Digital Commons Network^™

Lifetime Risk Of Diabetes In Metropolitan Cities In India, Shammi Luhar, Dimple Kondal, Rebecca Jones, Ranjit M. Anjana, Shivani A. Patel, Sanjay Kinra, Lynda Clarke, Mohammed K. Ali, Dorairaj Prabhakaran, Muhammad Masood Kadir

Community Health Sciences

Aims/hypothesis: We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI.
Methods: A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by …

Does Transcutaneous Vagal Nerve Stimulation (T-Vns) Reduce Seizure Frequency In Adult Patients With Pharmacoresistent Epilepsy?, Scott Poirier

PCOM Physician Assistant Studies Student Scholarship

Objective The objective of this selective EBM review is to determine whether or not transcutaneous vagal nerve stimulation is an effective measure in reducing seizure frequency in adult patients with pharmacoresistant epilepsy.

Study Design This systematic review comprises a randomized controlled trial and an observational pilot study, both published in 2014, as well as a double-blind randomized control trial published in 2016.

Data Sources All articles were published and displayed in English. The articles were obtained via the PubMed database.

Outcomes Measured Reductions in average seizure frequency were analyzed based on data from patient seizure diaries. Secondary outcomes, including quality …

Following Epidural Pca Use, Do Obstetric Patients Feel Satisfied With Their Pain Control, James Mcrae

Doctoral Projects

ABSTRACT

Pain is a source of anxiety for many patients, and uncontrolled pain can have deleterious effects on patient outcomes (Patak et al., 2014). Pain associated with labor is a particular concern of obstetric patients. Epidural analgesia is currently the frontline treatment for pain associated with labor, with epidural patient-controlled analgesia (PCA) often being utilized (Braveman, Scavone, Blessing, & Wong, 2013). Little evidence exists that details what factors of epidural PCA that patients considered important (Patak et al., 2014). In this project, a randomized questionnaire was administered to obstetric patients to assess satisfaction levels with their epidural PCA. The questionnaire …

Pregnancy Outcomes Among Women With An Unintended Pregnancy: Findings From A Prospective Registry In Rural Pakistan, Sumera Aziz Ali, Shiyam Sunder Tikmani, Margo S. Harrison, Sarah Saleem, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha

Community Health Sciences

Background: Unintended pregnancies are an important public health issue in both developed and developing countries. An unintended pregnancy may affect maternal health seeking behavior during the antenatal and postpartum periods, which can adversely affect perinatal outcomes. Aim: The specific aim of our study was to measure antepartum, intrapartum, and postpartum pregnancy outcomes among women with unintended pregnancies in a rural Pakistani population.
Methods: Using a prospective maternal and newborn health registry in Thatta Pakistan, we evaluated temporal associations between unintended pregnancy and several dimensions of health seeking behavior including: antenatal care, preference for private versus government facility for antenatal care, …

Prevention Of Ovarian And Endometrial Cancer By Combined Oral Contraceptives: A Demographics Study, Joanna S. Heywood

CMC Senior Theses

Endometrial cancer is the most common gynecologic cancer with 54,870 cases occurring in the United States in 2015 and causing 10,170 deaths, an 18.5% mortality rate (Elit and Reade, 2015). Ovarian cancer, while less common, is much more fatal. In 2015 in the United States, 21,290 cases occurred and resulted in 14,180 deaths, a 66.6% mortality rate. This mortality rate makes ovarian cancer the fifth most deadly cancer for women in the United States, which is largely explained by ineffective screening strategies and limited treatment possibilities (Cramer, 2012). Thus, developing effective prevention strategies is especially important to saving the lives …

Do Submental Deoxycholic Acid Injections Reduce Submental Fat In Adult Patients Enough To Create A Significant Increase In Patient Satisfaction?, Alec W. Curry

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Submental deoxycholic acid injections reduce submental fat in adult patients enough to create a significant increase in patient satisfaction”

Study Design: Review of 3 double blind, randomized control trials that were selected based on their relevance to the clinical question.

Data Sources: All three peer-reviewed articles were found using PubMed and Cochrane Database. The keywords “ATX-101”, “submental fat”, and “deoxycholic acid” were used.

Outcomes Measured: Satisfaction with appearance in association with face and chin evaluated by a patient reported subject self-rating scale …

Breastfeeding Education For Women With Diabetes, Pregnancy-Induced Hypertension And Multiple Gestations, Oluwapelumi Adefunmike Adeboyejo

Walden Dissertations and Doctoral Studies

Breastfeeding is considered a public health concern due to increased maternal/infant mortality and morbidity rates associated with persistent low rates in breastfeeding. Providing early breastfeeding education for women with diabetic, pregnancy-induced hypertension and multiple gestations can result in higher persistence rates and a decrease in maternal and infant mortality and morbidity rates. This quality improvement project provided early prenatal breastfeeding education for women with diabetes, pregnancy-induce hypertension and multiple gestations at a private clinic in Long Beach, Southern California. Evidence-based literature reviews were conducted through CINAHL and Medline (2009-2014). The descriptive study used for the project was made up questionnaires …

Disparities In Clinical Research Participation: Motivators, Barriers And Facilitators Of Primary Care Patients, Anita Kurt Phd, Rn, Charity Curtis Mph, Melanie B. Johnson Mpa, Henry Liu Md, Beth Careyva Md, Jerry Change Bs, Alex Winter Bs, Claudia P. Santiago Ba, Wendy H. York Bs, Ma, Kathleen Straubinger Rn, Bsn, Brian Stello Md

Department of Family Medicine

No abstract provided.

