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The serine/cysteine protease inhibitor phenylmethylsulfonyl fluoride (PMSF) has been used both to promote and to protect against neuropathic events of organophosphorus-induced delayed neuropathy (OPIDN) in hens (Lotti et al., 1991; Veronesi et al., 1985; Pope and Padilla, 1990; Pope et al., 1993). This study expands upon this work by correlating clinical and neuropathological findings in these modifications of OPIDN. To provide appropriate models of OPIDN, single phenyl saligenin phosphate (PSP) dosages of 0.5, 1.0, or 2.5 mg/kg were administered to adult hens. PMSF (90 mg/kg) was given either 4 hours after or 12 hours prior to PSP administration. Clinical signs and pathologic changes in the biventer cervicis nerve (El-Fawal et al., 1988) were monitored. PSP alone, 2.5 mg/kg, ellicitated severe OPIDN (terminal clinical score 7.5 & ± 1.0 [0-8 scale]; neuropathology score 2.7 ± 0.3 [0-4 scale, based on myelinated fiber degeneration]). PMSF given 12 hours prior to PSP gave complete protection (clinical and neuropathology scores of 0; p<0.0001). Signs and lesions of OPIDN were absent following 0.5 mg/kg PSP alone, but PMSF given 4 hours after PSP potentiated its neurotoxic effects (clinical score 4.0 ± 0.0; neuropathology score 3.5 ± 0.3; p<0.0001). At the time of sacrifice, there was a correlation (r = 0.61) between the clinical score on the last day of observation and the neuropathology scores (p<0.0001). This study demonstrates that the intensity of peripheral nerve myelinated fiber degeneration correlates with clinical deficits in PMSF-induced potentiation and protection in OPIDN. / Master of Science

Overweight and obesity and associated health risks have become epidemic in several regions around the world. Numerous studies have addressed the dietary habits of vegetarians and vegans in terms of disease prevention and nutritional deficiencies but the relationship between overweight and obesity and the demographic, psychosocial, lifestyle, and dietary intake of omnivores, vegetarians, and vegans has received less attention. Guided by the social-ecological model, this study included a cross-sectional, quantitative, anonymous web-based survey to obtain dietary information on omnivores, vegetarians, and vegans. Vegans demonstrated a significantly lower mean and median body mass index ( p=0.00) than omnivores, semi-vegetarians, and vegetarians. Multiple logistic regression analysis demonstrated no significant difference in the odds of overweight (OR=0.41; p=1.14) and obesity (OR=0.47; p=0.28) in vegans compared to omnivores. Alcohol was significantly protective against obesity for both 1-2 (OR=0.33; p=0.03) and 3-30 (OR=0.20; p=0.01) days drinking per month while binge drinking significantly increased the odds of obesity (OR=4.44; p=0.01). Multiple logistic regression analysis stratified for levels of exercise revealed an interaction between diet and exercise. A vegan diet was significantly protective against obesity for low-level exercise in terms of frequency (OR=0.31; p=0.02 ) and total minutes per week (OR=0.23; p=0.02) compared to omnivores. Coupled with prior studies these results may contribute to positive social change by facilitating a broad-based paradigm shift in the view of diet and exercise as well as providing evidence that can be implementated in broad-based obesity control programs to reduce the morbidity and mortality associated with obesity.

Fast food consumption among office workers is a common phenomenon. Frequent consumption of fast food is linked to cardiovascular risk factors. The pervasiveness of these risk factors has debilitated the office workers' health and contributed to low performance and absenteeism. However, there remains a significant gap in the current literature regarding the health impacts of frequent fast food consumption behavior of office workers. Consuming large portions of fast food has been associated with obesity. The purpose of this correlation study was to investigate the relationship between fast food consumption and obesity and hypertension among office workers. The theoretical foundations for this study are based on socio ecological model which is concerned with interactions between the individual and the different elements of the environment. Of 145 randomly selected office workers, 55 completed surveys about their food behavior and 36 of them had body mass index and blood pressure measured. Spearman rank-ordered correlations revealed significant correlations of moderate strength between fast food portion size and obesity (rs = .37) and between frequent fast food consumption and hypertension (rs = .40). These results constitute an important contribution to the existing literature and can be used by the health professionals and management to design workplace health intervention which focuses on the office workers and the social environment. Implications for positive social change include reducing the prevalence of obesity and hypertension.

