Digital Commons Network^™

The Project P.A.T.H.S. In Hong Kong--Lessons Learned And Implications For Positive Youth Development Programs, Daniel T. L. Shek, Rachel C. F. Sun

Pediatrics Faculty Publications

The Project P.A.T.H.S. is a positive youth development program which attempts to promote holistic development of junior secondary schools in Hong Kong. It is ground breaking in terms of the number of schools participating in the project and financial resources injected into the project. Based on the experiences gained from the implementation of the project and evaluation data collected from 2005 to 2011, several issues pertinent to the development of positive youth development programs in the Chinese culture are discussed. These issues include complexity of program development, importance of training, identification of factors governing program implementation, need for evaluation, and …

Helping Adolescents With Greater Psychosocial Needs: Subjective Outcome Evaluation Based On Different Cohorts, Daniel T. L. Shek, Tak Yan Lee

Pediatrics Faculty Publications

The Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) is designed to help students with greater psychosocial needs. This paper examines nine sets of subjective outcome evaluation data collected from 2005 to 2009 (n = 60, 241 participants). Based on the consolidated data with schools as units, results showed that participants generally had positive perceptions of the program, implementers, and benefits of the program. The subjective outcome evaluation instrument was found to be internally consistent. Multiple regression analysis revealed that perceived qualities of the program and the program implementers predicted perceived effectiveness of the …

Balloon-Occluded Retrograde Transvenous Obliteration For The Treatment Of Gastric Varices., Alia S Dadabhai, Jonathan M Fenkel, Daniel B Brown, Loren Laine

Division of Gastroenterology and Hepatology Faculty Papers

Clinical Perspectives in Hepatology aims to engage two experts with opinions supporting differing perspectives on the management of a case. Typically, the case represents an area of debate or evolving practice in clinical hepatology.

The patient presented below gives us the opportunity to discuss balloon-occluded retrograde transvenous obliteration (BRTO) for treatment of gastric varices. Although described since the mid-1990s and accepted as effective therapy, particularly in Japan, BRTO is used sporadically in the United States and Europe. In fact, it is not mentioned in the U.S. (AASLD) or European (EASL/Baveno V) guidelines. Hopefully, increased awareness of and expertise in this …

Technique Of Anaesthesia For Different Grades Of Caesarean Section: A Cross-Sectional Study, Samina Ismail, Faraz Shafiq, Aliya Malik

Department of Anaesthesia

OBJECTIVE: The percentage use of regional anaesthesia (RA) and failure rate of RA for different grades of caesarean section (CS) has become a marker of quality for obstetric anaesthesia service. The objective of our prospective observational study is to find out the technique of anaesthesia used in different grades of CS, reasons for choosing general anaesthesia (GA) and failure rate of RA in our hospital setting.

METHODS: This prospective cross sectional study was carried in the obstetric unit of Aga Khan University Hospital from 1st January 2010 to 31st May 2011. The anaesthetist performing the procedure filled out the data …

Sick With Fear: Popular Challenges To Scientific Authority In The Vaccine Controversies Of The 21st Century, Ellen Watkins

Annual Undergraduate Conference on Health and Society

In the 20th century, vaccines were heralded as one of the greatest medical inventions in history. In the late 1990’s, however, the myth of vaccine-caused autism caught fire. Despite mountains of evidence disproving the link, panicking Americans eschewed vaccines and turned against their physicians. Why did Americans turn their backs on doctors, scientists, and the health industry? This paper follows the vaccine controversy of the last thirty years, looking in particular at the relationship between science and the media. This paper analyzes the contrast between discussion of the hypothesized link in scientific circles and in popular news sources, seeking to …

The Pregnancy Project: Impact Of Ultrasound Use During Pregnancy Care, Paige Ricci

Annual Undergraduate Conference on Health and Society

Use of ultrasounds during pregnancy continues to increase and there is much debate as to what the best practice is regarding their use, for what types of patients, at what volume level. Current evidence suggests, the extended routine use of ultrasound technology should be for all women that present complications to screen for structural anomalies during pregnancy. However, others have suggested that excessive ultrasound use may be both unnecessary, costly and potentially harmful. Evidence further suggests that mothers find the use of technology to be security enhancing during pregnancy and through the process of care, and that ultrasound use is …

