published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / abstract / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Psychiatry / Master / Master of Research in Medicine

published_or_final_version / Nursing Studies / Master / Master of Nursing

Objective: To determine: 1) 12-month prevalence rates of major depressive disorder (MDD) by race, comparing African Americans and Hispanics with whites, while controlling for covariates; 2) if there are any differences in treatment (i.e., pharmacotherapy, provider, and CAM) for MDD among African Americans, Hispanics and whites diagnosed with major depressive disorder (MDD) in the past 12 months; and 3) if there are any racial differences in DSM-IV diagnosed alcohol and/or drug abuse among those with a diagnosis of 12-month MDD. Methods: This retrospective study utilized data from the National Comorbidity Survey-Replication, which was designed to collect information on the mental health status of a nationally representative sample (n = 9282) of U.S. adults. Respondents with an MDD diagnosis in the past 12 months were included. The dependent variables were: 12-month MDD, pharmacotherapy, provider (mental health specialist), CAM and alcohol and/or drug abuse. Pharmacotherapy was examined by assessing respondents’ reported antidepressant use and whether the medication used was an SSRI/SNRI. The primary independent variable was race. Additional covariates included: age, gender, income, education, marital and employment status. Logistic regression was used to address the study objectives. Results: African Americans were significantly less likely to be diagnosed with MDD during the preceding 12-month period, when compared to whites, while controlling for covariates (OR= 0.6, p = 0.0169). Other significant variables for prevalence were female gender (OR= 1.8, p <0.0001), divorced/separated (OR= 2.0, p <0.0001) and not in the labor force (e.g., homemaker/retired) (OR= 1.5, p = 0.0033). Although African Americans and Hispanics reported lower antidepressant use, the results were not significant. With respect to SSRIs/SNRIs, African Americans reported significantly lower use, when compared to whites (OR= 0.3, p = 0.0309). Hispanics in the study were less likely to see a mental health professional (OR = 0.2, p = 0.0002). CAM use was significantly lower among individuals with less than 12 years, 12 years and 13 to 15 years of education (OR = 0.3, p = 0.0110; OR = 0.3, p = 0.0035; OR = 0.7, p = 0.0368, respectively) when compared to respondents with 16 years or more of education. When examining alcohol and/or drug use in those with diagnosed MDD in the preceding 12 months, females were less likely to be abusers (OR = 0.4, p = 0.0204). Conclusion: Among respondents with a diagnosis of MDD, race plays an important role in the types of treatment utilized to manage the disorder. Considering, the disability associated with depression, greater efforts are needed to improve antidepressant therapy for African Americans and mental health specialty treatment for Hispanics. / text

Menopause is the period during which the level of estrogen secreted by the ovaries gradually declines and patients of menopausal syndrome may experience osteoporosis, cognitive decline, hot flush, mood disorder, night sweat, depression, nervous tension and insomnia. The report published by the World Health Organization in 1990 stated that the total population of postmenopausal women in the world was 476 million. By 2030, the predicted population will reach 1200 million. The current way to relieve menopausal syndrome is hormone replacement therapy (HRT) which restores the endogenous estrogen level by administration of supplementary exogenous estrogen or estrogen plus progestin. However, various studies showed that HRT might increase the incidence of breast cancer and ovarian cancer. There is a potential risk of using HRT for menopausal syndrome. The novel protein DO isolated in this study could be a potential alternative of HRT for the treatment of menopausal syndrome. DO isolated from Chinese yam Dioscorea opposite Thunb. had adistinctive N-terminal sequence Gly-Ile-Gly-Lys-Ile-Thr-Thr- Tyr-Trp-Gly-Gln-Tyr-Ser-Asp-Glu-Pro-Ser-Leu-Thr-Glu-Ala, indicating that DO might be a novel protein.DO was an acid stable and thermal stable protein. As determined by electro-chemiluminescence immunoassay (ECLIA) detection, DO could stimulate estradiol biosynthesis in rat granulosa cells in vitro as well as inducing both estradiol and progesterone secretion in female aging Sprague Darley (SD)-rat model in vivo. From the results of real-time PCR and Western blot, the possible mechanism might be through up-regulating the expression of ovarian follicle stimulating hormone receptor(FSHR)and aromatase. DO also exerted a beneficial effect on the cognitive function through elevating the translational level of brain derived neurotrophic factor (BDNF)and TrkB gp 145 receptor in the prefrontal cortex of female aging SD-rat model. Though further pharmacological studies are required, the results in this study suggested that DO could be a safer potential alternative for HRT in the treatment of menopausal syndrome with beneficial effects on hormone levels and cognitive function. / published_or_final_version / Chinese Medicine / Master / Master of Philosophy

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