Digital Commons Network^™

Cancer Survivorship: Promoting A Lifetime Of Health, Janelle Coleman-Smith

Master's Projects and Capstones

Abstract

Introduction Cancer survivors can face post-cancer treatment effects that need addressing throughout their care trajectory. Education provided to stakeholders and patients will be beneficial in preventing fragmented care, increasing patient satisfaction, and expanding ongoing supportive clinical survivorship care. Methods An adapted Dr. Joanne Lester survivorship needs survey was given to n=7 post-cancer treatment patients within a northern California cancer patient advisory committee. The survey results were analyzed to identify common underserved chronic long-term survivorship needs. Based on the data, an evidence-based educational component was included within a booklet to enhance future survivorship care. Additional surveys were sent to stakeholders …

Iron Deficiency Anemia As A Risk Factor For Simple Febrile Seizures, Tipu Sultan, Abdul Islam Hanif Hanif, Shaila Ali

Pakistan Journal of Neurological Sciences (PJNS)

To determine the association of iron deficiency anemia with simple febrile seizures in children presenting in a tertiary care hospital.

Beyond The End Line - Putting The Mental Health Of Female Athletes First, Katherine Scholten

Honors Projects

Currently one in five adults are affected by mental illness. Student-athletes are a population that is under diagnosed for mental illness. In the world of college athletics, mental pain is as regular as physical pain. Coaches often push their athletes to suffer in silence for the betterment of the team. The NCAA has recognized the importance of mental health in college athletics, yet there is still much work to be done among universities across the country. This document is to serve as a resource and a guide on the effects of mental health among female student athletes and the best …

Type 1 Diabetes Alters Lipid Handling And Metabolism In Human Fibroblasts And Peripheral Blood Mononuclear Cells, Albert R. Jones Iv, Emily L. Coleman, Nicholas R. Husni, Jude T. Deeney, Forum Raval, Devin Steenkamp, Hans Dooms, Barbara S. Nikolajczyk, Barbara E. Corkey

Clinical and Translational Science Faculty Publications

Triggers of the autoimmune response that leads to type 1 diabetes (T1D) remain poorly understood. A possibility is that parallel changes in both T cells and target cells provoke autoimmune attack. We previously documented greater Ca²⁺ transients in fibroblasts from T1D subjects than non-T1D after exposure to fatty acids (FA) and tumor necrosis factor α (TNFα). These data indicate that metabolic and signal transduction defects present in T1D can be elicited ex vivo in isolated cells. Changes that precede T1D, including inflammation, may activate atypical responses in people that are genetically predisposed to T1D. To identify such cellular differences …

Low Birth Weight: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, Clare L. Cutland, Eve M. Lackritz, Tamala Mallett-Moore, Azucena Bardají, Ravichandran Chandrasekaran, Chandrakant Lahariya, Muhammad Imran Nisar, Milagritos D. Tapia, Jayani Pathirana, Sonali Kochhar

Department of Paediatrics and Child Health

No abstract provided.

Failure To Thrive: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunisation Safety Data, Elizabeth Ross, Flor M. Munoz, Bassey Edem, Cassandra Nan, Fyezah Jehan, Julie Quinn, Tamala Mallett Moore, Sanie Sesay, Hans Spiegel, Librada Fortuna

Department of Paediatrics and Child Health

No abstract provided.

Setting Priorities For Knowledge Translation Of Cochrane Reviews For Health Equity: Evidence For Equity, Peter Tugwell, Jennifer Petkovic, Vivian Welch, Jennifer Vincent, Zulfiqar Ahmed Bhutta, Rachel Churchill, Don Desavigny, Lawrence Mbuagbaw, Tomas Pantoja

Department of Paediatrics and Child Health

Background: A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into …

Doula Services Within A Healthy Start Program: Increasing Access For An Underserved Population, Mary-Powel Thomas, Gabriela Ammann, Ellen Brazier, Philip Noyes, Aletha Maybank

Publications and Research

Purpose: Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support.