Cancer Awareness In Alternative Settings: Lessons Learned And Evaluation Of The Barbershop Men’S Health Project, Cheryl L. Holt, Theresa A. Wynn, Katrina Debnam, Mark S. Litaker, Sanford Jeames, Yu-Mei Schoenberger, Penny Southward, Virgil Simons

Journal of Health Disparities Research and Practice

Prostate and colorectal cancer are two of the leading causes of cancer deaths among African American men. This study describes lessons learned from the development, implementation and evaluation of a culturally appropriate, barbershop-based intervention to improve prostate and colorectal cancer screening awareness among African American men. Working with an Advisory Panel of shop owners, barbers, and cancer survivors, local barbers were recruited and trained as Community Health Advisors to educate, motivate, and assist their clients in becoming more knowledgeable about prostate and colorectal cancer. Survey results reveal increases in prostate and colorectal cancer knowledge and self-reported screening among participants. Lessons …

Coronary Artery Bypass Grafting: Quality Of Life Of Patients In Karachi, Rozina Barolia, Fauziya Ali, Salma Jaffar

School of Nursing & Midwifery

In the Third World, cardiac Patients often suffer not only from the nature of their illnesses, but also the insufficiency of the facilities available. Although the effectiveness of coronary artery bypass grafting (CABG) is being evaluated in terms of mortality, complications or recurrence of symptoms, empirical studies assessing the change in Patients' quality of life (QOL) after CABG within the Pakistani cultural context are lacking.
Aims: The aims of the present study are to assess and compare the change in health-related quality of life before and 1 month after CABG and to assess the differences in QOL with respect to …

Patient Safety In Developing Countries: Retrospective Estimation Of Scale And Nature Of Harm To Patients In Hospital, R. M. Wilson, P. Michel, S. Olsen, R. W. Gibberd, C. Vincent, R. El-Assady, O. Rasslan, S. Qsous, William Macharia, A. Sahel, S. Whittaker, M. Abdo-Ali, M. Letaief, N. A. Ahmed, A. Abdellatif, I. Larizgoitia

Paediatrics and Child Health, East Africa

Objective: To assess the frequency and nature of adverse events to patients in selected hospitals in developing or transitional economies.

Design: Retrospective medical record review of hospital admissions during 2005 in eight countries.

Setting: Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety.

Participants: Convenience sample of 26 hospitals from which 15 548 patient records were randomly sampled.

Main outcome measures: Two stage screening. Initial screening based on 18 explicit criteria. Records that screened positive were then reviewed …

Recommendations For The Use Of Common Outcome Measures In Pediatric Traumatic Brain Injury Research, Stephen R. Mccauley, Elisabeth A. Wilde, Vicki A. Anderson, Gary Bedell, Sue R. Beers, Thomas F. Campbell, Sandra B. Chapman, Linda Ewing-Cobbs, Joan P. Gerring, Gerard A. Gioia, Harvey S. Levin, Linda J. Michaud, Mary R. Prasad, Bonnie R. Swaine, Lyn S. Turkstra, Shari L. Wade, Keith O. Yeates

Psychiatry and Behavioral Sciences Faculty Publications

This article addresses the need for age-relevant outcome measures for traumatic brain injury (TBI) research and summarizes the recommendations by the inter-agency Pediatric TBI Outcomes Workgroup. The Pediatric Workgroup's recommendations address primary clinical research objectives including characterizing course of recovery from TBI, prediction of later outcome, measurement of treatment effects, and comparison of outcomes across studies. Consistent with other Common Data Elements (CDE) Workgroups, the Pediatric TBI Outcomes Workgroup adopted the standard three-tier system in its selection of measures. In the first tier, core measures included valid, robust, and widely applicable outcome measures with proven utility in pediatric TBI from …

Medical Education Digest, Vol. 14 No. 2 (March/April 2012), Nova Southeastern University

Medical Education Digest

No abstract provided.

