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Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

Understanding Zoonotic Enteric Disease In Minnesota: A Spatio Temporal Analysis And Causal Theory Approach, Suchismita Swain

All Graduate Theses, Dissertations, and Other Capstone Projects

With 75 percent of diseases in humans having origin in animals or animal products, zoonotic diseases have an enormous impact on the global disease burden. A significant portion of this can be attributed to bacterial zoonotic enteric pathogens. This study was designed to locate clusters of bacterial zoonotic enteric outbreaks in the State of Minnesota and study the seasonality of these outbreaks. In addition to identifying hot spots for zoonotic enteric outbreaks in Minnesota, the study also aimed to design a causal model to improve understanding of risk factors. This thesis considered only the bacterial zoonotic pathogens with significant disease …

Selection Of Best Videos Of The Year For 2016, Philippe E. Spiess

Urology Faculty Publications

No abstract provided.

Can Coloring Pre-Structured Designs That Have Complexity Aid In Reducing Anxiety In Those Greater Than 17 Years Of Age?, Kaitlyn P. Probasco

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence based medicine (EBM) review is to determine whether or not coloring mandalas or designs that have complexity and structure can aid in reducing anxiety in those greater than 17 years of age.

Study Design: Review of three English language randomized controlled trials (RCTs), published in 2007, 2012, and 2015.

Data Sources: Three randomized controlled trials published in peer-reviewed journals obtained using PubMed and EBSCOhost.

Outcomes Measured: The Curry and Kasser study and the van dV and Serice7study both used the State Anxiety Inventory (SAI) to record anxiety. The Henderson …

Does Belatacept Improve Patient/Graft Survival After 1 Year Versus Calcineurin Inhibitor Based Regimens?, Ashlie Burns

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not belatacept improves patient/graft survival after 1 year versus calcineurin inhibitors based regimens.

Study Design: Review of one randomized controlled trial published in 2010 and two randomized controlled trials published in 2011 were used for this review and selected based on their relevance to the clinical question.

Data Sources: Studies were found using PubMed, and Medline Plus. Outcomes Measured: All three studies measured patient/graft survival after 12 months as either a primary or secondary outcome.

Results: Vincenti et al (2010) showed belatacept to …

Pain And Anxiety Levels Of Patients Undergoing Tissue Expansion After Mastectomies: A Case Series Study, Nicole K. Le, Carla García-Molina, Ambuj Kumar, Lisa Griffin, Deniz Dayicioglu

Surgery Faculty Publications

The tissue expansion process is done after mastectomies to increase the submuscular space in preparation for the placement of permanent breast implant. The process is often believed to be painful by patients who are often intimidated by the prospect of mechanically stretching out their skin and muscle. This study aims to quantify the pain experienced by patients and determine the different pain management techniques used. We used a case series approach, in which patients who were undergoing serial tissue expansion process were asked to rate their pain and anxiety on a scale from 1 to 10, using a questionnaire and …

In The Age Of Breast Augmentation, Breast Reconstruction Provides An Opportunity To Augment The Breast, Amanda L. Zimmerman, Bugra Tugertimur, Paul D. Smith, Ambuj Kumar, Deniz Dayicioglu

Surgery Faculty Publications

Background: Augmentation mammoplasty remains the most common cosmetic surgery procedure performed. The objective of this article is to evaluate the impact of augmented volume of the reconstructed breast in patients that undergo nipple-sparing mastectomy and patients previously augmented who undergo mastectomy with tissue expander/implant-based reconstruction.

Methods: Patients undergoing skin-sparing mastectomy, nipple-sparing mastectomy, and mastectomy after previous augmentation followed by tissue expander/implant-based reconstruction between June 2011 and April 2015 by 2 surgeons at the same institution were included. Retrospective chart review of the patients identified using these criteria was performed to record patient characteristics, complications, breast volume, implant volume, and percentage …

Disparities In Use And Access To Postmastectomy Breast Reconstruction Among African American Women: A Targeted Review Of The Literature, Sara E. Soni, M. Catherine Lee, Clement K. Gwede

Surgery Faculty Publications

Postmastectomy breast reconstruction is a therapy that has been shown to have positive psychological effects on its recipients. There is evidence that racial disparities in its use exist, particularly among African American (AA) women. The purpose of this targeted review of the literature was to examine the use of postmastectomy breast reconstruction among AA women and to explore factors that contribute to such disparities. Published literature that evaluated rates of breast reconstruction in AA women, as well as barriers to reconstruction in this population, was reviewed. All of the reviewed data consisted of retrospective studies. There are conflicting data in …