Description: To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along …

Nutritional Supplement Practices Of Professional Ugandan Athletes: A Cross-Sectional Study, Haruna Muwonge, Haruna Muwonge, Robert Zavuga, Peninnah Kabenge, Timothy Makubuya

Educator Preparation & Leadership Faculty Works

BackgroundThe use of nutritional supplements (NS) places athletes at great risk for inadvertent doping. Due to the paucity of data on supplement use, this study aimed to determine the proportion of Ugandan athletes using nutritional supplements and to investigate the athletes’ motivation to use these supplements.MethodsA cross-sectional study was conducted in which an interviewer-administered questionnaire was used to collect data from 359 professional athletes participating in individual (boxing, cycling, athletics) and team (basketball, rugby, football, netball, and volleyball) sports. The data were categorized, and a Chi-square test was used for statistical analysis.ResultsOf the 359 athletes, 48 (13.4%) used nutritional supplements. …

Management Of Undernutrition And Failure To Thrive In Children With Congenital Heart Disease In Low- And Middle-Income Countries, Andrew C. Argent, Rakhi Balachandran, Balu Vaidyanathan, Amina Khan, R. Krishna Kumar

Section of Cardiology

Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low- and middle-income countries. Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible. Close attention should be paid …

Influence Of Dietary Salt Knowledge, Perceptions, And Beliefs On Consumption Choices After Stroke In Uganda, Martin N. Kaddumukasa, Elly Katabira, Martha Sajatovic, Svetlana Pundik, Mark Kaddumukasa, Larry B. Goldstein

Neurology Faculty Publications

Background

Previous research on Uganda's poststroke population revealed that their level of dietary salt knowledge did not lead to healthier consumption choices.

Purpose

Identify barriers and motivators for healthy dietary behaviors and evaluate the understanding of widely accepted salt regulation mechanisms among poststroke patients in Uganda.

Methods

Convergent parallel mixed methods triangulation design comprised a cross-sectional survey (n = 81) and 8 focus group discussions with 7-10 poststroke participants in each group. We assessed participant characteristics and obtained insights into their salt consumption attitudes, perceptions, and knowledge. Qualitative responses were analyzed using an inductive approach with thematic analytic procedures. Relationships …

High Burden Of Subclinical Lead Toxicity After Phase Out Of Lead From Petroleum In Pakistan, Hafsa Majid, Aysha Habib Khan, Nadeem Ullah Khan, Imran Siddiqui, Farooq Ghani, Lena Jafri

Department of Pathology and Laboratory Medicine

Objective: To evaluate the frequency of subclinical lead toxicity.
Study design: Cross-sectional study.
Place and duration of study: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from January 2011 to December 2014.
Methodology: Analysis of laboratory data for blood lead levels (BLL) was performed. Lead was tested by atomic absorption spectrometer. For all subjects, only initial test results were included while the results of repeated testing were excluded. Exemption was sought from institutional ethical review committee. BLL of 2-10 ug/dl and 10-70 ug/dl in children and adults, respectively were taken as subclinical lead toxicity.
Results: Amongst …

High Burden Of Subclinical Lead Toxicity After Phase Out Of Lead From Petroleum In Pakistan, Hafsa Majid, Aysha Habib Khan, Nadeem Ullah Khan, Imran Siddiqui, Farooq Ghani, Lena Jafri

Department of Pathology and Laboratory Medicine

Objective: To evaluate the frequency of subclinical lead toxicity.
Study design: Cross-sectional study.
Place and duration of study: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from January 2011 to December 2014.
Methodology: Analysis of laboratory data for blood lead levels (BLL) was performed. Lead was tested by atomic absorption spectrometer. For all subjects, only initial test results were included while the results of repeated testing were excluded. Exemption was sought from institutional ethical review committee. BLL of 2-10 ug/dl and 10-70 ug/dl in children and adults, respectively were taken as subclinical lead toxicity.
Result: Amongst …

National Trends In Admission And In-Hospital Mortality Of Patients With Heart Failure In The United States (2001–2014), Emmanuel Akintoye, Alexandros Briasoulis, Alexander Egbe, Shannon M. Dunlay, Sudhir Kushwaha, Diane Levine, Luis Afonso, Dariush Mozaffarian, Jarrett Weinberger

Internal Medicine Faculty Publications

Background-—To investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines.

Methods and Results-—Using data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in-hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF-associated admissions occurred. Rates (95% confidence intervals) of admissions and in-hospital mortality among primary HF hospitalizations declined by an average annual rate of 3% (2.5%–3.5%) and 3.5% (2.9%–4.0%), respectively. Compared with 2001 to 2005, the average annual rate of decline in primary HF admissions …

Are Tart Cherry Supplements Effective On Reducing Muscle Soreness And Perception Of Pain In Young, Healthy Males Following High Intensity Resistance Training?, Alyssa Davis

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not tart cherry supplements are effective at alleviating muscle soreness and pain following high resistance training.

