Digital Commons Network^™

Early Adoption Of Transoral Robotic Surgical Program: Preliminary Outcomes., David Cognetti, Adam Luginbuhl, Anthony L. Nguyen, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: The objective of this study is to demonstrate the feasibility and safety of establishing a transoral robotic surgical (TORS) program in the post-Food and Drug Administration (FDA) approval setting. Early outcomes are compared with the previously reported results of pioneering centers.

STUDY DESIGN: Clinical data from a prospective TORS study.

SETTING: Academic university institution.

SUBJECTS AND METHODS: Sixty-one patients treated with 63 TORS procedures. Main outcome measures: intraoperative times, margin status, complications, time to diet, and percutaneous endoscopic gastrostomy (PEG) tube retention rate. The authors also report oncologic outcomes on their first 30 patients.

RESULTS: The spectrum of subsites …

Diabetes Related Knowledge Among Residents And Nurses: A Multicenter Study In Karachi, Pakistan., Asma Ahmed, Abdul Jabbar, Lubna Zuberi, Muhammad Islam, Khusro Shamim

Department of Medicine

Background: Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan.

Methods: A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University …

Psychometrics Of The Scale Of Attitudes Toward Physician-Pharmacist Collaboration: A Study With Medical Students., Mohammadreza Hojat, John Spandorfer, Gerald A. Isenberg, Michael J. Vergare, Reza Fassihi, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Despite the emphasis placed on interdisciplinary education and interprofessional collaboration between physicians and pharmacologists, no psychometrically sound instrument is available to measure attitudes toward collaborative relationships.

AIM: This study was designed to examine psychometrics of an instrument for measuring attitudes toward physician-pharmacist collaborative relationships for administration to students in medical and pharmacy schools and to physicians and pharmacists.

METHODS: The Scale of Attitudes Toward Physician-Pharmacist Collaboration was completed by 210 students at Jefferson Medical College. Factor analysis and correlational methods were used to examine psychometrics of the instrument.

RESULTS: Consistent with the conceptual framework of interprofessional collaboration, three underlying …

Carrs Surveillance Study: Design And Methods To Assess Burdens From Multiple Perspectives, Manisha Nair, Mohammed K. Ali, Vamadevan S. Ajay, Roopa Shivashankar, Viswanathan Mohan, Rajendra Pradeepa, Hassan Mehmood Khan, Muhammad Masood Kadir, Zafar Fatmi, K Srinath Reddy, Nikhil Tandon, Km Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Background: Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011.
Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries.
Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort.Sites: Three urban settings (Chennai and New Delhi in India; Karachi in …

Reflective Journals Of Students Taking A Positive Youth-Development Course In A University Context In Hong Kong, Daniel T. L. Shek, Florence K. Y. Wu

Pediatrics Faculty Publications

To promote the holistic development of university students, a course entitled "Tomorrow's Leaders" was developed and offered at The Hong Kong Polytechnic University. Based on a case study approach, reflective journals of five outstanding students of the course are presented and analyzed (i.e., thick description), with several themes emerging from the reflection. First, the students liked the course, and they identified many positive attributes. Second, the students appreciated the instructors. Third, the students viewed that the course contributed to different aspects of their development. Fourth, some areas of improvements were proposed. In conjunction with other evaluation mechanisms, the present findings …

Parent-Clinician Communication Intervention During End-Of-Life Decision Making For Children With Incurable Cancer., Pamela S. Hinds, Linda L. Oakes, Judy Hicks, Brent Powell, Deo K. Srivastava, Justin N. Baker, Sheri L. Spunt, Nancy K. West, Wayne L. Furman

Pediatrics Faculty Publications

Background: In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents' rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child's clinicians in time to be of use in the family's care.

