Medicine and Health Sciences Commons^™

Not Queer Enough: How Current Medical School Curriculum Is Failing The Lgbt+ Community, Vanessa C. Iroegbulem

Audre Lorde Writing Prize

Lesbian, gay, bisexual and transgender (LGBT+) individuals have specific healthcare needs, and often experience barriers in accessing quality and reliable health services. Research has revealed that medical practitioners are inadequately prepared to attend to the needs of the LGBT+ community.This paper will draw on the concept of intersectionality to discuss current medical school curriculum and its lack of LGBT+ education. This paper's focus is specifically on older LGBT+ adults, specifically the ways in which the intersection of gender, sexuality, race, and even class play a role in the different experiences of older LGBT+ adults in regard to the medical care, …

How Do Nurse-To-Patient Ratios In The Emergency Department Impact Patient Experience?, Jessica L. Marcoux

Electronic Theses and Dissertations

There is a lack of consensus about the staffing matrix across nursing and especially in emergency

nursing, where variations in arrival patterns, acuity, social determinants of health, and length of stay all impact the workload of emergency nurses. The objective of this paper was to determine if government-mandated staffing ratios had a greater impact on patient experience at hospitals in California than staffing based on hours per patient visit at hospitals in Massachusetts. Seven hospitals from the state of California with government-mandated nurse-to-patient ratios were compared to 7 hospitals from Massachusetts that did not have mandated staffing ratios to determine …

Bone Marrow Dendritic Cells Deficient For Cd40 And Il-23p19 Are Tolerogenic In Vitro, Tahereh Kalantari, Bogoljub Ciric, Eskandar Kamali-Sarvestani, Abdolmohamad Rostami

Department of Neurology Faculty Papers

Objective(s): In addition to pro-inflammatory role, dendritic cells (DCs) can also be anti-inflammatory when they acquire tolerogenic phenotype. In this study we tested the role of CD40 and IL-23p19 in antigen presenting function of bone marrow-derived DCs (BMDCs) by comparing BMDCs derived from CD40 knockout (CD40KO-DCs) and IL-23p19 (IL-23p19KO-DCs) knockout mice with those from C57BL/6 mice (Cont-DCs). We have focused on CD40 and IL-23, as these molecules have well established pro-inflammatory roles in a number of autoimmune and inflammatory diseases.

Materials and Methods: The expression of maturation markers MHC II and co-stimulatory molecules CD40, CD80, and CD86 was analyzed by …

Inhibition Deficits Are Modulated By Age And Cgg Repeat Length In Carriers Of The Fmr1 Premutation Allele Who Are Mothers Of Children With Fragile X Syndrome, Jessica Klusek, Jinkuk Hong, Audra Sterling, Elizabeth Berry-Kravis, Marsha R. Mailick

Faculty Publications

Individuals who carry a premutation (PM) allele on the FMR1 gene may experience executive limitations associated with their genetic status, including inhibition deficits. However, poor understanding of individualized risk factors has limited clinical management of this group, particularly in mothers who carry the PM allele who have children with fragile X syndrome (FXS). The present study examined CGG repeat length and age as factors that may account for variable expressivity of inhibition deficits. Participants were 134 carriers of the PM allele who were mothers of children with FXS. Inhibition skills were measured using both self-report and direct behavioral assessments. Increased …

Synthesis And Characterization Of Hemocompatible Antibiotic Nanoparticles, Elvin Muhindo Walemba

Loma Linda University Electronic Theses, Dissertations & Projects

Porphyromonas gingivalis is a causative agent of periodontal disease and a risk factor for cardiovascular disease. Novel treatment of periodontal disease using nanomaterials can supplement or replace the use of antibiotics and mechanical debridement. Nanomaterials can be optimized for effectiveness and specificity and minimum toxicity. Synthesized Ag nanoparticles stabilized in Pluronic F127 were used to produce bimetallic core/shell Ag/Au nanoparticles with optimized Ag+ release and reduced toxicity. We tested the F127-stabilized nanoparticles for their antimicrobial activity and hemocompatibility in planktonic bacteria and citrated whole blood, respectively. Both Ag and Ag/Au bimetallic nanoparticles inhibited P. gingivalis W83 growth. We then evaluated …

Electronic Image Detectability Under Varying Illumination Conditions, Jeremy J. Miller