STUDY DESIGN: Review of two double blind randomized control trials, and one crossover randomized control trial. All three studies were published in English between 2006-2015.

DATA SOURCES: Two double blind randomized control trials and one crossover randomized control trial found using Cochrane and PubMed.

OUTCOMES MEASURED: The outcomes measured were muscle soreness and perception of pain. They were measured using a pressure-pain threshold and 10 point pain …

Is Weight Loss An Effective Treatment Of Pain Symptoms Related To Knee Joint Osteoarthritis In Obese Adults?, Samantha Sokol

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not weight loss is an effective treatment of pain symptoms related to knee joint osteoarthritis in obese adults.

Study Design: Systematic review of 2 randomized-controlled trials and 1 cohort study. All three articles were published in English between 2011-2015.

Data Sources: Two randomized, un-blinded, controlled studies and one cohort found using Pubmed.

Outcomes Measured: Each study evaluated change in pain symptoms related to knee osteoarthritis in obese adults as compared to weight loss.

Results: Studies showed that weight loss lead to a …

Cxc Chemokines Exhibit Bactericidal Activity Against Multidrug-Resistant Gram-Negative Pathogens, Erum Khan, Matthew A. Crawford, Debra J. Fisher, Lisa M. Leung, Sara Lomonaco, Christine Lascols, Antonio Cannatelli,, Gian Maria Rossolini, Yohei Doi, David R. Goodlett

Department of Pathology and Laboratory Medicine

The continued rise and spread of antimicrobial resistance among bacterial pathogens pose a serious challenge to global health. Countering antimicrobial-resistant pathogens requires a multifaceted effort that includes the discovery of novel therapeutic approaches. Here, we establish the capacity of the human CXC chemokines CXCL9 and CXCL10 to kill multidrug-resistant Gram-negative bacteria, including New Delhi metallo-beta-lactamase-1-producing Klebsiella pneumoniae and colistin-resistant members of the family Enterobacteriaceae that harbor the mobile colistin resistance protein MCR-1 and thus possess phosphoethanolamine-modified lipid A. Colistin-resistant K. pneumoniae isolates affected by genetic mutation of the PmrA/PmrB two-component system, a chromosomally encoded regulator of lipopolysaccharide modification, and containing …

Outbreak Response And Incident Management: Shea Guidance And Resources For Healthcare Epidemiologists In United States Acute-Care Hospitals., David B Banach, B Lynn Johnston, Duha Al-Zubeidi, Allison H Bartlett, Susan Casey Bleasdale, Valerie M Deloney, Kyle B Enfield, Judith A Guzman-Cottrill, Christopher Lowe, Luis Ostrosky-Zeichner, Kyle J Popovich, Payal K Patel, Karen Ravin, Theresa Rowe, Erica S Shenoy, Scott Stienecker Md, Pritish K Tosh, Kavita K Trivedi

Hospital Medicine

This expert guidance document was developed as a resource to provide healthcare epidemiologists working in acute-care hospitals with a high-level overview of incident management for infectious diseases outbreaks and to prepare them to work within an emergency response framework. It addresses how the epidemiologist’s skills and expertise apply to scenarios that require enhanced preparedness and response efforts, eg, when pathogens associated with outbreaks are poorly characterized or when outbreaks require additional interventions including, but not limited to, healthcare personnel education, enhanced infection prevention and control measures, added staffing, supplies, and resources, adjustments to clinical and support activities, and external communications. …

Spectrum Of Celiac Disease In Paediatric Population: Experience Of Tertiary Care Center From Pakistan, Danish Abdul Aziz, Misha Kahlid, Fozia Memon, Kamran Sadiq

Department of Paediatrics and Child Health

Objective: To determine clinical features and relevant laboratory investigations of patient with celiac disease (CD) and comparing classical celiac disease (CCD) with Non-diarrheal celiac disease (NDCD).
Methods: This is a five years retrospective study conducted at The Aga Khan University Hospital Karachi, Pakistan from January 2010 to December 2015, enrolling children from one year to 15 years of either gender diagnosed as celiac disease in accordance with revised ESPGHAN criteria. Biopsy samples with grade 2 or more on Modified Marsh Classification were considered as consistent with celiac disease. Celiac patients were categorized into Classical celiac disease (with Chronic Diarrhea) and …

