Browsing by Subject "Preventive Medicine"
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Item Activities of Daily Living and Cardiovascular Risk Factors' Impact on Cardiovascular Disease (CVD) and Cognitive Functioning: A Three Stage Longitudinal Model(2005-05-01) Bozo, Ozlem; Guarnaccia, Charles A.; Hall, James; Kelly, KimberlyBozo, Ozlem, Activities of Daily Living and Cardiovascular Risk Factors’ Impact on Cardiovascular Disease (CVD) and Cognitive Functioning: A Three Stage Longitudinal Model. Doctor of Philosophy (Health Psychology), May, 2005, 122 pp., 23 tables, 4 figures, references, 50 titles. The purpose of this study was to examine the longitudinal relationship of daily living (ADL), cardiovascular risk factors, and cardiovascular diseases to predict the future cognitive functioning of older Americans who are between the ages of 51 and 61 at the time of initial assessment. Three waves of the Health and Retirement Study (HRS) database between the years of 1992 and 2002 were examined with path analysis. The longitudinal hypotheses of the study were that (1) ADLs would positively predict future cognitive functioning, (2) ADLs would negatively predict future cardiovascular risk factors, (3) ADLS would negatively predict future cardiovascular diseases, (5) cardiovascular risk factors would negatively predict future cognitive functioning, (6) cardiovascular disease would negatively predict future cognitive functioning, (7) cardiovascular risk factors would mediate the relationship between ADLS and cardiovascular disease, and (8) cardiovascular disease would mediate the relationship between cardiovascular risk factors and cognitive functioning. The results of the analyses indicate that there was no effect of cardiovascular disease on cognitive functioning; however, there were significant effects of cardiovascular risk factors on cognitive functioning that ranged between B=-/021 and B=-/145. Moreover, it was found that cardiovascular risk factors mediate the relationship between ADLs and cognitive functioning, while cardiovascular disease does not. These results suggest that addressing cardiovascular risk factors may be more important than addressing existing cardiovascular disease to protect future cognitive functioning. This shows the importance of primary/secondary prevention versus tertiary interventions.Item Analysis of the Clinical Research Methodologies Employed During a Phrase Three Efficacy Study for Ultracet as a Post-Herniorrhaphy Analgesic(2001-08-01) Aguilar-Zanatta, Jorge; Rustin Reeves; Don Peska; Della WeisThe history of pain management stems back many thousands of years. However, not until recent times have significant advancements in biochemistry and pharmacology allowed analgesics to be incorporated in clinical interventions and everyday life. Due to these advancement, attempts to refine pharmacological action on receptors in terms of specificity would render medications with fewer side effects. The technology is present, but the application and development of modern analgesics in post-surgical settings is substandard. According to C.L. Ireson and R.W. Schwartz, (2001), the outcomes of ailment interventions in the United States are “…no better and in numerous situations worse that those achieved in other countries,” even though the United States has the most expensive healthcare in the world. Furthermore, a study performed by Carr et al. (1998), has identified the United States as demonstrating consistent inadequacies in postoperative pain management. Several factors have been identified as being contributors of poor post-surgical pain control in America. Lack of awareness of the available strategies in acute pain control and its implementation in post surgical care are labeled as being problematic observations (Puid et al., 2001). In response to these conditions as well as the managed health care time and cost limitations, new and efficacious pharmaceuticals must be made available to a broad spectrum of socio-economic strata. Currently, there is a great debate over the use of laparoscopic herniorrhaphy versus open tension free approaches. In terms of cost, the laparoscopic herniorrhaphy versus open tension free approaches. In terms of cost, the laparoscopic herniorrhaphy versus open tension free approaches. In terms of cost, the laparoscopic procedure is more expensive and yields less postoperative pain, however the open tension free approaches are less expensive and yield more postoperative pain (Sarli et al., 2001, Medical Research Council Laparoscopic Groin Hernia Trial Group, 2001, Parviz et al., 1995). There are advantages and disadvantages to both procedures. Assuming that efficacious postoperative analgesics were available, the open tension free repair would be more feasible in terms of cost and hernia recurrence rates (Sarli et al., 2001). In terms of pharmaceutical development, the laws and guidelines by the regulatory agencies such as the Food and Drug Administration, institutional review boards, and pharmaceutical sponsor protocols must be followed. Along with good clinical practice standards, interdisciplinary collaboration in pain studies produce results that are statistically and clinically salient. The patient’s well-being and comfort is the ultimate goal in clinical pain studies and in medicine in general, therefore postoperative pain should be aggressively managed.Item Clearfield, Michael, D.O.