Mechanisms Of Vasovagal Syncope In The Young: Reduced Systemic Vascular Resistance Versus Reduced Cardiac Output, Julian Stewart, Marvin Medow, R Sutton, Paul Visintainer, D Jardine, W Wieling

NYMC Faculty Publications

BACKGROUND: Syncope is a sudden transient loss of consciousness and postural tone caused by cerebral hypoperfusion. The most common form is vasovagal syncope (VVS). Presyncopal progressive early hypotension in older VVS patients is caused by reduced cardiac output (CO); younger patients have reduced systemic vascular resistance (SVR). Using a priori criteria for reduced CO ( downward arrowCO) and SVR ( downward arrowSVR), we studied 48 recurrent young fainters comparing subgroups of VVS with VVS- downward arrowCO, VVS- downward arrowSVR, and both VVS- downward arrowCO& downward arrowSVR. METHODS AND RESULTS: Subjects were studied supine and during 70-degrere upright tilt with a …

A Comparison Of Screening Tools For The Early Detection Of Peripheral Neuropathy In Adults With And Without Type 2 Diabetes, Jennifer J. Brown, Shana Pribesh, Kimberly G. Baskette, Aaron I. Vinik, Sheri R. Colberg

Educational Leadership & Workforce Development Faculty Publications

Objective. Examine the effectiveness of the 128 Hz tuning fork, two monofilaments, and Norfolk Quality of Life Diabetic Neuropathy (QOL-DN) questionnaire as tools for the early detection of diabetic peripheral neuropathy (DPN) in overweight, obese, and inactive (OOI) adults or those who have prediabetes (PD) or type 2 diabetes (T2D). Research Design and Methods. Thirty-four adults (mean age 58.4 years +/- 12.1) were divided by glycemia (10 OOI normoglycemic, 13 PD, and 11 T2D). Sural nerves were tested bilaterally with the NC-stat DPNCheck to determine sural nerve amplitude potential (SNAP) and sural nerve conduction velocity (SNCV). All other testing …

Risk Of Glucose Intolerance And Gestational Diabetes Mellitus In Relation To Maternal Habitual Snoring During Early Pregnancy., Chunfang Qiu, Wayne Lawrence, Bizu Gelaye, Lee Stoner, Ihunnaya O Frederick, Daniel A Enquobahrie, Tanya K Sorensen, Michelle A Williams

Articles, Abstracts, and Reports

BACKGROUND: Obstructive sleep apnea (OSA) or habitual snoring is known to be associated with impaired glucose tolerance and type 2 diabetes among both men and non-pregnant women. We examined the association of habitual snoring during early pregnancy with risk of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM).

METHODS: A cohort of 1,579 women was interviewed during early pregnancy. We collected information about snoring frequency during early pregnancy. Results from screening and diagnostic tests for IGT and GDM were abstracted from medical records. Multivariate logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% …

A Comparison Of Sex Differences In Psychotropic Medication Use In Older People With Alzheimer's Disease In The Us And Finland, Daniela C. Moga, Heidi Taipale, Anna-Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Qishan Wu, Gregory A. Jicha, Danijela Gnjidic

Pharmacy Practice and Science Faculty Publications

Aims—Given the high prevalence of psychotropic medication use in people with dementia and the potential for different prescribing practices in men and women, our study aimed to investigate sex differences in psychotropic medication use in older adults with Alzheimer’s disease (AD) living in the US and Finland.

Methods—We used data collected between 2005 and 2011 as part of the National Alzheimer’s Coordinating Center (NACC) in the US, and Medication use and Alzheimer’s disease (MEDALZ) cohorts in Finland. We evaluated psychotropic medication use (antidepressant, antipsychotic, anxiolytic, sedative, or hypnotic) in participants aged 65 years or older. We employed multivariable …

Swaziland: A Journey Into Culture And Health Care, Claire Hickey

Posters

Describes a global health learning experience with Baylor International Pediatrics AIDS Initiative in Swaziland in 2017.

