronic kidney disease (CKD) is a significant public health concern in the United States (U.S.), particularly among Hispanic populations, as its prevalence is rising. Limited health literacy (HL) in CKD patients hinders self-management of the disease and health-related outcomes. Social support (SS) significantly influences CKD patient outcomes, yet its interplay with HL remains unexplored. We investigated HL, perceived SS, and sociodemographic factors among Hispanic CKD patients, assessing their impact on mortality related-risk.
Methods:
We analyzed data stemming from the Hispanic sub cohort of the Chronic Renal Insufficiency Cohort (CRIC) study, a longitudinal examination of CKD and cardiovascular disease risk factors over 15 years. Measures included HL (Short Test of Functional Health Literacy in Adults), SS (Medical Outcomes Study Social Support Survey), and sociodemographic factors, with marital status as a metric for SS. We conducted linear regressions to examine the relationship between HL, SS, a sociodemographic factor. Additionally, we conducted a series of Cox proportional hazards models to assess the impact of HL, SS, and sociodemographic factors on survival outcomes.
Results:
While a total of 327 individuals were enrolled in the H-CRIC study, only 140 participants were included in the current study due to having complete data at year 5 (39.8% male, Mage=59.01, SD=11.17). U.S. birthplace, age, and educational attainment significantly predicted HL scores, while SS did not. Cox proportional hazard models were run to assess the impact of HL on mortality of Hispanic CKD patients. HL was predictive of death (HR = .978, p<.05) and lower HL was associated with earlier mortality. In additional models including social support variables, unmarried status was approaching significance, indicating that it is also associated with increased risk of death (HR = .548, p<.05). When controlling for other mortality risk factors, older age (p=<0.05), participant sex (p= <.01), having diabetes (p= <.001), having CVD (p=<.05), and lower eGFR (p=<.05) were predictive of increased mortality risk, and marriage status- approached significance whereas HL in later models became non-significant (p= .707).
Conclusion:
Our study highlights the significant impact of sociodemographic factors, including birthplace, age, and education on health literacy scores. Notably, participants born in the U.S. exhibited higher HL scores, emphasizing the need for culturally tailored interventions to bridge HL gaps among diverse populations. These findings emphasize the need for regular assessment and continued monitoring of HL and social support in Hispanic patients with chronic kidney disease as it has been shown to increase mortality risk. Future research should aim to create culturally competent tailored interventions to address the gaps in literacy within diverse populations
Proposal for Patient Education Program: Navigating Pregnancy Complications Does Not Have To Be Complicated
No full textFor this patient education rationale, the health issue is pregnancy complications, and the target population is pregnant women or women seeking to become pregnant. This topic is a cause for concern because pregnancy complications affect the health of both the baby and the mother. It can cause congenital disabilities, delayed fetal growth, preterm delivery, miscarriages, stillbirths, infections, organ damage, long-term health problems, and even death (NIH Office of Research on Women’s Health, 2018). Many of these problems will stay with the baby or mother for life and may cause further health problems in the future. So, in order to protect the future health of mothers and their babies, current pregnancy complications must be dealt with
Understanding the Caregiver's Perception of Physical Activity on Disease Progression for a Person Living with Dementia
No full textDementia is an umbrella term used to describe cognitive disabilities marked by a decline in a person’s mental health and reasoning, to the extent that which it impairs a person’s activities of daily living and communication skills. According to the World Health Organization (2023), nearly 55 million people have a form of dementia, costing more than a trillion dollars annually. Moreover, Alzheimer’s Disease is the most common dementia diagnosis and is the form most easily recognized by the public (Mehta & Schneider, 2021; Monfared et al., 2022). Although aging is the strongest known risk factor, dementia is not an inevitable consequence of growing old (Seifert et al., 2022). Therefore, the implementation of global prevention and early identification strategies is critical in reducing the speed of dementia diagnoses. Modern research concludes that one promising prevention strategy is exercise, yet many often fail to incorporate it into their routines early enough or neglect it totally (Mortimer, 2019; De la Rosa et al., 2020; Alty et al., 2020). Through an interview and research analysis, this project explored a caregiver’s perspective on the importance of quality and consistent physical exercise for people living with dementia (PLWD). A case study model was utilized to address this research gap. One interview was conducted with a caregiver of a person living with dementia, and conclusions were drawn based on the the feedback provided