Robotic Surgery Training With Commercially Available Simulation Systems In 2011: A Current Review And Practice Pattern Survey From The Society Of Urologic Robotic Surgeons., Costas D Lallas, John W Davis And Members Of The Society Of Urologic Robotic Surgeons

Department of Urology Faculty Papers

Abstract Objectives: Virtual reality (VR) simulation has the potential to standardize surgical training for robotic surgery. We sought to evaluate all commercially available VR robotic simulators. Materials and Methods: A MEDLINE(®) literature search was performed of all applicable keywords. Available VR simulators were evaluated with regard to face, content, and construct validation. Additionally, a survey was e-mailed to all members of the Endourological Society, querying the pervasiveness of VR simulators in robotic surgical training. Finally, each company was e-mailed to ask for a price quote for their respective system. Results: There are four VR robotic surgical simulators currently available: RoSS™, …

Continuous Renal Replacement Therapy, Gulzar Salman Amlani

School of Nursing & Midwifery

Acute renal failure refers to sudden deterioration in biochemical and physiological functioning of kidneys and often associated with multi organ failure. Continuous renal replacement therapy (CRRT) holds special significance for the treatment of renal failure due to a variety of factors. It is believed that CRRT helps in restoration of acid-base imbalances and electrolyte abnormalities. Along with that, with gradual solute removal, it ensures haemodynamic stability and prevents the risk of cerebral oedema in neurosurgery patients. Besides this, several studies have supported that CRRT enables practitioners to adjust drug dosages and prevent drug accumulation and overdose. In addition, gradual removal …

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

Digest

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

• Message from the President
• PCOM Updates
• Development News
• Tug of War
• Founders’ Day 2012
• Building Social and Emotional Competence in Preschool Children
• Pioneering Color in MRI Imaging
• Class Notes
• In Memoriam
• My Turn Essay
• The Fund for PCOM

Old Remedies For Epilepsy: Avicenna's Medicine., A A Asadi-Pooya, A R Nikseresht, E Yaghoubi

Department of Neurology Faculty Papers

BACKGROUND: The history of epilepsy and its treatments dates back to at least 4 millennia. Avicenna, c. 980 AD in Bukhara, Khorasan-1037 in Hamedan was a Persian-speaking Iranian physician, who has many recommendations and suggested various therapies for epilepsy in his book, The Canon of Medicine.

METHODS: We first reviewed the most important ancient treatments for epilepsy mentioned by Avicenna and considered those as the key words for our next step. Then, we made a literature search (medline and scopus) with those key words to find out new scientific findings in modern medicine about the Avicenna's suggestions.

RESULTS: Among the …

Can Community Based Interventions Control Hypertension In Developing Countries? What Is The Evidence From Pakistan?, Farzin Majeed, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Barriers And Perceptions Regarding Different Contraceptives And Family Planning Practices Amongst Men And Women Of Reproductive Age In Rural Pakistan: A Qualitative Study, Syed Khurram Azmat, Ghulam Mustafa, Waqas Hameed, Muhammad Ali, Aftab Ahmed, Mohsina Bilgrami

Community Health Sciences

Background: Pakistan ranks as one of the most poorest and most populous in the world with poor reproductive health indicators. This study helps in understanding barriers and perceptions regarding Family Planning (FP), modern contraception, quality of care and free of charge FP services amongst men and women in rural Pakistan.
Methods: Employing purposive sampling and Focus Group Discussion (FGD) technique, this qualitative study was conducted with men and women of reproductive age in Pakistan. A total of eight FGDs were conducted in Sindh and Punjab provinces. Being descriptive in nature, the study provided a thematic analysis of the relevant health …

Can Community Based Interventions Control Hypertension In Developing Countries? What Is The Evidence From Pakistan?, Farzin Majeed, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy

National Health Policy Forum

This document offers a basic description of the Older Americans Act of 1965. The Act is considered the major vehicle for promoting the delivery of social services to the aging population. The Act's seven titles and multiple programs are described, along with a chart showing fiscal year 2012 federal appropriations.

