Preetha Abraham | Uniformed Services University (original) (raw)
Papers by Preetha Abraham
The FASEB Journal
We investigated the association between heat‐induced stress responses and heat tolerance levels i... more We investigated the association between heat‐induced stress responses and heat tolerance levels in mice. Thirty‐eight mice were assigned into control and three heat exposure groups ‐ tolerant (TOL), moderately tolerant (MT) and intolerant (INT), based on their thermal responses. Real‐time core temperature, blood pressure, and heart rate were assessed during heat exposure (120 min at 39.5°C) under conscious condition. Tissue samples were collected 18–22 hours following heat exposure. INT mice had significantly higher peak mean arterial pressure and heart rate than TOL mice during heat exposure. Plasma corticosterone levels were significantly higher in INT than control mice. No changes in plasma cytokines or markers of oxidative status were observed. INT mice showed significant increases in HSP72 and HSP90 protein and mRNA levels in liver, heart and gastrocnemius muscles compared to TOL and control mice. In contrast, INT mice had significantly lower HSF1 and glucocorticoid receptor pr...
Depression Research and Treatment, 2011
Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CV... more Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals. Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements. Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers. Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.
The FASEB Journal
We investigated the effects of single dose quercetin (Q) on the responses to heat exposure in mic... more We investigated the effects of single dose quercetin (Q) on the responses to heat exposure in mice. Animals were exposed to heat under conscious conditions. Prior to the 2nd heat exposure mice were gavaged with Q (n=34) or vehicle (V, n=27). Tissue samples were collected after final heat exposure. Q‐treated mice had significantly lower plasma IL‐6 and IL‐12 levels, higher GSH/GSSG ratio and SOD, and lower 8‐isoprostane levels in plasma compared to V group. No significant differences in core temperature, blood pressure, and heart rate were observed between Q and V groups during heat exposure. However mice in the Q group that had a relatively high peak Tc during the 1st heat exposure showed a significant trend of having a lower peak Tc during the 2nd heat exposure. Overall, heat treatment groups had higher HSP72 and HSP90 protein levels in liver, heart and gastrocnemius muscle tissues compared to control group that were not exposed to heat (n=10). These results indicate single adminis...
Military Psychology
ABSTRACT This pilot-feasibility randomized control trial examined effects of an adjunctive short-... more ABSTRACT This pilot-feasibility randomized control trial examined effects of an adjunctive short-term service dog training program (SDTP) for service members in out-patient treatment for PTSD. Twenty-nine volunteer participants were randomly assigned to either the SDTP (n = 12) or waitlist (n = 17); 20 participants were available for post-treatment evaluation. SDTP protocol consisted of six structured one-hour sessions with a dog-trainer conducted over two weeks, intended to train a service dog to help a fellow Veteran. SMs completed symptom questionnaires (PTSD, insomnia, stress, depression, anxiety), and the SDTP group completed a post-intervention quantitative interview. Most effect sizes demonstrated moderate symptom reductions, both between-groups and within the SDTP group. Between-group effects were strongest for intrusive thoughts (Hedge’s g = −0.66; 95%CI: −1.72, 0.23) and overall PTSD symptoms (g = −0.45; 95%CI: −1.47, 0.45); within-SDTP group effects were strongest for stress (d = −1.31, 95%CI: −2.17, −0.42), intrusive thoughts (d = −0.78, 95%CI: −1.55, 0.01) and hypervigilance (d = −0.77, 95%CI: −1.48, −0.04). Qualitative analyses indicated participants found SDTP in some ways challenging yet beneficial in multiple aspects of personal and social lives. Future work should examine optimal treatment parameters (e.g., duration, “dosing”) when training dogs as an adjunct to other PTSD treatment.
