Digital Commons Network^™

Unreliable Bodies: A Follow-Up Twenty Years Later By A Mother And Daughter About The Impact Of Illness And Disability On Their Lives, Kaethe Weingarten, Miranda Worthen

Faculty Publications

We are a mother and daughter, both health care professionals, who offer a follow-up to an article we published twenty years ago about the impact of each other’s ongoing, serious medical problems on our relationship. In this article, we contribute a long-term perspective on the differences between having an illness that is well or poorly understood by medical professionals and the lay community. We also discuss health in the cont ext of identity formation and life stage, as during this interval the daughter left home, graduated college, married, and had two children. Also in this period, the mother survived a …

Work-Life Balance Is An Illusion: Replace Guilt With Acceptance., Tessie W. October

Pediatrics Faculty Publications

No abstract provided.

Uncovering Meanings Of Death, Trauma, And Loss As Experienced By Hospice Bereavement Coordinators: A Phenomenological Study, Rochelle S. Clarke

Department of Family Therapy Dissertations and Applied Clinical Projects

This study examined the experiences of Hospice Bereavement Coordinators (HBCs) and Hospice Chaplains working with grief narratives from patient-family units exhibiting signs of anticipatory or complicated grief. While a significant amount of research has been conducted on Hospice employees, no qualitative studies have examined the interpretation of meaning from employees whose primary role focused on the psychosocial-spiritual aspects of clients exhibiting anticipatory or complicated grief. The researcher identified shared meaning of death, trauma, and loss from six participants in the context of a high stress and high loss environment. This study‘s findings revealed ten central themes: Death is an earthly …

Progressive Cognitive Deficit, Motor Impairment And Striatal Pathology In A Transgenic Huntington Disease Monkey Model From Infancy To Adulthood, Anthony W. S. Chan, Jie Jiang, Yiju Chen, Chunxia Li, Melinda S. Prucha, Yijuan Hu, Tim Chi, Sean Moran, Tayeb Rahim, Shihua Li, Xiaojiang Li, Stuart M. Zola, Claudia M. Testa, Hui Mao, Rosa Villalba, Yoland Smith, Xiaodong Zhang, Jocelyne Bachevalier

Neurology Publications

One of the roadblocks to developing effective therapeutics for Huntington disease (HD) is the lack of animal models that develop progressive clinical traits comparable to those seen in patients. Here we report a longitudinal study that encompasses cognitive and motor assessment, and neuroimaging of a group of transgenic HD and control monkeys from infancy to adulthood. Along with progressive cognitive and motor impairment, neuroimaging revealed a progressive reduction in striatal volume. Magnetic resonance spectroscopy at 48 months of age revealed a decrease of N-acetylaspartate (NAA), further suggesting neuronal damage/loss in the striatum. Postmortem neuropathological analyses revealed significant neuronal loss in …

Identifying Cases Of Undiagnosed, Clinically Significant Copd In Primary Care: Qualitative Insight From Patients In The Target Population, Nancy K. Leidy, Katherine Kim, Elizabeth D. Bacci, Barbara P. Yawn, David M. Mannino, Byron M. Thomashow, R. Graham Barr, Stephen I. Rennard, Julia F. Houfek, Meilan K. Han, Catherine A. Meldrum, Barry J. Make, Russ P. Bowler, Anna W. Steenrod, Lindsey T. Murray, John W. Walsh, Fernando Martinez, High-Risk-Copd Screening Study Group

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Many cases of chronic obstructive pulmonary disease (COPD) are diagnosed only after significant loss of lung function or during exacerbations.

AIMS: This study is part of a multi-method approach to develop a new screening instrument for identifying undiagnosed, clinically significant COPD in primary care.

METHODS: Subjects with varied histories of COPD diagnosis, risk factors and history of exacerbations were recruited through five US clinics (four pulmonary, one primary care). Phase I: Eight focus groups and six telephone interviews were conducted to elicit descriptions of risk factors for COPD, recent or historical acute respiratory events, and symptoms to inform the …

A Feasibility Pilot Study On The Use Of Complementary Therapies Delivered Via Mobile Technologies On Icelandic Surgical Patients' Reports Of Anxiety, Pain, And Self-Efficacy In Healing, Margaret M. Hansen Edd, Msn, Rn

Nursing and Health Professions Faculty Research and Publications

Background Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients’ state anxiety, pain perception, and perceived self-efficacy in healing were determined. Methods A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an …

Programmed Physical Exertion In Recovery From Sports-Related Concussion: A Randomized Pilot Study, Arthur C. Maerlender, Wanda Rieman, Jonathan Lichtenstein, C. Condiracci

Department of Psychology: Faculty Publications

Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery.

