Digital Commons Network^™

Emergency Physicians' Perspectives On The Usability Of Health Information Exchange, Shirley A. Thorn

Theses and Dissertations (ETD)

Emergency physicians are key users of health information exchanges (HIE). Understanding their perspectives on the usability of HIE is important if the full potential of the HIE is to be achieved. The literature identified that emergency physician experiences with HIEs are unexplored areas requiring further studies. The purpose of this study using grounded theory methods was to understand the perspectives of emergency physicians concerning the usability of HIEs. The fundamental question was how do emergency physicians use the HIE in making clinical decisions?

Rich and thick data were collected from 15 emergency physicians in four urban hospitals in the mid-south …

Pharmacokinetic And Pharmacodynamic Studies Of A Novel Spectinamide Series Of Antituberculosis Agents, V. N. R. Pavan Kumar Vaddady

Theses and Dissertations (ETD)

Spectinamides are novel amide derivatives of the antibiotic spectinomycin that have emerged as a new class of agents to treat tuberculosis. These agents showed potent in vitro activity against Mycobacterium tuberculosis (MTB) compared to spectinomycin and in a preliminary in vivo study in interferon gamma (IFN‑γ) knockout mice, spectinamide Lee1329 reduced the lung bacillary load of TB comparable to streptomycin. We hypothesized that the application of an iterative pharmacokinetics and pharmacodynamics (PK/PD) guided approach would facilitate the optimization of these lead compounds suitable for further development.

A series of in vitro experiments including parallel artificial membrane permeability assay (PAMPA), microsomal …

Characterization Of The Sigma Factor Proteins And The Dna Binding Protein Euo Of Chlamydia, Cory L. Blackwell

Theses and Dissertations (ETD)

Chlamydia spp. are prokaryotic obligate intracellular pathogens with a unique, biphasic developmental cycle in which an infectious, extracellular form termed the elementary body (EB) interconverts with a metabolically active intracellular reticulate body (RB) within host cells. Subsets of genes are differentially expressed during the developmental cycle, and these genes are believed to be responsible for the transitions between the EB and RB forms. The goal of these studies was to explore two potential mechanisms that may function in regulating developmental cycle stage‑specific gene expression in chlamydiae: a cascade of sigma factor expression and the binding of the early stage protein …

Impact Of Adjuvants On The Antibody Responses To Pre-Pandemic H5n1 Influenza Vaccines, Ali Hassan Ellebedy

Theses and Dissertations (ETD)

Human influenza pandemics occur when influenza viruses to which the population has little or no immunity emerge and acquire the ability to transmit among humans. Since their emergence in 1996, human infections with highly pathogenic avian influenza A (H5N1) viruses presented a serious public health challenge. Additionally, H5N1 viruses caused significant agricultural and economic losses in the communities it has affected. Human infections with these viruses are rare but when they occur, these infections are highly fatal. A greater public health concern stems from the rapid evolution displayed by these viruses so far, which in turn might result in viruses …

The Occurrence Of An Abdominal Fauna In An Articulated Tapir (Tapirus Polkensis) Recovered From The Miocene Gray Fossil Site Northeast Tennessee., Shannon M. Mcconnell

Electronic Theses and Dissertations

The analysis of samples recovered from the abdominal area of an articulated tapir from the Late Miocene (4.5-7 million bp) Gray Fossil Site, revealed a rich palyno-fauna comprised of about 94% egg/oocyst-like structures and 6% pollen and other palynomorphs. In addition, a tight grouping of six hickory nuts (Carya) was recovered from the same area suggesting that the samples represent the abdominal contents. The analysis of a sample from immediately outside the tapir produced a sample with 98% pollen and less than 0.5% egg-like structures. The size, shape, and general morphology of egg-like structures were analyzed with light …

Host And Distribution Lists Of Chiggers (Trombiculidae And Leeuwenhoekiidae), Of North American Wild Vertebrates North Of Mexico, Brianne L. Walters, John O. Whitaker Jr., Nicholas S. Gikas, William J. Wrenn

