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P30. Optimizing Current Steering In Deep Brain Stimulation For Treating Parkinsonian Axial Motor Symptoms, Daphne Hui 2017 Western University

P30. Optimizing Current Steering In Deep Brain Stimulation For Treating Parkinsonian Axial Motor Symptoms, Daphne Hui

Western Research Forum

Background: The proposed study will investigate deep brain stimulation (DBS), of the subthalamic nucleus (STN) to improve gait dysfunctions in advanced Parkinson’s Disease (PD). DBS requires implantation of electrodes into the brain that contain contacts where current traverses to stimulate neurons. Imprecise electrode implantations are inherent in surgical implantation; thus, contributing to the elusiveness of DBS on gait.

Methods: The proposed investigation will divide current between two contacts to receive 0, 30, 50, 70, or 100% of current, to find the best combination to improve gait. Gait changes associated with fractional combinations will be visually assessed with clinical scales ...


P33. Design And Evaluation Of An Escherichia Coli Biomarker For Indication Of Ph, Kevin X. Zhou, Luana Langlois, Ashmita Singh, John Prince 2017 Western University

P33. Design And Evaluation Of An Escherichia Coli Biomarker For Indication Of Ph, Kevin X. Zhou, Luana Langlois, Ashmita Singh, John Prince

Western Research Forum

Measuring pH is one of the most commonly used techniques in both the laboratory as well as the field due to its importance in a multitude of biochemical processes. Traditional methods of measuring pH may be highly developed in accuracy and precision but often involve disruption of the environment. Biological markers offer an alternative that allows for long-term pH monitoring. This innovative approach allows for vast applications such as in the manufacturing, food processing and research industries. Under moderate acidic conditions, the asr (acid shock RNA) gene is highly inducible and has been demonstrated to be crucial for growth at ...


P34. The Effects Of Standing Desks On Classroom Performance Of University Students, Siobhan Smith 2017 Western University

P34. The Effects Of Standing Desks On Classroom Performance Of University Students, Siobhan Smith

Western Research Forum

Background:

It is well established that there are many health risks associated with prolonged sedentary time.1 Unfortunately, research conducted on university students is limited but yet they experience excessive periods of sitting time during class and while studying.

Methods:

Recently, we investigated the effect of sitting, dynamic sitting, and standing desks on classroom performance of university students.2 Participants performed three 3-minute classroom simulations, one for each of the three desks. The order of the desks and simulations were randomized. Each of the simulations included a different typing and memory task.

Results:

Results showed no significant difference in the ...


P35. Investigating The Effect Of Maternal Immune Activation On Sensory Filtering, Social Behaviour And Attention, Faraj Haddad 2017 Western University

P35. Investigating The Effect Of Maternal Immune Activation On Sensory Filtering, Social Behaviour And Attention, Faraj Haddad

Western Research Forum

Background

Altered brain development is associated with many neuropsychiatric disorders like Autism Spectrum Disorder (ASD) and schizophrenia. Environmental insults can interfere with neurodevelopment, and a prominent example is maternal infection during pregnancy. Epidemiological studies show that children born to mothers who were infected during pregnancy display a higher risk of developing ASD and schizophrenia, and this effect is mainly due to the maternal immune response. Polyinosinic-polycytidilic acid (Poly I:C) is a double stranded RNA molecule that mimics viral markers and elicits an immune response. When injected in pregnant rodents, this model produces offspring that exhibit core symptoms of ASD ...


