Tag Archives: Health

Influence of Meal Caloric Distribution in Metabolic Syndrome Parameters Among College Students

Alexis Elinkowski, Weber State University

Purpose/hypothesis We investigated the difference in metabolic syndrome parameters among college students based on their individual caloric distributions. We hypothesize that meal calorie distribution consumption will be influential on the MetS parameters in both males and females. Methodology We assessed MetS parameters in 108 Weber State University student participants, ages 18-54 years. Two-day diet records for each participant were collected and analyzed using Diet and Wellness Plus. Participants were separated by gender (Male:33; Female:75) and by meal calorie distribution. Groups included high, medium and low % of calories in breakfast, lunch, dinner, and snacks. Correlations between MetS parameters and calorie consumption, as well as mean comparisons between meal calorie distribution groups and MetS parameters, were assessed using SPSS software. Results Significant correlations in MetS parameters and total calories were found among participants in the categories of weight (r=0.27, p=0.005), waist circumference (r=0.23, p=0.01) and systolic blood pressure (r= 0.39, p=0.0001). Women in the high calorie breakfast distribution group presented lower systolic blood pressure than women in the low or medium breakfast group (ë_= 106.3 mm/Hg, ë_= 113.2. mm/Hg, ë_= 112.01 mm/Hg p – 0.05). Men in the high snack consumer group presented higher HDL than the low snack group (ë_= 41.9 mg/dL, ë_= 29.9 mg/dL p – 0.01). Men in the high snack consumer group also presented higher blood glucose than the low and moderate snack groups(ë_= 98.9 mg/dL, ë_= 92.9 mg/dL, ë_= 91.5 mg/dL p – 0.05). Conclusion In this study, males with a higher snack calorie distribution presented higher HDL-C than the lower snack calorie distribution counterparts. It is possible that this observation is due to HDL-C promoting foods consumed as snacks. High snack consumption is linked to increased exercise which is known to increase HDL-C. In females, higher caloric intake distribution for breakfast resulted in lower systolic blood pressure compared to the medium and lower breakfast intake groups. Previous studies have shown that skipping breakfast increases cortisol levels, which may result in higher blood pressure. Furthermore, many breakfast associated foods such as milk and eggs have shown to exert blood pressure lowering effects. Consumption of such foods may play a role in the results observed in this study. Meal calorie distribution seems to have an effect on MetS parameters. Further, research elucidating possible mechanisms behind this observation such as common foods consumed for each meal and meal effects on appetite hormones are warranted.

Subtalar Kinematics in Patients Treated for Tibiotalar Osteoarthritis with Arthrodesis: A High-speed Dual Fluoroscopy Study

Spencer Kendell, University of Utah

Osteoarthritis (OA) of the tibiotalar joint is a major cause of ankle pain, and is currently treated using one of two methods: fusion of the tibiotalar joint (i.e. arthrodesis) and total ankle replacement (TAR). Although the ankle joint seems simple, it is actually comprised of two complex, articulating interfaces: the tibiotalar and the subtalar joint, which represent the interface between the tibia and talus and talus and calcaneus, respectively. While arthrodesis and TAR are able to relieve pain in the short-term, many patients develop complications from surgery that can be difficult to address. Furthermore, patients who have received a tibiotalar arthrodesis commonly develop OA in the subtalar joint, which is thought to be caused by the subtalar joint having to compensate for motion lost at the tibiotalar joint as a result of fusion. Due to the difficulties associated with measuring the motion of small bones in the foot and ankle, the precise joint kinematics of the ankle are not yet realized. This work will study the kinematic differences in the subtalar joint between subjects with non-pathological, native joints in one ankle and tibiotalar fusion in the other ankle. This will be done using dual fluoroscopy to image the ankle joints in vivo, while subjects perform a double-heel-rise activity. Computed tomography (CT) scans are acquired of each subject‰Ûªs ankles and used to create three-dimensional computerized models of the tibia, talus, and calcaneus. These three-dimensional models of the ankle bones are then synced with the dual fluoroscopy images to determine the three-dimensional (3D) position and orientation of each bone throughout the heelrise activity. These bone positions are then used to calculate joint angles and translations (kinematics) throughout the activity. The kinematics of the fused ankle will be compared to the contralateral ankle to determine the effects of ankle fusion on subtalar mobility. It is expected that mechanistic differences between the subtalar joint of the contralateral and fused ankles will lend insight into the properties and motions of the joints. Specifically, it is hypothesized that tibiotalar arthrodesis will lead to compensatory hypermobility in the subtalar joint, since it is adjacent to the fused tibiotalar joint. Hypermobility of these adjacent joints may contribute to the development of OA in these joints, as observed clinically. Such findings will promote the development of improved surgical planning tools and novel techniques to treat tibiotalar OA.