Harold W. Manter Laboratory of Parasitology: Faculty Publications

Information concerning chiggers found on wild vertebrates of North America north of Mexico is summarized. Included are lists a) of the chiggers organized taxonomically, b) hosts from which each species has been reported, and c) states and provinces with references for each separate record

Drug Susceptibility Pattern Of Mycobacterium Tuberculosis Isolates Against Conventional Anti-Tuberculosis Drugs In Dhaka, Bangladesh., Abdul Mottalib, Murad Hossain, Ibrahim Khalil, Sirazul Islam, Anwar Hossain

Saudi Medical Journal

OBJECTIVES: To investigate the drug susceptibility pattern of isolated Mycobacterium tuberculosis (M. tuberculosis) against conventional anti-tuberculosis drugs in Dhaka, Bangladesh. METHODS: Sputum samples from 101 suspected new and previously treated patients were collected and M. tuberculosis was identified by microscopic observation and Ziehl-Neelsen staining. Drug susceptibility was performed against 4 anti-tuberculosis drugs, and the obtained data was analyzed. This study was performed in the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders Hospital, Dhaka, Bangladesh between October 2008 and November 2009. RESULTS: Among 101 suspected, 59 (58.4%) cases were identified as M. tuberculosis and the drug …

Device-Associated Infection Rates And Bacterial Resistance In The Intensive Care Units Of A Turkish Referral Hospital., Emin E. Tutuncu, Yunus Gurbuz, Irfan Sencan, Baris Ozturk, Gonul C. Senturk, Aysegul U. Kilic

Saudi Medical Journal

OBJECTIVES: To determine device-associated infection (DAI) rates, and the microbiological and antibiotic resistance profiles of infecting pathogens in our hospital. METHODS: Prospective surveillance of healthcare-associated infections was performed from January 2007 to March 2010 in 4 different intensive care units (ICUs) of SB Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. RESULTS: During the study period, 6,005 patients were followed-up in ICUs for a total of 46,355 patient-days. The total number of DAIs was 969. Catheter-associated urinary tract infection (CAUTI) was the most common DAI (55.3% of DAIs; 11.9 cases per 1000 catheter-days), followed by ventilator-associated pneumonia (VAP) (38.9% …

Hand Hygiene Compliance Rate Among Healthcare Professionals., Syed Z. Bukhari, Waleed M. Hussain, Abdulhakeem Banjar, Wail H. Almaimani, Talal M. Karima, Mohammad I. Fatani

Saudi Medical Journal

OBJECTIVES: To motivate healthcare professionals, with a focus on improving hand hygiene compliance. METHODS: An observational, prospective, longitudinal study was conducted on the evaluation of hand hygiene compliance at Hera General Hospital, Makkah, Kingdom of Saudi Arabia from May 2009 to May 2010. Four components to improve hand hygiene compliance were implied; daily audit, monthly staff education; quarterly workshops of hand hygiene, and education material distribution. The compliance rate was calculated by its adherence with number of opportunities. RESULTS: Of total 163 healthcare professionals were surveyed for hand hygiene compliance; 57 (35%) were doctors, 92 (56.4%) nurses, and 14 (8.6%) …

Rickettsia Parkeri In Gulf Coast Ticks, Southeastern Virginia, Usa, Chelsea L. Wright, Robyn M. Nadolny, Ju Jiang, Allen L. Richards, Daniel E. Sonenshine, Holly D. Gaff, Wayne L. Hynes

Biological Sciences Faculty Publications

We report evidence that Amblyomma maculatum tick populations are well established in southeastern Virginia. We found that 43.1% of the adult Gulf Coast ticks collected in the summer of 2010 carried Rickettsia parkeri, suggesting that persons living in or visiting southeastern Virginia are at risk for infection with this pathogen.