Methods: Sixty-two parents of 58 children and 126 clinicians participated. Within 72 hours after the treatment decision, parents responded to 6 open-ended interview questions and completed a 10-item questionnaire about the end-of-life …

Hormonal Induction Of Polo-Like Kinases (Plks) And Impact Of Plk2 On Cell Cycle Progression In The Rat Ovary, Feixue Li, Misung Jo, Thomas E. Curry, Jing Liu

Obstetrics and Gynecology Faculty Publications

The highly conserved polo-like kinases (Plks) are potent regulators of multiple functions in the cell cycle before and during mitotic cell division. We investigated the expression pattern of Plk genes and their potential role(s) in the rat ovary during the periovulatory period. Plk2 and Plk3 were highly induced both in intact ovaries and granulosa cells in vivo after treatment with the luteinizing hormone (LH) agonist, human chorionic gonadotropin (hCG). In vitro, hCG stimulated the expression of Plk2 in granulosa cells, but not Plk3. This induction of Plk2 expression was mimicked by both forskolin and phorbol 12 myristate 13-acetate (PMA). Moreover, …

Oncolog, Volume 57, Number 08, August 2012, Amelia Scholtz, Dawn Chalaire

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Preoperative Chemotherapy Offers Best Outcomes for Patients with Rare Bladder Cancer: A combination of neoadjuvant chemotherapy and surgery provides patients who have small-cell urothelial cancer (SCUC) with much longer survival times than does initial surgery, the previous standard treatment
• Addressing Psychological Concerns for Cancer Patients: Despite advances in cancer treatment over the past several years, for many people, a diagnosis of cancer can still feel like a death sentence. The added stress leads to psychological problems for many patterns
• INBRIEF: New Antibody Treatment Produces Responses in Patient with Advanced Cancer/Accelerated Partial-Breast Brachytherapy Associated with Decreased Long-Term Breast Preservation and Increased …

Digest Of The Philadelphia College Of Osteopathic Medicine (Summer 2012), Philadelphia College Of Osteopathic Medicine

Digest

The Summer 2012 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Message from the President
• PCOM Updates
• Commencement 2012
• Honors and Awards
• Development News
• Giving Back and Paying it Forward: Three alumni talk about their Careers and their Support for the College
• Top 100 Donors
• Transitioning into Retirement
• Trends in Forensic Medicine: Dramatic Rise in Prescription Drug Use
• Remembering Nicholas C. Pedano, DO ’61, FACOS
• Class Notes
• In Memoriam
• My Turn Essay
• The Fund for PCOM

Family And Personal Adjustment Of Economically Disadvantaged Chinese Adolescents In Hong Kong, Daniel T. L. Shek, Pik Fong Tsui

Pediatrics Faculty Publications

This study attempted to examine the relationship between poverty and adolescent developmental outcomes in the family and personal domains in 3,328 Chinese secondary school students in Hong Kong. Developmental outcomes included positive youth development constructs, problem behaviors, perceived family interaction, and parental parenting. Results showed that adolescents experiencing poverty did not differ from nonpoor adolescents in terms of risk behavior and in most indicators of positive youth development. On the other hand, adolescents with economic disadvantage displayed lower levels of positive identity, family interaction, and perceived paternal parenting than did those without economic disadvantage.

Subjective Outcome Evaluation Of The Project P.A.T.H.S. In Different Cohorts Of Students, Daniel T. L. Shek, Cecilia M. S. Ma

Pediatrics Faculty Publications

The project P.A.T.H.S. is an indigenously developed positive youth development program in Hong Kong. In the extension phase (2009/2010 school year), subjective outcome evaluation data were collected from 231 schools involving 89,068 participants after completion of the curricula-based Tier 1 Program. With schools as the units of analysis, results showed that participants generally had positive perceptions of the program content and implementers, with over four-fifth of the participants regarded the program as helpful to them. There were some significant grade differences in the subjective outcome evaluation findings, although the related effect size was not strong. Multiple regression analyses revealed that …

Student Classroom Misbehavior: An Exploratory Study Based On Teachers' Perceptions, Rachel C. F. Sun, Daniel T. L. Shek

Pediatrics Faculty Publications

This study aimed to examine the conceptions of junior secondary school student misbehaviors in classroom, and to identify the most common, disruptive, and unacceptable student problem behaviors from teachers' perspective. Twelve individual interviews with teachers were conducted. A list of 17 student problem behaviors was generated. Results showed that the most common and disruptive problem behavior was talking out of turn, followed by nonattentiveness, daydreaming, and idleness. The most unacceptable problem behavior was disrespecting teachers in terms of disobedience and rudeness, followed by talking out of turn and verbal aggression. The findings revealed that teachers perceived student problem behaviors as …

Effects Of Consuming Beans Before Or With A Meal On Satiety And Gastrointestinal Hormones Concentration In Obese Men And Women, Lisa Delia Griffith

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Consuming beans and staggering meals may control energy intake. We examined the effect of consuming 0.5 cup of beans 15 minutes before a meal on gastrointestinal (GI) peptides concentrations in obese men and women.

