Digital Commons Network^™

Reduced Cardiovascular Capacity And Resting Metabolic Rate In Men With Prostate Cancer Undergoing Androgen Deprivation: A Comprehensive Cross-Sectional Investigation, Bradley Wall, Daniel A. Galvao, Naeem Fatehee, Dennis Taaffe, Nigel Spry, David Joseph, Robert Newton

Research outputs 2014 to 2021

Objectives. To investigate if androgen deprivation therapy exposure is associated with additional risk factors for cardiovascular disease and metabolic treatment-related toxicities. Methods. One hundred and seven men (42-89 years) with prostate cancer undergoing androgen deprivation therapy completed a maximal graded objective exercise test to determine maximal oxygen uptake, assessments for resting metabolic rate, body composition, blood pressure and arterial stiffness, and blood biomarker analysis. A cross-sectional analysis was undertaken to investigate the potential impact of therapy exposure with participants stratified into two groups according to duration of androgen deprivation therapy (≥3 months). Results. Maximal oxygen uptake (26.1 ± 6.0 mL/kg/min …

Dry Needling For Myofascial Trigger Point Pain: A Clinical Commentary, Casey Unverzagt, Kathleen Berglund, J J. Thomas

Faculty Publications

Sports and orthopaedic physical therapists have long used a multitude of techniques in order to address pain and dysfunction associated with myofascial trigger points. One technique in particular has recently received overwhelming attention: trigger point dry needling (DN). Despite its efficacy and low risk, questions remain as to its effectiveness, safety, and whether the technique is within the scope of practice of physical therapists. Therefore, the purpose of this clinical commentary is to summarize the current literature related to the associated mechanisms of action of DN, the safety of DN, as well as to discuss relevant scope of practice concerns.

Existential Suffering And Cura Personalis: Dilemmas At The End-Of-Life, George P. Smith Ii

Scholarly Articles

Existential, or non-somatic suffering, is often associated with the management of refractory pain at the end-stage of life. Because of misleading sympathologies, this condition is often either mis-diagnosed or even ignored. When diagnosed as a part of a futile medical condition, this Paper argues that deep, palliative, or terminal sedation be offered to the distressed, dying patient as an efficacious and ethical response to preserving a semblance of human dignity in the dying process. Not only is this option of care humane and compassionate, it is consistent with the ideal of best patient care. The notion of care should not …

Trailmaking Test Performance Contributes To Subjective Judgment Of Visual Efficiency In Older Adults, Annalisa Setti, James Loughman, George Savva, Rose Anne Kenny

Articles

Introduction.

The determinant factors that influence self-reported quality of vision have yet to be fully elucidated. This study evaluated a range of contextual information, established psychophysical tests, and in particular, a series of cognitive tests as potentially novel determinant factors.

Materials &Methods. Community dwelling adults (aged 50+) recruited to Wave 1 of The Irish Longitudinal Study on Ageing, excluding those registered blind, participated in this study (N = 5,021). Self-reports of vision were analysed in relation to visual acuity and contrast sensitivity, ocular pathology, visual (Choice Response Time task; TrailMaking Test) and global cognition. Contextual factors such as having visited …

Neural Function, Injury, And Stroke Subtype Predict Treatment Gains After Stroke, Erin Burke Quinlan, Lucy Dodakian, Jill See, Alison Mackenzie, Vu Le, Mike Wojnowicz, Babak Shahbaba, Steven C. Cramer

Physical Therapy Faculty Articles and Research

Objective

This study was undertaken to better understand the high variability in response seen when treating human subjects with restorative therapies poststroke. Preclinical studies suggest that neural function, neural injury, and clinical status each influence treatment gains; therefore, the current study hypothesized that a multivariate approach incorporating these 3 measures would have the greatest predictive value.

