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Kidney function and cognitive aging and impairment among diverse Hispanic/Latino individuals: Study of Latinos‐Investigation of Neurocognitive Aging (HCHS/SOL)
Get PDFINTRODUCTION: The purpose of this study is to examine associations between kidney disease and cognitive impairment among diverse middle-aged and older Hispanic/Latino individuals. METHODS: Between 2016 and 2018, the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) enrolled diverse Hispanic/Latino individuals ages 50 years and older (n = 6377). Cognitive function, cognitive change, and mild cognitive impairment (MCI) were the primary outcomes. Chronic kidney disease (CKD, defined as estimated glomerular filtration rate [eGFR] < 60 mL/min per 1.73 m2 or urine albumin-creatinine ratio [uACR] ≥ 30 mg/g) and two independent secondary exposures (i.e., eGFR and uACR) were examined. RESULTS: CKD was associated with lower cognitive function and 7-year cognitive decline independent of diabetes and hypertension. CKD was associated with MCI, but the effect attenuated by adjustments for CVD risk factors. More albuminuria was associated with lower cognitive function, cognitive decline, independent of CVD risk factors. DISCUSSION: CKD and higher albuminuria were linked to lower cognitive function, cognitive decline, and elevated risk for MCI among diverse middle-aged and older Hispanic/Latino individuals. HIGHLIGHTS: Kidney disease has garnered increased attention in interpreting blood-based biomarkers of Alzheimer's disease and related disorders. Hispanic/Latino individuals are at increased risk for kidney disease. We found that urinary albumin-to-creatinine ratio outperformed estimated glomerular filtration in relation to cognitive function and impairment. Our findings suggest that kidney dysfunction is an independent marker of cognitive function and impairment
The role of identity on receptivity to environmental messaging and its impact on fandom
Get PDFNegative fan responses to social messages reinforce sport practitioners’ reluctance to implement and engage external stakeholders in environmental messaging out of fear of backlash. Drawing from the Sport Sustainability Campaign Evaluation Model (SSCEM) and its extended version (eSSCEM), we aim to empirically understand how consumers react to environmental messages. Specifically, the objectives of this paper are threefold: (1) Incorporate aspects of the SSCEM (internal constraints) and pre-existing perceptions of the importance of acting sustainably excluded from prior research into the extension; (2) Include two new KPIs specific to the sport organization (a stronger connection to the sport organization or supporting the sport organization less); and (3) Test the moderating effects of environmentalism identification on the model to determine whether environmentalism impacted the relationships within the model suggesting potential market segments. We use data from a sample of 429 NCAA Football Bowl Subdivision team ticket purchasers to show that fans’ receptivity to environmental sustainability messages impacts their connection with the organization and future support. The perceived fit between environmental sustainability and the organization strongly influences receptivity. Environmentalism identification moderates these relationships to some extent, indicating differing fan responses to sustainability efforts. The study’s results underscore the importance of sport organizations’ effective communication of sustainability efforts to elicit positive fan responses and strengthen connections to the team
Corrigendum to “Operating room teams display acceptable levels of patient safety behaviors during surgical cases”; J. Surg. Educ. 2024; 81(8):1105-1109
Get PDFCorrigendum to “Operating room teams display acceptable levels of patient safety behaviors during surgical cases
Data - Design Approaches for Developing Quality Checklists in Healthcare Organizations: A Scoping Review
No full textQuality checklists have demonstrated benefits in healthcare and other high-reliability organizations, but there remains a gap in the understanding of design approaches and levels of stakeholder engagement in the development of these quality checklists. This scoping review aims to synthesize the current knowledge base regarding the use of various design approaches for developing quality checklists in healthcare. Secondary objectives are to explore theoretical frameworks, design principles, stakeholder involvement and engagement, and characteristics of the design methods used for developing quality checklists. The review followed the Preferred Reporting Items for Systematic Reviews 2020 checklist. Seven databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, ACM Digital Library, and IEEE Xplore) were searched for studies using a comprehensive search strategy developed in collaboration with a health sciences librarian. Search terms included “checklist” and “user-centered design” and their related terms. The IAP2 Spectrum of Participation Framework was used to categorize studies by level of stakeholder engagement during data extraction. Twenty-nine studies met the inclusion criteria for this review. Twenty-three distinct design methods were identified that were predominantly non-collaborative in nature (e.g., interviews, surveys, and other methods that involved only one researcher and one participant at a given time). Analysis of the levels of stakeholder engagement revealed a gap in studies that empowered their stakeholders in the quality checklist design process. Highly effective, clear, and standardized methodologies are needed for the design of quality checklists. Future work needs to explore how stakeholders can be empowered in the design process, and how different levels of stakeholder engagement might impact implementation outcomes