The majority of data on adolescent pregnancy pertains to urban communities, therefore, the individual and social influences associated with adolescent pregnancy in rural communities have not been extensively explored. The pregnancy rate among adolescent women aged 15 to 19 in rural Vance County, North Carolina, is 113.7 per 1,000, nearly twice the state average. This sequential mixed-method study used the social ecological model to evaluate the intrapersonal and community-related factors associated with adolescent pregnancy in this rural area. A quantitative survey assessed intrapersonal factors, namely sexual health knowledge, sex-related attitudes, and self-esteem in pregnant or parenting and nonpregnant or nonparenting groups. Two sample t tests revealed significant differences between groups relative to personal sexual values and attitudes toward premarital sex. There were no significant differences between groups for sexual health knowledge scores or self-esteem scores. Qualitative focus group discussions with one group, consisting of pregnant, parenting, nonpregnant, and nonparenting participants, assessed community opportunity structure as a behavior-influencing dynamic. Open-coding analysis revealed perceptions of strained employment and education-related structures, low community expectations of pregnant adolescents, and the influence of peer-related normative beliefs in early sexual intercourse. To bring about social change, community organizations should collaborate to engage participant-driven research while prioritizing the implementation of county-wide, comprehensive sex education programs. Improved programming could repair social norms, increase sexual health knowledge, and encourage personal responsibility over sexual health decisions.

African institutions that perform health research need to continuously evaluate their practices in order to ensure compliance with international standards of good clinical practice (GCP). This mixed-methods study, undertaken at one clinical research site in Western Kenya, was an evaluation of GCP compliance at the site, research participants' satisfaction with research procedures, and research participants' comprehension of informed consent. The qualitative portion of the study involved audit of the site's compliance with GCP standards. The quantitative portion was an assessment of participant satisfaction and informed consent comprehension, undertaken through interviews with a sample of 297 participants. Thematic analysis of the qualitative data showed that the site's performance conformed with GCP standards. Descriptive statistical analysis of the quantitative data showed that the majority of study participants were content with study procedures. A majority understood those parts of the informed consent process related to study duration and purpose but not those parts of the informed consent process related to the purpose and benefits of the study. Univariate chi square analysis showed no statistically significant differences in the level of satisfaction by age, occupation, or level of education, and there were no statistically significant differences in the level of informed consent comprehension by duration in the study or staff levels of experience. Implications for positive social change include guiding future health research capacity-building efforts in Africa toward better compliance with GCP standards and development of higher quality of informed consent procedures.

The American Academy of Pediatrics and World Health Organization recommend exclusive breastfeeding for the first 4-6 months of life to reduce risk of obesity in pre-school children. Previous research has indicated a high rate of obesity among Hispanic children in the northeastern United States. There is also a gap in the literature regarding the effectiveness of exclusive breastfeeding in preventing obesity among preschool Hispanic children. Therefore, the purpose of this study was to determine if there was an association between exclusive breastfeeding and obesity among pre-school Hispanic children enrolled in the Special Supplemental Nutrition Education Program for Women, Infants and Children (WIC) in a metropolitan area of mid-Atlantic region between the years 2004 and 2009. This retrospective secondary analysis of data for 4454 Hispanic children compared the body mass index (BMI) at 36-59 months of age for those that were breastfed to those that were not breastfed using the Student's t-test. Duration of exclusive breastfeeding was examined for any correlation with BMI for the cohort of breastfeeding women using Pearson's correlation analysis. Results revealed that the BMI for 1181 breastfed children was not statistically different from the non-breastfed children (16.97 vs. 17.04). However, there was a statistically significant inverse relationship between duration of breastfeeding and BMI among children of breastfeeding mothers (r = -.75, p < .05). These results make an important contribution to the existing literature and can enhance social change initiatives by encouraging practitioners to educate Hispanic mothers on the positive effects of exclusive breastfeeding the first 4 months of life which could help minimize obesity prevalence among children.