Data As A Strategic Resource: Self-Determination, Governance, And The Data Challenge For Indigenous Nations In The United States, Stephanie Carroll Rainie, Jennifer Lee Schultz, Eileen Briggs, Patricia Riggs, Nancy Lynn Palmanteer-Holder 2017 University of Arizona

Data As A Strategic Resource: Self-Determination, Governance, And The Data Challenge For Indigenous Nations In The United States, Stephanie Carroll Rainie, Jennifer Lee Schultz, Eileen Briggs, Patricia Riggs, Nancy Lynn Palmanteer-Holder

The International Indigenous Policy Journal

Data about Indigenous populations in the United States are inconsistent and irrelevant. Federal and state governments and researchers direct most collection, analysis, and use of data about U.S. Indigenous populations. Indigenous Peoples’ justified mistrust further complicates the collection and use of these data. Nonetheless, tribal leaders and communities depend on these data to inform decision making. Reliance on data that do not reflect tribal needs, priorities, and self-conceptions threatens tribal self-determination. Tribal data sovereignty through governance of data on Indigenous populations is long overdue. This article provides two case studies of the Ysleta del Sur Pueblo and Cheyenne River ...


A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey JL Carson 2017 Western University

A Novel Hybrid Imaging System To Aid In Surgical Decision Making, Lawrence Yip, Madeleine Van De Kleut, Ivan Kosik, Astrid Chamson-Reig, Jeffrey Jl Carson

Western Research Forum

Background:

Breast cancer accounts for 25% of all cancer cases among women. In breast-conserving surgery, a common treatment, the tumour is excised with a healthy tissue margin. However, detection of the margin can be difficult. Current techniques to guide excision are often insufficient, and re-excision can occur up to 25% of the time.

Methods:

Photoacoustic imaging is a hybrid imaging modality that combines the advantages of optical imaging and ultrasound while using safe non-ionizing light. This project involves the development of a novel imaging system with a new scanner design to overcome common limitations and provide images to aid in ...


Parental Quality Of Life 10 Years After Their Child’S Epilepsy Diagnosis, Klajdi Puka, Kathy Nixon Speechley 2017 Western University

Parental Quality Of Life 10 Years After Their Child’S Epilepsy Diagnosis, Klajdi Puka, Kathy Nixon Speechley

Western Research Forum

Background: Although the long-term course of childhood epilepsy is favorable in terms of seizure control, patients often face debilitating cognitive and psychosocial deficits that persist even after seizure remission. Pediatric epilepsy also has a large impact on the family and has been shown to be associated with diminished quality of life (QOL) among parents. However, the long-term outcome of parental QOL is unknown. This study aimed to 1) evaluate parental QOL 10 years after their child was diagnosed with epilepsy and 2) identify epilepsy-, child- and family-related characteristics associated with diminished parental QOL.

Methods: Data were derived from the Health-Related ...


Pulmonary Surfactant Fortified With Cath-2 As A Novel Therapy For Bacterial Pneumonia, Brandon J. Baer 2017 University of Western Ontario

Pulmonary Surfactant Fortified With Cath-2 As A Novel Therapy For Bacterial Pneumonia, Brandon J. Baer

Western Research Forum

Background: Bacterial pneumonia is a leading cause of death worldwide, with high mortality rates persisting even after antibiotic treatment. Current treatments for pneumonia involve administration of antibiotics, however after the bacteria are killed they release toxic substances that induce inflammation and lung dysfunction. Host defense peptides represent a potential solution to this problem through their ability to down regulate inflammation. However, effective delivery to the lung is difficult because of the complex branching structure of the airways. My study addresses this delivery problem by using exogenous surfactant, a pulmonary delivery vehicle capable of improving spreading of these peptides throughout the ...


The Effects Of Intrauterine Growth Restriction (Iugr) On The Pulmonary Surfactant And Lung Injury, Reza Khazaee 2017 University of Western Ontario

The Effects Of Intrauterine Growth Restriction (Iugr) On The Pulmonary Surfactant And Lung Injury, Reza Khazaee

Western Research Forum

The Effects of Intrauterine Growth Restriction (IUGR) on the Pulmonary Surfactant and Lung Injury

Khazaee R1, McCaig LA2, Hardy D1, Yamashita CM2, Veldhuizen, RAW2

Department of Physiology and Pharmacology1, Western University, London, ON, Canada. Lawson Health Research Institute2, London, ON, Canada

Background: Acute respiratory distress syndrome (ARDS) is defined as severe lung dysfunction that occurs after an insult to the lung such as an infection. The lung dysfunction in ARDS is due to alterations to surfactant, a lipid-protein mixture coats the inside of the lung and maintains the lungs’ ability to expand easily ...