Moral Economy of Substance Use and Treatment Access in Rural Appalachia: An Analysis of Capital Exchange
Get PDFThis thesis examines how moral economies and the circulation of moral capital shape substance use stigma and access to treatment in rural Appalachia. Drawing from anthropological theories of capital exchange and stigma, this research analyzes the cultural and structural barriers that individuals face when seeking medication-assisted treatment (MAT) for substance use disorders. Based on observational work, interviews, and a theoretical application of moral economy frameworks, this project identifies three prominent forms of moral capital that are necessary for understanding the experience of substance users in rural Appalachia: access, deservingness and responsibility, and solidarity and neighborliness. Strong community expectations around personal responsibility simultaneously stigmatize substance users and devalue medication-assisted treatment, complicating users' efforts to seek recovery. The depletion of moral capital for substance users perpetuates marginalization and severely limits healthcare access. This work contributes to a broader understanding of how health disparities are culturally produced and offers insight into how community values must be considered in addressing substance use in rural Appalachian regions.Bachelor of Art
Topographic Organization of Projections from the Frontal Cortex to the Auditory Cortex
Get PDFTop-down modulation by the frontal cortex plays a critical role in shaping sensory processing, yet the anatomical organization of these long-range projections remains poorly understood. Recent work has implicated the orbitofrontal cortex (OFC) in predictive filtering and sensory suppression within primary sensory cortices, but whether distinct OFC subregions preferentially target different sensory areas has not been investigated. In this study, we employed retrograde viral tracing and intrinsic signal imaging to map the distribution of frontal cortical neurons projecting to functionally defined subregions of the auditory cortex—primary auditory cortex (A1), secondary auditory cortex (A2), and anterior auditory field (AAF)—as well as to primary visual (V1) and somatosensory (S1) cortices in mice. We found that projections to A1 were largely confined to ventrolateral OFC (OFCvl), while projections to A2 and AAF were more broadly from lateral and medial OFC subdivisions. Projections to S1 primarily originated from lateral OFC and secondary motor regions, as well as the piriform cortex. These preliminary findings suggest the potential existence of subregion-specific organization of frontal cortical projections to primary sensory areas. Our results may provide preliminary evidence for anatomical segregation within OFC outputs, supporting the possibility that different OFC subfields coordinate distinct top-down influences across sensory modalities.Bachelor of Scienc
White Matter Microstructure Correlates with Anxiety Symptoms in Adolescents
Get PDFAnxiety disorders are prevalent in adolescence, yet the neurobiology of these disorders, especially white matter (WM) microstructure, suggests further research. The current study looked at sex-specific associations between WM integrity, as measured by diffusion tensor imaging (DTI), and state and trait anxiety in a subsample of 81 adolescents (ages 9–16) from the CogNIT cohort. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in 20 WM tracts, and anxiety symptoms were assessed using the State-Trait Anxiety Inventory (STAI). Results showed positive correlation between FA in right cingulum hippocampus and state anxiety. Females had more negative FA-anxiety correlations in fronto-limbic tracts, while males had no significant associations. No such association was found between trait anxiety and MD. These findings show the right cingulum hippocampus as an important substrate of state anxiety and emphasizes sex-specific WM-anxiety interactions, indicating the importance of differentiated, more targeted treatment interventionsBachelor of Scienc
Understanding Childcare Center Needs in Providing Nutritious Healthy Meals
