Breast cancer affects 1 in 8 women and can be deadly; yet when detected early enough it is often treatable. Thus, early detection of breast cancer is imperative to save lives. The success of early detection depends, in part, on being able to stratify risk. A new approach to determining risk involves identifying genetic variants that alter an individual’s risk for developing breast cancer. This thesis identified key functional candidates involved in breast cancer development, some of which have been verified by other studies. For a few of the functional candidates, further research needs to be done in order to determine the biological significance they play in the development of breast cancer. The functional candidates were identified by comparing SNPs in Linkage Disequilibrium with high risk SNPS—determined by GWAS—using histone modification markers to identify functional genomic elements in breast cell lines. The results yielded three top tier candidates and multiple second tier candidates. Further research should be done in order to assess the risk involved with these variants and the underlying biological mechanism. As genetic testing becomes more accessible to the public, the identification and understanding of these high risk variants will be an essential tool in preventing and treating breast cancer.

A test of standing broad jump ability was administered to ninety-three sixth grade boys to compare the kinesthetic and demonstration methods of instruction. The subjects were classified on the Neilson-Cozens Classification Index and divided into three groups. The first group received the kinesthetic method of instruction, the second group was instructed using the demonstration method, and the third group did not receive any formal instruction. The data were examined by computing the mean and standard deviation of each pre-test and post-test group. The mean and standard deviation of the pre-test scores were 60.61 and 7.589. The mean and standard deviation of the post-test scores were 61.31 and 7.397. When each pre-test score was subtracted from its corresponding post-test score it was revealed that the demonstration group showed an increase in performance of eighteen boys, the kinesthetic group increased by sixteen boys and the group receiving no formal instruction increased by seven boys. Analysis of variance of matched groups revealed an F ratio of 2.68 which was not significant at the .05 level. An alternate approach was attempted in which the effect of the pre-test scores were partialled out from the post-test scores. Subjected to matched group analysis of variance design indicated an F ratio of 2.68 which was not significant at the .05 level. The resu1ts of a randomized group analysis without matching revealed an F ratio of 2.68 which was quite similar to the previous results and also insignificant at the .05 level. Randomized group analysis without matching between post-test scores and the regression equation indicated an F ratio of 2.72 which again was found insignificant at the .05 level of significance. It was found that no statistically significant difference could be obtained by use of one instructional technique exclusively in preference to another.

Pain and distress/anxiety are likely to result from breast cancer and/or the medical treatment associated with this illness. Breast cancer researchers have focused on massage therapy and its influence on pain and distress in breast cancer patients; however, these research efforts were limited by small sample sizes, homogeneous populations, and small to medium effect sizes. This study explores the effectiveness of massage therapy for decreasing pain and distress in a larger, heterogeneous population of breast cancer patients and across all durations and frequencies of treatment by pooling the findings of former studies. The gate control theory which relates to the experience of pain, the psychotherapy theory which suggests massage acts much like psychotherapy, and the physical touch theory all suggest that massage may decrease pain and distress/anxiety. In order to be included in the meta-analysis, the study needed to be printed in English between the years 2004 and 2012, use the same variables and same method of treatment, and report an effect size or statistics that allowed for effect size calculation. The meta-analysis was quantitative and the effect sizes for each study were calculated using Comprehensive Meta-Analysis (CMA) software. CMA also calculated the overall pooled effect size. Findings indicated that individual studies showed some improvements in pain and distress after receiving treatment; however, when pooled, the results indicated that massage therapy did not significantly improve levels of pain and distress in breast cancer patients. Although findings were non significant, the use of massage therapy improved symptoms of pain and distress in breast cancer patients.

Oxytocin is a neurohormone that has been correlated with lactation, uterine-contractions, postpartum behavior, pro-social behavior, trust, empathy, and decreased anxiety. In addition, oxytocin is believed to underscore the tend-and-befriend response to stress. In this study, adrenocorticotropic hormone (ACTH), cortisol and oxytocin levels were measured in response to a social stressor in human participants. Oxytocin was initially seen to increase with ACTH and cortisol in response to a social stressor. As levels of oxytocin increase, levels of ACTH and cortisol were shown to decrease or plateau. I conclude that oxytocin is released in response to a perceived stressor and display inhibitory effects over ACTH and cortisol.

The purpose of this study was to uncover the experience of health care providers (HCPs) as they work with fathers of children who are overweight and obese in the outpatient setting. Interpretative phenomenological analysis was used for data collection and analysis in this study. Seven HCPs were interviewed about their experiences. Two major themes emerged from the experiences of these HCPs: "dad in the backseat," and "paternal resistance." The theme of "dad in the backseat" captured to the HCPs' perception of parental roles and related stereotypes with respect to fathers' lack of presence in the health-care setting, family roles that relegate fathers to the backseat in dealing with this issue, and the tendency of fathers to take a passive role and defer to mothers in the management of their child's weight. "Paternal resistance" reflected the perceived tendency of the father to resist the acceptance of their child's weight as a problem, and to resist change and even undermine family efforts to make healthier choices. Health care providers' experiences of fathers as having a minimal role in the management of their child's overweight and obesity may lead them to neglect fathers as agents of change in this important issue.