Heat exposure induces tissue stress in heat-intolerant, but not heat-tolerant, mice
Journal of Thermal Biology, 2021
Abstract Heat strain monitoring indexes are important to prevent exertional heat illness (EHI) an... more Abstract Heat strain monitoring indexes are important to prevent exertional heat illness (EHI) and uncover risk factors. Two indexes are the Physiological Strain Index (PSI) and a subjective PSI analogue, the Perceptual Strain Index (PeSI). The PeSI is a feasible alternative to PSI in field conditions, although the validity has been variable in previous research. However, the PeSI has been rarely examined at a low heat strain with compensable heat stress, such as during a heat tolerance test (HTT). This study evaluated the discrepancy between the maximal PeSI and maximal PSI achieved during a HTT and determined their association with EHI risk factors, including history of EHI, percent body fat (%BF), relative VO2max, fatigue and sleep status. The PSI was calculated using the change in rectal temperature (Tre) and heart rate (HR) and PeSI was calculated based on the formula containing thermal sensation (TS), a Tre analogue, and rate of perceived exertion (RPE), a HR analogue. Significant associations were identified between PSI and PeSI and between PSIHR and PeSIHR in the total sample and between PSI and PeSI in the EHI group. Bland-Altman analyses indicated PeSI underestimated PSI in the total sample, PSIHR was greater than PeSIHR, and that PSIcore and PeSIcore were not significantly different, but values varied widely at different heat strains. This indicates the use of RPE underestimates HR and that the accuracy of TS to predict Tre may be subpar. This study also demonstrated that participants with higher %BF have a decreased perception of heat strain and that post-fatigue, sleep status and a prior EHI may increase the perception of heat strain. Overall, these results suggest that PeSI is a poor surrogate for PSI in a compensable heat stress environment at low heat strain.
PeerJ, 2021
We describe a mixed qualitative and quantitative research study in a military facility regarding ... more We describe a mixed qualitative and quantitative research study in a military facility regarding the role of nature in well-being. Study intervention included two 20-minute walks. One walk was in an intentionally designed woodland environment (Green Road) and the other was on a busy campus road in a medical treatment facility (Urban Road). Twelve volunteers from a military facility participated in both walks in a cross-over experimental design. The two walking sessions were randomly ordered and preceded by pre-walk instructions appropriate to each road’s characteristics and incorporated focused attention and present moment orientation. A semi-structured post-walk interview, the primary outcome, was conducted after the conclusion of each walk. Qualitative data analyses consisted of sentiments and themes by using NVivo 12 software. The Green Road was unanimously rated as positive (100%). Responses to Urban Road were evenly distributed among positive (33.3%), negative (33.3%), and neut...
Journal of Thermal Biology, 2019
Exertional heat stroke (EHS) is a leading cause of preventable morbidity and mortality among both... more Exertional heat stroke (EHS) is a leading cause of preventable morbidity and mortality among both athletes and warfighters. Therefore, it is important to find blood biomarkers to predict susceptibility to EHS. We compared gene expression profiling from blood cells between two groups of participantsthose with and those without a history EHSby using genome-wide microarray analysis. Subjects with a history of EHS (n ¼ 6) and non-EHS controls without a history of EHS (n ¼ 18) underwent a heat tolerance test and a thermoneutral exercise challenge on separate days. The heat tolerance test comprised of 2-h of walking, at 5 km/h and 2% incline, with ambient conditions set at 40 � C, 40% relative humidity; the thermoneutral test was similar, but had ambient conditions set at 22 � C. Next, we examined gene expression profiles, quantified based on arithmetic differences (post minus pre) during the heat test minus changes during the thermoneutral test. Genes related to interleukins and cellular stress were significantly down-regulated in participants with a history of EHS compared to their non-EHS counterparts. Suppression of these genes may be associated with susceptibility to exertional heat injury. Prospective research is required to determine whether similar gene expression profiling can be potentially used as blood biomarkers to predict susceptibility to EHS.
Journal of the Royal Army Medical Corps, 2018
Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how ... more Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how resilience can potentially develop. Yet, qualitative research is scant in comparison to the many quantitative studies of health outcomes associated with military service. Semistructured qualitative interviews were used to collect personal narratives of US Army CMs who had previously served in Iraq or Afghanistan. Thematic analysis revealed three key driving forces for how resilience develops in the context of combat and war. The first was patriotism, which captures loyalty and full commitment to the military and its missions. The second was commitment to their family, reflecting the balance of responsibility to family of origin with the obligation one feels towards their military family. The last driving force was faith, or the drive to reach towards the transcendent to provide a moral compass and develop empathy in the face of difficult situations. An individual's commitment to coun...
