Digital Commons Network^™

Birth Control: To What Extent Do Women Report Being Informed And Involved In Decisions About Pregnancy And Birth Procedures?, Rachel Thompson, Yvette D. Miller

Dartmouth Scholarship

Background: Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia.

Methods: Participants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about …

Serum C-X-C Motif Chemokine 13 Is Elevated In Early And Established Rheumatoid Arthritis And Correlates With Rheumatoid Factor Levels, Jonathan D. Jones, B. Jonell Hamilton, Gregory J. Challener, Artur J. De Brum-Fernandes

Dartmouth Scholarship

We hypothesized that serum levels of C-X-C motif chemokine 13 (CXCL13), a B-cell chemokine, would delineate a subset of rheumatoid arthritis (RA) patients characterized by increased humoral immunity.

Are Physicians More Technical In Their Approach And Less Humane? A Call For Reconsideration, Waris Qidwai

Department of Family Medicine

No abstract provided.

Leadership In Healthcare Is A Neglected Issue: A Call For Action, Waris Qidwai

Department of Family Medicine

Healthcare and medical profession stands at crossroads today. Unprecedented technological advances as a result of ongoing scientific research has revolutionized healthcare around the world. Despite these developments, we are still faced with a huge burden of communicable diseases, an ever rising burden of noncommunicable diseases, coupled with an increasing load of mental health diseases and accidents in healthcare. There are several reasons for our failure to address healthcare issues of our populations, including a desperate need to revamp existing medical and health care related curriculum. In addition to considering curriculum change, perhaps single most needed change we need to address …

Multiple Mini-Interviews (Mmi) And Semistructured Interviews For The Selection Of Family Medicine Residents: A Comparative Analysis, Marie Andrades, Seema Bhanji, Samreen Kausar, Fouad Majeed, Sheilla Pinjani

Department of Family Medicine

Background. Family Medicine Residency Program at the Aga Khan University has applicants for the residency position in excess of the positions offered resulting in formulation of certain selection criteria. The objective of this study was to compare MMI versus semistructured interviews for assessing noncognitive domains in the selection of residents. The secondary objectives were to determine perceptions of the interviewers and candidates for the acceptability and feasibility of MMI as a selection tool.
Methods: The candidates underwent semistructured interviews along with MMI and identical attributes were tested in both. The attributes tested were safe doctor, communication skills, professionalism, problem …

Use Of An Electrical Impedance Tomography Method To Detect And Track Fractures In A Gelatin Medium, Evan G. Lucas

Dissertations, Master's Theses and Master's Reports - Open

Electrical impedance tomography is applied to the problem of detecting, locating, and tracking fractures in ballistics gelatin. The hardware developed is intended to be physically robust and based on off-the-shelf hardware. Fractures were created in two separate ways: by shooting a .22 caliber bullet into the gelatin and by injecting saline solution into the gelatin. The .22 caliber bullet created an air gap, which was seen as an increase in resistivity. The saline solution created a fluid filled gap, which was seen as a decrease in resistivity. A double linear array was used to take data for each of the …

Educators' Knowledge Of And Attitudes Toward Concussions And The New Jersey Concussion Law, Einat Katz-Delong

PCOM Psychology Dissertations

Recent media attention, lawsuits from retiring athletes, and the early retirement of famous athletes have increased public awareness of sports-related head injuries. High school student athletes are more susceptible to concussions than older athletes. Athletes suffering from concussions may experience long-lasting effects on their lives, particularly in cognitive, emotional, and school functioning. Given the increased rates of concussions and their ramifications, state governments and the federal government have taken action. Beginning with the start of the 2011–2012 school year, the state of New Jersey has implemented legislation that requires all school districts with interscholastic sports programs to develop a written …

Letter From The Co-Editors, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Treatment Of Hallux Valgus With A Chevron Osteotomy Combined With A Lateral Release, Selina Silva, Richard A. Miller

UNM Orthopaedic Research Journal

Purpose: Current literature recommends proximal first metatarsal osteotomy for large hallux valgus deformities. Combined distal osteotomy with lateral release can be done and may provide a similar degree of correction. The concern with this technique is disruption of the blood supply to the first metatarsal head. We hypothesized that a chevron osteotomy in conjunction with a lateral release is effective in correcting some larger hallux valgus deformities without causing disruption of the blood supply to the first metatarsal head.

Methods: We reviewed the imaging studies of fortysix cases that underwent a distal chevron osteotomy with lateral release for correction of …

The Use Of Human Amniotic Membrane For Cartilage Repair: A Sheep Study, Samuel K. Tabet, David M. Conner

UNM Orthopaedic Research Journal

No abstract provided.

How Exercise Affects Fatigue In Adults With Multiple Sclerosis, Kristin Lucero, Marybeth Barkocy

UNM Orthopaedic Research Journal

No abstract provided.

Novel Partial Anomalous Pulmonary Venous Connection Associated With Brain Abscess., Anish Koka, Md, Amit Sachdev, Md, Moussa F Yazbeck, Md, Rodney Bell, Md, Christopher Farrellc, Md

Department of Neurology Faculty Papers

BACKGROUND: Right-to-left vascular shunts are associated with brain abscess.

CASE REPORT: We present a 47-year-old female with a cryptogenic left thalamic abscess on which Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirmed in a transthoracic echocardiogram study in which bubbles were injected into the left arm; this shunt had not previously been noted upon right-arm injection.

CONCLUSIONS: We recommend aggressive evaluation for right-to-left shunts in patients who present with cryptogenic brain abscesses. In addition to imaging, this should …

Perception And Use Of Complementary And Alternative Medicine Among Children And Adults With Epilepsy: The Importance Of The Decision Makers., Ali A Asadi-Pooya, Mehrdad Emami

Department of Neurology Faculty Papers

The aim of the current study was to assess the extent to which complementary and alternative medicine (CAM) has been used in children and adults to treat seizures and to compare the perceptions and usage of CAM between adult patients who decides for themselves and adults who decide for their sick children.In this cross-sectional study, patients who have been treated for epilepsy for at least one year at the outpatient epilepsy clinic at the Shiraz University of Medical Sciences were interviewed from January 2012 through March 2012. The questionnaire collected specific information of CAM perceptions and usage among patients. Pearson …

In Adult Patients With Diabetic Macular Edema Are Intravetrial Bevacizumab Injections More Effective Than Laser Therapy At Improving Best-Corrected Visual Acuity?, Heather Bladek

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not in adult patients with diabetic macular edema intravetrial bevacizumab injections are more effective than laser therapy at improving best-corrected visual acuity.

STUDY DESIGN: Review of three English language non-blinded randomized control trials from 2010 and 2012.

DATA SOURCES: Non-blinded randomized control trials comparing intravetrial bevacizumab injections to macular laser therapy found using Pubmed and EBSCOhost web databases. All articles were published in peer-reviewed journals.

OUTCOMES MEASURED: The primary outcome of best-corrected visual acuity (BCVA) was measured using the Early Treatment of Diabetic …

Is Music Therapy A Complementary Treatment Option For Perinatal Women Experiencing Stress And Anxiety?, Samantha L. Wallace Mph

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy is a complementary treatment option for perinatal women experiencing stress and anxiety.

STUDY DESIGN: Literature review of three English language studies, published between 2006 and present.

DATA SOURCES: Three randomized controlled trials (RCTs) were found using a search of Pubmed, Medline, OVID, and Cochrane databases. These studies analyzed the use of a music therapy intervention among pregnant or postpartum women suffering stress, anxiety and/or depression.

OUTCOMES MEASURED: The outcomes of interest include stress, anxiety and severity of depression symptoms. Outcomes …

Molecular Studies On The Anti-Tumor Effects Of Metal-Based Complexes: Involvement Of The Ubiquitin-Proteasome And Apoptotic Pathways, Sara M. Schmitt

Wayne State University Dissertations

The ubiquitin-proteasome pathway is crucial to normal cellular function, and as such, has been extensively investigated as a potential target for cancer therapeutics. Many compounds have been tested for their proteasome inhibitory ability, including various small peptide aldehydes, and, following the success of cisplatin, several metal-containing complexes. The efficacy of these compounds in preclinical studies ultimately resulted in the development and approval of the first-in-class proteasome inhibitor bortezomib, the use of which, unfortunately, has been hindered by toxicity and resistance. These limitations have led to a massive push toward designing and developing new, less toxic proteasome inhibitors for clinical use. …

Cervical Remodeling/Ripening At Term And Preterm Delivery: The Same Mechanism Initiated By Different Mediators And Different Effector Cells, Juan Miguel Gonzalez Velez

Wayne State University Dissertations

Premature cervical remodeling/ripening is believed to contribute to preterm delivery (PTD), the leading cause of perinatal morbidity and mortality. Despite considerable research, the causes of term and PTD remain unclear, and there is no effective treatment for PTD. We tested the hypothesis that complement activation plays a role in cervical remodeling and PTD. We studied cervical remodeling at term.

We studied two mouse models of inflammation-induced PTD. The first model was induced by vaginal administration of lipopolysaccharide (LPS)and the second one by administration of progesterone antagonist RU486. Increased cervical C3 deposition and macrophage infiltration and increased serum C3adesArg and C5adesArg …

Improving Anesthesia Professional Adherence To Hand Hygiene, Martha E. Seneca

UNF Graduate Theses and Dissertations

Performance of hand hygiene is among the most effective means of preventing healthcare associated infections (HAI) among patients. Deaths resulting from HAIs are one of the top ten leading causes of death in the United States. Any improvement in the frequency of hand hygiene among healthcare professionals may have a direct impact on patient mortality and associated costs. While anesthesia professionals have been found to have low rates of hand hygiene adherence, few targeted studies seeking to improve hand hygiene adherence among this group exist. Studies conducted to improve hand hygiene among health care professionals have reported limited improvement, with …

Increasing Physical Activity In Post Liver Transplant Patients, Jennifer Lynn Serotta

UNF Graduate Theses and Dissertations

The purpose of this quality improvement project was to increase physical activity among postoperative adult liver transplant patients, improve documentation of daily activity, and ultimately influence quality of life (QOL). Quality of life has been shown to improve dramatically after liver transplant, as patients enter transplant severely debilitated with limitations on their physical activity which carry over following transplant. The literature supports that liver transplant patients should engage in physical activity which may improve QOL. Thirteen liver transplant patients were recruited within the seven days of their post-operative hospitalization. Twelve patients consented, were educated about the benefits of walking, given …

A Retrospective Analysis Of Paramedic Student Performance Under Simulated Stress, Nicholas Franklin Miller

Online Theses and Dissertations

The paramedic profession is an inherently difficult, dangerous and stressful profession. The paramedic is constantly barraged with acute stressors during the performance of his duties. These stressors have predictable, documented, negative effects on performance. The acute and chronic exposure to stress can negatively impact the safety and the well being of the paramedic. These stressors, if not successfully managed, can also result in negative effects to patients. Despite the overwhelming presence of stress in the paramedic environment, most paramedics receive little or no training to successfully perform under stress. One exception was a program called Trauma Lanes that was held …

Metabolic Reprogramming Induced By Ketone Bodies Diminishes Pancreatic Cancer Cachexia, Surendra K. Shukla, Teklab Gebregiworgis, Vinee Purohit, Nina V. Chaika, Venugopal Gunda, Prakash Radhakrishnan, Kamiya Mehla, Iraklis I. Pipinos, Robert Powers, Fang Yu, Pankaj K. Singh

Journal Articles: Eppley Institute

BACKGROUND: Aberrant energy metabolism is a hallmark of cancer. To fulfill the increased energy requirements, tumor cells secrete cytokines/factors inducing muscle and fat degradation in cancer patients, a condition known as cancer cachexia. It accounts for nearly 20% of all cancer-related deaths. However, the mechanistic basis of cancer cachexia and therapies targeting cancer cachexia thus far remain elusive. A ketogenic diet, a high-fat and low-carbohydrate diet that elevates circulating levels of ketone bodies (i.e., acetoacetate, β-hydroxybutyrate, and acetone), serves as an alternative energy source. It has also been proposed that a ketogenic diet leads to systemic metabolic changes. Keeping in …

Survivorship Analysis For Osteosarcoma And Ewing’S Sarcoma In Children And Adolescents At A Single Pediatric Institution: Comparison To Seer Data, Chittalsinh M. Raulji, Hope Pritchett, Matthew Stark, Kenneth Ward, Velasco Cruz, Jaime Morales

Journal Articles: Pediatrics

Primary malignant bone tumors account for approximately 6% of all childhood malignancies. Osteosarcoma (OS) and Ewing’s sarcoma (ES) are the most common and have an annual incidence of 8.7 per million under the age of 20 years. The mean 5-year survival for OS and ES has been 61% and 60% respectively. The survival for OS and ES has not significantly improved for past 20 years.

We examined the cases of OS and ES, treated at Children’s Hospital of New Orleans (CHNOLA) from 1999-2012. Comparison to national survival data from the Survival, Epidemiological and End Results (SEER) study was done. The …

Regulation And Targeting Of Fyn In Human Cutaneous Squamous Cell Carcinoma, Sarah Fenton

Dissertations

Fyn, a member of the Src family kinases, is an oncogene in murine epidermis and is associated with cell-cell adhesion turnover and migration. Introduction of active H-Ras(G12V) into the HaCaT human keratinocyte cell line resulted in upregulation of FYN mRNA (200-fold) and protein, but did not increase the expression of other SFKs. We identified two nucleotides 74 bases upstream of the human FYN gene transcription start site as necessary for FYN upregulation in HaCaT-Ras cells. Further studies identified Lef-1 as the transcription factor most likely binding to this site and mediating FYN upregulation.

Transduction of active Ras or Fyn was …

Regulation Of Glucose Homeostasis By The Phlpp1 Phosphatase, Kara L. Larson

Theses and Dissertations--Molecular and Cellular Biochemistry

Type 2 diabetes mellitus is a metabolic disease that affects one in ten people in the United States. It is caused by a combination of genetics and lifestyle factors. Disease progression begins with insulin resistance in peripheral tissues followed by pancreatic beta-cell failure. The mechanisms behind disease progression are not completely understood. PH domain leucine rich repeat protein phosphatase 1 (PHLPP1) is a known regulator of Akt and other members of the AGC kinase family. Akt has been established to play a role in numerous metabolic signaling pathways, including insulin action. It is hypothesized that as a regulator of Akt, …

Within-Day Test-Retest Reliability Of Transcranial Magnetic Stimulation Measurements Of Corticomotor Excitability For Gastrocnemius And Tibialis Anterior Muscles, Beth E. Fisher, Ya-Yun Lee, Todd E. Davenport, Stephen F. Reischl, Elizabeth Ruckert, Kornelia Kulig

School of Pharmacy Faculty Articles

Background: Manual therapy interventions targeting the talocrural joint can improve gait and balance functions in individuals following ankle sprains. Less is known about the underlying mechanisms of functional improvements after manual therapy. One hypothesis involves change in corticomotor excitability (CE) following manual therapy procedures. Transcranial magnetic stimulation (TMS) is a brain imaging method that could provide important information regarding potential changes in CE associated with manual therapy techniques applied to the talocrural joint. However, within-day reliability of TMS to measure CE must first be established in order to measure CE changes associated with manual therapy procedures.