Childhood obesity has reached epidemic proportions in the United States and has been linked to hypertension, especially among African American youth. Optimistic bias leads youth to underestimate their susceptibility to negative health outcomes. Public health officials want to reduce risk factors to result in significant long term reduction in cardiovascular disease. The purpose of this study was to explore adolescent behavior practices in a school district and prevalence of high blood pressure and obesity in that population. The health belief model guided the framework for this study. Research questions examined relationship between individual health risk practices and optimistic bias on health outcomes. Using a correlational research design, 433 African American high school students were administered a face-to-face survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Among the health risk practices, engaging in moderate exercise for at least 30 minutes in the last 7 days and lower blood pressure was the only statistically significant relationship. Despite presence of clinical risk factors for hypertension and obesity, two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease, with males at greater risk than females. Reducing health optimistic bias is viewed as an effective way of motivating young people to adopt more positive behaviors. This study has social change implications for using educational institutions to implement intervention programs that promote positive health behavior among youth not as an individual responsibility but as a way to reduce health disparities at the systemic level.

The United States has set a 90% benchmark for influenza vaccinations for healthcare personnel. Unfortunately, healthcare personnel fall far short of that mark with current rates as low as 62%. Low vaccination rates are responsible for influenza, nosocomial influenza, influenza-like illness, and mortality during influenza season. The purpose of this quantitative correlational study was to understand the relationship between leadership styles, attitudes towards evidence-based practice, and vaccination intention among New Jersey registered nurses (RNs). Diffusion of innovations theory was the theoretical foundation. The 3 instruments used were the Multifactor Leadership Questionnaire, Evidence Based Practice Attitude Scale, and Behavioral Intention Scales, which measured independent variables such as transformational leadership and attitudes toward evidence-based practice. Vaccination intent was the dependent variable. The results showed that transformational leadership was positively related to vaccination intent r(353) = .16, p < .01. There was no relationship between transactional leadership and vaccination intent r(353) = .01, p > .05 nor between attitudes toward evidence-based practice and vaccination intent r(353) = .09, p > .05. The implication of the study is that the effects of transformational leadership constitute a predictive tool to identify how an organization can increase vaccination rates among RNs. Implementing the recommendations of the study could promote social change by providing nursing leadership with tools to facilitate increased vaccination rates among health care personnel. Increasing vaccination rates for healthcare personnel will decrease vaccine-preventable illnesses and improve outcomes for hospitalized patients.

This study examined the strength of association between food workers and food to norovirus in comparison to bacteria associated with foodborne-related gastroenteritis by whether norovirus had a direct (physical evidence), indirect (statistical evidence), or suspect (neither of the two) association with food or food handlers. The Centers for Disease Control and Prevention considers norovirus to cause the largest number of foodborne-related gastroenteritis cases in the United States. The association of norovirus with foodborne outbreaks through its information data collection form focuses on the food worker as the typical source. Yet, many outbreaks are not foodborne in nature. The gap in the research is the evidence supporting the theory that norovirus transmission is the same as bacterial transmission. A secondary data anaylsis was conducted on the data from the electronic Foodborne Outbreak Reporting System between 1998 and 2006. An odds ratio analysis showed no similarity between proportion of the implicated and nonimplicated numbers of outbreaks from norovirus and those from Salmonella. The odds ratios also showed a stronger similarity between proportions of food handler implicated outbreaks from norovirus than from Salmonella. An analysis showed, though, a significant emphasis was not placed on the food handler but on other indirect routes of transmission of norovirus in outbreaks. The analysis also indicated that norovirus transmission was not mainly through food. Norovirus transmission appeared to be through person-to-person rather than food and had more similarities with pandemic influenza than gastroenteritis-associated bacteria. A change in approach to norovirus by local, state, and federal agencies could have social change implications for prevention, surveillance, and public health programs to reduce infection and outbreaks.