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The 'Uberization' Of Healthcare: The Forthcoming Legal Storm Over Mobile Health Technology's Impact On The Medical Profession, Fazal Khan

Scholarly Works

The nascent field of mobile health technology is still very small but is predicted to grow exponentially as major technology companies such as Apple, Google, Samsung, and even Facebook have announced mobile health initiatives alongside influential healthcare provider networks. Given the highly regulated nature of healthcare, significant legal barriers stand in the way of mobile health’s potential ascension. I contend that the most difficult legal challenges facing this industry will be restrictive professional licensing and scope of practice laws. The primary reason is that mobile health threatens to disrupt historical power dynamics within the healthcare profession that have legally enshrined …

Barriers To Exclusive Breastfeeding Among Mothers During The First Four Weeks Postpartum, Jessy V. Thomas

Walden Dissertations and Doctoral Studies

According to the World Health Organization, breastfeeding is natural and the most effective way of nourishment to feed infants and young children to ensure child health and survival. Currently, the World Health Organization, the American Academy of Pediatrics, and other health organizations recommend exclusive breastfeeding during the first 6 months of life. Although exclusive breastfeeding has been shown to reduce the occurrence of adverse health outcomes to the infant and mother, the duration of exclusive breastfeeding remains relatively low in the United States. The theory of planned behavior was used as a theoretical framework for this study. The purpose of …

The Role Of Religiosity In The Development Of Obesity From Adolescence To Adulthood, Trini Gene Rangel

Walden Dissertations and Doctoral Studies

The development of obesity from adolescence to adulthood is not well understood, nor does the research support a multidimensional approach for this understanding. Studies have described primarily cross-sectional bivariate relationships between combinations of obesity, religiosity, depression, and social support, but it is still not known whether there is a relationship between adolescent religiosity, depression, and social support in the development of adult obesity or whether depression and social support mediate the religiosity-obesity relationship. The dynamic, multidimensional, functional model of wellness presented by Hawks was the basis for the spiritual, social, emotional, and physical interactions proposed in this study. The research …

A Community's Perception Of Pregnancy And Sexually Transmitted Infections And Prevention Programs, Felecity Nicole Burns

Walden Dissertations and Doctoral Studies

The United States has the highest rates of teenage pregnancies, births, abortions, and sexually transmitted infections in the industrialized world. African American teen pregnancies and sexually transmitted infections are on the rise in many rural southwest school districts in the State of Georgia where the sex education curriculum is nonexistent or solely focuses on abstinence. Georgia ranked 4th in cases of primary and secondary syphilis, 6th in AIDS, 12th in gonorrhea, 14th in teen pregnancies, and 17th in chlamydia in the United States in 2012. The purpose of this qualitative study was to evaluate the perceptions of residents of a …

Seroepidemiological Survey Of Bovine Tick-Borne Infections In Theblack Sea Region Of Turkey, Mustafa Açici, Cenk Soner Bölükbaş, Gökmen Zafer Pekmezci̇, Ali̇ Tümay Gürler, Şi̇nasi̇ Umur, Kadri̇ Zafer Karaer, Ayşe Çakmak, Ayşe Serpi̇l Nalbantoğlu, Cevat Ni̇sbet

Turkish Journal of Veterinary & Animal Sciences

Babesiosis, theileriosis, and anaplasmosis are the tick-borne diseases of cattle in most of the tropical areas and Turkey. A total of 270 cattle were randomly selected from 27 villages and 77 farms in the Black Sea Region of Turkey for the determination of infections by Babesia bigemina and Anaplasma marginale by using the indirect fluorescent antibody (IFA) test and the competitive enzyme-linked immunosorbent assay (cELISA). Of those, 242 and 256 sera were also analyzed for antibodies against Theileria annulata and Babesia bovis infections using the IFA test, respectively, during the period of June 2006 to June 2007. Of the 256 …

Comparative Study Between Formalin-Killed Vaccine And Developed Gammairradiation Vaccine Against Mannheimia Haemolytica In Rabbits, Sahar Ahmed, Basem Ahmed, Ghada Mahmoud, Waleed Nemr, Emam Abdel Rahim

