medical field which is widely covered in medicine

Impact of Glaucoma Disease 1

Impacts of Glaucoma Disease on African Americans

Lendora Ogunbode

PSY 625

Dr. N

July 27, 2019

Impacts of Glaucoma Disease on African Americans

Specific Aims

Neuroscience refers to a medical field which is widely covered in medicine. It generally

involves the study of the human brain and its association with the entire human body’s nervous

system coordination. Therefore, all the human senses are studied under this neuroscience field of

medicine. Specifically, for this assignment, blindness as a branch of neuroscience will be dealt

with. The sense of seeing is usually aided by the relay of visual information within the human

brain. Several diseases which are related to human nervous system like Glaucoma have been

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2 Impacts of Glaucoma Disease

analyzed both neurologically and technologically. Although it is generally a complex process as

far as medical is concern to bringing a remedy or cure to a disease which is associated with the

human nervous system more especially when some specific tasked relays and neurons within the

system have been damaged, especially during accidents, technology is recently playing a great

advancement towards finding the possible ways at achieving an effective treatment to

neuroscience related cases (Charlson et al. 2015).

Glaucoma disease has been given priority in this research since it’s the most common

blindness condition which has threatened the entire world. “Glaucoma occurs about five times

more often in African Americans. Blindness from glaucoma is about six times more common. In

addition to this higher frequency, glaucoma often occurs earlier in life in African Americans —

on average, about ten years earlier than in other ethnic populations” (“African Americans and

Glaucoma,” n.d.). Many research results have indicated the technology in collaboration with

neuroscience have taken a significant step in coming out with innovative measures which are

aimed at understanding the causes, the impacts as well as the remedy actions of blindness. These

efforts of neuroscience and medical technology will be evaluated in this study as well.

The specific aim of this proposal is to access three main aspects that are related to

Glaucoma, first is the examination of ethnic variations which are closely related to Glaucoma

disease, the second examination will be on the potential causes of Glaucoma, and finally

monitoring the impacts of cognitive progress of patients that are clinically diagnosed with

Glaucoma disease (Freedman, Shen, & Ahrens, 2016).

Background of the Study

Cases of glaucoma have been reported all over the world. The number of people affected

by glaucoma to an extend of becoming blind has increased significantly in recent years. This

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2

1. n.d.).

Correct citation format and

give page number for direct

quote. [Irene Nielsen]

2. the

You can discuss all three but

for a manageable research

proposal pick one to focus on

and develop deeply. [Irene

Nielsen]

3 Impacts of Glaucoma Disease

increase in severe cases of glaucoma has led to more research being conducted to discover ways

of dealing with the problem. Over the years, neuroscience experts have been able to advance in

medical procedures to limit the prevalence of glaucoma. Various medications have been

developed by neurologists to solve the issue of glaucoma. However, the medications and

prevention measures have not been beneficial to everyone. Some ethic groups have positively

benefited from the discoveries made through research while others have experienced no

meaningful impact. To be more specific, people of black color pigmentation are still widely

affected by glaucoma. The rate of glaucoma among black people, especially African Americans,

is very much greater compared to incidence rate in white people populations, (Hoster, 2011).

Despite the clear identification of a relationship between glaucoma incidence and

black pigmentation, very little research has been conducted. This study aims at analyzing the

relationship that does exist between glaucoma and black pigmentation. Also, the study will focus

on establishing how the relationship could be altered so as to facilitate and enhance treatment of

glaucoma in people of African origin. A lot of insight and relevant knowledge has been offered

through various neuroscience research that have been conducted. The information available form

previously conducted research indicates that a relationship exists between the cranial nerves

within the human nervous system and glaucoma. This research intends to advance the knowledge

available about the relationship stated above.

People of African origin have for long been affected by partial or complete

blindness due to glaucoma. The disorder affects African people of all ages and becomes more

severe in adults. The probability of any African person becoming blind as a result of glaucoma is

very high compared to the probability of blindness for other ethnic groups affected by glaucoma.

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1. blindness

Is this true in al environments

or more preveland where

there is more sunlight?

[Irene Nielsen]

4 Impacts of Glaucoma Disease

Different researchers in the neurosciences profession have attempted to come up with theories

that explain the high rate of glaucoma level in people of African heritage, (Iwase, et.al., 2014).