QUALITY OF HISPANIC ORAL HEALTH IN THE U.S.: PERCEPTIONS OF DENTISTS AND A CALL FOR IMPROVEMENT

Mitchell Merrill, Brigham Young University

An examination of the perceptions of U.S. dentist‰Ûªs regarding the quality of Hispanic oral health in the United States. This thesis investigates both the dentist‰Ûªs potential for making positive change and the challenges that stand in their way in improving the state of Hispanic oral health. Twelve dentists were spoken with by phone to discuss three main questions. Those chosen for the calls practice in the top ten states with the highest percentage of Hispanics. An analysis was conducted of the recorded calls that consisted of comparing each response with patient demographics, practice location and years of experience. Responses were categorized and analyzed numerically in graphs to study trends and patterns. Patient education and pro bono dental work were the top two most frequently mentioned responses regarding how dentists can improve Hispanic oral health. They were also the top two most mentioned responses regarding the difficulties dentist‰Ûªs face in making a positive difference. 66% of dentists thought that Hispanic oral health was not ‰ÛÏworse than the general U.S. population‰Û while 33% thought that Hispanic oral health was worse. Given the divided responses, the perception amongst dentists about Hispanic oral health quality in the U.S. varies greatly. This suggests that many oral healthcare professionals are likely unaware or incorrectly informed of the demographics that are most struggling. This identifies the need to make sure dentists across the U.S. stay better educated on issues of race, ethnicity and culture within the world of oral health.

Mechanical Testing of Novel Anterior Vertebral Clamp

Arianna Reay, Aubrie Taylor, Brigham Young University

Degenerative Disc Disease is a common and even debilitating source of back pain. A common treatment for low back pain is spinal fusion, which involves two separate surgeries‰ÛÓone anterior, the other posterior‰ÛÓin which the patient‰Ûªs degenerated disk is removed and replaced by bone graft. Current surgeries typically employ the use of thick screws, which are destructive to the vertebrae and must be installed posteriorly because they are unable to maintain stability in the mostly porous material of the vertebral body. Success and patient satisfaction rates with spinal fusion are comparatively low, and recent research suggests that after spinal fusion, neighboring spinal disks begin to degenerate more quickly. Our research involves the mechanical testing of a novel, compliant-mechanism vertebral clamp that would be used to attach anteriorly to the vertebral body, enabling a single surgery approach to spinal treatment that does not permanently damage the vertebrae. We hypothesize that the clamp can maintain secure fixation under the severe loading of the lumbar spine by attaching to the anterior side of the vertebral body‰Ûªs sturdy cortical shell without penetrating the delicate, porous interior. Our research involves the mechanical testing of this clamp in the primary modes of spinal loading (compression, lateral bending, extension and flexion, and axial rotation). Loads are applied using a custom spine tester that maintains the segmental instantaneous screw axis and allows for the application of a compressive follower load to simulate the dynamic muscle forces and torso weight imposed upon lumbar spine during activities of daily living. The clamp will be tested in isolation to validate the analytical and numerical models used in its design. Subsequently, it will be tested when attached to a vertebrae to measure fixation strength during spinal motion. This work paves the way for future pre-clinical and clinical testing.

Kinematics of Hip Joints with Cam Femoroacetabular Impingement

Joseph Hartle, University of Utah

Femoroacetabular impingement (FAI) is one of the most prevalent causes of osteoarthritis of the hip. Cam FAI is an orthopaedic pathology characterized by abnormal bony growth on the femoral head-neck junction. Cam FAI is thought to limit range of motion, which may result in chondral lesions and extensive labral tears. The purpose of this project was to quantify the variance in kinematics and the location of the hip joint center (HJC) between hip joints with cam FAI and asymptomatic controls using dual fluoroscopy (DF). For this DF study, 6 cam FAI patients and 11 control subjects were recruited. For each subject, hip joint kinematics were determined using DF. First, computed tomographic (CT) images were obtained for each subject. The images were segmented to delineate the bony surfaces and converted to 3D digitally reconstructed radiographs (DRRs). For the capture of bone movement, subjects performed activities in the combined field of view of two fluoroscopes, which collect x-ray video data. Specifically for identification of the HJC, subjects performed the StarArc pattern with their leg. This activity provided a large range of motion that allowed accurate determination of hip joint kinematics and the HJC location. After data capture, the DRR was matched to the DF data during the markerless tracking process. The data was processed in Matlab to provide visualization of the kinematics using subject-specific bone reconstructions in Postview. Abnormal, aspherical morphology of the femoral head in patients with cam FAI may cause the femoral head to translate more within the joint while also limiting the range of movement. Therefore, patients with cam FAI are expected to display a greater degree of translational motion of the HJC and a lower degree of rotational motion than control subjects. DF techniques provide arthrokinematics of the hip, which is how the joint moves in vivo relative to subject-specific bone anatomy. Using this data as a gold standard, errors in the calculation of the hip joint center using standard motion capture techniques can be measured. This method can be applied to help us better understand the kinematics of cam FAI and how the asphericity of the femoral head can cause pain and cartilage erosion which is associated with osteoarthritis.

Modeling Ebola Outbreaks: Analyzing the Effects of Contact Tracing

Alexander Mitchell, Dixie State University

Ebola is a disease transmitted by contact with the bodily fluids of those infected and can lead to internal bleeding, organ failure, and death. One method used to suppress the spread of Ebola is contact tracing, which consists of documenting and quarantining those who have come into contact with an infected individual. To understand the spread and containment of Ebola, we need to better understand the relationship between the suppression of the disease and the use of contact tracing, which is the focus of this project. We developed a mathematical model utilizing a system of differential equations with the goal of investigating how contact tracing affects transmission dynamics and outbreak behavior, specifically as it relates to the 2014-2016 Ebola Zaire outbreak. We then validated our model with data from the World Health Organization and used sensitivity analysis to quantify the usefulness of the different aspects of contact tracing. Furthermore, we applied matrix theory to explore the dynamics of our model and ran numerical simulations to verify the model‰Ûªs predictions and explore the use of multiple control strategies in effectively containing the Ebola virus. As a result we found that contact tracing has a large effect on the epidemic when used between 150 and 800 days into the epidemic, and has little effect outside of this time range. The results from this model can be used to help optimize the allocation of resources in future Ebola outbreaks.

Synthesis and Examination of Chalcone Derivatives for Antitumor Activity

Brian Farnsworth, Parker Ferguson, Tracy Covey, Weber State University

Chalcone compounds have been found effective at inhibiting the growth of cancer cell lines. In an attempt to discover structure-activity relationships, mechanism of action and create more potent anti-tumor substrates, portions of the original chalcone structure have been modified and tested for anti-cancer activity. So far it has been discovered that substituting the 1-phenyl group with hydrogen, to produce cinnamaldehyde, or with an ester or nitro group, yielded a substrate with greater anti-tumor activity than chalcone itself. The lack of activity of substrates without the alkene group, suggests the mechanism of action involves a Michael reaction. Substrates were generally formed using an aldol condensation or esterification of cinnamic acid, using DCC and a suitable alcohol.