Theses and Dissertations

Light in the built environment plays an essential role in the vision and the health of humans through non-visual receptors in the eyes. Unfortunately, image analysts and other Air Force personnel who engage in the detection of objects on softcopy displays are often required to work in very dimly-lit or dark environments as higher illumination reduces the contrast of displayed information. Literature has shown that increases in light exposure improves circadian rhythm entrainment and reduces the negative health consequences of insufficient lighting. This research examines the effects of indoor lighting to determine if increases in ambient illumination or changes to …

Effects Of Individualised Homoeopathic Intervention In Stage I Essential Hypertension: A Single-Blind, Randomised, Placebo-Controlled Trial, Roja Varanasi, Raju Kolli, Yogendra Rai, Dubashi Ramesh, R Kiranmayee, G Chandra Reddy, H Baig, Tejaswini Patole, Priyanka Srivastava

Indian Journal of Research in Homoeopathy

Background: Hypertension (HTN) is a leading risk factor for death and disability and responsible for over 1.6 million deaths in India. Clinical case reports, observational studies and randomised controlled trials show the effects of homoeopathic medicine in HTN. Objectives: The results of this study will add to the evidence of effectiveness of individualised homoeopathic medicine in Stage I HTN. Methods: A single-blind, randomised, placebo-controlled trial was undertaken from October 2013 to March 2018. The primary outcome measure was to evaluate the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) every month for 3 months. Of 2127 patients …

Homoeopathic Drug Proving Researches (1996–2018): A Scoping Review, Raj Manchanda, Anil Khurana, Peter Fisher, Bhopal Arya, Pritha Mehra, Subhranil Saha, Munmun Koley, Meenakshi Bhatia

Indian Journal of Research in Homoeopathy

Background: A systematic review on homoeopathic pathogenetic trials (HPTs) from 1945 to 1995 was published in 2007, and the basic question whether the effect produced by homoeopathic drugs in healthy human volunteers is equivalent to placebo or otherwise remained unanswered. There is a need to take up another review of HPTs conducted in the last two decades, to assess the changes in the methodologies adapted and to assess whether the effects produced in apparently healthy volunteers is due to homoeopathic medicines in high dilutions or not. Objective: To seek, collect, review and describe HPTs published during 1996–2018. Materials and Methods: …

Consortium Of Otolaryngology Journal Editors: Collegiality And Contributions, Robert T. Sataloff, Rakesh Chandra, Edward W. Fisher, David Goldenberg, Ehab Y. Hanna, Jonas Johnson, David W. Kennedy, Dennis H. Kraus, John H. Krouse, Michael Link

School of Medicine Publications and Presentations

There is a new tradition in the otolaryngology publishing community that is unique to our specialty, so far as we know. Editors-in-Chief of otolaryngology journals in the United States, and intermittently some of our international colleagues such as the Editor of the Journal of Laryngology and Otology (England), sit down together twice a year to discuss topics of mutual interest, maintain lines of communication and friendships, and share perspectives on the evolution of otolaryngology—head and neck surgery and needs that our journals might help address. To establish these collegial, uninhibited, informative, and productive meetings, Dr Robert Ruben proposed the idea …

Meeting The Educational Needs Of An Increasingly Diverse Surgical Workforce, Minerva Angelica Romero Arenas

School of Medicine Publications and Presentations

To the Editor Yeo et al¹ evaluated factors associated with American Board of Surgery (ABS) examination pass rates in a cohort of categorical surgical residents from the internship (2007) to eligibility/certification. They found that first-time ABS pass rate was associated with nonmodifiable factors, such as nonwhite race/ethnicity, sex (women), and having children.¹ Additionally, Hispanic residents were less likely to attempt the ABS examinations at all. We must place these findings in the context of diversity in surgery, or rather, the lack thereof. The cohort included only 55 Hispanic residents, most of whom did pass the ABS examinations (n …

Sex-Specific Outcomes In A Substance Use Intervention Program., Alexandra Amaducci, Marna R. Greenberg Do, Mph, Facep, Andrew W. Sheen Do, Hanna R. Warren Do, Pratik M. Parikh Do, Paige Roth Lsw, Kevin Weaver D.O.,Facoep, David M. Richardson Md, David B. Burmeister Do, Facep, Cpe, Jennifer Stephens Do, Robert D. Cannon Do

Department of Emergency Medicine

PURPOSE: We performed an emergency department (ED)-based substance use screening, motivational interview-based intervention, and treatment referral program with the goal of determining sex-specific outcomes. Specifically, in this quality improvement project, we aimed to determine whether there was a difference among sexes in the type of substances used; the frequency of positive screening results for substance use disorder; agreeing to an intervention; the type of follow-up evaluation, participation, and referral; and attempts to change substance use after intervention.

