Digital Commons Network^™

The Corbett Pain Scale: A Multidimensional Pain Scale For Adult Intensive Care Patients, Gina M. Corbett

Theses and Dissertations

There are no reliable tools that evaluate pain in adult critical care patients who cannot communicate as a result of sedation or illness. This was an observational study in which postoperative cardiothoracic intensive care patients were assessed for pain using both the newly devised Corbett Pain Scale (CPS) and the Numerical Pain Scale (NPS). The CPS was evaluated for content validity, criterion validity, construct validity, test re-test reliability and internal consistency. Thirteen male and seven female patients (n=20) were enrolled and underwent a maximum of five pain assessments each. The mean total scores of the CPS (.740, SD+1.03) and the …

Analyse De L'Evolution De La Pratique De L'Excision Au Burkina Faso: L'Environment Institutionel, Politique Et Programmatique De La Lutte Contre La Pratique De L'Excision, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

La présente analyse du projet Frontiers du Population Council fait un tour historique des événements majeurs de la lutte contre la pratique de l’excision au Burkina Faso avant d’aborder les conventions internationales auxquelles le pays a adhéré ainsi que les textes nationaux adoptés en ce qui concerne les droits de l’homme, spécifiquement le droit des femmes et des enfants. Elle analyse également l’application de la loi à travers l’évolution des cas de condamnation depuis l’adoption de la loi. Enfin, elle s’intéressera à quelques programmes d’intervention mis en place en identifiant les acquis et les limites. Ce travail fait partie d’une …

Effect Of A Paediatric Incentive Spacer And Reinforcement Of Inhalation Technique Training In Preschool Children, Jasminka Murdzoska

Theses : Honours

Incorrect inhaled drug delivery technique is a common problem in paediatric asthma [1-4]. Previously, device technique training has been shown to significantly improve inhaler skills, using subjective methods, namely check-list analysis [5-8]. However, more objective measures are needed to examine more comprehensively the effect of training in preschool children and parents. Resistance to regular asthma therapy is also a frequent problem when attempting to treat young children. Reasoning with young children can be very difficult and parents often have to struggle with their child to achieve compliance [2]. The Funhaler spacer (FH) (Funhaler™; InfaMed, Australia) has been developed in an …

Innate Antiviral Response Targets Hiv-1 Release By The Induction Of Ubiquitin-Like Protein Isg15, Atsushi Okumura, Gengshi Lu, Ian Pitha-Rowe, Paula M. Pitha

Dartmouth Scholarship

The goal of this study was to elucidate the molecular mechanism by which type I IFN inhibits assembly and release of HIV-1 virions. Our study revealed that the IFN-induced ubiquitin-like protein ISG15 mimics the IFN effect and inhibits release of HIV-1 virions without having any effect on the synthesis of HIV-1 proteins in the cells. ISG15 expression specifically inhibited ubiquitination of Gag and Tsg101 and disrupted the interaction of the Gag L domain with Tsg101, but conjugation of ISG15 to Gag or Tsg101 was not detected. The inhibition of Gag-Tsg101 interaction was also detected in HIV-1 infected, IFN-treated cells. Elimination …

Engendering Student Empathy For Disabled Clients With Urinary Incontinence Through Experiential Learning, Karen A. Karlowicz, Kay L. Palmer

Ellmer School of Nursing Faculty Publications

As part of a rehabilitation clinical course for senior baccalaureate nursing students, a disability-incontinence experiential learning activity is required. The assignment is intended to familiarize students with some of the challenges encountered by a client with mobility problems, including continence management issues using disposable undergarments. Wearing the undergarments dry and wet while being confined to a wheelchair provides insight and promotes empathy for patients with bladder control problems.

Unplanned Prolonged Postanaesthesia Care Unit Length Of Stay And Factors Affecting It, Khalid Samad, Mueenullah Khan, Hameedullah, Fauzia A. Khan, Mohammad Hamid, Fazal Hameed Khan

Department of Anaesthesia

Objective: To identify the factors that prolong the length of stay in the post anaesthesia care unit (PACU).
Methods: This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designated recovery nurse for all included patients including those admitted …

Development Of An Audio Visual Tool For Medical Training At Kennedy Space Center, Rimawi, Nidal El