Comparative Effectiveness And Safety Of Empagliflozin On Cardiovascular Mortality And Morbidity In Adults With Type 2 Diabetes, Wilbert S. Aronow, Tatyana Shamliyan

NYMC Faculty Publications

Background: Based on a single placebo-controlled randomized clinical trial, empagliflozin is licensed to reduce cardiovascular death in diabetes and comorbid cardiovascular disease. Methods: We examined the comparative effectiveness of empagliflozin on mortality and cardiovascular morbidity in type 2 diabetes. We conducted random-effects direct frequentist meta-analyses of aggregate data and appraised the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Our search in PubMed, EMBASE, the Cochrane Library, clinicaltrials.gov, and PharmaPendium up to May 2017 identified 11 meta-analyses, multiple publications, and unpublished data from 29 randomized controlled trials (RCTs). Results: Empagliflozin reduces all-cause mortality [relative …

Masked Hypertension, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Successful Reversal Of Furosemide-Induced Secondary Hyperparathyroidism With Cinacalcet., Tarak Srivastava, Shahryar Jafri, William E. Truog, Judith Sebestyen Vansickle, Winston M. Manimtim, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Secondary hyperparathyroidism (SHPT) is a rare complication of furosemide therapy that can occur in patients treated with the loop diuretic for a long period of time. We report a 6-month-old 28-weeks premature infant treated chronically with furosemide for his bronchopulmonary dysplasia, who developed hypocalcemia and severe SHPT, adversely affecting his bones. Discontinuation of the loop diuretic and the addition of supplemental calcium and calcitriol only partially reversed the SHPT, bringing serum parathyroid hormone level down from 553 to 238 pg/mL. After introduction of the calcimimetic Cinacalcet, we observed a sustained normalization of parathyroid hormone concentration at 27 to 63 pg/mL …

Understanding Biological Mechanisms Underlying Adverse Birth Outcomes In Developing Countries: Protocol For A Prospective Cohort (Amanhi Bio-Banking) Study, Abdullah H. Baqui, Rasheda Khanam, Fyezah Jehan, Muhammad Imran Nisar, Atiya Hussain, Muhammad Ilyas, Aneeta Hotwani, Muhammad Sajid, Shahida Qureshi, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Objectives: The AMANHI study aims to seek for biomarkers as predictors of important pregnancy-related outcomes, and establish a biobank in developing countries for future research as new methods and technologies become available.
Methods: AMANHI is using harmonised protocols to enrol 3000 women in early pregnancies (8-19 weeks of gestation) for population-based follow-up in pregnancy up to 42 days postpartum in Bangladesh, Pakistan and Tanzania, with collection taking place between August 2014 and June 2016. Urine pregnancy tests will be used to confirm reported or suspected pregnancies for screening ultrasound by trained sonographers to accurately date the pregnancy. Trained study field …

Societal Costs Of Micronutrient Deficiencies In 6- To 59-Month-Old Children In Pakistan, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development.
Objective: To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months.
Methods: We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and …

Linkage, Whole Genome Sequence, And Biological Data Implicate Variants In Rab10 In Alzheimer's Disease Resilience., Perry G Ridge, Celeste M Karch, Simon Hsu, Ivan Arano, Craig C Teerlink, Mark T W Ebbert, Josue D Gonzalez Murcia, James M Farnham, Anna R Damato, Mariet Allen, Xue Wang, Oscar Harari, Victoria M Fernandez, Rita Guerreiro, Jose Bras, John Hardy, Ronald Munger, Maria Norton, Celeste Sassi, Andrew Singleton, Steven G Younkin, Dennis W Dickson, Todd E Golde, Nathan D Price, Nilüfer Ertekin-Taner, Carlos Cruchaga, Alison M Goate, Christopher Corcoran, Joann Tschanz, Lisa A Cannon-Albright, John S K Kauwe

Articles, Abstracts, and Reports

BACKGROUND: While age and the APOE ε4 allele are major risk factors for Alzheimer's disease (AD), a small percentage of individuals with these risk factors exhibit AD resilience by living well beyond 75 years of age without any clinical symptoms of cognitive decline.