Methods: A randomized crossover design was used to measure GI peptides response to two test meals in 28 healthy obese adults. Subjects consumed a standardized breakfast meal on each test day followed by one of two test meals: a meal incorporating 0.5 cup of beans (control bean meal), and an isocaloric meal (staggered bean meal) in which 0.5 cup of beans was consumed 15 minutes …

Multidrug Resistant Pulmonary Tuberculosis Treatment Regimens And Patient Outcomes: An Individual Patient Data Meta-Analysis Of 9,153 Patients, Shama D. Ahuja, David Ashkin, Monika Avendano, Rita Banerjee, Melissa Bauer, Jamie N. Bayona

Dartmouth Scholarship

Dick Menzies and colleagues report findings from a collaborative, individual patient-level meta-analysis of treatment outcomes among patients with multidrug-resistant tuberculosis.

Background: Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB.

Evaluating The Effectiveness Of The Blood Pressure Plus Program At Thomas Jefferson University, Adam C. Winters

Department of Family & Community Medicine Faculty Papers

Thomas Jefferson University Hospital’s Blood Pressure Plus program enhances the role of the community in chronic disease prevention and management. There is much evidence that controlling disease and cost is greatly improved through the involvement of community leaders and resources. By offering free blood pressure screenings, the BP+ program was able to document the current status of many underserved individuals in the city of Philadelphia, provide the necessary education and referrals. Perhaps more importantly, the program allowed us to foster relationships with individuals who could further the efforts of chronic care management within their communities. More and more we’re seeing …

“That Pregnancy Can Bring Noise Into The Family”: Exploring Intimate Partner Sexual Violence During Pregnancy In The Context Of Hiv In Zimbabwe, Simukai Shamu, Naeemah Abrahams, Marleen Temmerman, Tamara Shefer, Christina Zarowsky

Obstetrics and Gynaecology, East Africa

Background: Globally, studies report a high prevalence of intimate partner sexual violence (IPSV) and an association with HIV infection. Despite the criminalisation of IPSV and deliberate sexual HIV infection in Zimbabwe, IPSV remains common. This study explored women’s and health workers’ perspectives and experiences of sexuality and sexual violence in pregnancy, including in relation to HIV testing.

Methods: This qualitative study was part of a larger study of the dynamics of intimate partner violence and HIV in pregnancy in Zimbabwe. Key informant interviews were conducted with health workers and focus group discussions were held with 64 pregnant or nursing mothers …

Cerebral And Lower Limb Near-Infrared Spectroscopy In Adults On Extracorporeal Membrane Oxygenation, Joshua K Wong, Thomas N Smith, Harrison T Pitcher, Hitoshi Hirose, Nicholas C. Cavarocchi

Department of Surgery Faculty Papers

Percutaneous femoral venoarterial (VA) or jugular venovenous (VV) extracorporeal membrane oxygenation (ECMO) can result in delivery of hypoxic blood to the brain, coronaries, and upper extremities. Additionally, VA-ECMO by percutaneous femoral artery cannulation may compromise perfusion to the lower limbs. Use of near-infrared spectroscopy (NIRS) detects regional ischemia and warns of impending hypoxic damage. We report the first known series with standardized monitoring of this parameter in adults on ECMO. This is an institutional review board-approved single institution retrospective review of patients with NIRS monitoring on ECMO from July 2010 until June 2011. Patients were analyzed for drops in NIRS …

Observer Variation In Mri Evaluation Of Patients With Suspected Lumbar Disc Herniation And Nerve Root Compression: Comparison Of Neuroradiologist And Neurosurgeon's Interpretations, Imaad-Ur Rehman, Rana Shoaib Hamid, Waseem Akhtar, Muhammad Shahzad Shamim, Rohana Naqi, Haji Ismail Siddiq