In A Right State Of Mind: An Analysis Of Cognitive And Linguistic Function Following A Rare Case Of Atypical Language Dominance In Aphasia, Emily Manton

Undergraduate Review

As the foundation for effective communication, the power of the human brain to create and execute language derives from the ability of its structural components to remain intact. Extensive research has found that in 97% of people worldwide, language is typically carried out by the left hemisphere of the brain. Research for lesions in this area therefore, have been well documented. For the 3% of individuals who fall in the category of "atypical cerebral dominance" however, there is little in the available literature. Therefore, this empirical prospective case study sought to document the cognitive and linguistic functions of a 59 …

A Dietary Intervention For Chronic Diabetic Neuropathy Pain: A Randomized Controlled Pilot Study, A. E. Bunner, C. L. Wells, J. Gonzales, U. Agarwal, Elham Bayat, Neal D. Barnard

Neurology Faculty Publications

Background:

Diabetic neuropathy is a common and often debilitating condition for which available treatments are limited. Because a low-fat plant-based diet has been shown to improve glycemic control in individuals with type 2 diabetes, we hypothesized that such a diet would reduce painful symptoms of diabetic neuropathy.

Methods:

In this 20-week pilot study, individuals with type 2 diabetes and painful diabetic neuropathy were randomly assigned to two groups. The intervention group was asked to follow a low-fat, plant-based diet, with weekly classes for support in following the prescribed diet, and to take a vitamin B12 supplement. The control group was …

Educational Neuroscience, Constructivism, And The Mediation Of Learning And Creativity In The 21st Century., M. Layne Kalbfleisch

Pediatrics Faculty Publications

No abstract provided.

Characterizing The Propagation Of Uterine Electrophysiological Signals Recorded With A Multi-Sensor Abdominal Array In Term Pregnancies., Diana Escalona-Vargas, Rathinaswamy B. Govindan, Adrian Furdea, Pam Murphy, Curtis L Lowery, Hari Eswaran

Pediatrics Faculty Publications

The objective of this study was to quantify the number of segments that have contractile activity and determine the propagation speed from uterine electrophysiological signals recorded over the abdomen. The uterine magnetomyographic (MMG) signals were recorded with a 151 channel SARA (SQUID Array for Reproductive Assessment) system from 36 pregnant women between 37 and 40 weeks of gestational age. The MMG signals were scored and segments were classified based on presence of uterine contractile burst activity. The sensor space was then split into four quadrants and in each quadrant signal strength at each sample was calculated using center-of-gravity (COG). To …

Graduate Medical Education 2014-2015 Annual Report, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Analysis Of Lean/Six Sigma Production Model In A Tertiary Care Asthma And Allergy Clinlic, Erika Lynn Bullert, Laura Johnson, Ariel M. Schibilla

All Electronic Theses and Dissertations

In response to demands on healthcare, systems have looked to refine current processes to use time, materials, and finances more efficiently. Lean/Six Sigma (L/SS) is a model that has been used to improve procedural efficiency in various settings. The purpose of this study was to implement L/SS into an outpatient private practice setting and to evaluate the effect on efficiency as measured in the length of individual patient visits who presented to that clinic for routine re-evaluation. In this study, the amount of time between a patient’s entrance and exit from the clinic was documented for 878 patients before implementation …

The Experiences Of Black American Older Adults Managing Pain: A Nursing Ethnography, Sheria Grice Robinson

Wayne State University Dissertations

Introduction: Pain can negatively affect quality of life for Black elders. They are less likely to report pain concerns and have voiced pain needs adequately met. To better understand the pain management experiences and concerns of Black elders, an ethnographic study was completed within an urban, low-income, elder housing facility. Methods: 106 participants completed a questionnaire comprised of a demographic tool, the PROMIS Global Health Scale (PROMIS), the Brief Pain Inventory (BPI), and the Psychological Stress Measure (PSM-9). Additionally, participant observation, informal interviews, and 20 formal recorded interviews with individuals identified as having pain were completed. Qualitative and frequency analysis …

What Impacts Life Satisfaction Of Aging Adults Following Stressful Life Events?: An Examination Of The Buffering Effect Of Personal Resources, Cassandra Barragan

Wayne State University Dissertations

Purpose: Existing research has shown that elders experience changes in their life satisfaction following stressful life events. There is an abundance of literature supporting the predictive nature of not only stressful life events on life satisfaction, but social support, autonomy, and financial security. What the literature is lacking, is examination of the buffering effect of social support, autonomy, and financial security on the relationship between stressful life events and life satisfaction. This study hypothesizes that increases in social support, autonomy, and financial security will buffer the impact of SLEs for elders and thus, they will experience increases in their life …

Genetic Modifiers Of Duchenne Muscular Dystrophy And Dilated Cardiomyopathy., Andrea Barp, Luca Bello, Luisa Politano, Paola Melacini, Chiara Calore, Eric P. Hoffman, +16 Additional Authors

Genomics and Precision Medicine Faculty Publications

OBJECTIVE: Dilated cardiomyopathy (DCM) is a major complication and leading cause of death in Duchenne muscular dystrophy (DMD). DCM onset is variable, suggesting modifier effects of genetic or environmental factors. We aimed to determine if polymorphisms previously associated with age at loss of independent ambulation (LoA) in DMD (rs28357094 in the SPP1 promoter, rs10880 and the VTTT/IAAM haplotype in LTBP4) also modify DCM onset.