Browse all Theses and Dissertations

As part of an effort to improve efficiency of space-flight medical support at Kennedy Space Center, a training video was created to replace a series of lectures given before a launch or landing of the Space Shuttle. The video was designed to familiarize volunteer physicians from around the country with the specific emergency response protocols for a Space Shuttle launch or landing emergency at Kennedy Space Center. The methods used were consistent with standard film making techniques as outlined in several film making texts. The Production was divided into three phases; A pre-production phase wherein the research, screenwriting and production …

Understanding The Nature Of Surgical Excellence Using A Competency Modeling Approach, Hope S. Hanner-Bailey

Psychology Theses & Dissertations

Currently, a thorough description of the knowledge, skills, abilities, and other personal characteristics (KSAOs) that distinguish an exceptional surgeon does not exist. This knowledge is pertinent to the development of selection, training, and performance assessment methods that can be used to develop high performing surgeons. Expert surgeons from around the country were recruited to participate in an interview to discuss the KSAOs (i.e., the competencies) needed to be exceptional in the field. A smaller number of novice surgeons were also interviewed. The expert interview data were distilled into a competency model that consists of ten competencies and patterns within the …

Perforated Meckel's Diverticulitis Presenting As A Mesenteric Abscess: Case Report, Ronald Wasike, Hassan Saidi

General Surgery, East Africa

Only 2% of patients with Meckel’s diverticulae (MD) will manifest clinical problems. Diverticulitis occurs in approximately 10-20% of patients with symptomatic MD and more often in the elderly population. We report a case of Meckels diverticulitis presenting with perforation and mesenteric abscess in a young African man. The authors present information on diagnostic pitfalls and advise a lower threshold for consideration of MD as a differential diagnosis of acute right iliac fossa pain especially when the CT scan denotes a normal appendix in a male patient.

Acceptability And Outcomes Of The Percutaneous Endoscopic Gastrostomy (Peg) Tube Placement--Patients' And Care Givers' Perspectives, Muhammad K. Anis, Shahab Abid, Wasim Jafri, Zaigham Abbas, Hasnain A. Shah, Saeed Hamid, Rozina Wasaya

Section of Gastroenterology

Background: Percutaneous endoscopic gastrostomy tube has now become a preferred option for the long-term nutritional support device for patients with dysphagia. There is a considerable debate about the health issues related to the quality of life of these patients. Our aim of the study was to assess the outcome and perspectives of patients/care givers, about the acceptability of percutaneous endoscopic gastrostomy tube placement.

Methods: This descriptive analytic study conducted in patients, who have undergone percutaneous endoscopic gastrostomy tube placement during January 1998 till December 2004. Medical records of these patients were evaluated for their demographic characteristics, underlying diagnosis, indications …

The Use Of The Tripartite Model Of Attitudes To Explain Ems Providers' Attitudes About The Ems Agenda For The Future, Carolyn Angela Rinaca

Health Services Research Dissertations

A dynamic and revolutionary health care system compels the Nation to develop a more cohesive, unified healthcare workforce. The Emergency Medical Services (EMS) profession has contributed to this development with the publication of the EMS Agenda for the Future. The EMS Agenda for the Future describes the future direction for emergency medical services agencies and organizations within the nation. It is a vision that integrates EMS systems with other health care professions. The EMS Agenda for the Future is designed to assist EMS professionals in realizing their full potential for proficiency and contributes to the development of the EMS profession. …

The Use Of Proteomic Technologies To Identify Serum Glycoproteins For The Early Detection Of Liver And Prostate Cancers, Elizabeth Ellen Schwegler

Theses and Dissertations in Biomedical Sciences

The application of proteomic technologies to identify serum glycoproteins is an emerging technique to identify new biomarkers indicative of disease severity. Many of these newly evolving protein-profiling methodologies have evolved from previous global protein expression profiling studies such as those involving SELDI-TOF-MS technologies. Though the SELDI approach could distinguish disease from normal by utilizing protein patterns as shown herein with the HCC study of chapter II, it was unable to offer sequence information on the selected peaks, and did not have the ability to analyze the entire dynamic range of the serum/plasma proteome. To address these deficiencies, new strategies that …

Spectrum And Outcome Of Infections In Systemic Lupus Erythematosus Patients, Bushra Jamil, Sobia Rafi, Hammad Hussain, Khizar Hameed

Department of Medicine

No abstract provided.

Breast Cancer Risk Factor Knowledge Among Nurses In Teaching Hospitals Of Karachi, Pakistan: A Cross-Sectional Study, Faiza Ahmed, Sadia Mahmud, Juanita Hatcher, Shaista M. Khan

Community Health Sciences

Background: Breast cancer is the most common cancer among women in both the developed and the developing world. The incidence of breast cancer in Karachi, Pakistan is 69.1 per 100,000 with breast cancer presentation in stages III and IV being common (>or= 50%). The most pragmatic solution to early detection lies in breast cancer education of women. Nurses constitute a special group having characteristics most suited for disseminating breast cancer information to the women. We assessed the level of knowledge of breast cancer risk factors among registered female nurses in teaching hospitals of Karachi. We also identified whether selected …

Coping Processes Of Couples Experiencing Infertility, Brennan Peterson, Christopher R. Newton, Karen H. Rosen, Robert S. Shulman

Psychology Faculty Articles and Research

This study explored the coping processes of couples experiencing infertility. Participants included 420 couples referred for advanced reproductive treatments. Couples were divided into groups based on the frequency of their use of eight coping strategies. Findings suggest that coping processes, which are beneficial to individuals, may be problematic for one's partner. Couples where men used high amounts of distancing, while their partner used low amounts of distancing, reported higher levels of distress when compared to couples in the other groups. Conversely, couples with women who used high amounts of self-controlling coping, when paired with men who used low amounts of …

Gender Differences In How Men And Women Referred With In Vitro Fertilization (Ivf) Cope With Infertility Stress, Brennan Peterson, C. R. Newton, K. H. Rosen, G. E. Skaggs

Psychology Faculty Articles and Research

Men and women use a variety of coping strategies to manage stress associated with infertility. While previous research has helped us understand these coping processes, questions remain about gender differences in coping and the nature of the relationship between coping and specific types of infertility stress. Methods: This study examined the coping behaviors of 1,026 (520 women, 506 men) consecutively referred patients at a Universityaffiliated teaching hospital. Participants completed the Ways of Coping Questionnaire, Fertility Problem Inventory, and the Dyadic Adjustment Scale. Results: Women used proportionately greater amounts of confrontive coping, accepting responsibility, seeking social support, and escape/avoidance when compared …

Vital Pulp Therapy With Mineral Trioxide Aggregate: An Outcomes Study, Heather H. Lauer

Loma Linda University Electronic Theses, Dissertations & Projects

Mineral trioxide aggregate (MTA) is used in a variety of endodontic procedures. MTA is proven to provide good marginal adaption to dentin, to be biocompatible, and to stimulate dentin bridge formation through animal studies. These properties make MTA a potentially useful material to be used in vital pulp therapy. Clinical data on the use of MTA as a vital pulp medicament is sparse. The purpose of this study was to evaluate the clinical outcome of vital pulp therapy using MTA as the pulp medicament. Inclusion criteria for patient selection for recall was based on pulp treatment necessary from carious pulp …

Ricketts And Steiner Analysis Using Newtom 3g™ Scout Images, James I. Gibson Iii

Loma Linda University Electronic Theses, Dissertations & Projects

NewTom 3G™ scout images have the general appearance of traditional lateral cephalometric radiographs. The purpose of this research was to determine if Ricketts and Steiner analyses could be accomplished on NewTom 3G™ scout images.

This was a retrospective study comparing the use of NewTom 3G™ scans in DICOM (Digital Imaging and Communications in Medicine) format to scout images from 25 consecutive patients of the Loma Linda University School of Dentistry Department of Orthodontics, three of these patients did not meet the inclusion criteria. The DICOM images were used to create controls. The controls and scout images were digitized using QuickCeph™. …

Validity Of Frozen Section In The Diagnosis Of Breast Lumps: 5 Years Experience At The Aga Khan University Hospital., Naila Kayani, Nuzhat Sultana

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the accuracy of frozen section in the diagnosis of breast lump. Methods: Frozen section diagnosis given in consecutive breast biopsies performed in 5 years in our laboratory was evaluated against the final pathology report of permanent sections. Results: The Aga Khan University Hospital Lab receives more than 400 cases per year for frozen section. Three hundred and nineteen consecutive frozen sections of breast lumps examined from 1999-2003 were considered for analysis. Age of patients ranged between 22 and 90 years (mean age 49 years). In 316 cases (99%) there was no difference between the frozen section …

Medical Education Digest, Vol. 7 No. 6 (November/December 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.