Objective: This purpose of this study was to describe pediatric medical residents' knowledge of oral health and dental-referral behavior and to examine factors that may influence whether providers can identify tooth decay, provide risk assessment or refer children to dental providers. The objective was to provide baseline data of pediatric medical residents prior to receiving the oral health education and training in the provision of preventive oral health services.Methods: This project utilized a cross-sectional prospective cohort study design. An oral health knowledge and referral behavior questionnaire was delivered to pediatric medical residents in training at two academic health centers. This project aimed to describe pediatric medical residents' knowledge of oral health and dental referral behavior as measured by the questionnaire. This study was designed to provide baseline information for a larger project called "Bright Smiles" developed by the Virginia Department of Health's Division of Dental Health. The self-administered questionnaire focused on extracting knowledge and opinions of residents and faculty in selected areas of infant oral- health services along with their confidence in providing these services. Results: The frequency of dental examinations correlated with how often providers see tooth decay in infants and toddlers. The frequency of examining for signs of dental decay was correlated with confidence in detecting tooth decay. The frequency of assessing the potential for developing tooth decay in infants and toddlers was correlated with the providers' confidence in evaluating risk of tooth decay. All above findings were correlated to a statistically significant value. Conclusion: Providers, while able to identify tooth decay in infants and toddlers, lack confidence in the ability to refer children to dental providers and the ability to perform certain aspects of oral-health risk assessment.

Background: Arthritis interferes with quality of life, results in enormous medical and social costs, and is the leading cause of disability in the United States. Overweight and obesity have been found to be associated with specific types of arthritis, but the relationship between excess body weight and arthritis in general has not been well characterized at the population level. Furthermore, previous studies failed to utilize the CDC validated surveillance case definition of arthritis. Objectives: To examine the association between body mass index (BMI: kg/m2) and arthritis using the CDC validated surveillance case definition of arthritis and to describe the prevalence of arthritis across population subgroups based on body mass index and other select characteristics. Methods: Cross-sectional data from the 2005 Behavioral Risk Factor Surveillance System survey were analyzed. Using population weights, descriptive statistics and prevalences were generated. Univariate and multivariate analyses with 95% confidence intervals (CI) were conducted to examine the risk estimates (odds ratios/ORs) and to assess the relationship between body mass index and arthritis among U.S. adults, (N=356,112). SAS 9.1 software was used for all analyses.Results: Overall, 26% of US adults had self-reported arthritis. Obese persons (BMI: >30) were 2 times more likely to report arthritis compared to normal weight respondents, (BMI: 40): OR= 3.1, 95%CI= 2.9, 3.4; Class II Obesity, (BMI: 35-39.9): OR=2.4, 95% CI= 2.3, 2.6; Class I Obesity, (BMI: 30-34.9): OR= 2.0, 95% CI= 1.9, 2.1] The association between the BMI groups and arthritis did not change significantly after taking demographic and socioeconomic variables into account. Older age, female gender, higher income, and lack of any physical activity were associated with a higher odds of reporting arthritis, while insurance status and being non-White were not.Conclusions: BMI is an important independent risk factor for self-reported arthritis. Resources must be allocated to prevent and reduce weight gain in the population, especially among women and younger adults.

The purpose of this study was to explore how stereotypes affect physical performance in older adults. A multigroup pretest post test design was utilized to determine whether implicit activation of positive or negative stereotypes has an effect on physical performance. Ninety six community dwelling older adults 65 years of age or older were included in the sample. Participants were randomly assigned to one of three groups: exposure to positive stereotypes of aging, exposure to negative stereotypes of aging, or a control condition. In order to simulate how older adults are exposed to stereotypes in real world settings, participants were primed with objects representing aging stereotypes. Gait speed, standing balance, and lower extremity muscle performance were tested before and after exposure to stereotypes. Results of MANCOVA analysis, using self-relevance as a covariate, revealed no significant differences between those exposed to positive stereotypes, negative stereotypes, or the neutral condition. Physical performance is not affected by exposure to implicit stereotypes of aging in a more real world setting. In real world settings, there are multiple factors, like motivation and self-focus, competing for the control of behavior which are not present in the lab. These psychosocial factors may lessen the effect of stereotype activation on physical performance

OBJECTIVE:To compare and contrast patients that receive treatment following an osteoporotic fracture to those patients that do not. METHODS:Data were taken from the Medical Expenditures Panel Survey (MEPS). Subjects who reported a wrist, vertebral, or hip fracture were identified. Prescription data were assessed for these subjects and two groups were identified: those who received treatment following a fracture and those who did not. RESULTS:The final sample consisted of n=129 subjects. Of these subjects, only 38% received treatment following an osteoporotic fracture. The only variable showing significant effects on treatment were type of insurance coverage. There was evidence of a relationship for other variables: race, inability to obtain necessary prescription medicines, family income, vertebral fracture and patient's perceived health.CONCLUSIONS: Overall treatment rates following a fracture remain low. Substantial efforts should be made to close the gap between guideline recommendations and clinical practice.

The purpose of this study was to compare the antimicrobial effect of MTAD, two of its components, doxycycline and citric acid, and NaOCl on E. faecalis in two in vitro models: the bovine tooth model and the agar diffusion model. In the tooth model, the lumens of thirty bovine dentin discs were standardized, autoclaved and infected with E. faecalis for 14 days. The infected dentin discs were treated with either MTAD, doxycycline 100mg/ml, 10% citric acid, 5.25% NaOCl or saline for 10 minutes. Dentinal shavings were collected using sterile 037 and 040 round burs. The number of bacteria in the shavings was enumerated by overnight CO2 culturing on TSA agar plates. For the agar diffusion model, E. faecalis was plated before placing paper discs wetted with three dilutions of each irrigant. The zone of inhibition was recorded after overnight culture. The data were analyzed with a two-way ANOVA and Tukey-Kramer post-hoc test. In the bovine tooth model, NaOCl and doxycycline were more effective than control in killing E. faecalis at the shallow bur depth but at the deeper bur depth, only NaOCl was significantly more effective (psE. faecalis.