Objective: To determine the …

Boning Up On Autophagy: The Role Of Autophagy In Skeletal Biology., Irving Shapiro, Robert Layfield, Martin Lotz, Carmine Settembre, Caroline Whitehouse

Department of Orthopaedic Surgery Faculty Papers

From an evolutionary perspective, the major function of bone is to provide stable sites for muscle attachment and affording protection of vital organs, especially the heart and lungs (ribs) and spinal cord (vertebrae and intervertebral discs). However, bone has a considerable number of other functions: serving as a store for mineral ions, providing a site for blood cell synthesis and participating in a complex system-wide endocrine system. Not surprisingly, bone and cartilage cell homeostasis is tightly controlled, as is the maintenance of tissue structure and mass. While a great deal of new information is accruing concerning skeletal cell homeostasis, one …

Ahead Of Their Time: The Story Of Alice Berry Graham And Katharine Berry Richardson, The Founders Of Children's Mercy Hospital In Kansas City, Jane F. Knapp Md, Robert Schremmer

Posters

Describes the founding of Children's Mercy Hospital through the story of its founders, Katharine Berry Richardson and Alice Berry Graham.

Update Of The Who/Iuis Allergen Nomenclature Database Based On Analysis Of Allergen Sequences, C. Radauer, A. Nandy, F. Ferreira, Richard E. Goodman, J. N. Larsen, J. Lidholm, A. Pomés, M. Raulf-Heimsoth, P. Rozynek, W. R. Thomas, Heimo Breiteneder

Department of Food Science and Technology: Faculty Publications

The IUIS Allergen Nomenclature Sub-Committee, under the auspices of the World Health Organization and the International Union of Immunological Societies, maintains the systematic nomenclature of allergenic proteins and publishes a database of approved allergen names on its Web site, www.allergen.org. In this paper, we summarize updates of allergen names approved at the meetings of the committee in 2011 through 2013. These changes reflect recent progress in identification, cloning, and sequencing of allergens. The goals of this update were to increase consistency in the classification of allergens, isoallergens, and variants and in the incorporation of the evolutionary classification of proteins into …

Development And Evolution Of Risk Assessment For Food Allergens, Rene W. R. Crevel, Joseph Baumert, Athanasia Baka, Geert Houben, André C. Knulst, Astrid Kruizinga, Stefano Luccioli, Stephen L. Taylor, Charlotte B. Madsen

Department of Food Science and Technology: Faculty Publications

The need to assess the risk from food allergens derives directly from the need to manage effectively this food safety hazard. Work spanning the last two decades dispelled the initial thinking that food allergens were so unique that the risk they posed was not amenable to established risk assessment approaches and methodologies. Food allergens possess some unique characteristics, which make a simple safety assessment approach based on the establishment of absolute population thresholds inadequate. Dose distribution modelling of MEDs permitted the quantification of the risk of reaction at the population level and has been readily integrated with consumption and contamination …

Translating Reference Doses Into Allergen Management Practice: Challenges For Stakeholders, René W. R. Crevel, Joseph Baumert, Stefano Luccioli, Athanasia Baka, Sue Hattersley, Jonathan O.B. Hourihane, Stefan Ronsmans, Frans Timmermans, Rachel Ward, Yong-Joo Chung

Department of Food Science and Technology: Faculty Publications

Risk assessment describes the impact of a particular hazard as a function of dose and exposure. It forms the foundation of risk management and contributes to the overall decision-making process, but is not its endpoint. This paper outlines a risk analysis framework to underpin decision-making in the area of allergen cross-contact. Specifically, it identifies challenges relevant to each component of the risk analysis: risk assessment (data gaps and output interpretation); risk management (clear and realistic objectives); and risk communication (clear articulation of risk and benefit). Translation of the outputs from risk assessment models into risk management measures must be informed …