Some of the researchers have focused on identifying viable ways of reducing the

rate of blindness among African people affected by glaucoma. The extensive research conducted

in this area has led to development of special drops which are used to relieve pressure from the

eye and thus reduce the likelihood of blindness caused by glaucoma, especially among people of

African heritage, (Jawitt, et.al., 1991). The availability of such data and information serves as a

good basis upon which this study would be referenced to.

The study will focus on advancing the available information to facilitate a better

understanding of the relationship between glaucoma and blindness amongst the African

American population. A study conducted by NIH analyzed the effectiveness of eye drops in

reducing pressure in the eye amongst African American populace. A large study group of African

American men was used in the research which later came to be known as Ocular Hypertension

Treatment Study (OHTS). The aim of the study was to identify the usefulness and advantage of

using eye drops as a treatment measure to reduce the probability of blindness. The research

findings supported the theories that had already been developed in previous research.

In another research, Obrien, et.al., (2018) found that open angle glaucoma in people of

African origin was much more expected where the family had a history of glaucoma. The

research conducted indicates that glaucoma may be inherited form one generation in a family to

another. The research suggests that family background is among the factors causing more

glaucoma incidence in African Americans that in other ethnic groups. The study indicates that

genetics and other factors such as ocular comorbidities, which are in some cases hereditary are

the main causal factors of glaucoma in people of African heritage.

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2

1. especially

This source is outdated but

find a current source with

similar conclusions. [Irene

Nielsen]

2. African

Is this conclusion supported

by the genome study through

23 and me? I think there is a

descrepiancy of conclusions.

[Irene Nielsen]

5 Impacts of Glaucoma Disease

Retrepo, et.al., (2018), conducted an extensive research to identify the

relationship between glaucoma and genetics among people of African origin. The research

focused on analyzing the genetic ancestry of various persons within the study group. The

research indicates that open angle glaucoma is the most common type of visual disorder among

people of African heritage. On further research and analysis, the study identifies that the

environmental factors are the main causal factors of open angle glaucoma among African people.

Exposure to extreme environmental conditions is noted as the contributing factor to glaucoma

incidence.

Yuecel & Gupta, 2008. Conducted a research on the relationship between central

nervous system and glaucoma in African Americans. The research findings indicated that

retrograde degeneration as well as anterograde degeneration of the optic nerve occurred in the

recovery process after the central nervous system had experienced an injury. The degeneration

of the optic nerve was also noted to have a certain level of impact on the cognitive ability of the

affected person. The resulting effect of the degenerative optic nerve is a condition of partial

blindness which develops into complete blindness with time.

Different research studies conducted by neuroscientists have analyzed various variables

in the quest to prove and give factual information about the high incidence of glaucoma among

African American people. Some of the theories have been developed to explain the difference in

oxygen levels supplied to the eye, indicating that African people supply more oxygen to the eye

more than any other ethnic group. The ultimate outcome of excess oxygen supply to the eye is

increased intraocular pressure. This would happen due to too much oxidative pressure on the eye

membranes leading to damages eye cells. Damages cells would not be able to hold and protect

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2

1. open

Explain open angle and relate

it to neurology. [Irene

Nielsen]

2. injury.

what kind of injury? A broken

toe? [Irene Nielsen]

6 Impacts of Glaucoma Disease

the eye from excess pressure thus resulting to a condition of partial blindness. The conditions

further manifests to glaucoma and ends up causing blindness, (Yuecel & Gupta, 2008).

Lawlor, et.al., (2018) conducted a study to establish the relationship between

glaucoma and blindness among people of African origin. The study established that glaucoma is

a condition caused by degeneration of the optic nerves in the eye. The research was done through

analysis of different patients who suffered from glaucoma. The findings indicated that there were

variations in the optic nerves of the patients due to trans-synaptic degeneration of optic nerves in

the eye, (Lawlor, et.al., 2018).

In another research, Racette, et.al., (2015), examined a study group of 50 white

men and 50 black men. The study intended to establish the type of variations that exist in optic

nerves of white people and black people. The sizes of the optic nerves varied in size. This finding

is supported by Seider et.al., (2019) through a study that took over 3 years to be concluded.