Perception And Responses To Different Forms Of Aqua-Based Exercise Among Older Adults With Osteoarthritis, Alison L. Fisken, Debra L. Waters, Wayne A. Hing, Michael Craig Steele, Justin W. Keogh 2017 Australian Catholic University

Perception And Responses To Different Forms Of Aqua-Based Exercise Among Older Adults With Osteoarthritis, Alison L. Fisken, Debra L. Waters, Wayne A. Hing, Michael Craig Steele, Justin W. Keogh

Justin Keogh

Osteoarthritis (OA) is prevalent among older adults. Aqua-based exercise is often recommended as a therapeutic intervention. Limited evidence exists on the effectiveness of this form of exercise intervention. Perceptions of pain, mean, and maximum heart rate (HR) responses, ratings of perceived exertion (RPE), and subjective enjoyment to different forms of aqua-based exercise were investigated. Thirteen older adults with documented OA completed five aquatic exercise sessions: body-weight aqua-fitness (AF), body-weight aqua-jogging (AJ), resisted aqua-fitness (RAF), resisted aqua-jogging (RAJ), and hydrotherapy (HYD). HYD was rated most enjoyable with AF deemed as an acceptable alternative. Pain scores immediately postexercise were significantly lower than ...


Cost Variability Of Suggested Generic Treatment Alternatives Under The Medicare Part D Benefit, Rajul A. Patel, Mark P. Walberg, Emily Tong, Florence Tan, Ashley E. Rummel, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal 2017 University of the Pacific

Cost Variability Of Suggested Generic Treatment Alternatives Under The Medicare Part D Benefit, Rajul A. Patel, Mark P. Walberg, Emily Tong, Florence Tan, Ashley E. Rummel, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal

Joseph Woelfel

BACKGROUND: The substitution of generic treatment alternatives for brand-name drugs is a strategy that can help lower Medicare beneficiary out-of-pocket costs. Beginning in 2011, Medicare beneficiaries reaching the coverage gap received a 50% discount on the full drug cost of brand-name medications and a 7% discount on generic medications filled during the gap. This discount will increase until 2020, when beneficiaries will be responsible for 25% of total drug costs during the coverage gap. OBJECTIVE: To examine the cost variability of brand and generic drugs within 4 therapeutic classes before and during the coverage gap for each 2011 California stand-alone ...


Minimizing Part D Costs For Medicare Beneficiaries: Not Just A Drop In The Bucket, Rajul A. Patel, Kate M. O'Dell, Kim-Anh Vo, Tiffany Chu, Kenneth Wang, Shu Lu, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal, Berit Gundersen 2017 University of the Pacific

Minimizing Part D Costs For Medicare Beneficiaries: Not Just A Drop In The Bucket, Rajul A. Patel, Kate M. O'Dell, Kim-Anh Vo, Tiffany Chu, Kenneth Wang, Shu Lu, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal, Berit Gundersen

Joseph Woelfel

Background: Although Medicare Part D has been largely successful in providing prescription drug coverage for Medicare beneficiaries, many continue to be burdened with unnecessary out-of-pocket (OOP) costs. Objective: This study sought to identify the frequency and impact of cost-lowering strategies used to assist Medicare beneficiaries with their Part D drug costs. Methods: Twelve outreach events were conducted in 6 different cities throughout Northern/Central California during the 2013 Medicare open enrollment period. During each event, trained student pharmacists under the supervision of licensed pharmacists assisted beneficiaries to minimize their OOP costs. Individualized assistance included: optimization of the beneficiary's Part ...


Medicare Part D Prescription Drug Costs And Plan Satisfaction As A Function Of Student Pharmacists' Assistance, Rajul A. Patel, Kate M. O'Dell, Kenneth Wang, Shu Lu, Tiffany Chu, Kim-Anh Vo, Sian M. Carr-Lopez, Joseph A. Woelfel, Suzanne M. Galal, Berit Gundersen 2017 University of the Pacific

Medicare Part D Prescription Drug Costs And Plan Satisfaction As A Function Of Student Pharmacists' Assistance, Rajul A. Patel, Kate M. O'Dell, Kenneth Wang, Shu Lu, Tiffany Chu, Kim-Anh Vo, Sian M. Carr-Lopez, Joseph A. Woelfel, Suzanne M. Galal, Berit Gundersen

Joseph Woelfel

Background: Beneficiaries can become overwhelmed by the myriad of Medicare Part D (MPD) plans that offer prescription drug coverage. Poor choice and increased out-of-pocket (OOP) costs can be reduced through annual plan reevaluation. Objective: To examine beneficiaries' plan satisfaction and MPD drug costs as a function of prior assistance from trained student pharmacists. Methods: Twelve outreach events, nine at the same location as the previous year, were held throughout Northern/Central California during October-November 2012. Trained student pharmacists, at each event, identified the MPD plan best meeting a beneficiary's needs based on their current medications and personal preferences (e ...


Medicare Part D Roulette: Potential Implications Of Random Assignment And Plan Restrictions, Rajul A. Patel, Mark P. Walberg, Joseph A. Woelfel, Michelle M. Amaral, Paresh Varu 2017 University of the Pacific

Medicare Part D Roulette: Potential Implications Of Random Assignment And Plan Restrictions, Rajul A. Patel, Mark P. Walberg, Joseph A. Woelfel, Michelle M. Amaral, Paresh Varu

Joseph Woelfel

Background: Dual-eligible (Medicare/Medicaid) beneficiaries are randomly assigned to a benchmark plan, which provides prescription drug coverage under the Part D benefit without consideration of their prescription drug profile. To date, the potential for beneficiary assignment to a plan with poor formulary coverage has been minimally studied and the resultant financial impact to beneficiaries unknown. Objective: We sought to determine cost variability and drug use restrictions under each available 2010 California benchmark plan. Methods: Dual-eligible beneficiaries were provided Part D plan assistance during the 2010 annual election period. The Medicare Web site was used to determine benchmark plan costs and ...


Medication Adherence Behaviors Of Medicare Beneficiaries, Sian M. Carr-Lopez, Allen Shek, Janine Lastimosa, Rajul A. Patel, Joseph A. Woelfel, Suzanne M. Galal, Berit Gundersen 2017 University of the Pacific

Medication Adherence Behaviors Of Medicare Beneficiaries, Sian M. Carr-Lopez, Allen Shek, Janine Lastimosa, Rajul A. Patel, Joseph A. Woelfel, Suzanne M. Galal, Berit Gundersen

Joseph Woelfel

Background: Medication adherence is crucial for positive outcomes in the management of chronic conditions. Comprehensive medication consultation can improve medication adherence by addressing intentional and unintentional nonadherence. The Medicare Part D prescription drug benefit has eliminated some cost barriers. We sought to examine variables that impact self-reported medication adherence behaviors in an ambulatory Medicare-beneficiary population and to identify the factors that influence what information is provided during a pharmacist consultation.Methods: Medicare beneficiaries who attended health fairs in northern California were offered medication therapy management (MTM) services during which demographic, social, and health information, and responses to survey questions regarding ...


Medicare Part D Plan Optimization: The Need For An Annual Check-Up, Rajul A. Patel, Mark P. Walberg, Nataliya McElroy, Anil Mallya, Aesun Kim, Yvonne Mai, Justin Seo, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal 2017 University of the Pacific

Medicare Part D Plan Optimization: The Need For An Annual Check-Up, Rajul A. Patel, Mark P. Walberg, Nataliya Mcelroy, Anil Mallya, Aesun Kim, Yvonne Mai, Justin Seo, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal

Joseph Woelfel

Background: Since its inception, Medicare Part D requires beneficiaries to choose from a myriad of insurance plans in order to receive prescription drug coverage. Moreover, each year beneficiaries are confronted with plan cancellations, new plan offerings, changes in existing plan formularies and cost-sharing structure. Objective: This study prospectively examined the relationship between stand-alone prescription drug plan (PDP) costs, subsidy status, and the number of plans offered in California from 2009-2012. Methods: Forty-one community outreach events were held throughout Central/Northern California during the Medicare Part D annual election periods from 2008-2011. In total, 1,578 beneficiaries were assisted, 983 (62 ...


Healthcare Provider Utilization And Patient Outcomes: The Call For Enhanced Coordinated Care For Medicare Beneficiaries, Yvonne Mai, Rajul A. Patel, Suzanne M. Galal, Sian M. Carr-Lopez, Joseph A. Woelfel 2017 University of the Pacific

Healthcare Provider Utilization And Patient Outcomes: The Call For Enhanced Coordinated Care For Medicare Beneficiaries, Yvonne Mai, Rajul A. Patel, Suzanne M. Galal, Sian M. Carr-Lopez, Joseph A. Woelfel

Joseph Woelfel

Background: The use of complementary and alternative medicine (CAM) and other non-physician health care providers (dentists, optometrists, etc.) has steadily increased in the United States; however, the associated outcomes reported in the Medicare population is limited. Objective: To evaluate the utilization of different healthcare providers by Medicare beneficiaries and assess resultant patient outcomes. Methods: Fourteen outreach events targeting Medicare beneficiaries were conducted throughout Northern/Central California during the 2014 open enrollment period. Trained student pharmacists (working under licensed pharmacist supervision) provided beneficiaries with comprehensive medication therapy management (MTM) services. During each intervention, demographic, quality-of-life, health behavior, and health provider/service ...


Toward The Global Control Of Human Scabies: Introducing The International Alliance For The Control Of Scabies, Daniel Engelman, Karen Kiang, Olivier Chosidow, James McCarthy, Claire Fuller, Patrick Lammie, Roderick Hay, Andrew Steer 2017 Selected Works

Toward The Global Control Of Human Scabies: Introducing The International Alliance For The Control Of Scabies, Daniel Engelman, Karen Kiang, Olivier Chosidow, James Mccarthy, Claire Fuller, Patrick Lammie, Roderick Hay, Andrew Steer

Daniel T. Engelman MD

Scabies, the human skin disease caused by infestation by the mite Sarcoptes scabiei var. hominis, causes considerable morbidity and mortality through direct effects and as a result of secondary bacterial infection. Scabies is a truly neglected disease, largely absent from the global health agenda, and its huge burden of disease is largely underappreciated. We contend that coordinated, global efforts to control this ubiquitous pathogenic mite are both important and achievable.


Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone 2017 Department of Geriatrics, Aurora Health Care

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Jodi Punke

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium ...


Risk Of Infection Associated With Subsequent Biologic Agent Use After Rituximab: Results From A National Rheumatoid Arthritis Patient Registry, Leslie R. Harrold, George W. Reed, Chitra Karki, Robert P. Magner, Ashwini Shewade, Ani John, Joel Kremer, Jeffrey D. Greenberg 2017 University of Massachusetts Medical School

Risk Of Infection Associated With Subsequent Biologic Agent Use After Rituximab: Results From A National Rheumatoid Arthritis Patient Registry, Leslie R. Harrold, George W. Reed, Chitra Karki, Robert P. Magner, Ashwini Shewade, Ani John, Joel Kremer, Jeffrey D. Greenberg

Leslie R. Harrold

OBJECTIVE: To assess whether the time between the last rituximab infusion and initiation of a different biologic agent influenced infection risk in patients with rheumatoid arthritis (RA). METHODS: Patients with RA who newly initiated rituximab within the Consortium of Rheumatology Researchers of North America registry were included if they switched to a nonrituximab biologic agent and had > /=1 followup visit within 12 months of switching. Patients were categorized by duration of time between their last rituximab infusion and initiation of a subsequent biologic agent (< /=5 months, 6-11 months, and > /=12 months). The primary outcome was time to first infectious event. Adjusted Cox regression models estimated ...


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