Activation And Expansion Of Natural Killer Cells For Cancer Immunotherapy With Ex21 Exosomes, Sara Khederzadeh

Honors Undergraduate Theses

In the field of cancer immunotherapy, NK cells are recognized for their ability to provide a form of innate immunity against tumor cells. However, the average abundance of NK cells in the blood can be as low as 5% of the total lymphocyte population. As a result, it has been a focus to find novel therapies to expand NK cells in vitro while subsequently enhancing the cytotoxicity of these cells. Previously-defined methods include the minimal expansion of NK cells with high levels of cytokines such as IL-2 and IL-15, as well as co-culturing NK cells with feeder cell populations that …

Promotion Of Early Pediatric Hearing Detection Through Patient Navigation, Matthew L. Bush

Theses and Dissertations--Clinical and Translational Science

Congenital hearing loss is the most common neonatal sensory disorder and it is crucial to diagnose hearing loss as soon as possible after birth in order to facilitate rapid treatment. Universal standards of infant hearing healthcare dictate that infant hearing screening should be completed by one month of age and abnormal screening tests should be followed with definitive audiological testing by three months of age. Obtaining diagnostic testing can be complicated by limited access to care in rural areas, breakdowns in communication, lack of parental support, and poor coordination of care. There is no established method to address appointment non-adherence …

The Impact Of A Referral Card-Based Intervention On Intimate Partner Violence, Psychosocial Health, Help-Seeking And Safety Behaviour During Pregnancy And Postpartum: A Randomized Controlled Trial, An-Sofie Van Parys, Ellen Deschepper, Kristien Roelens, Marleen Temmerman, Hans Verstraelen

Obstetrics and Gynaecology, East Africa

Background: We aimed to investigate the impact of a referral-based intervention in a prospective cohort of women disclosing intimate partner violence (IPV) on the prevalence of violence, and associated outcomes psychosocial health, help-seeking and safety behaviour during and after pregnancy.

Methods: Women seeking antenatal care in eleven Belgian hospitals were consecutively invited from June 2010 to October 2012, to participate in a single-blind randomized controlled trial (RCT) and handed a questionnaire. Participants willing to be interviewed and reporting IPV victimisation were randomised. In the Intervention Group (IG) participants received a referral card with contact details of services providing assistance and …

“The Co-Authors Of Pregnancy”: Leveraging Men’S Sense Of Responsibility And Other Factors For Male Involvement In Antenatal Services In Kinshasa, Drc, Michelle M. Gill, John Ditekemena, Aimé Loando, Vicky Ilunga, Marleen Temmerman, Franck Fwamba

Obstetrics and Gynaecology, East Africa

Background: Despite efforts to improve male involvement (MI), few male partners typically attend antenatal care (ANC). MI in ANC and interventions to prevent mother-to-child HIV transmission have been demonstrated to be beneficial for the HIV-positive mother and her child. This study aimed to explore factors influencing partner attendance and highlight interventions with potential to improve MI within a Congolese context.

Methods: This was an exploratory, qualitative study conducted in two urban and two semi-urban catchment areas of Kinshasa, DRC in June–September 2016. Two women-only and two men-only focus group discussions (FGDs) were held; participants were recruited from ANC clinics and …

The Write Stuff - Winter 2017 (Vol. 14, No. 1), Research Medical Library

Write Stuff 2017

• Reusing your own previously published material: When is it okay?
• Think. Check. Submit: Selecting a trusted journal for your manuscript
• NIH revises its grant appendix policy and font recommendations
• Minimizing text on scientific posters
• Winter and spring schedule for the Research Medical Library webinar program
• Unusual terms used in scientific writing and publishing: Predatory journals, misleading metrics, and other publishing hazards

Bangladesh: Using Strong Evidence And Strategic Collaboration To Increase Access To Menstrual Regulation With Medication, Nancy Termini Lachance, Sharif M.I. Hossain

Reproductive Health

Through close cooperation with the Ministry of Health and Family Welfare of Bangladesh, and other partners, STEP UP generated strong evidence and cultivated ongoing collaboration that contributed to policy changes and program expansions to increase access to menstrual regulation with medication (MRM). Study results demonstrate that MRM is acceptable and effective in Bangladesh, and has thus been legalized and folded into the national FP program and scaled up nationwide. However, ongoing observation and studies are still needed to understand whether the efficacy and acceptability of MRM remains the case when services are delivered at scale on a national level. Furthermore, …

Introduction And Approval Of Menstrual Regulation With Medication In Bangladesh: A Stakeholder Analysis, Fauzia Akhter Huda, Sadia Afrin, Bidhan Krishna Sarker, Hassan Rushekh Mahmood, Anadil Alam

Reproductive Health

Despite the significant progress that the government of Bangladesh has made toward introducing menstrual regulation with medication (MRM) into the national health program, there has been no systematic documentation on the introduction of MRM in Bangladesh, and on the approval process of local manufacturing of the mifepristone-misoprostol combination for menstrual regulation. This Research Report presents findings from the stakeholder analysis which was initiated to document the entire process of introducing MRM in the country. Findings from key informant interviews indicated some crucial factors that facilitated the process; these are presented here according to a four-part policy analysis framework: context, content, …