Methods

Patients 3 to 6 months poststroke underwent a battery of assessments before receiving 3 weeks of standardized upper extremity robotic therapy. Candidate predictors included measures of brain injury (including to gray and white matter), neural function (cortical function and cortical connectivity), and clinical …

Job Stress Among Female Residents During Postgraduate Training At A University Hospital In Karachi, Pakistan, Madiha Hashmi, Fauzia A. Khan, Khan S, Ali S. K

Department of Anaesthesia

Background: Postgraduate medical training is a stressful experience for both male and female doctors but previous studies have shown that stress might be more prevalent amongst female residents. Since women make up 70-80% of medical graduates in Pakistan we conducted this study to determine the prevalence of stress among female residents during postgraduate training and identify the most common stressors.

Methodology: All female residents enrolled in postgraduate training programmes at the Aga Khan University meeting the inclusion criteria were recruited and informed written consent was obtained. Job Stress Inventory (JSI) was used to identify symptoms and sources of job stress. …

The Feasibility Of Implementing A Novel Electrical Stimulation Device In The Self-Management Of Hand Burn Pain, Katrina Liddiard

Theses : Honours

Burns are widely acknowledged as one of the most painful injuries experienced, and poorly controlled pain following burn injury has been linked to reduced psychological adjustment, lower quality of life, and increased risk of developing a chronic pain state. Transcutaneous electrical nerve stimulation has been used for pain relief in a range of medical conditions, and may have the potential to reduce pain and analgesic consumption for burns patients. The burn care environment presents unique challenges to the introduction of new interventions, and the feasibility of introducing a novel form of electrical stimulation into this environment has not been tested. …

The Prospective Association Between Positive Psychological Well-Being And Diabetes, Julia K. Boehm, Claudia Trudel-Fitzgerald, Mika Kivimaki, Laura D. Kubzansky

Psychology Faculty Articles and Research

Objective: Positive psychological well-being has protective associations with cardiovascular outcomes, but no studies have considered its association with diabetes. This study investigated links between well-being and incident diabetes.

Methods: At study baseline (1991-1994), 7,800 middle-aged British men and women without diabetes indicated their life satisfaction, emotional vitality, and optimism. Diabetes status was determined by self-reported physician diagnosis and oral glucose tolerance test (screen detection) at baseline and through 2002-2004. Incident diabetes was defined by physician-diagnosed and screen-detected cases combined and separately. Logistic regression estimated the odds of developing diabetes controlling for relevant covariates (e.g., demographics, depressive symptoms). Models …

Dancing Around Infertility: The Use Of Metaphors In A Complex Medical Situation, Angela L. Palmer-Wackerly, Janice L. Krieger

Department of Communication Studies: Faculty Publications

People use metaphors to cognitively frame their experiences as well as to explain those experiences to others, especially in complex medical situations. However, previous research has not fully explored the extent to which metaphors may be helpful or harmful to achieving well-being. This investigation fills this gap by identifying and explaining metaphor use in the context of infertility. Guided by self-determination theory, in-depth interviews were conducted with 22 women and men who had experienced an inability to conceive a child. Analysis of participant narratives yielded 10 prominent metaphors that reflect how participants’ need for competence, autonomy, and relatedness were (and …

Preventative Strategies To Improve Birth Outcomes Among African American Women In Rhode Island, Yvonne Michele Heredia

Walden Dissertations and Doctoral Studies

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also …

The Clinical Utility Of Multidisciplinary Rehabilitation In Individuals With Huntington’S Disease, Travis Miles Cruickshank

Theses: Doctorates and Masters

Background

Huntington’s disease (HD) is a chronic neurodegenerative disorder characterised by a progressive loss of cognitive function, motor control and psychiatric features. Individuals also display a variety of systemic features. Progressive neuronal dysfunction and neuronal cell death are thought to underlie the onset and progression of many clinical features of HD.