METHODS: We prospectively studied a convenience sample of patients at 3 hospitals in Northeastern Pennsylvania from May 2017 through February 2018. Inclusion criteria …

Energy And Protein Requirements For Children With Ckd Stages 2-5 And On Dialysis-Clinical Practice Recommendations From The Pediatric Renal Nutrition Taskforce., Vanessa Shaw, Nonnie Polderman, José Renken-Terhaerdt, Fabio Paglialonga, Michiel Oosterveld, Jetta Tuokkola, Caroline Anderson, An Desloovere, Laurence Greenbaum, Dieter Haffner, Christina Nelms, Leila Qizalbash, Johan Vande Walle, Bradley A. Warady, Rukshana Shroff, Lesley Rees

Manuscripts, Articles, Book Chapters and Other Papers

Dietary management in pediatric chronic kidney disease (CKD) is an area fraught with uncertainties and wide variations in practice. Even in tertiary pediatric nephrology centers, expert dietetic input is often lacking. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, was established to develop clinical practice recommendations (CPRs) to address these challenges and to serve as a resource for nutritional care. We present CPRs for energy and protein requirements for children with CKD stages 2-5 and those on dialysis (CKD2-5D). We address energy requirements in the context of poor growth, obesity, and different …

Mainstreaming Nutrition Services: Stabilization Centers And Outpatient Therapeutic Program Centers, Ashar Muhammad Malik

Community Health Sciences

No abstract provided.

Drill Into What Makes People Socially Responsible, David Chan

Research Collection School of Social Sciences

In an invited commentary, SMU Behavioural Sciences Institute Director Professor David Chan explained why being socially responsible is critical in Singapore’s efforts to contain the Covid-19 outbreak and mitigate its effects. He discussed the psychology underlying people’s behaviour change and suggested that we pay attention to issues of values, image, norms, convenience and enforcement.

Celebrate! The Legacy Of Community Water Fluoridation Continues In Grand Rapids, James Wieland Dds

The Journal of the Michigan Dental Association

Michigan dentistry continues to tell the world about the great advance in public health that began in Grand Rapids 75 years ago. This article looks back at past commemorations, and a tribute to those who worked so hard to make a permanent monument to community water fluoridation.

The Flint Water Crisis And Community Water Fluoridation: A Lesson In Communication. Communicating With The Public And Connecting With Community Leaders, Traci J. Dantzler Dds, Raymond Gist Dds

The Journal of the Michigan Dental Association

This article presents how not only was Flint’s water compromised lead contamination of residential waterlines during the Flint Water Crisis, but area dentists had to work hard to refute unsubstantiated claims that adding fluoride to the community water supply increased the level of lead in the water. Oral health advocacy to reassure citizens and build confidence in the community water supply following remediation efforts required sharing the best evidence while most importantly actively listening to assure that community members were heard; that they felt that they have a voice, and to know that we are here to listen to their …

An Evidence-Based Intervention To Enhance Provider Awareness And Confidence In Addressing Polypharmacy, Catherine Marie Steiner

Doctoral Dissertations and Projects

Polypharmacy is a healthcare problem of epidemic proportions in the United States. It is frequently associated with negative health outcomes in the lives of both elderly and chronically ill persons at excessive costs to the United States healthcare system. Appropriate medication management incorporating evidence-based guidelines is essential to addressing polypharmacy. Prescribing clinicians in all disciplines have expressed a lack of confidence and perceived gaps in knowledge to address polypharmacy through deprescribing. This scholarly project aimed to determine if a polypharmacy protocol intervention, based on the most current evidence-based guidelines in prescribing and deprescribing, would improve clinician confidence in the decision …

Targeted Therapy For Advanced Salivary Gland Carcinoma Based On Molecular Profiling: Results From Mypathway, A Phase Iia Multiple Basket Study, R Kurzrock, D W Bowles, H Kang, F Meric-Bernstam, J Hainsworth, D R Spigel, R Bose, H Burris, C J Sweeney, M S Beattie, S Blotner, K Schulze, V Cuchelkar, C Swanton

2020-Current year OA Pubs

BACKGROUND: Systemic therapy options for salivary cancers are limited. MyPathway (NCT02091141), a phase IIa study, evaluates targeted therapies in non-indicated tumor types with actionable molecular alterations. Here, we present the efficacy and safety results for a subgroup of MyPathway patients with advanced salivary gland cancer (SGC) matched to targeted therapies based on tumor molecular characteristics.