Department of Radiology

Objective: To analyse inter-observer variation between a neuroradiologist and neurosurgeon in the MRI diagnosis of lumbar nerve root compression. Although lumbar MFI is primarily analyzed and reported by a radiologist, neurosurgeons often analyse it independently as they have sufficient clinical background as well as radiological expertise to diagnose most spinal pathologies on Magnetic Resonance Imaging (MRI).
Methods: Retrospective analysis was carried out for images of 54 patients who underwent MRI between March and July 2010 of lumbar spine with suspected lumbar disc herniation and nerve root compression, at Aga Khan Hospital, Karachi, Pakistan. One fellowship trained neuroradiologist and one neurosurgeon …

Classroom Misbehavior In The Eyes Of Students: A Qualitative Study, Rachel C. F. Sun, Daniel T. L. Shek

Pediatrics Faculty Publications

Using individual interviews, this study investigated perceptions of classroom misbehaviors among secondary school students in Hong Kong (N = 18). Nineteen categories of classroom misbehaviors were identified, with talking out of turn, disrespecting teacher, and doing something in private being most frequently mentioned. Findings revealed that students tended to perceive misbehaviors as those actions inappropriate in the classroom settings and even disrupting teachers' teaching and other students' learning. Among various misbehaviors, talking out of turn and disrespecting teacher were seen as the most disruptive and unacceptable. These misbehaviors were unacceptable because they disturbed teaching and learning, and violated the values …

Postlecture Evaluation Of A Positive Youth Development Subject For University Students In Hong Kong, Daniel T. L. Shek

Pediatrics Faculty Publications

The purpose of this study was to examine the postlecture evaluation by the students taking a course (Tomorrow's Leaders) that attempted to promote their leadership qualities and intrapersonal competencies at The Hong Kong Polytechnic University in Hong Kong. Except for the last lecture, students were invited to respond to a 12-item postlecture questionnaire after each lecture. Results showed that the students had positive perceptions of the subject, class, and teacher attributes, and they had positive global evaluation of the teacher and the subject. The postlecture evaluation questionnaire was found to possess good psychometric properties. Multiple regression analyses showed that subject, …

Management Of Periprosthetic Joint Infection: The Current Knowledge: Aaos Exhibit Selection., Javad Parvizi, Bahar Adeli, Benjamin Zmistowski, Camilo Restrepo, Alan Seth Greenwald

Rothman Institute Papers

Periprosthetic joint infection continues to frustrate the medical community. Although the demand for total joint arthroplasty is increasing, the burden of such infections is increasing even more rapidly, and they pose a unique challenge because their accurate diagnosis and eradication can prove elusive. This review describes the current knowledge regarding diagnosis and treatment of periprosthetic joint infection. A number of tools are available to aid in establishing a diagnosis of periprosthetic joint infection. These include the erythrocyte sedimentation rate, serum C-reactive protein concentration, synovial white blood-cell count and differential, imaging studies, tissue specimen culturing, and histological analysis. Multiple definitions of …

American Indian Community Leader And Provider Views Of Needs And Barriers To Colorectal Cancer Screening, Christine M. Daley

Journal of Health Disparities Research and Practice

Colorectal cancer is a great concern for the American Indian/Alaska Native (AI/AN) community, as incidence and mortality rates remain high and screening rates stay low. We conducted interviews with community leaders (n=13) and with providers from the Indian Health Service (IHS), tribal clinics, and urban safety-net clinics (n=17) in Northeast Kansas and the Kansas City Metro Area to determine their understanding of needs and barriers to colorectal cancer screening among American Indians. Using a community-based participatory research (CBPR) approach for this pilot study, community leaders and providers identified similar needs, including: culturally-appropriate education about colorectal cancer and screenings, the potential …

An Innovative Approach For Community Engagement: Using An Audience Response System, Jenna L. Davis, Kara E. Mcginnis, Margaret L. Walsh, Coni Williams, Kevin B. Sneed, Julie A. Baldwin, B. Lee Green

Journal of Health Disparities Research and Practice

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge …

Com Outlook Summer 2012, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Medical Education Digest, Vol. 14 No. 4 (July/August 2012), Nova Southeastern University

Medical Education Digest

No abstract provided.