Turkish Journal of Veterinary & Animal Sciences

Mannheimia haemolytica is responsible for considerable economic losses to sheep, goats, and cattle and other livestock industries in Egypt. This study aimed to evaluate the effectiveness of a newly developed gamma irradiation vaccine against Mannheimia haemolytica in comparison to a formalin-killed vaccine. Three groups of rabbits were used in this study. Group 1 animals were inoculated with 4 × 109 bacterial cells per dose of the formalin-killed vaccine. Group 2 was inoculated with 2 × 109 bacterial cells per dose of gamma-irradiated vaccine. Group 3 (control group) was injected with 2 mL of sterile PBS. The vaccines were injected subcutaneously …

Modern Estimation Problems In Group Testing, Md Shamim Sarker

Theses and Dissertations

In the simplest form of group testing, pools are formed by compositing a fixed number of individual specimens (e.g., blood, urine, swab, etc.) and then the pools are tested for a binary characteristic, such as presence or absence of a disease. Group testing is commonly used to screen for a variety of sexually transmitted diseases in epidemiological applications where the main goal is to increase testing efficiency. In this dissertation, we study three estimation problems that are motivated by real-life applications. We propose new methods to model group testing data for both single and multiple infections. In the first problem, …

Mechanism By Which Commensal Bacteria Limit Inflammation, Mallory Paynich

Dissertations

Trillions of bacteria live within the gastrointestinal tract and are critical for maintaining intestinal homeostasis; however, the mechanisms utilized by specific bacterial molecules to contribute to homeostasis are not well understood. We utilize a mouse model in which a single oral dose of the probiotic, Bacillus subtilis, protects mice from acute colitis induced by the enteric pathogen Citrobacter rodentium. Our goal is to elucidate the mechanism by which B. subtilis prevents inflammation.

We identified exopolysaccharides (EPS) to be the active molecule of B. subtilis, and a single dose of EPS protects mice from disease. EPS binds F4/80+CD11b+ peritoneal macrophages, and …

United States Foreign Policy Toward Hiv/Aids In Africa: The Role Of Pharmaceutical Companies In The Formulation And Implementation Of The President’S Emergency Plan For Aids Relief (Pepfar) 2003-2008, Toussaint Kafarhire Murhula

Dissertations

During his 2003 State of the Union Address, President Bush announced his Emergency Plan for AIDS Relief (PEPFAR) and asked Congress, over the next five years, to authorize the appropriation of $15 billion to provide treatment, prevention and care to people infected and affected by HIV/AIDS, mostly in Sub-Saharan Africa. Given the existing pattern of neglect and indifference in U.S.-Africa relations and the Bush campaign’s statement in 2000 dismissing Africa from his foreign policy priorities, what then justifies his administration’s undertaking of this massive foreign policy change?

My dissertation offers insight into the role played by private US pharmaceutical companies …

Moral Distress And The Health Care Organization, Andy Kondrat

Dissertations

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress.

In …

Identifying Patient-Specific Epstein-Barr Nuclear Antigen-1 Genetic Variation And Potential Autoreactive Targets Relevant To Multiple Sclerosis Pathogenesis, M Tschochner, S Leary, D Cooper, K Strautins, A Chropra, H Clark, L Choo, D Dunn, I James, W Carroll, A Kermode, D Nolan

Health Sciences Papers and Journal Articles

Background: Epstein-Barr virus (EBV) infection represents a major environmental risk factor for multiple sclerosis (MS), with evidence of selective expansion of Epstein-Barr Nuclear Antigen-1 (EBNA1)-specific CD4+ T cells that cross-recognize MS-associated myelin antigens in MS patients. HLA-DRB1*15-restricted antigen presentation also appears to determine susceptibility given its role as a dominant risk allele. In this study, we have utilised standard and next-generation sequencing techniques to investigate EBNA-1 sequence variation and its relationship to HLA-DR15 binding affinity, as well as examining potential cross-reactive immune targets within the central nervous system proteome.