PATIENTS AND METHODS: MyPathway is an ongoing, multiple basket, open-label, non-randomized, multi-center study. Patients with advanced SGC received pertuzumab + trastuzumab (HER2 alteration), vismodegib (PTCH-1/SMO mutation), vemurafenib (BRAF V600 mutation), or atezolizumab [high tumor mutational burden (TMB)]. The primary endpoint is the objective response rate …

Synthetic Pesticides And Health In Vulnerable Populations: Agricultural Workers, Cynthia L. Curl, Meredith Spivak, Rachel Phinney, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Purpose of Review: This review aims to summarize epidemiological literature published between May 15, 2018 and May 14, 2019 that examines the relationship between exposure to synthetic pesticides and health of agricultural workers.

Recent Findings: Current research suggests that exposure to synthetic pesticides may be associated with adverse health outcomes. Agricultural workers represent a potentially vulnerable population, due to a combination of unique social and cultural risk factors as well as exposure to hazards inherent in farm work. Pesticide exposure among agricultural workers has been linked to certain cancers, DNA damage, oxidative stress, neurological disorders, as well as respiratory, metabolic, …

The Impact Of Education On The Attitudes Of Staff Of A Rehabilitation Hospital, Kathryn Voreis, Kathryn G. Voreis

Electronic Theses and Dissertations

Stroke, also known as CVA or cerebrovascular accident, is a major chronic disease worldwide. In the United States, it is the leading cause of disability, costing a billion dollars each year (CDC, 2017). Typically, Western medicine is used for the treatment of stroke in the United States. An approach that has potential to improve general health outcomes, movement, mobility, aphasia, and quality of life includes acupuncture along with the standard therapies. The purpose of this quantitative research was to determine if the staff of a rehabilitation hospital would have a change in attitude after an educational program on acupuncture. The …

The Effect Of Heart Score Risk Stratification Tool On Length Of Stay, Kelly Huffman

Electronic Theses and Dissertations

Abstract

With increasing national health care expenditures, different methods of reducing health care costs, along with supportive evidence-based research, are essential. This research will lead to changes in clinical practice standards including the utilization of tools by emergency room and hospitalist providers to reduce costs by decreasing the length of stay for acute chest pain admissions. The researcher utilized a retrospective review of charts for participants admitted into the acute care setting with the primary diagnosis of acute chest pain, with a focus on determining whether an initial calculation of a HEART Score risk stratification variable was completed and if …

Clinical Features And Outcomes Of Takotsubo (Stress) Cardiomyopathy In South Texas Hispanics, Cesar H. Gutierrez, Wady Aude

School of Medicine Publications and Presentations

Background

Takotsubo cardiomyopathy (TSC) can be preceded by emotional, physical, or no identifiable trigger. Despite being a transient condition, it is associated with a substantial risk for in-hospital adverse events. The clinical features and the short-term outcomes of TSC in South Texas Hispanics (STH) are unknown.

Methods

We identified patients with the diagnosis of TSC at an academic institution from 2005-2017. Patients who did not have coronary angiography were excluded. Demographics, presenting symptoms, triggers, left ventricular characteristics and outcomes were expressed as percentages. Continuous variables were expressed as means.

Results

Of 41 patients with TSC, the diagnosis was confirmed in …

Correlation Of Early Outcomes And Intradiscal Interleukin-6 Expression In Lumbar Fusion Patients., John D Koerner, Dessislava Z Markova, Greg D Schroeder, Christopher L Antonacci, Joseph Mendelis, Alexander R Vaccaro, D Greg Anderson, Chris K Kepler

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: To determine if there is correlation between intradiscal levels of interleukin-6 (IL-6) and early outcome measures in patients undergoing lumbar fusion for painful disc degeneration.

METHODS: Intervertebral disc tissue was separated into annulus fibrosus/nucleus pulposus and cultured separately in vitro in serum-free medium (Opti-MEM). Conditioned media was collected after 48 hours. The concentration of IL-6 was quantified using enzyme-linked immunosorbent assay. Pearson correlation coefficients quantified relationships between IL-6 levels and pre- and postoperative visual analogue scale (VAS) back pain and Oswestry Disability Index (ODI), as well as change in VAS/ODI.

RESULTS: Sixteen discs were harvested from 9 patients undergoing …

Exploring Changes In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Fafan And West Arsi Zones, Ethiopia, Getaneh Mehari, Asabneh Molla, Ayantu Mamo, Dennis Matanda

Reproductive Health

Globally, more than 200 million women and girls have undergone FGM/C. More than half of these girls and women live in three high-prevalence countries: Egypt, Ethiopia, and Indonesia. Given the increase in population growth, recent estimates show that the number of girls and women subject to FGM/C will continue to rise in the coming years unless sufficient efforts are undertaken to encourage abandonment of the practice. A descriptive analysis of changes in FGM/C prevalence over time in Ethiopia shows that the percentage of women aged 15–49 years who report undergoing FGM/C has been declining. Despite the decline, the FGM/C prevalence …

Pilomatrix Carcinoma Of The Lacrimal Caruncle: A Case Report., Ibrahim Inan Harbiyeli, Altan A Ozcan, Arbil Acıkalin, Emine Ciloglu, Carol L Shields

Wills Eye Hospital Papers

A 45-year-old man presented with a 3-month history of a mass located in the caruncle of his right eye. An incisional biopsy had been performed one month prior by another specialist, and the histopathology report showed basal cell carcinoma. The mass was completely excised with a 2 mm safety margin, and the large conjunctival defect was reconstructed with one sheet of amniotic membrane allograft. A histological diagnosis of pilomatrix carcinoma was established. To prevent recurrence after surgery, we added bevacizumab (25 mg/mL, 1.25 mg/mL per drop) eye drops four times per day for three months. At the one-year follow-up, the …

Causes Of Congenital Corneal Opacities And Their Management In A Tertiary Care Center., Remzi Karadag, Christopher J Rapuano, Kristin M Hammersmith, Parveen K Nagra

Wills Eye Hospital Papers

PURPOSE: To evaluate causes and management of congenital corneal opacities (CCO) diagnosed in a tertiary care eye center and to compare the data with a previous study at the same institution.

METHODS: Computerized medical records in all patients with congenital corneal opacities diagnosed in the Cornea Service at Wills Eye Hospital (Philadelphia, PA) between January 1, 2007, and December 31, 2015, were retrospectively reviewed. Children aged 12 years and younger at the first visit were included in the study. Patients' demographics, ocular diagnosis, laterality, associated ocular abnormalities, other ocular surgery performed prior or subsequent to the first visit, and their …

The Dietary Management Of Calcium And Phosphate In Children With Ckd Stages 2-5 And On Dialysis-Clinical Practice Recommendation From The Pediatric Renal Nutrition Taskforce., Louise Mcalister, Pearl Pugh, Laurence Greenbaum, Dieter Haffner, Lesley Rees, Caroline Anderson, An Desloovere, Christina Nelms, Michiel Oosterveld, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, José Renken-Terhaerdt, Jetta Tuokkola, Bradley A. Warady, Johan Vande Walle, Vanessa Shaw, Rukshana Shroff

Manuscripts, Articles, Book Chapters and Other Papers

In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and …

Immunogenicity In Clinical Practice And Drug Development: When Is It Significant?, Valentina Shakhnovich, Bernd Meibohm, Amy Rosenberg, Andrzej M. Kierzek, Rachel Hasenkamp, Ryan S. Funk, Craig J. Thalhauser, Piet H. Van Der Graaf, Yow Ming C. Wang, Lora Hamuro

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Analysis On Addiction And Opioid Crisis: Implications And Solutions, Bhavika Korat

Electronic Theses, Projects, and Dissertations

Opioids have become a popular way of pain management treatment over the past decades and although they have proven to be very successful to treat pain, they require serious attention as they have become the cause of addiction and overdose deaths. Opioid overdose costs the US government $78.5 billion each year. This project exhibits the background on opioids, the different types of opioids and their role in the addiction and overdose epidemic. The objective behind this project was to demonstrate what kind of people are more vulnerable to addiction and overdose.

This project shows the statistics of opioid overdose deaths …

Anomalous Origin Of The Left Coronary Artery From The Pulmonary Artery: A Surgical Certainty, Ayesha Butt, Muhammad Muneer Amanullah, Mehnaz Atiq Ahmed, Asif Hasan, Waris Ahmad

Medical College Documents

This study aims to assess the clinical presentation and the outcomes of a surgical correction of an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). A retrospective review was carried out on the charts of six patients admitted for ALCAPA surgery at Aga Khan University Hospital, Karachi from March 2017 to May 2018.Dyspnoea, palpitation, poor feeding, fatiguability, pallor and a murmur of mitral regurgitation were the main presenting features. The pre-operative median left ventricular ejection fraction (LVEF) was 64%. Coronary reimplantation was performed in all the patients with a mitral valve repair being done in only …