Oncolog, Volume 50, Number 10, October 2005, Beth Notzon, Rachel Williams, Maurie Markman Md

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

• Cytogenetics: Major Insights from Microscopic Details
• Breaking the News
• House Call: From My Bookshelf to Yours
• DiaLog: Intraperitoneal Chemotherapy: A New Strategy for Advanced Ovarian Cancer, by Maurie Markman, MD, Vice President for Clinical Research

Methemoglobinemia Induced By Topical Anesthesia During Fiberoptic Endotracheal Intubation, Matthew C. Miller, Michael T. Gaslin, Kathleen Herb, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presentation at 2005 American Academy Of Otolaryngology Head and Neck Surgery Annual Meeting, Los Angeles, CA September 25-28, 2005.

Introduction: Although local anesthetics are usually well tolerated, otolaryngologists need to be aware of the sometimes serious adverse events they can cause. The benzocaine containing sprays Hurricaine and Cetacaine are occasionally associated with the onset of life-threatening methemoglobinemia. The specific treatment for this condition is methylene blue.

Methods and Measures: We describe a case report of a 48 year old female who developed a methemoglobin level of 41% after receiving topical benzocaine to her oropharynx. We discuss the case in …

Medical Education Digest, Vol. 7 No. 5 (September/October 2005), Nova Southeastern University

Medical Education Digest

No abstract provided.

Depression In Primary Care: Difficulties And Paradoxes, Haider Naqvi, Murad Moosa Khan

Department of Psychiatry

The presentation of depression in primary care is in many ways different from that seen in psychiatric settings. The process of detection and treatment is also different. This is particularly so in developing countries like Pakistan, which has high prevalence rates of depression but poorly organized primary health care services and primary care physicians (PCPs) who have little psychiatric training, either at undergraduate or postgraduate levels. There is a need to review difficulties faced by primary care physicians in detection and management of depression. It is hoped this would lead to better and more effective management of depression at primary …

Dealing With A Terrorist Attack: A University Hospital Perspective, Muhammad Shahid, Rifat Rehmani, Muhammad Saleem Khan

Department of Emergency Medicine

No abstract provided.

A Case For Case Reports, Saba Sohail

Department of Radiology

No abstract provided.

The Outcome Of Mta As A Root End Filling Material: A Long Term Evaluation, Christopher M. Sechrist

Loma Linda University Electronic Theses, Dissertations & Projects

Periradicular surgery is a viable option to save natural teeth when non-surgical treatment fails or when endodontic retreatment is not feasible or contraindicated. Laboratory and animal studies have demonstrated that MTA is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to provide long term (>3 years) clinical evidence for its use as a root-end filling material in endodontics. The clinical records of 294 patients who had MTA used during endodontic treatment from 1996 to 2001 were reviewed. From these, 75 patients whose root end cavities had been filled …

Treatment Outcome Of Root Perforations Repaired With Mineral Trioxide Aggregate, Stephen H. Paik

Loma Linda University Electronic Theses, Dissertations & Projects

Root perforations during root canal therapy have a significant negative impact on long-term prognosis of teeth. Proper treatment is critical in managing these accidental procedures. Laboratory and animal studies have demonstrated that Mineral Trioxide Aggregate (MTA) is biocompatible, provides an excellent seal against penetrating bacteria, and promotes hard tissue healing. The purpose of this study was to determine the long term treatment outcome of root perforations repaired with MTA.

Ninety-nine records from the Graduate Endodontic Clinic at Loma Linda University School of Dentistry from 1996 to 2001 were reviewed. Clinical and radiographic evaluations were completed. Three independent examiners evaluated digitized …

The Relationship Of Attitude, Self-Efficacy, Physician, And Significant Other Influence To Type 2 Diabetes Outcomes, Heidi A. Larson

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to investigate the Theory of Planned Behavior (TPB) and its' relationship to Type 2 diabetes outcomes. One hundred and sixty-two adults ages 45 to 75 with Type 2 diabetes were recruited from two physicians' offices in the Midwest. Participants completed instruments that assessed (a) diabetes-specific attitude, (b) diabetes-specific self-efficacy, ( c) physician influence, ( d) significant other influence, and ( e) diabetes-specific quality of life. A measurement of metabolic control was also obtained. Multiple regressions were performed using (a) quality of life and (b) metabolic control as criterion variables. Attitude, self-efficacy, and physician influence …

Vital Signs, Fall 2005, Boonshoft School Of Medicine

Vital Signs

A twenty-eight page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, faculty profiles, class notes, and more.