Discovery And Molecular Characterization Of Selenoprotein M In The Salivary Glands Of Amblyomma Maculatum, The Gulf Coast Tick, Parul Singh

Master's Theses

The Gulfcoast ticks transmit disease-causing pathogens to humans and animals. Rickettsia parkeri is notable among the pathogens transmitted by A. maculatum to humans. Heavy infestations of A. maculatum on animal ears cause them to become thickened and curled, a condition commonly called "gotch ear." The tick's multifunctional salivary glands are vital to their biological success and likely also play a critical role in transmission of disease; tick saliva contains a broad array of secretory products that facilitate prolonged tick attachment and feeding; disrupting tick blood feeding or inactivating key tick salivary proteins presents a novel strategy for tick-borne disease prevention. …

Rrh Library Newsletter, May 2011, Libraries At Rochester Regional Health

Rochester Regional Health authored publications and proceedings

Newsletter sections include: Hand Hygiene in the Prevention of Healthcare Associated Infections

Preventing The Spread Of Infections In Patients' Homes: What Is The Best Evidence?, Julie Ferry

Theses and Dissertations

Nurses need evidence-based practices to prevent the spread of infections in patients' homes. Nursing equipment must be cleaned and disinfected properly between patients and proper hand hygiene should be done to decrease health-care associated infections in the home and community setting. A review and synthesis of the most current literature was done by searching the Cumulative Index to Nursing and Allied Health literature (CINAHL), Cochrane Database, Google Scholar™ and Google™ databases. Key words include infection control, home visits, public health, cleaning, home health, equipment, disinfectants and combinations of those words. Tools were created for dissemination to nurses providing care in …

Cocaine Dependence: The Role Of Serotonin Genes In, Lorena Maili

Dissertations and Theses (Open Access)

Animal studies have shown that behavioral responses to cocaine-related cues are altered by serotonergic medications. The effects of pharmacological agents on serotonin receptors 2a (5-HT2A) and 2c (5-HT2C), have yielded results suggesting that selective 5-HT2A antagonists and 5-HT2C agonists promote the disruption of cocaine-associated memories. One measure of cocaine related cues in humans is attentional bias, in which cocaine dependent individuals show greater response latency for cocaine related words than neutral words. Data from our laboratory shows that cocaine dependent subjects have altered attentional bias compared to controls. The purpose of this thesis was to investigate the role of the …

Role Of Vitamin-D3 And Retinoic Acid In A Human Thp-1 Macrophage Model Of Mycobacterium Tuberculosis Infection, Jaymie L. Estrella

Dissertations and Theses (Open Access)

Mycobacterium tuberculosis (Mtb) replicates within the human macrophages and we investigated the activating effects of retinoic acid (RA) and vitamin D3 (VD) on macrophages in relation to the viability of Mtb. A combination of these vitamins (RAVD) enhanced the receptors on THP-1 macrophage (Mannose receptor and DC-SIGN) that increased mycobacterial uptake but inhibited the
subsequent intracellular growth of Mtb by inducing reactive oxygen species (ROS) and autophagy. RAVD also enhanced antigen presenting and homing receptors in THPs that suggested an activated phenotype for THPs following RAVD treatment. RAVD mediated activation was also associated with a marked phenotypic change in Mtb …

Immune Modulation Of The Mycobacterium Tuberculosis Granulomatous Response, Kerry J. Welsh

Dissertations and Theses (Open Access)

Tuberculosis (TB) remains a major public health burden. The immunocompetant host responds to Mycobacterium tuberculosis (MTB) infection by the formation of granulomas, which initially prevent uncontrolled bacterial proliferation and dissemination. However, increasing evidence suggests that granuloma formation promotes persistence of the organism by physically separating infected cells from effector lymphocytes and by inducing a state of non-replicating persistence in the bacilli, making them resistant to the action of antibiotics. Additionally, immune-mediated tissue destruction likely facilitates disease transmission. The granulomatous response is in part due to mycobacterial glycolipid antigens. Therefore, studies were first undertaken to determine the innate mechanisms of mycobacterial …

Molecular Mechanisms Underlying The Transcriptional Regulation Of T Helper 17 And Regulatory T Cells, Gustavo Javier Martinez

Dissertations and Theses (Open Access)

CD4⁺ T helper (Th) lymphocytes are vital for integrating immune responses by orchestrating the function of other immune cell types. Naïve Th cells can differentiate into different effector subsets that are characterized by their cytokine profile and immune regulatory functions. These subsets include Th1, Th2, Th17, natural and inducible regulatory T cells (nTreg and iTreg respectively), among others. We focused our investigation on two Th lineages, Th17 and regulatory T cells, with opposing functions in the immune system. These subsets have been suggested to be reciprocally regulated since they both require TGF-b for their development. We investigated the role …

Multimethod Teaching Strategies To Integrate Selected Qsen Competencies In A Doctor Of Nursing Practice Distance Education Program, Mary Lou Manning, Phd, Crnp, Anthony J. Frisby, Phd

College of Nursing Faculty Papers & Presentations

The Quality and Safety Education for Nurses (QSEN) initiative identified 6 competencies for the education of nurses (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) and the related knowledge, skills, and attitudes (KSAs) for each competency. The initial QSEN focus was on competency development during prelicensure nursing education, with subsequent attention on adapting the KSAs for graduate programs that prepare advanced practice nurses for clinical roles. Description of successful QSEN competency integration in Doctor of Nursing Practice (DNP) programs is limited. Although the ultimate goal is executing DNP programs where quality and safety is thoroughly integrated …

Randomized Phase Iii Trial Of Paclitaxel/Carboplatin With Or Without Pf-3512676 (Toll-Like Receptor 9 Agonist) As First-Line Treatment For Advanced Non–Small-Cell Lung Cancer, Vera Hirsh, Luis Paz-Ares, Michael Boyer, Rafael Rosell, Gary Middleton, Wilfried Eberhardt, Aleksandra Szczesna, Pavel Reiterer, Mansoor Saleh, Oscar Arrieta

Haematology and Oncology, East Africa

Purpose: This phase III study examined efficacy of the synthetic Toll-like receptor 9–activating oligodeoxynucleotide PF-3512676 in combination with standard paclitaxel/carboplatin chemotherapy in patients with advanced non–small-cell lung cancer (NSCLC).

Patients and Methods: Chemotherapy-naive patients with stage IIIB or IV NSCLC were randomly assigned (1:1) to receive up to six courses of paclitaxel/carboplatin (intravenous paclitaxel 200 mg/m2 and carboplatin at area under the [concentration-time] curve 6 on day 1 of a 3-week cycle) alone (control arm) or in combination with 0.2 mg/kg subcutaneous PF-3512676 on days 8 and 15 (investigational arm). Primary end point was overall survival (OS).

Results: Baseline demographics …

Rhinocerebral Zygomycosis In Pakistan: Clinical Spectrum, Management, And Outcome, Mubasher Ikram, Moghira Iqbal, Muhammad Aslam Khan, Erum Khan, Mahnaz Shah, Raymond A., Jr Smego

Section of Otolaryngology, Head & Neck Surgery

OBJECTIVE: To study the disease spectrum and salient management features of 36 patients with histopathologically-confirmed rhinocerebral zygomycosis seen at our academic center over a 16-year period.

METHODS: Retrospective review of patients admitted to the Aga Khan University Hospital in Karachi, Pakistan from January 1991 to December 2006 with histopathologically-confirmed zygomycosis of the head and neck.