Methods: Sanger sequencing was performed on DNA isolated from peripheral blood …

Predicting Suitable Habitat Decline Of Midwestern United States Amphibians And Quantifying The Consequence Of Declines Using Pond-Breeding Salamanders, Brock Struecker

Master's Theses

With current declines of vertebrate taxa meeting or exceeding those of historic mass extinction events, there is a growing need to investigate the main drivers of declines. Amphibians are perhaps at greatest risk of global climate change and land-use changes than most other vertebrate classes and also have significant roles in ecosystem processes – combined, this creates a cause for concern. I designed a study that would investigate the effects of current and predicted climate change and land-use changes on amphibians using species distribution models and a field study to identify the potential consequences of amphibian species declines by investigating …

A Study Of Immune-Regulation Of Microbiota Supernatant On Macrophage Function, An N. Nguyen

Master's Theses

The diverse human microbial ecosystem colonizes many different body sites. The gastrointestinal (GI) tract, especially, is a major region that that harbors a complex microbial community composed of trillions of commensal bacteria. Interactions between the commensal bacteria and the host immune system begin at birth and continue through the human lifespan. In the gut, commensal bacteria help the host to ensure the maintenance of intestinal homeostasis as well as the mucosal barrier structure through host stimulation of mucus and antimicrobial molecules. The secretion of these host factors functions to inhibit pathogenic invasion and maintain the population of commensal bacteria. The …

Characterization Of Il-22-Producing Cells In The Human Thymus And The Mechanism By Which Il-22 Expression Is Modulated By Thymic Epithelial Cells., Nadine N. Morgan

Master's Theses

Thymic epithelial cells (TECs) are indispensable for T cell development and maturation. Therefore, damages to the thymic epithelial cells are detrimental to thymic function and immune response. In young healthy individuals, TECs have a high regenerative potential and are capable of renewal from serious damage; however, the molecular mechanism of this recovery is unclear. A recent study has shown that IL-22-producing ILCs are present in the mouse thymus and can regenerate thymic epithelial cells following radiation induced injuries. However, it is unknown whether IL-22-producing cells are also found in the human thymus. Thus, the goal of this study is to …

Defining The Role Of A Putative Peptidase In Staphylococcus Aureus Quorum Sensing And Pathogenesis, Chelsea Rose White

Master's Theses

The pathogenic bacterium Staphylococcus aureus encounters a variety of immune cells that restrict bacterial growth and dissemination during infection. However, S. aureus counters these immune cell functions by producing myriad virulence factors that facilitate evasion of host defenses. Therefore, it is important to understand S. aureus-immune cell interactions and the virulence factors that perturb normal immune function to promote pathogenesis. In a genetic screen designed to identify S. aureus secreted factors that modulate macrophage activity our lab identified a transposon insertion mutant in the gene SAUSA300_1984, encoding a putative membrane spanning peptidase. To investigate the role of 1984 in pathogenesis, …

Childhood Obesity, A Public Health Crisis: Narrative Review Of Public Health Interventions For Childhood Obesity, Sumera Aziz Ali, Savera Aziz Ali, Nadir Suhail, Shiyam Sunder Tikmani, Gulshan Bano

Community Health Sciences

Introduction: Child obesity is the major pediatric public health crisis of the current century and its trend is increasing in the developing countries due to nutrition and epidemiologic transition. Considering the burden of childhood obesity and its associated outcomes need for obesity prevention in children has become priority both for government and researchers.
Objective: The objective of this review is to provide the updated knowledge and evidence from various research studies, designed to provide interventions either in school or at home.
Methodology: Electronic databases like Google scholar, PubMed and Sciencedirect were used as search engines. Key terms used during the …

High Borate Glasses For The Controlled Release Of Therapeutic Metal Ions, Kathleen O'Connell

Theses

Within the biomaterial community significant effort has been directed towards engineering materials that induce precise host responses, which are tailored to specific applications. However, this has also seen an increase in the complexity of some biomaterials, which is being increasingly criticised within the literature, as it is attributed to hindering their clinical utility. In this context the release of therapeutic metal ions from glass-based biomaterials have been shown to promote hard tissue repair and regeneration through angiogenesis and osteogenesis processes. Within this thesis project two separate quaternary high borate glass systems were prepared containing the therapeutic metal ions strontium and …

Resurgence Of Acropora Corals On Mid Shelf Patch Reefs, Southwater Caye Marine Reserve, Central Belize, Jillian J. Keefer

Undergraduate Honors Thesis Projects

Acropora cervicornis (staghorn) and Acropora palmata (elkhorn) are ecologically important corals that grow quickly and provide topography and refuges for fish and invertebrates. Historically, Acropora was the most abundant coral in shallow patch reef zones in the Caribbean. During the 1980s, white band disease eliminated most Acropora causing a loss in rugosity and an increase of macroalgae on many reefs. Although Acropora remains rare throughout most of the Caribbean, this study documents its partial comeback and possible limiting factors in Southwater Caye Marine Reserve (SWCMR), Central Belize. Patch reefs in the reserve averaged 19% live coral cover with A. palmata …

A Five Residue Insertion Between Codons 28 And 29 Of The Hiv-1 Protease Gene Reduces The Replicative Capacity Of The Virus, Cathy Mcleod

Wayne State University Theses

HIV-1 protease (PR) is a 99 amino acid protein responsible for cleavage of the viral polyprotein. We have identified a novel clinical isolate, MDR/28, which contains a five residue insertion between codons 28 and 29 of a multi-drug resistant (MDR) PR. This clinical isolate displays reduced viral replicative capacity compared to the wild-type. As opposed to drug-resistance mutations, studies on insertions remain largely underrepresented in the literature, and the consequences of such insertions are largely unknown. To understand the mechanism leading to reduced replicative capacity, three PR models were created and subjected to 40ns molecular dynamics simulations: MDR/28, wild type, …

Zoonotic Transmission Of Waterborne Disease: A Mathematical Model, Edward K. Waters

Medical Papers and Journal Articles

Waterborne parasites that infect both humans and animals are common causes of diarrheal illness, but the relative importance of transmission between humans and animals and vice versa remains poorly understood. Transmission of infection from animals to humans via environmental reser12

voirs, such as water sources, has attracted attention as a potential source of endemic and epidemic infections, but existing mathematical models of water borne disease transmission have limitations for studying this phenomenon, as they only consider contamination of environmental reservoirs by humans. This paper develops a mathematical model that represents the transmission of waterborne parasites within and between both animal …

Seasonal Trivalent Influenza Vaccination During Pregnancy And The Incidence Of Stillbirth: Population-Based Retrospective Cohort Study, Annette Regan, Hannah C. Moore, Nicholas De Klerk, Saad B. Omer, Geoffrey Shellam, Donna Mak, Paul Effler

Medical Papers and Journal Articles

Concern for the safety to the fetus is a commonly cited reason for vaccine refusal during pregnancy. Results from this investigation support the safety of seasonal influenza vaccination during pregnancy and suggest seasonal influenza vaccination may be protective against stillbirth.

A Middle-Aged Man With Cellulitis, R Sullivan, G Fulde

Medical Papers and Journal Articles

A middle-aged man presents with an extremely painful swollen red leg and signs of sepsis. He has a history of chronic venous insufficiency, obesity, diabetes, hypertension and obstructive sleep apnoea. What are your differential diagnoses and how should he be managed?

Survey Of Australian Father's Attitudes Towards Infant Vaccination: Findings From The Australian Father's Study, N Prosser, R Petersen, J Quinlivan

Medical Papers and Journal Articles

Objective: To investigate the attitudes of expectant Australian fathers towards vaccination, and to identify factors which may influence these attitudes.

Methods: A cross-sectional survey study of 407 Australian men with expectant partners, mean age 30.4 (SD 6.7). Self reported attitude, level of knowledge and information resources accessed regarding pregnancy related issues. Participant demographics collected included: Age, number of children, relationship status, level of education, employment information and smoking status.

Results: Majority (89%) of participants had a positive attitude towards infant vaccination, 9% felt neutral and 2% had negative attitudes. Positive attitudes towards vaccination were associated with lower self-reported knowledge …

New Techniques To Characterise The Vaginal Microbiome In Pregnancy, G Mendz, N Kaakoush, J Quinlivan

Medical Papers and Journal Articles

Understanding of the vaginal microbiome in health and disease is essential to screen, detect and manage complications in pregnancy. One of the major complications of pregnancy is preterm birth, which is the leading world-wide cause of death and disability in children under five years of age. The aetiology of preterm birth is multifactorial, but a causal link has been established with infection. Despite the importance of understanding the vaginal microbiome in pregnancy in order to evaluate strategies to prevent and manage PTB, currently used culture based techniques provide limited information as not all pathogens are able to be cultured.