METHODS: A multicentric cohort of 178 DMD patients was genotyped by TaqMan assays. We performed a time-to-event analysis of DCM onset, with age as time variable, and finding of left ventricular ejection fraction < 50% and/or end diastolic volume > 70 mL/m2 as …

Expert Consensus Document: Mind The Gaps—Advancing Research Into Short-Term And Long-Term Neuropsychological Outcomes Of Youth Sports-Related Concussions, Aaron J. Carman, Rennie Ferguson, Robert Cantu, R. Dawn Comstock, Penny A. Dacks, Gerard A. Gioia, +20 Additional Authors

Psychiatry and Behavioral Sciences Faculty Publications

Sports-related concussions and repetitive subconcussive exposure are increasingly recognized as potential dangers to paediatric populations, but much remains unknown about the short-term and long-term consequences of these events, including potential cognitive impairment and risk of later-life dementia. This Expert Consensus Document is the result of a 1-day meeting convened by Safe Kids Worldwide, the Alzheimer's Drug Discovery Foundation, and the Andrews Institute for Orthopaedics and Sports Medicine. The goal is to highlight knowledge gaps and areas of critically needed research in the areas of concussion science, dementia, genetics, diagnostic and prognostic biomarkers, neuroimaging, sports injury surveillance, and information sharing. For …

Parental Understanding Of Tuberous Sclerosis Complex, Pauline Samia, Kirsten A. Donald, Birgit Schlegel, Jo M. Wilmshurst

Paediatrics and Child Health, East Africa

Tuberous sclerosis complex is a genetic disorder with multisystem involvement that poses significant challenges to the affected child and family. Caregiver knowledge in the South African population has not previously been reported. A prospective study of the parents of 21 children with tuberous sclerosis complex was undertaken. Median parental age was 38 (interquartile range 34.5-45) years. Parents were randomly allocated to receive written information about the condition, or to receive verbal counselling already established in clinic. A significant difference (P ¼ .001) was observed in the change in the mean knowledge scores for the parent group that received written information …

Behavioral Implications Of A Cognitive Training Program For Individuals With Moderate Cognitive Impariment, Joseph L.D. Kennedy

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to evaluate the effectiveness of a cognitive training program on behavioral outcomes for individuals with moderate cognitive impairment. A total of twenty participants were randomized into either a waitlist control or an experimental group. Collateral individuals familiar with each participant completed a series of measures of behavioral and emotional functioning at both pre- and post-intervention. Results demonstrated little effectiveness for the cognitive training program in stabilizing or improving behavioral functioning. Limitations and future directions are then provided to enhance future research in this area.

An Analysis Of Cognitive Factors In School-Aged Children With Emotional Disturbance And Adhd Using The Wisc-Iv, Maria Fragnito Maddalo

PCOM Psychology Dissertations

Children with Emotional Disturbance and ADHD demonstrate social, emotional, and behavioral symptoms that present many challenges for School Psychologists because of differences between each student’s individual needs. A high level of comorbidity exists for these children with internalizing and externalizing symptoms. Little is known about neurocognitive factors as they relate to ED versus ADHD. The current study examined the cognitive profiles of a total of 58 children with ED versus ADHD, using the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Index scores that were examined included Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. The groups were compared …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

Clinical Utility Of Pharmacogenomic Testing To Support Prescriptive Decision Making Among Anesthesia Providers: A Mixed-Method Study, Jonathan Dru Riddle

MUSC Theses and Dissertations

Anesthesia care is delivered world wide on a daily basis. Provision of anesthesia cares for surgical, obstetrical, or pain management procedures mandate a thorough understanding of physiology, pathophysiology, and pharmacology. Nearly 4 million anesthetics are delivered in the United States each year and the impact of genetics on anesthesia care is becoming greater. Anesthesia providers make prescriptive decisions based on an individual patient's disease processes, proposed surgical or therapeutic procedure, and a thorough clinical history. The age of personalized medicine is upon us and the ability to use genetic testing to help predict how a patient will respond to various …

Surface Electromyography Of The Forearm Musculature During The Windmill Softball Pitch, D. Trey Remaley, Bryce Fincham, Bryan Mccullough, Kirk Davis, Charles Nofsinger, Charles Armstrong, Julie M. Stausmire

Orthopaedics and Sports Medicine Faculty Publications

Background: Previous studies investigating the windmill softball pitch have focused primarily on shoulder musculature and function, collecting limited data on elbow and forearm musculature. Little information is available in the literature regarding the forearm. This study documents forearm muscle electromyographic (EMG) activity that has not been previously published.