Perception And Knowledge About Dietary Intake In Patients With Liver Cirrhosis And Its Relationship With The Level Of Education, Rustam Khan, Ashfaq Ahmed, Faisal Wasim Ismail, Shahab Abid, Safia Awan, Syed Hasnain Shah, Saeed Hamid, Wasim Jafri

Section of Gastroenterology

Objective: To determine patients perception and knowledge regarding diet in cirrhosis and its relationship with the level of patients education.
Study Design: Cross-sectional observational study. Place and Duration of Study: This study was conducted at Gastroenterology Outpatient Clinics at the Aga Khan University Hospital, Karachi, the Aga Khan Health Services, Malir, Karachi and Hamdard University, Karachi, from January to December 2010.
Methodology: Consecutive adult patients with compensated cirrhosis were enrolled. Demographic data, level of education, type and reason of food restriction as well as the source of dietary information was asked. Baseline laboratory test were performed, and nutritional status was …

Interventions For Improving Research Productivity In Clinical Radiology, Waseem Akhtar, Mubashir Aslam Arain, Arif Ali, Zafar Sajjad

Section of Dental-Oral Maxillofacial Surgery

The purpose of this study was to evaluate the effects of research promotion activities on overall quality and quantity of research output in a clinical department of a teaching tertiary care hospital. Simple research enhancing strategies including regular journal club, research hour, basic research skills training, hiring of research faculty, research awards, and annual research retreat and research board to increase research production were implemented in the Department of Radiology of a teaching hospital in Pakistan. A total of 77 papers were produced by the Department of Radiology before the intervention, which increased to 92 after the introduction of research …

Unintentional, Paediatric Domestic Injury In A Semi Rural Area Of Karachi., Emaduddin Siddiqui, Kiran Ejaz, Uzma Siddiqui

Department of Emergency Medicine

OBJECTIVE:

To identify the characteristics of unintentional domestic injury in children living in a semi-rural area of Karachi.

METHODS:

This retrospective descriptive study was carried out at a private hospital located at the northern outskirts of Karachi, Pakistan, from January 2005 to January 2007. We enrolled 271 out-patient children of either gender with a positive injury history. A questionnaire inquiring socio-demographic characteristics, timing of injury, monthly variation, injury pattern and factors was filled out. Descriptive analysis and Chi-square test were applied to find out the statistically significant differences.

RESULTS:

Among the 271 patients, the male-to-female ratio was 1.2:1. Fall from …

The Relationship Between Cancer-Related Fatigue And Upper Extremity Function In Breast Cancer Survivors, Meryl Marger Picard

Seton Hall University Dissertations and Theses (ETDs)

Background: Cancer-related fatigue (CRF) and arm morbidity constitute the two most common symptom complexes impacting breast cancer survivors (BCS) following surgery and adjuvant treatment, but these multifaceted entities have traditionally been researched as if they were separately occurring events in the survivor’s recovery. Objective: This study examined the relationship between breast cancer survivors’ perceptions of CRF and upper extremity function one to six years post-diagnosis. The study further investigated the impact of multiple adjuvant therapies, node dissection procedures, caring for dependent children, and physical aspects of employment on CRF and upper extremity function. Methods: One hundred fifty-eight BCS responded to …

Intermediate-Term Mortality And Cardiac Transplantation In Infants With Single-Ventricle Lesions: Risk Factors And Their Interaction With Shunt Type., James S. Tweddell, Lynn A. Sleeper, Richard G. Ohye, Ismee A. Williams, Lynn Mahony, Christian Pizarro, Victoria L. Pemberton, Peter C. Frommelt, Scott M. Bradley, James F. Cnota, Jennifer Hirsch, Paul M. Kirshbom, Jennifer S. Li, Nancy Pike, Michael Puchalski, Chitra Ravishankar, Jeffrey P. Jacobs, Peter C. Laussen, Brian W. Mccrindle, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The study objective was to identify factors associated with death and cardiac transplantation in infants undergoing the Norwood procedure and to determine differences in associations that might favor the modified Blalock-Taussig shunt or a right ventricle-to-pulmonary artery shunt.

METHODS: We used competing risks methodology to analyze death without transplantation, cardiac transplantation, and survival without transplantation. Parametric time-to-event modeling and bootstrapping were used to identify independent predictors.

RESULTS: Data from 549 subjects (follow-up, 2.7 ± 0.9 years) were analyzed. Mortality risk was characterized by early and constant phases; transplant was characterized by only a constant phase. Early phase factors associated …