METHODS: We used over 200 "AD resilient" individuals and an innovative, pedigree-based approach to identify genetic variants that segregate with AD resilience. First, we performed linkage analyses in pedigrees with resilient individuals and a statistical excess of AD deaths. Second, we used whole genome sequences to identify candidate SNPs in significant linkage regions. Third, we replicated SNPs …

Monitoring And Management Of Hypertension With Obesity In Adolescents., Bonita Falkner

Department of Pediatrics Faculty Papers

Largely due to the childhood obesity epidemic, there has been an increase in the prevalence of hypertension in children and adolescents. Obesity associated hypertension is the most common hypertension phenotype among adolescents. Approximately 30% of obese adolescents have elevated blood pressure (BP) or hypertension. Updated definitions of elevated BP and hypertension in adolescents are now similar to definitions of BP status in adults. For adolescents ≥13 years of age, elevated BP is 120 to 129/Hypertension, stage 1, is ≥130 to 139/80 to 89 mm Hg, and hypertension, stage 2, is ≥140/90 mm Hg. BP measurements over separate clinic visits are …

A Low Carbohydrate, Ketogenic Diet For Treatment Of Type Ii Diabetes An Integrative Literature Review, Steven Lisowski

Grace Peterson Nursing Research Colloquium

A Low Carbohydrate, Ketogenic Diet for Treatment

of Type II Diabetes: An Integrative Literature Review

Steven Lisowski

Faculty Sponsor: Larry Maturin

Abstract

Background: Dietary modifications are commonly prescribed initial interventions in those recently diagnosed with type II diabetes. Presently, various researchers support that there is a growing body of evidence that advises to restrict carbohydrate intake to minimum levels to achieve optimal blood glucose levels and reduce complications related to poor diabetes management.

Objectives: To explore if the low carbohydrate, ketogenic diets (LCKD), in which carbohydrate intake of any kind is restricted, are very effective at reducing obesity and controlling …

Advancing Stroke Genomic Research In The Age Of Trans-Omics Big Data Science: Emerging Priorities And Opportunities, Mayowa Owolabi, Emmanuel Peprah, Huichun Xu, Rufus Akinyemi, Hemant K. Tiwari, Marguerite R. Irvin, Kolawole Wasiu Wahab, Donna K. Arnett, Bruce Ovbiagele

Epidemiology and Environmental Health Faculty Publications

Background—We systematically reviewed the genetic variants associated with stroke in genome-wide association studies (GWAS) and examined the emerging priorities and opportunities for rapidly advancing stroke research in the era of Trans-Omics science.

Methods—Using the PRISMA guideline, we searched PubMed and NHGRI- EBI GWAS catalog for stroke studies from 2007 till May 2017.

Results—We included 31 studies. The major challenge is that the few validated variants could not account for the full genetic risk of stroke and have not been translated for clinical use. None of the studies included continental Africans. Genomic study of stroke among Africans presents …

Cardiovascular Health Is Associated With Physical Function Among Older Community Dwelling Men And Women., Yichen Jin, Toshiko Tanaka, Yan Ma, Stefania Bandinelli, Luigi Ferrucci, Sameera A Talegawkar

Exercise and Nutrition Sciences Faculty Publications

Background

Age related decline in physical function is a significant concern affecting the quality of life of older individuals.

Methods

We examined the associations between baseline overall cardiovascular health (CVH), its components, and physical function in 906 men and women from the InCHIANTI cohort. Physical function was assessed using the Short Performance Physical Battery and poor physical function was defined as an Short Performance Physical Battery score less than 10. Overall CVH score, ranging from 0 to 12 in the cohort, was operationalized using adherence to ideal levels for health behaviors including smoking status, physical activity, body mass index, and …

Modelling Stunting In List: The Effect Of Applying Smoothing To Linear Growth Data, Simon Cousens, Jamie Perin, Parul Christian, Lee Shu-Fune Wu, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta, Claudio Lanata, Richard L. Guerrant, Aldo A. M. Lima, Kåre Mølbak

Department of Paediatrics and Child Health

Background: The Lives Saved Tool (LiST) is a widely used resource for evidence-based decision-making regarding health program scale-up in low- and middle-income countries. LiST estimates the impact of specified changes in intervention coverage on mortality and stunting among children under 5 years of age. We aimed to improve the estimates of the parameters in LiST that determine the rate at which the effects of interventions to prevent stunting attenuate as children get older.
Methods: We identified datasets with serial measurements of children's lengths or heights and used random effects models and restricted cubic splines to model the growth trajectories of …