Seider et.al., (2019), found that black people often have thick optic nerves compared to white

people therefore increasing the rate of glaucoma in black people.

Significance

The proposed research is expected to benefit the persons affected by glaucoma in society.

It has been reported through various studies that African Americans are the mostly affected by

glaucoma. It is also noted that the same group of people are the most common to experience

open angle glaucoma which often results to blindness, (Charlson, at al. (2015). The proposed

research aims at shedding new light on the issue and further defining the existing relationship

between blindness caused by glaucoma and pigmentation of various ethnic groups.

The first step of gaining power over glaucoma related blindness is through

advancement of existing knowledge on the issue. Therefore, the proposed research will offer

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2

3

1. nerves

Get this organized with

previous statements. [Irene

Nielsen]

2. degeneration

What is the cause? [Irene

Nielsen]

3. increasing

Why does an increased sized

nerve increase the disease?

Explain. [Irene Nielsen]

7 Impacts of Glaucoma Disease

relevant information to enhance the understanding of how different ethnic groups are pre-

exposed to glaucoma. The research proposed will also add on the existing knowledge. Through

review done on existing material, both theoretical and empirical, the research will identify links

that may be yet to be discovered in the field of neuroscience, (Williams et.al., 2018).

The research would also facilitate the filling of knowledge gaps that exist in the

already published research work. The research will attempt to answer questions that have

remained unanswered about the relationship between glaucoma related blindness and ethnicity as

well as how glaucoma affects cognitive ability. Also, the research will provide information about

how glaucoma in African Americans may be caused by some hereditary factors such as genes,

(Salowe, 2017). Availability of the information will be crucial to set stage for a discussion on

how to prevent the disorder and not just providing treatment to the affected persons, (Pressman,

2018). The research will also design a database where all findings will be recorded to facilitate

future reference.

Proposed Research

Participants:

This proposed research will involve a sample study group of 80 individuals. This

group number will be subdivided into various sample sizes of equal number of individuals

depending on the geographical location of the sample as well as the ethnic groups. The ethnic

groups that will be considered in this study sample include African American, Asian American,

Native American, Hispanic American as well as Native Africans. The study duration will range

from two months to five months, with two months being the minimum and five months being the

maximum. The study sample will comprise various categories of individuals which include age,

youth, and adults as well as gender sensitive (Pressman, 2018). The individuals who will be

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1. 80

This is too large for a small

study with only $60,000.

[Irene Nielsen]

8 Impacts of Glaucoma Disease

taking part in the study will be expected to be available throughout the entire study period. On

the side of professionals, there will be two certified ophthalmologists, one clinician who will be

well informed on research topic. These professionals are inclusive just to ensure that everything

goes on successfully.

Procedures:

Once the sample has been identified, they will be visited in their homes by the

professionals with our assistance. They will be given the necessary training concerning what they

will be expected of throughout the entire study period. The assessment of their eyesight will be

evaluated once every month and the results analyzed (Restrepo, Laper, Farber-Eger, & Crawford,

2018).

Research Methodology and Design

This research will employ the research methods that will satisfy the objectives of the study.

Besides making use of quantitative stats, this section will deal with the design, population, and

collection of data and how it will be analyzed.

Research Design

This is the research planning framework besides the methodology to be applied in the

study, assumptions as well as models. In this research, quantitative stats will be employed as well

as positivist ontological paradigm. This model describes besides explaining the real

characteristics by collecting data on observable behavior of a sample. The research problem will

be studied by using descriptive research design.

Population of the Study

This study will consider a population sample of 80 individuals who will be subdivided

into sub-samples within the United States which will constitute the requisite population. Castillo

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2

3

4

1. successfully.

Will they give clinical care if a

subjects claims harm or

damage? [Irene Nielsen]

2. training

Outline the specific training

program. [Irene Nielsen]

3. will

What is your research

question? What is your

hypothesis, variables, study

design, risks, and

methodology? Use the

alternative template I required

in the announcement at the

beginning of class, including

research terminology. [Irene

Nielsen]

4. sample

Organize this with previous

statements. [Irene Nielsen]

9 Impacts of Glaucoma Disease

(2018), defined a population as clearly defined objects possessing similar attributes with

observable traits upon which an opinion will be based.