Despite scientific progress, there is still no cure or disease modifying therapy for HD, and available pharmaceutical agents only provide partial relief of motor and psychiatric features. An emerging body of evidence indicates that lifestyle enrichment may delay the onset and progression of clinical features, and exert favourable effects …

Just A “Click” Away From Evidence-Based Online Breast Cancer Information, Advice And Support Provided By A Specialist Nurse: An Ethnonetnographic Study, Cynthia Ann Witney

Theses: Doctorates and Masters

Breast cancer has had, and will continue to have, a devastating impact on the lives of many Australian women, their families, friends and the wider community. The concomitant treatment of this disease places a considerable burden on the health care system and the supporters of the person diagnosed with this disease. While there are many government and non-government organisations that provide treatment and support services for the person with breast cancer, these services are usually provided in person either in the home or at the organisation’s offices. This study extended the information advice and support aspects of these services to …

Saying ‘No’: A Biographical Analysis Of The Experiences Of Women With A Genetic Predisposition To Developing Breast/Ovarian Cancer Who Reject Risk Reducing Surgery, Doreen Molloy

Theses: Doctorates and Masters

Background: Genetic technologies have identified some of the genes implicated in cancer susceptibility. Women with mutations in breast/ovarian cancer-susceptibility genes (BRCA1 and 2) have a lifetime combined risk of breast/ovarian cancer of more than 80%. Risk reducing surgery (RRS) reduces cancer risk by as much as 90% in high risk populations. Despite this, some BRCA1/2 mutation-positive women say no to RRS.

Purpose: To illuminate an understanding of why women at high risk of developing breast/ovarian cancer say no to risk reducing surgery (RRS).

Design: Denzin’s (1989) interpretive biography was combined with Dolby-Stahl’s (1985) literary folkloristic methodology to provide a contextualised …

Practices Of Tracheal Suctioning Technique Among Health Care Professionals: Literature Review, Rozina Khimani, Fauziya Ali Dr., Salma Rattani, Mohammad Sohail Awan

Department of Surgery Docs

The current study aims to assess tracheal suctioning practices among health care practitioners; nurses, critical care technicians and physiotherapist. Employing literature review as the methodology, multiple databases were searched focusing on three phases of tracheal suctioning (a) the pre suctioning phase, (b) the suctioning phase, (c) the post suctioning phase and complications related to tracheal suctioning. It was concluded that to provide quality care it is important that the evidence based practice guidelines should be followed.

Awareness Of Diabetes Risk Associated With Individuals 18 And Older, Rebecca Jane Boone

Walden Dissertations and Doctoral Studies

The risk of developing Type 2 diabetes is increasing at epidemic proportions, and is 12-17% higher in Marion County Florida than it is across the state, based on Florida Department of Health statistics. The purpose of this DNP project was to determine if awareness of individual risk of developing Type 2 diabetes through a questionnaire would result in high-risk participants agreeing to attend a diabetes prevention program (DPP) at a local medical clinic. The health belief model and Rosswurm and Larrabee's model for change were used as frameworks. The review of the literature showed that prevention programs were highly effective …

Women's Perspectives On Adequacy Of Screening And Treatment For Postpartum Depression, Gloria Marcia Watson

Walden Dissertations and Doctoral Studies

Postpartum depression affects some 10% to 20% of mothers. Its impact on the health and well-being of mothers and their infants is well documented. If not identified and addressed early, it can result in emotional burden, costly hospitalization and treatment, and, at worst, suicide and or infanticide. Empowerment theory was the conceptual framework for this hermeneutic phenomenological study. The purpose was to understand the lived experiences of the screening and treatment processes of 10 women from New York City experiencing postpartum depression and their perceived adequacy of the treatment received. In-depth interviews were used to investigate participants' lived experiences of …

Support After Brain Tumor Means Different Things: Family Caregivers' Experiences Of Support And Relationship Changes, T. Ownsworth, E. Goadby, Suzanne K. Chambers