RESULTS: Mean patient age was 40 +/- 5.0 years (range, 34-63 years), and 23 (64%) patients were male. Thirty-two (89%) patients were referred from clinical services other than otolaryngology. Underlying predisposing conditions included diabetes mellitus (21 patients), haematologic diseases (9), and renal failure (6). Twenty …

Ontology For Psychophysiological Dysregulation Of Anger/Aggression, Swathi Vasanthapuram

School of Computing: Dissertations, Theses, and Student Research

The advancement of Information Technology in the last four decades led to the use of computers in medicine. A new area called Medical Informatics has emerged. This area comprises the application of IT to healthcare with the aim of creating tools that help healthcare personnel diagnose and treat patients more accurately and efficiently. IT not only provides tools for storing, integrating, and updating patient information base but also for processing information efficiently. One of such tools is a Clinical Decision Support System. Ontologies are an integral part of clinical decision support systems because they help formalize and integrate domain knowledge. …

Microbiological, Thermal Inactivation, And Sensory Characteristics Of Beef Eye-Of-Round Subprimals And Steaks Processed With High-Pressure Needleless Injection, Laura Kahealani Jefferies

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

High-pressure needleless injection (HPNI) is a process where small-diameter, high-velocity burst of liquid, penetrate foods at pressures ≤ 10,000 psi. The potential of HPNI as an enhancing technique for meat was studied. In study 1, HPNI translocated surface E. coli O157 into the interior of beef eye-of-round subprimals with an incidence of 40 (±7), 25 (±8), and 25 (±8)% for meat that had been surface-inoculated with a four-strain cocktail at 0.5, 1, and 2 log₁₀ CFU/cm², respectively. Run-off water contained 2, 2, and 3 log₁₀ CFU/ml and was used for HPNI of additional subprimals, which resulted …

Use Of Audit, And Measures Of Drinking Frequency And Patterns To Detect Associations Between Alcohol And Sexual Behaviour In Male Sex Workers In Kenya, Stanley Luchters, Scott Geibel, Masila Syengo, Daniel Lango, Nzioki King'ola, Marleen Temmerman, Matthew F. Chersich

Population Health, East Africa

Background: Previous research has linked alcohol use with an increased number of sexual partners, inconsistent condom use and a raised incidence of sexually transmitted infections (STIs). However, alcohol measures have been poorly standardised, with many ill-suited to eliciting, with adequate precision, the relationship between alcohol use and sexual risk behaviour. This study investigates which alcohol indicator - single-item measures of frequency and patterns of drinking ( > = 6 drinks on 1 occasion), or the Alcohol Use Disorders Identification Test (AUDIT) - can detect associations between alcohol use and unsafe sexual behaviour among male sex workers.

Methods: A cross-sectional …

Meissen Porcelain: Precision, Presentation, And Preservation. How Artistic And Technological Significance Influence Conservation Protocol, Nicole Peters

Graduate Theses, Dissertations, and Problem Reports (ETD)

invention of Meissen porcelain and how these factors impact certain restoration and conservation protocol. The diversity and range of objects produced at the Meissen studio paired with the artistic genius of their design repositioned European ceramics as a superior craft form among its pottery-producing competitors. The ware's enthusiastic reception amongst upper-class European society established the pieces as being highly-valued and prompted their widespread recognition. What resulted was an efflorescence of creativity, artistic and technical accomplishments, and an original aesthetic quality that initiated a new conceptual reframing of how ceramic media could be presented. Throughout the past three centuries, Meissen porcelain …

California School Nurse Survey, Rachel Van Niekerk Phd

Dissertations

The purpose of this study was to obtain evidence to support the assumption that school nurses have a positive effect on school attendance and medication administration practices and to hear the voice of the California school nurse. Data from this exploratory, descriptive study came from an online researcher developed survey consisting of both forced choice and open-ended questions completed by California school nurses representing the three major regions of California (Northern, Central, and Southern). The following three research questions guided the study: 1) What is the relationship between school and nurse factors on student outcomes? 2) How valued do California …

Chemical Ecology, Population Dynamics And Insecticide Susceptibility Of Lesser Mealworm Alphitobius Diaperinus (Panzer) (Coleoptera: Tenebrionidae), Narinderpal Singh