Data Collection

The data will be generally collected by making use of primary data collection method.

This will be achieved via questionnaires as a tool for data collection from the identified

population who will be the respondent. The Questionnaire will consist of a series of verbal or

written questions followed by medical examination.

Data Analysis and Hypothesis

Data analysis will entail summarily organizing data by making use of mathematical tools

with a view of establishing the existing relationship within the collected data. According to

(Williams et al. 2018), data analysis refers to a method of extracting useful and relevant

information from collected data so as to facilitate brief description of research work. In this

research, both regression analysis as well as quantitative stats will be applied. In establishing the

relationship between glaucoma and black pigmented individuals, the following logical regression

expression will be applied, G = f(x1, x2, x3, x4); more specifically, the regression quantitative

equation will be as follows; Y = α0 +α1×1+ α2×2+ α3×3+ α4×4 in this case, Y is the dependent

variable which demoted glaucoma and X represents the independent variable which denoted

color pigmentation. α0 is a constant with x1, x2, x3 and x4 being the color pigmentation variables

(Williams et al. 2018).

Budget Justification

It’s obvious that for a graduate research assistant, funding is necessary for the purpose of

effectively carrying out training, recruitment of the five required professionals as well as

collecting data. Another extra 25% funding will be required for the payment of principle

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1. entail

What is your research

question? What is your

hypothesis? [Irene Nielsen]

10 Impacts of Glaucoma Disease

investigator who will be overseeing that the study is smoothly carried out, and to ensure that the

data collected is accurately analyzed besides the results publication.

Travelling funding will be also asked for; this will cater for PI attendance to medical

conferences besides presenting the preliminary findings of the research. Extra funding will be

required to cater for the transportation expenses by the graduate research assistant who will be

moving from one home to another to collect data from the proposed sample size. Subject

imbursement of $45 for every subject (35 in total) is requested to repay subjects for their

participation time.

Funding will also be required in hiring the clinical equipment’s to be used in population

assessment plus funding to cater for life scale quality as well as office stationeries and supplies.

Finally, in the collection and analysis of data, technology will be required for speed and

efficiency; therefore, two laptops will be required of processor speed of 2.4GHz and storage

capacity of 500 MB each.

See Appendix A: Budget for detailed budget figures.

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1. imbursement

spelling [Irene Nielsen]

11 Impacts of Glaucoma Disease

References:

Charlson, E. at al. (2015). The Primary Open-Angle African-American Glaucoma Genetics

(POAAGG) Study: Baseline Demographics. Ophthalmology. 122(4).

Freedman, J., Shen, E., & Ahrens, M. (2016). Trabeculectomy is a Black American glaucoma

population. British Journal of Ophthalmology, 60(8), 573-574.

Girkin, C. A. (2018). Differences in optic nerve structure between individuals of predominantly

African and European ancestry: Implications for disease detection and

pathogenesis. Clinical Ophthalmology (Auckland, NZ), 2(1), 65.

Jawitt, J.C., et al. (1991). Undertreatment of glaucoma among black Americans. New England

Journal of Medicine .325(20).

Lawlor, M., Danesh-Meyer, H., Levin, L. A., Davagnanam, I., De Vita, E., & Plant, G. T. (2018).

Glaucoma and the brain: trans-synaptic degeneration, structural change, and implications

for neuroprotection. Survey of Ophthalmology, 63(3), 296-306.

PSY625: Biological Bases of Behavior Ashford University

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1

1. (1991).

The source you have used is

outdated. Be sure to focus

your research on things that

have been published within

the last five to ten years,

unless referring to seminal

works or thinkers. [Irene

Nielsen]

12 Impacts of Glaucoma Disease

O’Brien, J. M., Salowe, R. J., Fertig, R., Salinas, J., Pistilli, M., Sankar, P. S., … & Gordon, K.

(2018). Family history in the primary open-angle African American glaucoma genetics

study cohort. American journal of ophthalmology, 192, 239-247.