Research outputs 2014 to 2021

Shorter hospital stays and greater emphasis on outpatient care means that family members have the primary responsibility for supporting a person with brain tumor to manage the physical, cognitive, behavioral, and emotional effects of the illness and its treatment. Given the integral role of family caregivers, it is essential to understand their experience of the impact of brain tumor and their own support needs. Accordingly, this qualitative study aimed to investigate family caregivers' experiences of support and relationship changes in the context of brain tumor. In-depth interviews were conducted with 11 family caregivers (8 spouse/partner, 3 parents) of people with …

Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta

Walden Dissertations and Doctoral Studies

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in …

Increasing Initiation And Exclusivity Of Breastfeeding In The Hospitalized Postpartum Dyad, Candace L. Rouse

Walden Dissertations and Doctoral Studies

The purpose of this project was to highlight an intervention to increase breastfeeding initiation and exclusive breastfeeding during the birth hospitalization in a coastal mid-Atlantic inner city hospital. Although researchers and national standards promote early initiation and exclusive breastfeeding, there continues to be a significant number of women who do not breastfeed and/or supplement with formula. The advantages of breastfeeding for mother and infant are substantial and include protecting babies from allergens to reducing maternal breast and ovarian cancer. Breastfeeding rates of initiation and exclusivity at the project hospital were below benchmarks set by international, national, and state agencies. The …

Global Medical Education Partnerships To Expand Specialty Expertise: A Case Report On Building Neurology Clinical And Research Capacity, Marco A. Costa, Anthony Furlan, Chris T. Longenecker, Shirley Moore, Svetlana Pundik, Daniel I. Smith, Kathleen A. Smyth, Martha Sajatovic

Faculty Scholarship

Background: Neurological disorders are a common cause of morbidity and mortality in sub-Saharan African, but resources for their management are scarce. Collaborations between training institutions in developed and resource-limited countries can be a successful model for supporting specialty medical education and increasing clinical and research capacity. Case report: This report describes a US National Institutes of Health (NIH) funded Medical Education Partnership Initiative (MEPI) to enhance expertise in neurology, developed between Makerere University College of Health Sciences in Kampala, Uganda, and Case Western Reserve University School of Medicine in Cleveland, OH, USA. This collaborative model is based on a successful …

Left Ventricular Assist Device As Destination Therapy, Maya Guglin, Leslie W. Miller

The VAD Journal

Mechanical circulatory support is the most rapidly evolving strategy in heart failure management. The growing number of patients who need better results than medical therapy can offer, the limited pool of donors for cardiac transplantation, and several technological breakthroughs have all made the option of implanting a left ventricular assist device (LVAD) as destination therapy more important.

In this review, we outline the indications and decision making process of considering a patient for a destination therapy LVAD, as well as outcomes, complications, and issues related to management of patients on currently approved devices. The future direction of the field will …

Gestational Weight Gain, Pregnancy Outcomes, And Use Of Perinatal Health Services, Lujing Zhan

Theses and Dissertations

This dissertation consists of three studies that were undertaken to better understand 1) the role of gestational weight gain (GWG) during early pregnancy on subsequent blood pressure changes and the risk of pregnancy-induced hypertension (PIH), 2) the causal effect of GWG in both early and mid-late pregnancy on the subtypes of preterm births, and 3) the impact of personal capital on the use of perinatal health services (i.e., prenatal care use and preconception care counseling). The first two studies were based on the data from the 1988 National Maternal and Infant Health Survey and the third study employed the data …

Pelvic Pain, Pelvic Organ Prolapse, Urinary And Colorectal Distress Incidence And Relationship To Quality Of Life And Birth Mode, Lori Maria Walton, Christine Abreu, Eliena Jeffus, Amy Trautwein, Shenya Xavier