African Health Sciences, 2017
Background: Obesity is a modifiable risk factor for hypertension and T2D. Objective(s): We examin... more Background: Obesity is a modifiable risk factor for hypertension and T2D. Objective(s): We examined relations between fasting plasma adiponectin (ADIP), C-reactive protein (CRP) concentrations and markers of T2D in African Americans (AA). Methods: Fasting plasma ADIP, CRP, Insulin (IN), HOMA-IR, lipid profiles, body fat percent (%BF), waist circumference (WC), body mass index (BMI) and blood pressure measures were determined in AA women (W: n=77) and men (M: n=34). Participants were classified into: 1) Normal fasting glucose (FG) and Normal %BF; 2) Normal FG and High %BF; and 3) High FG.
Cleveland Clinic Journal of Medicine, Aug 1, 2011
Cleveland Clinic Journal of Medicine
Ethnicity & disease, 2012
African Americans (AA) experience a high mortality from cardiovascular disease (CVD), even withou... more African Americans (AA) experience a high mortality from cardiovascular disease (CVD), even without an increase in the prevalence of the metabolic syndrome (MetS). The potential role of sleep impairment in this phenomenon has not been studied. The current study examined the relationship between self-reported sleep and MetS components among AAs. Sleep variables included total sleep quality and specific symptoms: loud snoring, difficulty breathing, and sleep duration. Anthropometric (BMI, BP, waist circumference, body fat percent) and biologic (fasting glucose, triglycerides, total cholesterol, and HDL) measures were obtained from 248 community-recruited AA (63% female; mean age 44 years). The Pittsburgh Sleep Quality Index (PSQI), a 19-item scale with a total sleep quality score and 7 subscales, was used to assess self-reported sleep quality. Analyses were controlled for age and sex. PSQI total sleep quality predicted neither presence of MetS (Beta=.04, P=.29) nor individual CVD varia...
Ethnicity & disease, 2013
Dehydroepiandrosterone sulfate (DHEAS) declines with age and low endogenous DHEAS concentrations ... more Dehydroepiandrosterone sulfate (DHEAS) declines with age and low endogenous DHEAS concentrations have been associated with obesity. In addition, DHEAS has been studied for its role in mood and wellbeing. However, limited data are available on salivary DHEAS concentrations in African Americans. Thus, we examined age-related changes in morning salivary DHEAS and the association between DHEAS and obesity risk factors among African Americans. Salivary DHEAS samples (n=170) were obtained from men and women divided into three age groups: 18 to 30 (young), 31 to 45 (middle) and 46 to 60 (older) years. Anthropometric, blood glucose, high sensitivity c-reactive protein (hsCRP), and blood pressure measures were obtained. Participants completed the Center for Epidemiologic Studies Depression (CESD), Beck Depression Inventory (BDI), Daily Hassles Scale (DHS), Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) scales to assess depression, daily hassles, stress and quality of ...
Military medicine, 2018
This study presents a grounded theory analysis of in-depth interviews of United States Army Comba... more This study presents a grounded theory analysis of in-depth interviews of United States Army Combat Medics (CMs) who had served in Iraq and/or Afghanistan. The study explores how 17 CMs nominated by their peers as resilient cope with military stressors in order to identify the factors that enable them to thrive amidst harsh conditions. Four distinct categories of characteristics unique to this group emerged: (1) social bonding, (2) readiness, (3) dual loyalty as performance, and (4) leader by example. Forging loyalty underpins these characteristics and represents the main process used by resilient CMs and comprised three behavior patterns: (1) commitment to the family, (2) commitment to the military mission, and (3) commitment to their guiding religious and spiritual beliefs. Prominent behavioral tendencies of forging loyalty likely developed during childhood and re-enforced by families, friends, and other role models. Based on the findings, new training and education efforts should ...
License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals. Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37 % male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements. Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers. Conclusions. It has been well documented that higher levels of depressive symptoms are associated wi...
Depression Research and Treatment, 2011
International Journal of Medical Genetics, 2015
ABSTRACT Genetic variants of the human serotonin transporter (SERT) may contribute to HPA axis dy... more ABSTRACT Genetic variants of the human serotonin transporter (SERT) may contribute to HPA axis dysregulation. SERT has two promoter region polymorphisms (5-HTTLPR: VNTR and SNP: rs25531), which may alter levels of SERT protein and its function. Combining these polymorphisms creates a functional polymorphism (FN) which may modulate mRNA expression. This study examines the relationship between these genetic variants and morning and evening salivary samples of both cortisol and dehydroepiandrosterone sulfate (DHEAS) concentrations in 269 African American (AA) adults. Resultant allele frequencies for the VNTR, SNP, and FN genotypes were 70% L (2% XLL), 84% A, and 54% LA (2% XLLA), respectively. The XLL genotype was associated with significantly higher concentrations of cortisol (~3X) and DHEAS (~2X) for both VNTR and FN polymorphisms. No significant differences were found for SNP genotypes. Conclusions were that persons with VNTR and FN XLL polymorphisms had significantly higher cortisol and DHEAS concentrations than other genotypes. AAs also appear to have a higher frequency of the rare XL allele than Caucasians. Whether the XLL genotype predisposes AAs to greater health challenges will require further research to determine the implications of these findings.
Brain research, Jan 13, 2008
The expression and characteristics of β-adrenoceptor subtypes (β 1 and β 2 ) and their agonist ac... more The expression and characteristics of β-adrenoceptor subtypes (β 1 and β 2 ) and their agonist actions on synaptic transmission in the basolateral amygdala (BLA) of the rat were examined using in situ hybridization, quantitative real-time PCR, Western blot analysis and field potential recording. In situ hybridization data revealed an intense distribution of β 1 -and β 2 -adrenoceptor mRNA in the BLA. Real-time PCR analysis of rat amygdala revealed significant transcriptional expression levels of both β-adrenoceptors, with β 2 -adrenoceptors outnumbering β 1 -adrenoceptors in a ratio of 2.9 to 1. Bath application of the selective β 1adrenoceptor agonist xamoterol hemifumarate (10 µM) facilitated the excitatory field synaptic potential evoked in the BLA by stimulation of the external capsule by 186.5 ± 10.7% of control amplitude. In the presence of the selective β 1 -adrenoceptor antagonist betaxolol hydrochloride (30 µM), the facilitating effects of field excitatory synaptic potential induced by the agonist were reduced to 126.1 ± 2.3 % of control amplitude in the BLA. Bath application of the selective β 2 -adrenoceptor agonist salmeterol (15 µM) facilitated the excitatory field synaptic potential evoked in the BLA by stimulation of the external capsule by 167.3 ± 9.7 % of control amplitude. In the presence of the selective β 2 -adrenoceptor antagonist ICI 118,551
The FASEB Journal
We investigated the association between heat‐induced stress responses and heat tolerance levels i... more We investigated the association between heat‐induced stress responses and heat tolerance levels in mice. Thirty‐eight mice were assigned into control and three heat exposure groups ‐ tolerant (TOL), moderately tolerant (MT) and intolerant (INT), based on their thermal responses. Real‐time core temperature, blood pressure, and heart rate were assessed during heat exposure (120 min at 39.5°C) under conscious condition. Tissue samples were collected 18–22 hours following heat exposure. INT mice had significantly higher peak mean arterial pressure and heart rate than TOL mice during heat exposure. Plasma corticosterone levels were significantly higher in INT than control mice. No changes in plasma cytokines or markers of oxidative status were observed. INT mice showed significant increases in HSP72 and HSP90 protein and mRNA levels in liver, heart and gastrocnemius muscles compared to TOL and control mice. In contrast, INT mice had significantly lower HSF1 and glucocorticoid receptor pr...
Depression Research and Treatment, 2011
Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CV... more Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals. Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements. Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers. Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.
The FASEB Journal
We investigated the effects of single dose quercetin (Q) on the responses to heat exposure in mic... more We investigated the effects of single dose quercetin (Q) on the responses to heat exposure in mice. Animals were exposed to heat under conscious conditions. Prior to the 2nd heat exposure mice were gavaged with Q (n=34) or vehicle (V, n=27). Tissue samples were collected after final heat exposure. Q‐treated mice had significantly lower plasma IL‐6 and IL‐12 levels, higher GSH/GSSG ratio and SOD, and lower 8‐isoprostane levels in plasma compared to V group. No significant differences in core temperature, blood pressure, and heart rate were observed between Q and V groups during heat exposure. However mice in the Q group that had a relatively high peak Tc during the 1st heat exposure showed a significant trend of having a lower peak Tc during the 2nd heat exposure. Overall, heat treatment groups had higher HSP72 and HSP90 protein levels in liver, heart and gastrocnemius muscle tissues compared to control group that were not exposed to heat (n=10). These results indicate single adminis...
Military Psychology
ABSTRACT This pilot-feasibility randomized control trial examined effects of an adjunctive short-... more ABSTRACT This pilot-feasibility randomized control trial examined effects of an adjunctive short-term service dog training program (SDTP) for service members in out-patient treatment for PTSD. Twenty-nine volunteer participants were randomly assigned to either the SDTP (n = 12) or waitlist (n = 17); 20 participants were available for post-treatment evaluation. SDTP protocol consisted of six structured one-hour sessions with a dog-trainer conducted over two weeks, intended to train a service dog to help a fellow Veteran. SMs completed symptom questionnaires (PTSD, insomnia, stress, depression, anxiety), and the SDTP group completed a post-intervention quantitative interview. Most effect sizes demonstrated moderate symptom reductions, both between-groups and within the SDTP group. Between-group effects were strongest for intrusive thoughts (Hedge’s g = −0.66; 95%CI: −1.72, 0.23) and overall PTSD symptoms (g = −0.45; 95%CI: −1.47, 0.45); within-SDTP group effects were strongest for stress (d = −1.31, 95%CI: −2.17, −0.42), intrusive thoughts (d = −0.78, 95%CI: −1.55, 0.01) and hypervigilance (d = −0.77, 95%CI: −1.48, −0.04). Qualitative analyses indicated participants found SDTP in some ways challenging yet beneficial in multiple aspects of personal and social lives. Future work should examine optimal treatment parameters (e.g., duration, “dosing”) when training dogs as an adjunct to other PTSD treatment.
Heat exposure induces tissue stress in heat-intolerant, but not heat-tolerant, mice
Journal of Thermal Biology, 2021
Abstract Heat strain monitoring indexes are important to prevent exertional heat illness (EHI) an... more Abstract Heat strain monitoring indexes are important to prevent exertional heat illness (EHI) and uncover risk factors. Two indexes are the Physiological Strain Index (PSI) and a subjective PSI analogue, the Perceptual Strain Index (PeSI). The PeSI is a feasible alternative to PSI in field conditions, although the validity has been variable in previous research. However, the PeSI has been rarely examined at a low heat strain with compensable heat stress, such as during a heat tolerance test (HTT). This study evaluated the discrepancy between the maximal PeSI and maximal PSI achieved during a HTT and determined their association with EHI risk factors, including history of EHI, percent body fat (%BF), relative VO2max, fatigue and sleep status. The PSI was calculated using the change in rectal temperature (Tre) and heart rate (HR) and PeSI was calculated based on the formula containing thermal sensation (TS), a Tre analogue, and rate of perceived exertion (RPE), a HR analogue. Significant associations were identified between PSI and PeSI and between PSIHR and PeSIHR in the total sample and between PSI and PeSI in the EHI group. Bland-Altman analyses indicated PeSI underestimated PSI in the total sample, PSIHR was greater than PeSIHR, and that PSIcore and PeSIcore were not significantly different, but values varied widely at different heat strains. This indicates the use of RPE underestimates HR and that the accuracy of TS to predict Tre may be subpar. This study also demonstrated that participants with higher %BF have a decreased perception of heat strain and that post-fatigue, sleep status and a prior EHI may increase the perception of heat strain. Overall, these results suggest that PeSI is a poor surrogate for PSI in a compensable heat stress environment at low heat strain.
PeerJ, 2021
We describe a mixed qualitative and quantitative research study in a military facility regarding ... more We describe a mixed qualitative and quantitative research study in a military facility regarding the role of nature in well-being. Study intervention included two 20-minute walks. One walk was in an intentionally designed woodland environment (Green Road) and the other was on a busy campus road in a medical treatment facility (Urban Road). Twelve volunteers from a military facility participated in both walks in a cross-over experimental design. The two walking sessions were randomly ordered and preceded by pre-walk instructions appropriate to each road’s characteristics and incorporated focused attention and present moment orientation. A semi-structured post-walk interview, the primary outcome, was conducted after the conclusion of each walk. Qualitative data analyses consisted of sentiments and themes by using NVivo 12 software. The Green Road was unanimously rated as positive (100%). Responses to Urban Road were evenly distributed among positive (33.3%), negative (33.3%), and neut...