The Therapeutic Role Of Turmeric In Treatment And Prevention Of Alzheimer’S Disease, Rylan M. Mcquade

Selected Honors Theses

As a devastating neurological condition that expends millions of lives each year, Alzheimer’s disease (AD) is a subject of intense investigation.¹ Although AD has been known for over a century, the precise mechanisms that underlie AD pathogenesis and development are still poorly understood. The Alzheimer phenotype is typified by extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs), causing researchers to notice several key enzymes implicated in this process.¹ Most notable are β and γ secretases (which drive Aβ plaque production) and phospholipase

A₂ (which stimulates major cascade activation through the specific cleavage of fatty acyl esters). …

The Effect Of Strength And Plyometric Training On Functional Dance Performance In Elite Ballet And Modern Dancers, Joe Girard, Kristina Koenig, David Village

Faculty Publications

Background:

Ballet and modern dance are both art forms that require technique, artistry, grace and precision. Both dance forms require a degree of strength and muscular endurance for optimal performance. It is not known what value strength or plyometric training may have on functional dance performance.

Objective:

To systematically review the effects of strength and/or plyometric training on functional dance performance in elite ballet and modern dancers.

Methods:

A systematic review of literature indexed in the following databases: Medline, CINAHL, SportsDiscus, Physiotherapy Evidence Database (PEDro) and PubMed was conducted. The quality of the studies was graded using the PEDro Scale. …

Women's Empowerment And Contraceptive Use: The Role Of Independent Versus Couples' Decision-Making, From A Lower Middle Income Country Perspective, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque Sheikh, Ghazunfer Abbas, Marleen Temmerman, Bilal Iqbal Avan

Obstetrics and Gynaecology, East Africa

Introduction: There is little available evidence of associations between the various dimensions of women’s empowerment and contraceptive use having been examined - and of how these associations are mediated by women’s socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.

Methods: We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15–49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision making, …

Women's Empowerment And Contraceptive Use: The Role Of Independent Versus Couples' Decision-Making, From A Lower Middle Income Country Perspective, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque Sheikh, Ghazunfer Abbas, Marleen Temmerman, Bilal Iqbal Avan

Community Health Sciences

Introduction: There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined--and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.
Methods: We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15-49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and …

The Role Of Inflammation In Contrast-Induced Nephropathy, Elijah Kwasa, Sudhir Vinayak, Robert Armstrong

Imaging & Diagnostic Radiology, East Africa

Objective: Global incidence of contrast-induced nephropathy (CIN) is 2-5%, but a recent Kenyan study highlighted a local incidence of 12-14% without offering an explanation for the higher incidence. This study proposes that inflammatory states confer a higher relative risk for development of CIN. Our objective was to determine the risk of developing CIN given the presence of an inflammatory state in patients in Kenya.

Methods: Prospective cohort study of patients undergoing a contrast-enhanced CT (CECT) scan in a private university teaching hospital in Kenya and having no known risk factors for CIN. 423 patients were recruited and grouped into those …

Refugee Health In Montgomery County: A Retrospective Descriptive Study Of Refugee Health Screening Results From April 2007 - April 2008, Marjan Lyons

Master of Public Health Program Student Publications

Introduction: The top refugee health concerns characteristically are associated with parasitic infections, infectious diseases such as malaria, tuberculosis, and parasites, as well as nutritional deficiencies such as anemia, and malnourishment. Understanding the specific health needs of the refugee population will not only improve the transition of the refugees within the United States healthcare systems, but also improve public health within the community.

Methods: Health records from Public Health - Dayton & Montgomery Country were used to obtain the prevalence of both acute and chronic health conditions within the newly resettled refugee population. There were a total of 193 refugees included …

Metabolic Syndrome And Migraine., Amit Sachdev, Michael J Marmura

Department of Jefferson Headache Center Papers and Presentations

Migraine and metabolic syndrome are highly prevalent and costly conditions. The two conditions coexist, but it is unclear what relationship may exist between the two processes. Metabolic syndrome involves a number of findings, including insulin resistance, systemic hypertension, obesity, a proinflammatory state, and a prothrombotic state. Only one study addresses migraine in metabolic syndrome, finding significant differences in the presentation of metabolic syndrome in migraineurs. However, controversy exists regarding the contribution of each individual risk factor to migraine pathogenesis and prevalence. It is unclear what treatment implications, if any, exist as a result of the concomitant diagnosis of migraine and …

Gender Roles And Their Influence On Life Prospects For Women In Urban Karachi, Pakistan: A Qualitative Study, Tazeen S. Ali, Gunilla Krantz, Raisa Gul, Nargis Asad, Eva Johansson, Ingrid Mogren