Faculty Publications

Abstract Purpose: To determine the incidence and impact of pelvic pain, pelvic organ prolapse, urinary and colorectal distress and quality of life by birth mode for women in the chronic postpartum period. Study design: Cross-sectional correlational design utilizing purposive sampling of (n=21) female postpartum subjects ages 18-45. Background: Caesarean Section (CS) incidence is reported at 32% nationwide, well above the recommended safe rate of 10% (WHO). Literature is not clear regarding role of birth mode in postpartum symptoms including: pelvic pain, colorectal distress, pelvic organ prolapse, and quality of life. Methods: Data collection took place after IRB approval from Andrews …

Palliative Care In Africa: A Global Challenge., Christian R Ntizimira, Jean Luc Nkurikiyimfura, Olive Mukeshimana, Scholastique Ngizwenayo, Diane Mukasahaha, Clare Clancy

Ambulatory and Primary Care Articles

We are often asked what challenges Rwanda has faced in the development of palliative care and its integration into the healthcare system. In the past, patients have been barred from accessing strong analgesics to treat moderate to severe pain, but thanks to health initiatives, this is slowly changing. Rwanda is an example of a country where only a few years ago, access to morphine was almost impossible. Albert Einsten said 'in the middle of difficulty lies opportunity' and this sentiment could not be more relevant to the development of palliative care programmes. Through advocacy, policy, and staunch commitment to compassion, …

Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children's postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children's postoperative pain. Targeting the myriad barriers to children's pain management by capitalizing upon the use of tailored interventions may help bridge the …

Accommodating Hyperaroused Information Processing In Persons At Risk For Alcoholism, Kellianne Clark, Jaclyn Cutler

Student Scholar Symposium Abstracts and Posters

In the search for the factors related to the heightened alcoholism risk in adult children of alcoholics (ACOA), it has been reported that these persons possess a high incidence of attention deficit disorders (ADD) as determined by clinical assessment instruments. However, investigations of alcoholism risk and ADD indicate that, in contrast to the hypoarousal model of ADD, the ACOA’s attention problems represent hyperarousal of attention mechanisms resulting in reduced ability to select and encode relevant information. If true, then unlike persons with ADD, clinical and cognitive assessments of ACOAs would benefit if the ACOA was provided with more time to …

A Randomized Noninferiority Trial Of Condensed Protocols For Genetic Risk Disclosure Of Alzheimer's Disease, Peter J. Whitehouse, Melissa Barber Butson

Faculty Scholarship

Introduction Conventional multisession genetic counseling is currently recommended when disclosing apolipoprotein E (APOE) genotype for the risk of Alzheimer's disease (AD) in cognitively normal individuals. The objective of this study was to evaluate the safety of brief disclosure protocols for disclosing APOE genotype for the risk of AD. Methods A randomized, multicenter noninferiority trial was conducted at four sites. Participants were asymptomatic adults having a first-degree relative with AD. A standard disclosure protocol by genetic counselors (SP-GC) was compared with condensed protocols, with disclosures by genetic counselors (CP-GC) and by physicians (CP-MD). Preplanned co-primary outcomes were anxiety and depression scales …

Retrospective Study To Identify Predictors Of Withdrawal In Pediatric Intensive Care Patients On Long-Term Sedation, Lindsay Fakete Pharmd, Jenny Boucher Pharmd, Jd, Bcps, Scott Wheatley Md

Department of Pharmacy

No abstract provided.

Integrative Therapy Use For Management Of Side Effects And Toxicities Experienced By Pediatric Oncology Patients, Shana Jacobs

Pediatrics Faculty Publications

Integrative Therapies (IT), otherwise known as Complementary and Alternative Medicine, are widely used among pediatric oncology patients, despite a paucity of available evidence. This review summarizes surveys that describe the prevalence of IT use by pediatric oncology patients, both during therapy and in survivorship, as well as the modalities being used. Additionally, the evidence that exists for specific treatments that appear to be efficacious in controlling specific symptoms is described. Finally, there are recommendations for practitioners on how to best counsel patients about IT use.

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …