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Associations between greater perceived racial discrimination and both higher levels of depressive symptomology and higher blood pressure have been established in the literature. Research has found that depression is often comorbid with diabetes and individuals with type 2 diabetes are at an increased risk for depression as the prevalence of depression is 2 to 3 times higher in people with diabetes when compared to the general population. Additionally, individuals with type 2 diabetes are also at an increased risk for high blood pressure. Although these associations are present in the literature, no studies have been found that examine all of these variables in conjunction. The current study used data from the 2014 Health and Retirement Study to examine the associations among perceived racial/ethnic discrimination, depression symptoms, and blood pressure for older Latinx adults (ages 50+) with type 2 diabetes (n = 303) and without type 2 diabetes (n = 521), while controlling for sex, age, partner status, and education. Findings indicated diabetes status was positively associated with both depression symptoms (t(790) = 5.32, p < .001) and systolic blood pressure (t(703) = 2.74, p = .006). Racial/ethnic discrimination was positively associated with depression (r(206) = .14, p = .045); however, it was not associated with blood pressure. No statistically significant interactions were found. Discussion focuses on possible explanations for the research findings, future directions, and clinical implications.

The focus of this dissertation was the biomechanics of blast-induced traumatic brain injury (bTBI). This study had three specific aims. One of the specific aims was to investigate the thoracic mechanism of bTBI by characterizing the cerebral blood pressure change during local blast exposure to head or chest in a rat model. This model utilized a shock tube to simulate the blast wave. The results showed that there is a blood pressure rise with high amplitude and short duration during both Head-Only and Chest-Only exposure conditions. It was shown that cerebral blood pressure rise was significantly higher in Chest-Only exposure, and resulted in astrocyte reactivation, and infiltration of blood-borne macrophages into the brain. It was concluded that due to chest exposure to a blast wave, high amplitude pressure waves that transfer from thoracic large vessels to cerebrovasculature can lead to blood-brain barrier disruption or perivascular injury and consequently trigger secondary neuronal damage. The second and third aims were related to the viscoelasticity and heterogeneity of brain tissue respectively for blast rate loading conditions. For the second specific aim, a novel test method was developed to apply shear deformation to samples of brain tissue with strain rates in the range of 300 to 1000 s-1. The results of shear tests on cylindrical samples of bovine brain showed that the instantaneous shear modulus (about 6 kPa) increased about 3 times compared to the values reported in the literature. For the third specific aim, local viscoelastic behavior of rat brain was characterized using a micro-indentation setup with the spatial resolution of 350 mm. The results of micro-indentation tests showed that the heterogeneity of brain tissue was more pronounced in long-term shear moduli. Moreover, the inner anatomical regions were generally more compliant than the outer regions and the gray matter generally exhibited a stiffer response than the white matter. The results of this study can enhance the prediction of brain injury in finite element models of TBI in general and models of bTBI in particular. These results contribute to development of more biofidelic models that can determine the extent and severity of injury in blast loadings. Such predictions are essential for designing better injury mitigation devices for soldiers and also for improving neurosurgical procedures among other applications. / Mechanical Engineering / Accompanied by one .pdf file.

<p> Supervised isometric handgrip training (IHG) has been shown to lower blood pressure (BP) and therefore, may be an effective non-pharmacological treatment for hypertension. The present investigation examined the efficacy of unsupervised IHG to lower BP in patients who were recently diagnosed as hypertensive. Since the mechanisms responsible for attenuating BP remain unclear, this study also investigated the concurrent effects of IHG training on the autonomic nervous system (ANS) and arterial stiffness.</p> <p>Eight participants were randomized to the experimental group and the remaining six served as controls. Lifestyle modifications to lower BP were recommended for both groups. In addition, the experimental group completed IHG three times per week for six weeks. IHG consisted of four two-minute isometric contractions at 30% maximal voluntary contraction using alternate hands, each separated by a one-minute rest period. Pre- (PRE) and post-intervention (POST), BP was measured and the ANS was assessed by baroreceptor sensitivity (BRS) and both systolic and diastolic blood pressure variability (SBPV and DBPV) and arterial stiffness was evaluated by carotid-finger pulse wave velocity (PWV). All measures were assessed during a period of supine rest and during a 60° passive tilt.</p> <p> There were no significant changes in any BP measure from PRE to POST for either the experimental or control groups. There was a non-significant trend toward decreased heart rate (p = 0.065). BRS decreased from PRE to POST in both the experimental (10.7 ± 2.4 mm Hg to 9.7 ± 2.3 mm Hg) and control groups (8.6 ± 2.1 mm Hg to 7.6 ± 1.5 mm Hg), but there was no difference between groups. SBPV LF:HF was lower at POST than PRE in both experimental (6.8 ± 1.5 to 4.6 ± 1.1) and control (3.4 ± 1.9 to 2.3 ± 0.9), but there were no other differences in any other BPV variable. There were no significant changes in PWV.</p> <p> In conclusion, unsupervised IHG did not lower resting BP in newly diagnosed hypertensive patients, so there were no improvements in autonomic indices. There was a decrease in SBPV LF:HF indicating improved sympathovagal balance, but this was likely a result of lifestyle modification rather than IHG. Future studies are necessary to determine appropriate use of IHG as a treatment for hypertension and to verify the mechanisms responsible for BP attenuation with IHG.</p> / Thesis / Master of Science (MSc)

<p> Recent evidence suggests that isometric handgrip training improves resting arterial blood pressure (BP) in normotensive and hypertensive individuals, however the mechanisms remain elusive. The purposes of the current investigation were to replicate the finding that 8 weeks of isometric handgrip training (IHG) improve resting BP in persons medicated for hypertension, to determine if training could improve aortic stiffness and to examine the acute cardiovascular response to IHG. Seventeen participants were recruited and familiarized with the laboratory and techniques used. Training consisted of 8 weeks of thrice weekly IHG training sessions using a pre-programmed handgrip dynamometer (4, 2-minute contractions separated by 4 minutes rest). Measurements of resting ABP (assessed by automated oscillometry), aortic stiffness (assessed by simultaneous ultrasound and applanation tonometry), and the acute cardiovascular response (heart rate, blood pressure, rate-pressure product, and cardiac output) were made at baseline and following 8 weeks of IHG training.</p> <p> Following training, there were no differences observed in resting systolic or diastolic systolic blood pressure, resting heart rate or cardiac output. Furthermore, handgrip training did not improve aortic distensibility or reduce stiffness index. The acute responses of heart rate, blood pressure, rate pressure product and cardiac output were not altered with training. In response to an acute bout of IHG there were significant increases seen in heart rate (55±2 to 65±3 BPM, p<0.01), blood pressure (systolic: 137.2±3.7 to 157.1±7.3; diastolic: 77.8±3.4 to 92.2±4.8 mmHg, p<0.01) and rate-pressure product (7369.4±302.0 to 10159.0±666.6 beatsxmmHg/min). Thus isometric handgrip training is a safe modality which does not appear to alter the stiffness of the proximal aorta or generate a significant cardiovascular strain in the acute phase.</p> / Thesis / Master of Science (MSc)