Graduate Theses and Dissertations

The lesser mealworm, Alphitobius diaperinus (Panzer) (Coleoptera: Tenebrionidae), is a serious, cosmopolitan pest present in poultry production facilities, where it slows down weight gain in chicks, carries disease–causing organisms, and causes damage to poultry insulation. The first study estimated that the lesser mealworm densities in poultry litter applied to pastures were 3.5, 2.2 and 0.4 million larvae, adults and pupae, respectively, per hectare in Savoy, Arkansas. The repercussions of these adult beetles are that they often disperse to and reinfest poultry houses with the potential to vector disease to poultry, and disperse to invade human dwellings resulting in litigation. The …

An Assessment Of Hpv Vaccination By Georgia Physicians: Knowledge, Barriers, Supports, Practices, And Adherence To Acip Guidelines And Recommendations, Elizabeth Dixon

College of Graduate Studies: Theses & Dissertations

The purpose of this study was to examine Georgia physicians' administration of the quadrivalent human papillomavirus (HPV) vaccine to 11-12 year old females according to the Advisory Council Immunization Practices (ACIP) guidelines, their intention to recommend HPV vaccine to 11-12 year old males, and their perceived knowledge and barriers associated with HPV vaccination. A distinction between urban and rural was examined to determine if there were differences in HPV vaccination recommendation. A stratified sample was created from the Georgia Vaccine For Children (VFC) provider list. The final sampling frame included 264 (n = 264) providers. Of these, 218 physicians were …

In Vitro Susceptibility Of Typhoidal Salmonellae Against Newer Antimicrobial Agents: A Search For Alternate Treatment Options, Saba Qaiser, Seema Irfan, Erum Khan, Tanwir Ahsan, Afia Zafar

Department of Pathology and Laboratory Medicine

OBJECTIVES: To determine the minimum inhibitory concentrations (MICs) of ceftriaxone, azithromycin, pefloxacin, cefipime and imipenem for Salmonella Typhi (S. Typhi) and Paratyphi.

METHODS: One hundred and fifty four isolates of Salmonella Typhi and S. Paratyphi A, B and C growing in blood culture were selected. MICs of ceftriaxone, azithromycin, pefloxacin, cefipime and imipenem were performed by agar dilution method as recommended by clinical laboratory standard institutes.

RESULTS: MIC90 of azithromycin and pefloxacin was 8 microg/ml, cefipime was 0.06 microg/ml and imipenem was 0.5 microg/ml. None of the strains were found to be resistant to ceftriaxone but 3 isolates showed higher …

Impact Of Information Computer Technology On Primary Health Care Services To Rural Communities In Niger Delta Region Of Nigeria, Sylvester O. Anie

Library Philosophy and Practice (e-journal)

This is the empirical study of 4 communities under survey in Niger-Delta. This article examines the impact of Information and Communication Technology (ICT) on primary health care services to rural communities in Niger Delta. Questionnaire, interview and personal observation methods were employed to elicit information on the impact of ICT on primary health care services in rural communities in Niger Delta. The study reveals the personal characteristics of the respondents. The findings also reveal that rural dwellers need to be encouraged by providing them with relevant information and communication technology gadgets in order to enhance effective retrieval and dissemination of …

Health Needs Of Hiv-Infected Women In The United States: Insights From The Women Living Positive Survey., Kathleen E Squires, Sally L Hodder, Judith Feinberg, Dawn Averitt Bridge, Staats Abrams, Stephen P Storfer, Judith A Aberg

Department of Medicine Faculty Papers

The objective of this study was to describe attitudes, opinions, and perceived health needs of HIV-infected women in the United States. In this cross-sectional study, women were invited to participate in the Women Living Positive survey, a structured interview instrument with 45 questions. Collected data were deidentified and the margin of error was calculated as four percentage points. Incoming toll-free phone interviews were conducted from December 21, 2006, through March 14, 2007 among subjects recruited from a U.S. national network of AIDS counseling centers. Seven hundred HIV-infected women (43% African American, 28.5% Hispanic, 28.5% Caucasian; median age, 42.5 years) receiving …