Matrix Metalloproteinase Genes Are Transcriptionally Regulated By E2f Transcription Factors: A Link Between Cell Cycle Control And Metastatic Progression, Jacqueline Lea Johnson

USF Tampa Graduate Theses and Dissertations

The RbµE2F transcriptional regulatory pathway plays a critical role in the cell cycle. Rb is inactivated through multiple waves of phosphorylation, mediated mainly by cyclin D and cyclin E associated kinases. Once Rb is inactivated, cells can enter Sµphase. Collectively, three Rb family members and ten E2F proteins coordinate every additional stage of the cell cycle, from quiescence to mitosis. However the RbµE2F pathway is frequently altered in cancer. Aside from cell proliferation, the RbµE2F pathway regulates other essential cellular processes including apoptosis, cell differentiation, angiogenesis and DNA damage repair pathways, but its role in invasion and cancer progression is …

Loss Of Αt-Catenin Alters The Hybrid Adhering Junctions In The Heart And Leads To Dilated Cardiomyopathy And Ventricular Arrhythmia Following Acute Ischemia., Jifen Li, Steven Goossens, Jolanda Van Hengel, Erhe Gao, Lan Cheng, Koen Tyberghein, Xiying Shang, Riet De Rycke, Frans Van Roy, Glenn L Radice

Center for Translational Medicine Faculty Papers

It is generally accepted that the intercalated disc (ICD) required for mechano-electrical coupling in the heart consists of three distinct junctional complexes: adherens junctions, desmosomes and gap junctions. However, recent morphological and molecular data indicate a mixing of adherens junctional and desmosomal components, resulting in a 'hybrid adhering junction' or 'area composita'. The α-catenin family member αT-catenin, part of the N-cadherin-catenin adhesion complex in the heart, is the only α-catenin that interacts with the desmosomal protein plakophilin-2 (PKP2). Thus, it has been postulated that αT-catenin might serve as a molecular integrator of the two adhesion complexes in the area composita. …

Music Therapy To Sever The Silence Of A Childhood Holocaust Survivor, Amy Clements-Cortés

Music Faculty Publications

No abstract provided.

Neuroscience Of Personality: Principles Of The Psyche As A Living System, Dario Nardi

Systems Science Friday Noon Seminar Series

The brain is a complex living system. Using colorful slides and anecdotes, Dario Nardi, PhD will overview his hands-on research of the past 5 years in his social neuroscience lab using EEG technology to better understand the neocortex. He spends 2 to 3 hours with each subject, offering a variety of tasks from solo activities like meditating, drawing, and recalling to social activities like poker and speed-dating. The results are in. The neocortex relies upon a dynamic of modules, circuits, and holistic modes to continuously coordinate with the environment in both a top-down and a bottom-up manner. Moreover, individual differences …

Cross-Sectional Study Identifying Forms Of Tobacco Used By Shisha Smokers In Pakistan, Sameer-Ur-Rehman, Mohammed Ali Sadiq, Maria Adnan Parekh, Ali Bin Sarwar Zubairi, Philippe. Frossard, Javaid Khan

Section of Otolaryngology, Head & Neck Surgery

Objectives: To estimate the frequency of different forms of tobacco intake such as smoker's tobacco, chewable tobacco and snuff tobacco among shisha smoker's and to study the patterns and predictors of shisha smoking affecting youth from different cities of Pakistan.
Methods: A cross-sectional study was conducted including youth from four cities. Participants were asked to fill out a data collection tool at shisha cafes, shopping malls and restaurants. Data was analyzed using SPSSv.18.
Results: A total of 406 participants, 296 (73%) males and 110 (27%) females were included in the study. There were 163 (40%) cigarette smokers; 65 (16%) chewed …

Puerperal Fever From Hippocrates To Pasteur, Hunter A. Hammill

Houston History of Medicine Lectures (2006-2012)

The death of a mother in childbirth leaving a newborn deserted is a sort of a desecration. This was a frequent event for early physicians. It was felt to be caused by miasmas or punishment from the gods. DaVinci felt the cause was milk stasis, Hippocrates - lochia, Virchow - weather. Then came Semmelweis, Pasteur and Lister. They started a battle with ignorance, hospital administration, budget and academic politics. Ending with the murder of Semmelweis!