Harmonizing National Abortion And Pregnancy Prevention Laws And Policies For Sexual Violence Survivors With The Maputo Protocol, Jill Thompson, Chi-Chi Undie, Avni Amin, Ronald Johnson, Rajat Khosla, Ian Askew, Leopold Ouedraogo, Triphonie Nkurunziza, Sarah Rich, Elizabeth Westley, Melissa Garcia

Reproductive Health

In April 2016, the Population Council, the World Health Organization (WHO), and the International Consortium for Emergency Contraception (ICEC) convened a three-day regional technical meeting aimed at helping participating countries meet their obligations under the Maputo Protocol to protect and promote the reproductive health rights of women and girls, with a special emphasis on survivors of sexual and intimate partner violence. Participants included representatives from six countries in sub-Saharan Africa—Botswana, Ethiopia, Kenya, Malawi, Rwanda, and Zambia—as well as international and regional experts on reproductive health, law, and human rights. Presentations and discussions focused primarily on the prevention and management of …

Development Of A Health Care Systems Curriculum., Zachary Pruitt, Rahul Mhaskar, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Deborah J Dewaay, Alexander M. Rosenau Do, Kristin A. Bresnan Md, Marna R. Greenberg Do, Mph, Facep

Department of Emergency Medicine

Background: There is currently no gold standard for delivery of systems-based practice in medical education, and it is challenging to incorporate into medical education. Health systems competence requires physicians to understand patient care within the broader health care system and is vital to improving the quality of care clinicians provide. We describe a health systems curriculum that utilizes problem-based learning across 4 years of systems-based practice medical education at a single institution.

Methods: This case study describes the application of a problem-based learning approach to system-based practice medical education. A series of behavioral statements, called entrustable professional activities, was created …

Parents Of Children Who Had Hypoxic-Ischemic Encephalopathy: A Mixed-Methods, Exploratory Study, Natalene Kramer

Electronic Theses and Dissertations

Background: There is scant literature addressing the parents of children who had hypoxic-ischemic encephalopathy (HIE). therefore only inferences may be made as to issues of that experience affecting parents.

Purpose: The purposes of this study was to uncover the lived experiences of parents of children who had HIE, evaluate issues of stress, depression, coping, and impact of neurologic disability in order to better care for them and thus their families

Methods: A parallel, convergent mixed-methods design was used to explore experiences and perceptions of these parents regarding their experiences and life changes. The quantitative strand addressed four research questions which …

"The Co-Authors Of Pregnancy": Leveraging Men's Sense Of Responsibility And Other Factors For Male Involvement In Antenatal Services In Kinshasa, Drc, Michelle M. Gill, John Ditekemena, Aimé Loando, Vicky Ilunga, Marleen Temmerman, Franck Fwamba

Department of Obstetrics & Gynaecology

Background: Despite efforts to improve male involvement (MI), few male partners typically attend antenatal care (ANC). MI in ANC and interventions to prevent mother-to-child HIV transmission have been demonstrated to be beneficial for the HIV-positive mother and her child. This study aimed to explore factors influencing partner attendance and highlight interventions with potential to improve MI within a Congolese context.
Methods: This was an exploratory, qualitative study conducted in two urban and two semi-urban catchment areas of Kinshasa, DRC in June–September 2016. Two women-only and two men-only focus group discussions (FGDs) were held; participants were recruited from ANC clinics and …

Effects Of Screen Light Filtering Software On Sleep And Morning Alertness, Hengyu Chi

All Master's Theses

Research has shown that blue light can impact the circadian rhythm. Research has also suggested that use of electronic devices, such as computers and televisions that emit blue light before sleep, can negatively impact sleep quality. This research has led to the creation of computer software which lowers the levels of blue light in the evening to help with sleep. This study looked at the impact of wavelength filtering software on sleep onset, sleep duration and subjective alertness after morning waking of four college students. The college students were randomized into two groups and had the wavelength filtering software f.lux …

The Dosimetric Evaluation On Photon Energy Effect For Cervical Carcinoma In 3d-Crt, Imrt, And Vmat Plans, Vanida Poolnapol

Chulalongkorn University Theses and Dissertations (Chula ETD)