School of Nursing & Midwifery

BACKGROUND: Pakistan is a patriarchal society where men are the primary authority figures and women are subordinate. This has serious implications on women's and men's life prospects.
OBJECTIVE: The aim was to explore current gender roles in urban Pakistan, how these are reproduced and maintained and influence men's and women's life circumstances.
DESIGN: Five focus group discussions were conducted, including 28 women representing employed, unemployed, educated and uneducated women from different socio-economic strata. Manifest and latent content analyses were applied.
FINDINGS: TWO MAJOR THEMES EMERGED DURING ANALYSIS: 'Reiteration of gender roles' and 'Agents of change'. The first theme included perceptions …

Cefuroxime Pharmacokinetics In Pediatric Cardiovascular Surgery Patients Undergoing Cardiopulmonary Bypass, Chad A. Knoderer, Sarah A. Saft, Scott G. Walker, Markl D. Rodefeld, Mark W. Turrentine, John W. Brown, Daniel P. Healy, Kevin M. Sowinski

Scholarship and Professional Work – COPHS

Objectives

The objective of this study was to determine the pharmacokinetics of cefuroxime in children undergoing cardiopulmonary bypass (CPB) for cardiovascular surgery.

Design

A prospective study.

Setting

A tertiary pediatric teaching hospital.

Participants

Infants and children undergoing CPB were enrolled in the study.

Intervention

An initial dose (mean, 24.2 ± 1.6 mg/kg) of cefuroxime was administered before surgical incision, and a second dose (mean, 14.4 ± 7.9 mg/kg) was administered in the CPB prime solution. Serial blood samples were obtained before, during, and after the CPB process. Samples were shipped on dry ice to the analytic laboratory and concentrations determined …

Expectations Of Pain Relief Utilizing Epidural Analgesia, Kelly Powell Morris

Nursing Theses and Capstone Projects

This study describes patient expectations and actual pain relief reported by patients experiencing childbirth while utilizing epidural analgesia as their method of choice to reduce the pain associated with childbirth using a quantitative descriptive design. Data were collected using the Expectations of Pain Relief Utilizing Epidural Analgesia Questionnaire. The sample (N=17) consisted of first-time mothers delivering at an acute community hospital who were participants in the county's Nurse-Family Partnership Program. The questionnaire, developed by the researcher, was distributed to participants by their Nurse-Family Partnership Registered Nurse during a routine postpartum home visit during the three month study time span. The …

Pathological Sub-Types, Risk Factors And Outcome Of Stroke At The Nairobi Hospital, Kenya, James Jowi, Peter Mativo

Internal Medicine, East Africa

Background: Stroke is one of the most common causes of morbidity and mortality the world over. Established risk factors such as arterial hypertension, diabetes mellitus, cigarette smoking, hyper-lipidaemia, micro-vascular rupture, male gender, age and observed co-morbities such as sickle cell disease, HIV/AIDS infection and cerebral malaria are increasingly being encountered in the tropics.

Objectives: To determine pathological sub-types, risk factors, in-hospital period prevalence and in-hospital outcome of stroke.

Design: Hospital-based retrospective study.

Setting: The Nairobi Hospital, Nairobi, Kenya.

Subjects: Patients with recorded diagnosis of stroke/cerebral vascular accident; as per WHO criteria for diagnosis of stroke, …

Factors Associated With Atypical Moles In New Hampshire, Usa, L Titus-Ernstoff, J Ding, A. E. Perry, S. K. Spencer, B. F. Cole, M. S. Ernstoff

Dartmouth Scholarship

Only a few studies, conducted in Sweden, assessed factors associated with the presence of atypical moles in the general population. We conducted a population-based, case-control study in New Hampshire, USA, to identify factors associated with atypical moles. In our study, atypical moles affected 14% of the study population. The adjusted odds ratio (OR) was 0.34 (95% confidence interval (CI)=0.14-0.80) for those with the highest adulthood recreational sun exposure, relative to the lowest. The OR for any freckles, compared to none, was 2.24 (95% CI=1.18-4.25). We found a linear relationship between the number of benign moles and the presence of atypical …

Revisiting Vaccine Hesitancy, Barriers And Motivators To Obtaining A Flu Vaccine In A New Covid-19 Pandemic World, Ann M. Mayo Rn, Dnsc, Faan, Steffanie R. Cobler Np

School of Nursing and Health Science: Faculty Scholarship

Purpose

To describe and compare patient perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who receive flu vaccines and those who do not.

Data Sources

Data collection during 2003 included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight (108) patients participated in the study.

Conclusions

Top barriers included fear of side effects from vaccine (35%) and fear of contracting the flu (30%). Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Barriers, motivators and patient decisional conflict differed depending upon patient …

American Association Of Cancer Institutes (Aaci), 1970, Office Of The President

Director's Office Records: Ernst Bertner and R. Lee Clark Archives

Series 7, National Committees, 1958-1972

Fiche: 1.2327B-1.2327C