Surgical Outcome In Pet-Positive, Mri-Negative Patients With Temporal Lobe Epilepsy, Carla Lopinto-Khoury, Michael R. Sperling, Christopher Skidmore, Maromi Nei, James Evans, Ashwini Sharan, Scott Mintzer

Department of Neurology Faculty Papers

PURPOSE:

Fluorodeoxyglucose positron emission computed tomography (FDG-PET) hypometabolism is important for surgical planning in patients with temporal lobe epilepsy (TLE), but its significance remains unclear in patients who do not have evidence of mesial temporal sclerosis (MTS) on magnetic resonance imaging (MRI). We examined surgical outcomes in a group of PET-positive, MRI-negative patients and compared them with those of patients with MTS.

METHODS:

We queried the Thomas Jefferson University Surgical Epilepsy Database for patients who underwent anterior temporal lobectomy (ATL) from 1991 to 2009 and who had unilateral temporal PET hypometabolism without an epileptogenic lesion on MRI (PET+/MRI-). We compared …

Cross-Sectional Study Identifying Forms Of Tobacco Used By Shisha Smokers In Pakistan, Sameer Ur Rehman, Mohammed Ali Sadiq, Maria Adnan Parekh, Ali Bin Sarwar Zubairi, Javaid Khan, Philippe M. Frossard

Department of Medicine

Objectives: To estimate the frequency of different forms of tobacco intake such as smoker's tobacco, chewable tobacco and snuff tobacco among shisha smoker's and to study the patterns and predictors of shisha smoking affecting youth from different cities of Pakistan.
Methods: A cross-sectional study was conducted including youth from four cities. Participants were asked to fill out a data collection tool at shisha cafes, shopping malls and restaurants. Data was analyzed using SPSSv.18.
Results: A total of 406 participants, 296 (73%) males and 110 (27%) females were included in the study. There were 163 (40%) cigarette smokers; 65(16%) chewed tobacco …

Functional, Cognitive And Psychological Outcomes, And Recurrent Vascular Events In Pakistani Stroke Survivors: A Cross Sectional Study., Maria Khan, Bilal Ahmed, Maryam Ahmed, Myda Najeeb, Emmon Raza, Farid Khan, Anoosh Moin, Dania Shujaat, Ahmed Arshad, Ayeesha Kamran Kamal

Department of Medicine

Background: There is little direct data describing the outcomes and recurrent vascular morbidity and mortality of stroke survivors from low and middle income countries like Pakistan. This study describes functional, cognitive and vascular morbidity and mortality of Pakistani stroke survivors discharged from a dedicated stroke center within a nonprofit tertiary care hospital based in a multiethnic city with a population of more than 20 million.

Methods: Patients with stroke, aged > 18 years, discharged alive from a tertiary care centre were contacted via telephone and a cross sectional study was conducted. All the discharges were contacted. Patients or their legal surrogate …

Primary Care Providers’ Perspectives On Online Weight-Loss Programs: A Big Wish List, Kevin O Hwang, Heather L Stuckey, Monica C Chen, Jennifer L Kraschnewski, Samuel N Forjuoh, Jennifer M Poger, Kathleen M Mctigue, Christopher N Sciamanna

Faculty, Staff and Student Publications

BACKGROUND: Integrating online weight-loss programs into the primary care setting could yield substantial public health benefit. Little is known about primary care providers' perspectives on online weight-loss programs.

OBJECTIVE: To assess primary care providers' perspectives on online weight-loss programs.

METHODS: We conducted focus group discussions with providers in family medicine, internal medicine, and combined internal medicine/pediatrics in Texas and Pennsylvania, USA. Open-ended questions addressed their experience with and attitudes toward online weight-loss programs; useful characteristics of existing online weight-loss programs; barriers to referring patients to online weight-loss programs; and preferred characteristics of an ideal online weight-loss program. Transcripts were analyzed …

Countertransference In Two Settings: A Case Report, Randi L. Plotkin M.D.

Jefferson Journal of Psychiatry

No abstract provided.