Omoti, A., & Akpe, B. A. (2009). Race and Primary Glaucoma. Current Medical Literature:

Ophthalmology, 19(1), 1–7. Retrieved from http://search.ebscohost.com.proxy-

library.ashford.edu/login.aspx?direct=true&db=a9h&AN=36660950&site=eds-

live&scope=site

Pressman, P. (2018). The Cranial Nerves and Their Functions. Very Well Health. Retrieved

from https://www.verywellhealth.com/the-cranial-nerves-2488654

Restrepo, N. A., Laper, S. M., Farber-Eger, E., & Crawford, D. C. (2018). Local genetic ancestry

in CDKN2B-AS1 is associated with primary open-angle glaucoma in an African

American cohort extracted from de-identified electronic health records. BMC medical

genomics, 11(3), 70.

Salowe, R., O’Keefe, L., Merriam, S., Lee, R., Khachatryan, N., Sankar, P., … O’Brien, J.

(2017). Cost and yield considerations when expanding recruitment for genetic studies: the

primary open-angle African American glaucoma genetics study. BMC Medical Research

Methodology, 17, 1. Retrieved from http://search.ebscohost.com.proxy-

library.ashford.edu/login.aspx?direct=true&db=edb&AN=124149300&site=eds-

live&scope=site

Swierkowska, J., & Gajecka, M. (2017). Genetic factors influencing the reduction of central

corneal thickness in disorders affecting the eye. Ophthalmic Genetics, 38(6), 501–510.

https://doi-org.proxy-library.ashford.edu/10.1080/13816810.2017.1313993

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13 Impacts of Glaucoma Disease

Williams, A. M., Huang, W., Muir, K. W., Stinnett, S. S., Stone, J. S., & Rosdahl, J. A. (2018).

Identifying risk factors for blindness from primary open-angle glaucoma by race: a case-

control study. Clinical ophthalmology (Auckland, NZ), 12, 377.

Yuecel, Y., & Gupta, N. (2008). Glaucoma of the brain: a disease model for the study of

transsynaptic neural degeneration. Progress in brain research, 173, 465-478.

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1

1. Glaucoma

Outdated. Find a

complimentary article that is

current. [Irene Nielsen]

14 Impacts of Glaucoma Disease

Appendix A

Budget

SUMMARY PROPOSAL BUDGET FOR INSTITUTION USE ONLY

ORGANIZATION PROPOSAL NO. DURATION

(MONTHS)

PRINCIPAL INVESTIGATOR (PI)/PROJECT

DIRECTOR

Instructor (N/B Name)

AWARD NO.

A. PERSONNEL: PI/PD, Co-PIs, Faculty, Graduate Assistants, etc. Funds List each separately with name and title. (Write your

NAME) Proposer)

1. Instructor (N/B Name) ($90,000 annually) – 30% effort for 5 months $11,250.00

2.Research Assistant (RA) – 80% effort for 5 months $16,667.00

TOTAL SALARIES $27,917.00

B. EQUIPMENT (LIST ITEM AND DOLLAR AMOUNT FOR EACH

ITEM EXCEEDING $5,000.) None $0.00

None $0.00

TOTAL EQUIPMENT COST $0.00 C. TRAVEL 1. DOMESTIC- PI attendance at national meeting $1,300.00

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15 Impacts of Glaucoma Disease

2. OTHER- Travel for RA to participants home $800.00

TOTALTRAVEL $2,100.00

D. PARTICIPANT SUPPORT $1,575.00 1. STIPENDS $ 45 by 35 participants

2. TRAVEL $0.00

3.

SUBSISTENC

E

$0.00

4. OTHER $0.00 TOTAL NUMBER OF PARTICIPANTS (35) TOTAL PARTICIPANT

COSTS

$1,575.00

E. OTHER DIRECT COSTS

1. MATERIALS AND SUPPLIES- Computer for patient training, data

collection and analysis

$5,300.00

2. OTHER Quality of Life scale $550.00

3 OTHER Office supplies $645.00

4. OTHER (Hiring Clinical Equipment’s) $400.00

TOTAL OTHER DIRECT COSTS $6,895.00

F. TOTAL DIRECT COSTS (A THROUGH E) $38,487.00

G. TOTAL INDIRECT COSTS (F&A) (Rate = 37.5%) $14,432.625

H. TOTAL DIRECT AND INDIRECT COSTS (F + G) $52,919.625

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