In the previous time, 3D-CRT technique has been considered as the primary treatment for cervical cancer treatment. Nowadays, advanced techniques, IMRT and VMAT, are used to treat because of the dosimetric and clinical benefit over 3D-CRT technique. However, each of these technique generates difference outcomes. The purpose of this study was to investigate the dosimetric outcomes between 6 and 15 MV photon energies in each 4 fields box 3D-CRT, 9 fields IMRT, and 2 arcs VMAT plans of five advanced cervical cancers using parameters of D95%, TC, HI, CI, CN from PTV, V45 Gy and V50 Gy from OARs, NTID, …

Design And Challenges Of A Randomized Clinical Trial Of Medical Expulsive Therapy (Tamsulosin) For Urolithiasis In The Emergency Department., Pamela K. Burrows, Judd E. Hollander, Allan B. Wolfson, Michael C. Kurz, Lorna Richards, Sara Difiore, Phillip Watts, Nivedita Patkar, Jeremy Brown, Stephen Jackman, Ziya Kirkali, John W. Kusek, Chloe Michel, Andrew C. Meltzer

Department of Emergency Medicine Faculty Papers

Urolithiasis or urinary stone disease has been estimated to affect about 1 in 11 Americans. Patients with urinary stone disease commonly present to the emergency department for management of their acute pain. In addition to providing analgesia, administration of drug (medical expulsive therapy) is often prescribed to assist passage of the urinary stone. In this methodology paper, we describe the design of a prospective, multi-center, randomized, double-blind placebo controlled clinical trial of the alpha-adrenergic blocker, tamsulosin, to evaluate its effectiveness as medical expulsive therapy. In addition, we describe the unique challenges of conducting a trial of this type within the …

Targeting The Nrf2-Heme Oxygenase-1 Axis After Intracerebral Hemorrhage., Jing Chen-Roetling, Raymond F. Regan

Department of Emergency Medicine Faculty Papers

BACKGROUND: Injury to cells adjacent to an intracerebral hemorrhage (ICH) is likely mediated at least in part by toxins released from the hematoma that initiate complex and interacting injury cascades. Pharmacotherapies targeting a single toxin or pathway, even if consistently effective in controlled experimental models, have a high likelihood of failure in a variable clinical setting. Nuclear factor erythroid-2 related factor 2 (Nrf2) regulates the expression of heme oxygenase-1 (HO-1) and multiple other proteins with antioxidant and antiinflammatory effects, and may be a target of interest after ICH.

METHODS: Studies that tested the effect of HO and Nrf2 in models …

Factors Associated With Post-Arrest Withdrawal Of Life-Sustaining Therapy., Anne V. Grossestreuer, David F. Gaieski, Benjamin S. Abella, Douglas J. Wiebe, Ari Moskowitz, Daniel J. Ikeda, Jason S. Haukoos, Sarah M. Perman

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Most successfully resuscitated cardiac arrest patients do not survive to hospital discharge. Many have withdrawal of life sustaining therapy (WLST) as a result of the perception of poor neurologic prognosis. The characteristics of these patients and differences in their post-arrest care are largely unknown.

METHODS: Utilizing the Penn Alliance for Therapeutic Hypothermia Registry, we identified a cohort of 1311 post-arrest patients from 26 hospitals from 2010 to 2014 who remained comatose after return of spontaneous circulation. We stratified patients by whether they had WLST post-arrest and analyzed demographic, arrest, and post-arrest variables.

RESULTS: In our cohort, 565 (43%) patients …

Adiponectin Partially Rescues High Glucose/High Fat-Induced Impairment Of Mitochondrial Biogenesis And Function In A Pgc-1Α Dependent Manner., H. Wang, W.-J. Yan, J.-L. Zhang, F.-Y. Zhang, C. Gao, Y.-J. Wang, W.B. Lau, L. Tao

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Plasma adiponectin (APN) levels are decreased in diabetic patients. Dysfunctional mitochondrial biogenesis is involved in type 2 diabetes (T2DM) pathogenesis, by unclear mechanisms. The present study determined (1) whether myocardial mitochondrial biogenesis was impaired in cardiomyocytes exposed to a high glucose/high fat (HGHF) medium (a T2DM in vitro model), (2) the effects of APN administration upon mitochondrial biogenesis in cardiomyocytes affected by HGHF incubation, and 3) the involved underlying mechanisms.

MATERIALS AND METHODS: Neonatal rat ventricular myocytes (NRVMs) were isolated and incubated in HGHF medium. Mitochondrial function was assessed by ATP content, and fluorescent microscopic analysis of myocardial apoptosis …