Purpose: Elbow and upper extremity overuse injuries are on the rise in fast-pitch softball pitchers. This study attempts to describe forearm muscle activity in softball pitchers during the windmill softball pitch. Overuse injuries can be prevented if a better understanding of mechanics is defined.

Study Design: Descriptive laboratory study.

Methods: Surface EMG …

Parenting Skills And Emotional Availability: An Rct, Aisha K. Yousafzai, Muneera A. Rasheed, Arjumand Rizvi, Robert Armstrong, Zulfiqar A. Bhutta

Paediatrics and Child Health, East Africa

Objective: To investigate whether a responsive stimulation intervention delivered to caregivers of young children either alone or integrated with nutrition interventions would benefit parenting skills and emotional availability to promote children’s development and growth compared with either a nutrition intervention alone or the usual standard of care.

Methods: A cluster randomized factorial effectiveness trial was implemented in an impoverished community in Pakistan. The 4 trial arms were control (usual standard of care), responsive stimulation (responsive care and stimulation), enhanced nutrition (education and multiple micronutrients), and a combination of both enriched interventions. The 4 intervention packages were delivered by community health …

Anti-Nmda Receptor Encephalitis In A Patient With Previous Psychosis And Neurological Abnormalities: A Diagnostic Challenge, R. David Heekin, Maria C. Catalano, Alfred T. Frontera, Glenn Catalano

Neurology Faculty Publications

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune disorder characterized by IgG autoantibodies directed against the NR1 subunit of the NMDA glutamate receptor. Psychiatric symptoms are common and include psychosis, mania, depressed mood, aggression, and speech abnormalities. Neurological symptoms such as seizures, decreased responsiveness, dyskinesias, and other movement abnormalities and/or autonomic instability are frequently seen as well. We present the case of a woman who was followed up at our facility for over 14 years for the treatment of multiple neuropsychiatric symptoms. Initially, she presented with paresthesias, memory loss, and manic symptoms. Nine years later, she presented to our facility again, …

Vital Signs, Winter 2015, Boonshoft School Of Medicine

Vital Signs

A sixty 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, a research spotlight, alumni notes, and more.

Physical, Cognitive, Social And Mental Health In Near-Centenarians And Centenarians Living In New York City: Findings From The Fordham Centenarian Study, Daniela S. Jopp, Min-Kyung S. Park, Jonathan Lehrfeld, Michelle E. Paggi

Publications and Research

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators.

Methods: A total of 119 individuals aged 95 to 107 …

Restraint Stress Alters Pro-Inflammatory Cytokine Expression And Increases Superoxide Dismutase In The Rat Hypothalamus And Hippocampus, Kristina Isabel Barron

Open Access Theses & Dissertations

The impact of restraint stress on changes in cytokine expression and oxidative stress markers in hippocampal (Hipp) and hypothalamic (Hyp) regions of the brain, were assessed in a rat model. In addition, immune and inflammatory variables were assessed in peripheral blood. Male Wistar rats were acutely (30 min) or repeatedly (30 min/d for 14 consecutive days) exposed to a restraint stress, or maintained as non-stressed controls. At the time of sacrifice, whole blood and brain tissues enriched in Hyp or Hipp regions were collected; blood was collected with EDTA as an anticoagulant and centrifuged to yield plasma. All tissue samples …

Impact Of Caregiving Role In The Quality Of Life Of Family Caregivers For Persons With Alzheimer's Disease, Supriya Sarkar

All Graduate Theses, Dissertations, and Other Capstone Projects

This study investigated quality of life of family caregivers of persons with Alzheimer's disease (AD). Caregiving is a strenuous and challenging job. Family caregivers experience poor quality of life after they take the role of caregiving which might be related to depression. Purpose of this study was to find if caregiving duration and depression has any role in affecting family caregivers' emotional, physical, and general health.

Data for this study were collected through electronic and mailed survey methods. The questionnaires completed by subjects: Medical Outcomes Study Short Form 36 (MOS-36) and Center for Epidemiologic Studies Depression Scale (CES-D). Descriptive statistics …

Impact Of Service Provision Platforms On Maternal And Newborn Health In Conflict Areas And Their Acceptability In Pakistan: A Systematic Review, Zohra S. Lassi, Wafa Aftab, Shabina Ariff, Rohail Kumar, Imtiaz Hussain, Nabiha Musavi, Zahid Memon, Sajid B. Soofi, Zulfiqar A. Bhutta

Woman and Child Health

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas.

The literature search revealed ten studies that …