Get PDFIntroduction: Out-of-home childcare centers are vital environments for shaping children's eating behaviors and promoting early health. With many children spending up to 31 hours per week in these settings, ensuring access to nutritious meals is critical. However, childcare centers often face barriers to meeting dietary guidelines, including limited budgets, food storage challenges, and difficulty balancing nutritional goals with children’s food preferences. The Childcare Healthy Meals Project was developed to better understand these challenges and identify practical solutions to improve meal quality in childcare centers. Methods: A mixed-methods design was used, consisting of an online survey and follow-up qualitative interviews. Eleven childcare centers in the Chapel Hill and Durham areas participated in a structured Qualtrics survey assessing meal planning practices, perceived barriers, and resource availability. Four directors participated in an in-depth interview to explore challenges and solutions in greater detail. Menus were also collected and analyzed to assess adherence to nutrition standards. Results: Survey and interview results indicated that although many centers strive to align with CACFP guidelines, barriers such as staying within budget, providing enough menu variety, and preparing meals children will eat still persist. Limited food preparation resources and storage capacity further constrained options. Directors valued healthy eating, child autonomy at meals, and family involvement, but emphasized the difficulty in consistently offering nutritious, appealing meals. Centers expressed a preference for solutions such as access to affordable, healthy recipes and frozen prepared meals that meet CACFP standards. Discussion: This study highlights the critical but varied challenges childcare centers face in providing nutritious meals. Despite resource limitations, centers showed strong commitment to supporting children's healthy eating habits. Effective solutions—such as simple, cost-effective, CACFP-compliant meals and enhanced support for menu planning—could help address these barriers. Further research expanding to a more diverse sample will be essential to develop expandable interventions that promote early childhood nutrition.Bachelor of Science in Public Healt
Investigating the Electromagnetic Dipole Response of 104Ru at the HIS Facility at TUNL
Get PDFThe electromagnetic dipole response of the medium-mass nucleus 104Ru was systematically investigated over the energy range of 2.30 to 8.50 MeV using nuclear resonance fluorescence (NRF) with linearly polarized gamma rays. The experiment was performed at the Triangle Universities Nuclear Laboratory (TUNL) at Duke University, employing nearly monoenergetic, linearly polarized photon beams provided by the High Intensity Gamma-ray Source (HIS) facility. These photons were used to irradiate a 2 gram, isotopically enriched 104Ru target. The emitted -ray were detected using the Clover Array, a specialized detector system consisting of eight high-purity germanium (HPGe) detectors and twelve CeBr scintillators. After applying corrections for energy (calibration) and detector efficiency, the resulting spectra were carefully analyzed to identify ground-state (elastic) transitions, determine the spin and parity of associated states, and characterize inelastic transitions to known lower-lying states to uniquely established nuclear levels. This investigation identified 224 previously unobserved dipole states. Among these, 40 transitions were identified as magnetic dipole (M1) and 184 as electric dipole (E1) in nature. An additional four states with J^π = 2+ and another nine states with J^π = 2- were confirmed. The dipole strength below 4 MeV was found to be dominated by M1 excitations, suggesting a strong contribution from the scissors mode. In contrast, the region above 4 MeV up to the neutron separation threshold exhibited a clear dominance of E1 excitations, consistent with features attributed to the pygmy dipole resonance (PDR). This work marks the first comprehensive study of the dipole response of 104Ru using polarized photon scattering via the technique, providing new insights into its low-energy dipole structure.Bachelor of Scienc
Maternal Obsessional-Compulsive Symptoms and Fetal Health Outcomes
Get PDFObsessive-compulsive disorder (OCD) is a chronic psychiatric condition that involves the presence of obsessional thoughts, images, or urges and/or compulsions that can be debilitating. Obsessive-compulsive symptoms (OCS) during pregnancy are known to increase maternal distress; however, their impact on fetal health outcomes remains unclear. This study examined the association between maternal OCS and adverse fetal health outcomes. Using data from a longitudinal study of 256 women assessed through pregnancy and the postpartum period, we administered measures of OCS, maternal anxiety, depression, and pregnancy outcomes. Results revealed no significant associations between maternal OCS during pregnancy and fetal health outcomes. These findings indicate that maternal OCS is not a critical determinant of fetal health outcomes. These results help contribute to better understanding maternal OCS and its effects while adding to the limited body of research on this topic.Bachelor of Art