The …

Changing The Antibiotic Prescribing Of General Practice Registrars: The Chap Study Protocol For A Prospective Controlled Study Of A Multimodal Educational Intervention, Mieke L. Van Driel, Simon Morgan, Amanda Tapley, Lawrie Mcarthur, Patrick Mcelduff, Lucy Yardley, Anthea Dallas, Laura Deckx, Katie Mulquiney, Joshua S. Davis, Andrew Davey, Kim Henderson, Paul Little, Parker J. Magin

Medical Papers and Journal Articles

Background: Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career …

From Qasc To Qascip: Successful Australian Translational Scale-Up And Spread Of A Proven Intervention In Acute Stroke Using A Prospective Pre-Test/Post-Test Study Design, S Middleton, A Lydtin, D Comerford, D Cadilhac, P Mcelduff, S Dale, K Hill, M Longworth, J Ward, N Cheung, C D'Este

Health Sciences Papers and Journal Articles

Objectives: To embed an evidence-based intervention to manage FEver, hyperglycaemia (Sugar) and Swallowing (the FeSS protocols) in stroke, previously demonstrated in the Quality in Acute Stroke Care (QASC) trial to decrease 90-day death and dependency, into all stroke services in New South Wales (NSW), Australia’s most populous state.

Design: Pre-test/post-test prospective study.

Setting: 36 NSW stroke services.

Methods: Our clinical translational initiative, the QASC Implementation Project (QASCIP), targeted stroke services to embed 3 nurse-led clinical protocols (the FeSS protocols) into routine practice. Clinical champions attended a 1-day multidisciplinary training workshop and received standardised educational resources and ongoing support. Using the …

A Weighted Gene Co-Expression Network Analysis For Streptococcus Sanguinis Microarray Experiments, Erik C. Dvergsten

Theses and Dissertations

Streptococcus sanguinis is a gram-positive, non-motile bacterium native to human mouths. It is the primary cause of endocarditis and is also responsible for tooth decay. Two-component systems (TCSs) are commonly found in bacteria. In response to environmental signals, TCSs may regulate the expression of virulence factor genes.

Gene co-expression networks are exploratory tools used to analyze system-level gene functionality. A gene co-expression network consists of gene expression profiles represented as nodes and gene connections, which occur if two genes are significantly co-expressed. An adjacency function transforms the similarity matrix containing co-expression similarities into the adjacency matrix containing connection strengths. Gene …

Considerations In The Provision Of Mental Health Services Toward Arabs, Dalia Khoury

Theses and Dissertations

Existing evidence suggests that disparities exist in the use of mental health services by Arabs in the U.S. While there are likely many factors that contribute, lack of cultural competence of mental health providers is one potentially important barrier for mental health service use among racial/ethnic minorities, including Arabs. The primary purpose of this study was to identify and examine factors related to the development and existence of cultural competence toward Arabs. Variables measuring demographics, professional characteristics, familiarity with Arabs, prior experience and knowledge of Arabs, and readiness for change were tested with a randomly selected sample of mental health …

Resolution Of Inflammation Rescues Axon Initial Segment Disruption, Nicholas M. George

Theses and Dissertations

Axonal domains are required for proper neuron function. These domains are unstable and degenerate concurrent with the inflammation in multiple sclerosis (MS) and the inflammatory disease models experimental autoimmune encephalomyelitis (EAE) and lipopolysaccharide (LPS) induced inflammation. Previous studies from our laboratory have shown that the axon initial segment (AIS) is maintained independently of the presence of myelin, but that AIS disruption is seen in MS as well as EAE and LPS-mediated inflammation. AIS loss can be interrupted in the early stage of EAE using the anti-inflammatory drug Didox. However, the potential for Didox directed repair of the AIS in later …

Influence Of Historic Landscapes And Contemporary Species Management On Chesapeake Bay Bald Eagles And Osprey, Catherine B. Viverette

Theses and Dissertations

Influence of historic landscapes and contemporary species management on Chesapeake Bay Bald Eagles and Osprey

Catherine B. Viverette

Co-distributed species with well documented demographic histories can provide good models for testing alternative hypotheses about the impact of evolutionary history, contemporary landscapes, and species management on current distribution and population structure. The Osprey (Pandion haliaetus) and Bald Eagle (Haliaeetus leucocephalus) have been extensively studied, managed and monitored across their North American breeding range, particularly in the Chesapeake Bay. We used a combination of ecological niche modelling, diet reconstruction, and population genetic modeling to understand the role of …