Journal of Thermal Biology, 2019
Exertional heat stroke (EHS) is a leading cause of preventable morbidity and mortality among both... more Exertional heat stroke (EHS) is a leading cause of preventable morbidity and mortality among both athletes and warfighters. Therefore, it is important to find blood biomarkers to predict susceptibility to EHS. We compared gene expression profiling from blood cells between two groups of participantsthose with and those without a history EHSby using genome-wide microarray analysis. Subjects with a history of EHS (n ¼ 6) and non-EHS controls without a history of EHS (n ¼ 18) underwent a heat tolerance test and a thermoneutral exercise challenge on separate days. The heat tolerance test comprised of 2-h of walking, at 5 km/h and 2% incline, with ambient conditions set at 40 � C, 40% relative humidity; the thermoneutral test was similar, but had ambient conditions set at 22 � C. Next, we examined gene expression profiles, quantified based on arithmetic differences (post minus pre) during the heat test minus changes during the thermoneutral test. Genes related to interleukins and cellular stress were significantly down-regulated in participants with a history of EHS compared to their non-EHS counterparts. Suppression of these genes may be associated with susceptibility to exertional heat injury. Prospective research is required to determine whether similar gene expression profiling can be potentially used as blood biomarkers to predict susceptibility to EHS.
Journal of the Royal Army Medical Corps, 2018
Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how ... more Qualitative insights may demonstrate how combat medics (CM) deal with stressors and identify how resilience can potentially develop. Yet, qualitative research is scant in comparison to the many quantitative studies of health outcomes associated with military service. Semistructured qualitative interviews were used to collect personal narratives of US Army CMs who had previously served in Iraq or Afghanistan. Thematic analysis revealed three key driving forces for how resilience develops in the context of combat and war. The first was patriotism, which captures loyalty and full commitment to the military and its missions. The second was commitment to their family, reflecting the balance of responsibility to family of origin with the obligation one feels towards their military family. The last driving force was faith, or the drive to reach towards the transcendent to provide a moral compass and develop empathy in the face of difficult situations. An individual's commitment to coun...
African Health Sciences, 2017
Background: Obesity is a modifiable risk factor for hypertension and T2D. Objective(s): We examin... more Background: Obesity is a modifiable risk factor for hypertension and T2D. Objective(s): We examined relations between fasting plasma adiponectin (ADIP), C-reactive protein (CRP) concentrations and markers of T2D in African Americans (AA). Methods: Fasting plasma ADIP, CRP, Insulin (IN), HOMA-IR, lipid profiles, body fat percent (%BF), waist circumference (WC), body mass index (BMI) and blood pressure measures were determined in AA women (W: n=77) and men (M: n=34). Participants were classified into: 1) Normal fasting glucose (FG) and Normal %BF; 2) Normal FG and High %BF; and 3) High FG.
Cleveland Clinic Journal of Medicine, Aug 1, 2011
Cleveland Clinic Journal of Medicine
Ethnicity & disease, 2012
African Americans (AA) experience a high mortality from cardiovascular disease (CVD), even withou... more African Americans (AA) experience a high mortality from cardiovascular disease (CVD), even without an increase in the prevalence of the metabolic syndrome (MetS). The potential role of sleep impairment in this phenomenon has not been studied. The current study examined the relationship between self-reported sleep and MetS components among AAs. Sleep variables included total sleep quality and specific symptoms: loud snoring, difficulty breathing, and sleep duration. Anthropometric (BMI, BP, waist circumference, body fat percent) and biologic (fasting glucose, triglycerides, total cholesterol, and HDL) measures were obtained from 248 community-recruited AA (63% female; mean age 44 years). The Pittsburgh Sleep Quality Index (PSQI), a 19-item scale with a total sleep quality score and 7 subscales, was used to assess self-reported sleep quality. Analyses were controlled for age and sex. PSQI total sleep quality predicted neither presence of MetS (Beta=.04, P=.29) nor individual CVD varia...
Ethnicity & disease, 2013
Dehydroepiandrosterone sulfate (DHEAS) declines with age and low endogenous DHEAS concentrations ... more Dehydroepiandrosterone sulfate (DHEAS) declines with age and low endogenous DHEAS concentrations have been associated with obesity. In addition, DHEAS has been studied for its role in mood and wellbeing. However, limited data are available on salivary DHEAS concentrations in African Americans. Thus, we examined age-related changes in morning salivary DHEAS and the association between DHEAS and obesity risk factors among African Americans. Salivary DHEAS samples (n=170) were obtained from men and women divided into three age groups: 18 to 30 (young), 31 to 45 (middle) and 46 to 60 (older) years. Anthropometric, blood glucose, high sensitivity c-reactive protein (hsCRP), and blood pressure measures were obtained. Participants completed the Center for Epidemiologic Studies Depression (CESD), Beck Depression Inventory (BDI), Daily Hassles Scale (DHS), Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI) scales to assess depression, daily hassles, stress and quality of ...
Military medicine, 2018
This study presents a grounded theory analysis of in-depth interviews of United States Army Comba... more This study presents a grounded theory analysis of in-depth interviews of United States Army Combat Medics (CMs) who had served in Iraq and/or Afghanistan. The study explores how 17 CMs nominated by their peers as resilient cope with military stressors in order to identify the factors that enable them to thrive amidst harsh conditions. Four distinct categories of characteristics unique to this group emerged: (1) social bonding, (2) readiness, (3) dual loyalty as performance, and (4) leader by example. Forging loyalty underpins these characteristics and represents the main process used by resilient CMs and comprised three behavior patterns: (1) commitment to the family, (2) commitment to the military mission, and (3) commitment to their guiding religious and spiritual beliefs. Prominent behavioral tendencies of forging loyalty likely developed during childhood and re-enforced by families, friends, and other role models. Based on the findings, new training and education efforts should ...
License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals. Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37 % male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements. Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers. Conclusions. It has been well documented that higher levels of depressive symptoms are associated wi...
Depression Research and Treatment, 2011
International Journal of Medical Genetics, 2015
ABSTRACT Genetic variants of the human serotonin transporter (SERT) may contribute to HPA axis dy... more ABSTRACT Genetic variants of the human serotonin transporter (SERT) may contribute to HPA axis dysregulation. SERT has two promoter region polymorphisms (5-HTTLPR: VNTR and SNP: rs25531), which may alter levels of SERT protein and its function. Combining these polymorphisms creates a functional polymorphism (FN) which may modulate mRNA expression. This study examines the relationship between these genetic variants and morning and evening salivary samples of both cortisol and dehydroepiandrosterone sulfate (DHEAS) concentrations in 269 African American (AA) adults. Resultant allele frequencies for the VNTR, SNP, and FN genotypes were 70% L (2% XLL), 84% A, and 54% LA (2% XLLA), respectively. The XLL genotype was associated with significantly higher concentrations of cortisol (~3X) and DHEAS (~2X) for both VNTR and FN polymorphisms. No significant differences were found for SNP genotypes. Conclusions were that persons with VNTR and FN XLL polymorphisms had significantly higher cortisol and DHEAS concentrations than other genotypes. AAs also appear to have a higher frequency of the rare XL allele than Caucasians. Whether the XLL genotype predisposes AAs to greater health challenges will require further research to determine the implications of these findings.
Brain research, Jan 13, 2008
The expression and characteristics of β-adrenoceptor subtypes (β 1 and β 2 ) and their agonist ac... more The expression and characteristics of β-adrenoceptor subtypes (β 1 and β 2 ) and their agonist actions on synaptic transmission in the basolateral amygdala (BLA) of the rat were examined using in situ hybridization, quantitative real-time PCR, Western blot analysis and field potential recording. In situ hybridization data revealed an intense distribution of β 1 -and β 2 -adrenoceptor mRNA in the BLA. Real-time PCR analysis of rat amygdala revealed significant transcriptional expression levels of both β-adrenoceptors, with β 2 -adrenoceptors outnumbering β 1 -adrenoceptors in a ratio of 2.9 to 1. Bath application of the selective β 1adrenoceptor agonist xamoterol hemifumarate (10 µM) facilitated the excitatory field synaptic potential evoked in the BLA by stimulation of the external capsule by 186.5 ± 10.7% of control amplitude. In the presence of the selective β 1 -adrenoceptor antagonist betaxolol hydrochloride (30 µM), the facilitating effects of field excitatory synaptic potential induced by the agonist were reduced to 126.1 ± 2.3 % of control amplitude in the BLA. Bath application of the selective β 2 -adrenoceptor agonist salmeterol (15 µM) facilitated the excitatory field synaptic potential evoked in the BLA by stimulation of the external capsule by 167.3 ± 9.7 % of control amplitude. In the presence of the selective β 2 -adrenoceptor antagonist ICI 118,551