(1994-02-22) Clearfield, Michael; Hailey, BlakeDr. Clearfield, Chairman of the Department of Medicine, began at TCOM in 1979. He discusses his long career with TCOM, his research and his thoughts on the school's future. Interviewed by Blake Hailey, February 22, 1994Item Cunniff, Nelda, D.O.(1985-11-05) Cunniff, Nelda; Stokes, C. RayAfter her career as an R.N., Dr. Cunniff entered TCOM as the only female student in its first graduating class (1974). She describes her 10 years of semi-rural general practice in Burleson, Texas. Dr. Cunniff serves on the board of the TCOM Foundation and is active in the TCOM Alumni Association. Interviewed by C. Ray Stokes, November 5, 1985.Item Effects of Cardiorespiratory Fitness on Serum Ferritin Concentration and Type 2 Diabetes: Evidence from the Aerobics Center Longitudinal Study (ACLS)(2008-05-01) Le, Tuan D.; Sejong Bae; Karan Singh; Steven BlairLe, Tuan D., Effects of Cardiorespiratory Fitness on Serum Ferritin Concentration and Type 2 Diabetes: Evidence from the Aerobics Center Longitudinal Student (ACLS). Doctor of Public Health (Clinical Research). May 2008, 114 pp., 12 tables, 8 figures, bibliography, 68 titles. Recent studies suggest that an elevated serum ferritin concentration is considered an independent factor associated with increased risk of type 2 diabetes and cardiorespiratory fitness (CRF) is inversely associated with diabetes. Using secondary data from Aerobics Center Longitudinal Study at the Cooper Institute, Dallas, Texas, the author explored the association between serum ferritin levels and diabetes, CRF and diabetes, and the effect of CRF on the association between serum ferritin levels and diabetes. A cross-sectional study and a longitudinal cohort study were used. In the cross-sectional study, an increased CRF level found to be associated with a decreased serum ferritin concentration and a lowered prevalence of type 2 diabetes. Participants with high ferritin levels and high triglyceride levels were 1.89 and 1.57 times more likely to have diabetes respectively. Overweight or obese individuals were 1.35 to 1.40 times more likely to have diabetes. Participants with a family history of diabetes were 3.69 times more likely to have diabetes. Participants in the highest CRF quintile levels were 40% and 15% less likely to have type 2 diabetes among persons with normal and high blood glucose, respectively. In the prospective cohort study, it was found that serum ferritin might predict the development of type 2 diabetes in males and high serum ferritin concentration levels. The incidence rate among males increased with serum ferritin quartile (ptrend [less than] 0.05). A reduction of serum ferritin concentration was associated with a reduction of diabetes risk in those participating in physical activity. It suggests physicians might use patients' serum ferritin concentrations as a marker for predicting risk for new-onset diabetes and patients should be encouraged to participate in physical activities.Item Gracy, Robert, PhD.(1994-01-26) Gracy, Robert; Hailey, BlakeDr. Gracy, Associate Dean of Basic Sciences and Research, recounts the process of bringing TCOM and North Texas together. Interviewed by Blake Hailey, January 26, 1994Item Jennings, Virgil L., D.O.(1988-12-01) Jennings, Virgil L.; Stokes, C. RayDr. Jennings, a GP in the Fort Worth area since 1946, now specializes in preventative medicine, and is a founder of the International Academy of Preventative Medicine. Dr. Jennings, a founding staff member of Fort Worth Osteopathic Hospital, built and operated Hurst General Hospital (now Northeast Community Hospital) in Hurst, Texas, from 1959 until 1981. Interviewed by C. Ray Stokes, December 1, 1988.Item North Texas Health & Science - 2011, Issue 1(University of North Texas Health Science Center at Fort Worth, 2011-01-01)Item North Texas Health & Science - 2012, Issue 1(University of North Texas Health Science Center at Fort Worth, 2012-01-01)Item North Texas Health & Science - 2012, Issue 2(University of North Texas Health Science Center at Fort Worth, 2012-06-01)Item North Texas Health & Science - 2013, Issue 1(University of North Texas Health Science Center at Fort Worth, 2013-01-01)Item Ogilvie, Charles D., D.O.(1984-01-18) Ogilvie, Charles D.; Stokes, C. RayThe first chairman of the department of medical humanities at TCOM and professor of radiology, Dr. Ogilvie retired from the full-time faculty in 1981 to return to his role as a country doctor in East Texas. He shares his experiences at TCOM as chairman of the Curriculum Committee, including the activities of the Task Force on Educational Goals, which designed the current TCOM Goals Statement and fostered the college’s innovative health-oriented medical curriculum. Interviewed by C. Ray Stokes, January 18, 1984Item Racial and Ethnic Differences in Cardiovascular Disease Risk Factors in U.S. Older Women: Findings from the Behavioral Risk Factor Surveillance Survey(2006-08-01) Kurian, Anita K.; Sejong Bae; Karan Singh; Kristine LykensKurian, Anita K., Racial and Ethnic Differences in Cardiovasular Disease Risk Factors in U.S. Older Women: Findings from the Behavioral Risk Factor Surveillance Survey, 2003 & 2004. Doctor of Public Health (Clinical Research), August 2006, 118 pp., 55 tables, 14 illustrations, references, 69 titles. Objectives- The study sought to determine if there were any significant racial and ethnic differences in six modifiable cardiovascular disease risk factors in women aged 65 years and older. It also examined the dynamic relationships of race/ethnicity, socioeconomic status and cardiovascular risk factors. Methods- Data were extracted