Oral Health Programs for Uninsured Free Clinic patients

Clayton Booth, Mitch Johansen, University of Utah

Oral health is an important aspect of systemic health as well as emotional and mental health. Uninsured and low income populations are at particular risk for poor oral health. The purpose of this research is to examine the effectiveness of an oral health class amongst low income and uninsured populations utilizing a free clinic in Salt Lake City, Utah. Oral health classes are offered once a week (several separate sessions each time) at a free clinic from September to November 2017. Each participant fills a pre-class survey that includes oral health history and access to dental care, attends a 20 minute oral health class, and answers a post-class survey about the satisfaction of the class. Field notes were also taken during the class. The classes are offered in English and Spanish. All materials are also available in English and Spanish. Overall, the participants were highly satisfied with the class. They learned new things about home dental care such as how to brush properly and what kinds of tooth paste they should use. Since, at this point, the free clinic does not provide dental treatment, access to dental treatment is very challenging for the patients of the clinic. Low income and uninsured populations need to be better informed of resources for low cost dental treatment. Home dental care classes seem to be effective for such populations to better take care of their teeth and gums, and should be widely available for underserved populations.

Patient adherence to provider recommendations and medication among uninsured free clinic patients

Jazmine Hurley, University of Utah

The purpose of this study is to examine patient adherence to provider recommendations and prescription drugs among uninsured free clinic patients. Patient adherence to provider recommendations and prescription drugs are very important to manage chronic illnesses, but uninsured free clinic patients tend to have low levels of health literacy and may have a problem of not adhering to direction. Data is collected using a self-administered paper survey at the Maliheh Free Clinic, Salt Lake City in the fall of 2017. Patients of the clinic who are aged 18 or older and speak English or Spanish are eligible to participate in the survey. As October 11, 2017, 369 patients participated in the survey. Approximately half of the participants reported that they were able to adhere to doctor instruction most, or all of the time. For specific recommendations, the adherence rates were 17% for exercising regularly, 41% for taking prescribed medication, and 17% for a low fat or weight loss diet. Less than half of the participants (43.8%) reported they had never forgotten to take medicine. While half of the patients were able to adhere to provide, recommendations the other half were unfortunately unable to follow recommended instruction. The low adherence rates suggest potential preventable negative effects on patient health in the uninsured and health illiterate community. Free clinics benefit the health of the uninsured greatly, but if patient adherence rates were able to rise, chronic health conditions of this population would be much improved.

The Benefits of Culturally Adapted Mental Health Treatments: A Meta-Analysis

Juan Valladares, Hanna Prieto, Niyeli Herrera, Yerina Flores, Brigham Young University

The goal of this meta-analysis is to establish the overall comparative efficacy of culturally adapted mental health treatments. Mental health care given to ethnic minorities has been a central focus of those seeking to improve psychological and therapeutic care. Cultural values, ideas, and beliefs may affect the way an intervention is received and therefore its ultimate effectiveness. The influence of culture is present across all aspects of psychotherapy, impacting the theoretical conceptualization, delivery, and assessment of an intervention. Tailoring and modifying mental health treatments to better fit clients‰Ûª cultural needs is commonly known in the literature as cultural adaptations. Through the process of cultural adaptation, (1) the cultural and historical biases and assumptions that are inherently intertwined in psychotherapy are addressed and (2) empathic attunement to the client‰Ûªs culture facilitate the successful reception of the mental health treatment. Although various cultural adaptations of mental health treatments have added to the existing literature, there is an impending need to examine these studies together in order to provide empirically supported recommendations to guide practice. To address this need, we conducted a meta-analysis to establish the relative effect of those mental health interventions that have been explicitly adapted to clients‰Ûª racial, ethnic, or cultural backgrounds. We conducted a number of searches through various electronic databases in an attempt to grasp the totality of the literature on this subject. We included studies that used experimental or quasi-experimental research designs comparing mental health treatments that were culturally adapted to those that did not contain cultural adaptations. We examined only interventions that explicitly intended to improve emotional or psychological well-being. Data was extracted from 99 studies, containing 13,183 individuals, and the aggregate random effects weighted effect size was d = 0.499 (se = .039, 95% CI = 0.42 to 0.58, p < .0001). The types of cultural adaptations reported in individual studies varied substantially, both in terms of the number of adaptations and in terms of the specific types of adaptations. In addition, Egger‰Ûªs regression test (an estimate of effect size asymmetry) was statistically significant (p < .001), providing evidence of publication bias which was statistically accounted for in our overall results. We review the importance of this research in terms of its implications in training, therapeutic practices, and research construction. Ultimately, cultural adaptations to mental health treatments prove somewhat more effective than treatment as usual with clients of color in North America.