from the merged 2003 & 2004 Behavioral Risk Factors Surveillance Survey (BRFSS). Prevalence estimates and 95% of each of the six cardiovascular disease risk factors considered (Hypertension, Diabetes, Obesities, Hypercholesterolemia, Smoking, and No leisure-time physical activity) were calculated by race/ethnicity. Multinomial (for indicator outcomes) and multiple logistic regression analyses (for binary outcomes) were performed. Path analysis was performed to assess the complex pathways by which race/ethnicity and socioeconomic status (SES) were associated with cardiovascular disease risk factors. Results- Of the 77,492 survey respondents included in the sample, there were 68,251 whites, 4,912 blacks, 3,656 Hispanics and 673 AIANs. The odds of the cardiovascular risk factors were higher in race/ethnicity minority women (non-Hispanic black, Hispanic, American Indian Alaskan Native) compared to white women aged 65 years and older. Socioeconomic status was found to be a moderator rather than a mediator of the relationship between race/ethnicity and cardiovascular disease risk factors. The re-specified model with the behavioral risk factors (smoking and no leisure-time physical activity) as mediators was deemed a good fit to the data. Age, race/ethnicity, SES, smoking and leisure-time physical activity were found to have significant direct, indirect and total effects on cardiovascular disease risk factors. Conclusions- There is a need to find better ways to measure race/ethnicity, and future research should consider the impact of more fundamental determinants of CVD risk factors. Area-based measures, such as neighborhood conditions, should also be given consideration for influencing these risk factors. Identification of potential mediating and moderating factors in these pathways (for example, sense of personal control or social support) will help clinicians and public health professionals to develop culturally sensitive intervention or prevention programs specifically targeted toward risk burdens in each of these populations.Item Risk for Stroke Among Migraine Sufferers(2001-05-01) Hall, Rebecca G.; Antonio Rene; Manuel BayonaHall, Rebecca G., Risk for Stroke Among Migraine Sufferers. Master of Public Health (Epidemiology), May, 2000, 27 pp., 9 tables, references, 33 titles. The objective of this study was to investigate, using the National Health Interview Survey (NHIS), whether those who suffer from migraine or severe headache do. Odds ratios were calculated for stroke among migraine sufferers compared to those who do not suffer from migraine. Results were adjusted for age, gender, and race. Risk factors for stroke were also analyzed. The crude odds ratio for stroke among migraine sufferers compared to non-migraine sufferers is 2.17, increasing 3.77 with age-adjustment. These results suggest that vascular events that are associated with migraine may also be associated with an increased risk for stroke. Discovering the mechanism that generates this relationship has widespread implication to the population and may save taxpayers billions of dollars annually be leading to better treatments for and possible prevention of migraine.Item Street, E. Bruce, Sr.(1989-03-16) Street, E. Bruce; Stokes, C. RayMr. Street, a member of the UNT/TCOM Board of Regents since 1975 and a recipient of the TCOM Founders Medal in 1981, shares his interest in preventative nutrition. A former mayor and president of the Chamber of Commerce of Graham, Texas, Mr. Street promoted his interest by establishing the annual Roger J. Williams Award in Preventive Nutrition with gift of $50,000. Interviewed by C. Ray Stokes, March 16, 1989Item Synergy 2010: Annual Research Report(2010-01-01)Item Synergy 2011: Annual Research Report(2011-01-01)Item The Effects of Cardiorespiratory Fitness and Body Mass Index on the Development of Osteoarthritis in Women(2001-05-01) Hathwar, Supriya; Sally Blakley; Steven Blair; Antonio ReneHathwar, Supriya, The Effect of Cardiorespiratory Fitness and Body Mass Index on the Development of Osteoarthritis in Women, (ACLS 1970-1999). Master of Public Health (Epidemiology), May, 35 pp., 6 tables, references, 48 titles. Osteoarthritis (OA) of the hip and knee is one of the most important causes of pain and disability affecting nearly 21 million people in the United States. Obesity is one of the primary causes of secondary osteoarthritis especially of the hip and knee. (Felson, 1992). The aim of this prospective cohort study is to determine whether higher levels of CRF reduce the risk of development of OA in women across different body mass index (BMI) levels. The study population consisted of 3847 women, ages 20-87, examined at the Cooper Clinic, Dallas, Texas between 1970 and 1999. There were 379 cases of physician-diagnosed OA during 31,657 woman-years of follow-up. After adjustment for age, exam year and health status, obesity and overweight were found to be significant predictors of OA in women. At all levels of CRF, the odds of developing OA increase as weight increases. In the overweight category, the odds of developing OA are 80% higher among the low-fit women [OR=1.8,95% CI (1.1-3.1)], and 60% higher among the moderately fit women [OR=1.6,95%CI (1.0-2.3)] compared to high fit, normal weight women. In the obese category, the low-fit and the high fit women had the same odds of developing OA (OR=2.6), while moderately fit women had lower odds of developing OA (OR=1.7). These data suggest that CRF is not a consistent predictor for development of OA in women.