Medicine and Health Sciences Commons^™

Relational Intelligence: A Framework To Enhance Interprofessional Collaborative Care, Elizabeth Ekole

Walden Dissertations and Doctoral Studies

Many studies have reported that the training for practitioners does not stimulate reflexes that contribute to the tenets of teamwork and collaboration. No studies were found to investigate relational intelligence (RQ) in pharmacist-physician relationships as a catalyst for collaborative and hence cost effective quality care. This study addressed the role and potential opportunity to promote RQ as a critical leadership skill in the collaboration between pharmacists and physicians. Using RQ as the conceptual framework, this phenomenological study explored how pharmacists and physicians in a hospital setting perceive RQ as a leadership skill when working collaboratively. A total of 10 participants …

Beers Medication: Empowering The Elderly Through Education, Amanda J. Parker

DNP Projects

The elderly population (those aged 65 years and older) has an increased risk of experiencing adverse effects from their prescribed medications. These adverse effects are due to many reasons, one being changes that naturally occur in the aging body, such as diminished kidney function or decreased gastrointestinal motility. This project explores the prescribing practices of one primary care practice setting. Specifically, this project sought to determine the number of patients in a primary care practice who were prescribed medications on the Beers list and whether or not the patients received education on adverse effects. The results concluded the most frequently …

Obesity Management: Clinical Review And Update Of The Pharmacologic Treatment Options, Raymond A. Plodkowski, Megan E. Mcgarvey, Keith Reisinger-Kindle, Bradley Kramer, Erik Nelson, Jennifer Lee, Quang T. Nguyen

College of Osteopathic Medicine (TUN) Publications and Research

The toolbox of medications available for medical weight management is more robust than ever and includes a wide variety of mechanisms of actions and options for patients.

Piperlongumine (Piplartine) And Analogues: Antiproliferative Microtubule-Destabilising Agents, Mary J. Meegan, Seema M. Nathwani, Brendan Twamley, Daniela M. Zisterer, Niamh O'Boyle

Articles

Piperlongumine (piplartine, 1) is a small molecule alkaloid that is receiving intense interest due to its antiproliferative and anticancer activities. We investigated the effects of 1 on tubulin and microtubules. Using both an isolated tubulin assay, and a combination of sedimentation and Western blotting, we demonstrated that 1 is a tubulin-destabilising agent. This result was confirmed by immunofluorescence and confocal microscopy, which showed that microtubules in MCF-7 breast cancer cells were depolymerised when treated with 1. We synthesised a number of analogues of 1 to explore structure-activity relationships. Compound 13 had the best cytotoxic profile of this series, …

Continuous Stationary Phase Gradients For Planar And Column Chromatography, Veeren Dewoolkar

Theses and Dissertations

Surfaces that exhibit a gradual change in their chemical and/or physical properties are termed as surface gradients. Based on the changes in properties they are classified either as physical or chemical gradients. Chemical gradients show variations in properties like polarity, charge, functionality concentration and have found potential applications in fields of biology, physics, biosensing, catalysis and separation science. In this dissertation, surface gradients have been prepared using controlled rate infusion (CRI).

CRI is a simple method in which a surface gradient is formed by carrying out the infusion of organoalkoxysilane in a time-dependent fashion using a set infusion rate. Depending …

Total Quality System Breakdowns In Outsourced Clinical Trials, Hemali Barrios

Walden Dissertations and Doctoral Studies

Numerous deaths, tragedies, and underreported drug side effects occur in outsourced clinical trials. Total quality system breakdowns occur even though quality agreement contracts and quality management systems are used by pharmaceutical organizations. The purpose of this single case study was to explore strategies clinical quality assurance managers use to avoid breakdowns in quality with outsourced clinical trials in Asia-Pacific countries. The study included a purposeful sample of 15 clinical quality assurance managers from 1 pharmaceutical organization located in the Northeast region of the United States. The conceptual framework was von Bertalanffy's general systems theory. Face-to-face semistructured interviews or e-mail questionnaires …

The Indian Pharmaceutical Industry's Supply Chain Management Strategies, Prasad Bolineni

Walden Dissertations and Doctoral Studies

Indian pharmaceutical companies spend one-third of their revenue from supply chain management (SCM) activities due to inherently poor transportation infrastructure. SCM is a vital function for many companies, as it is usually employed to lower expenses and increase sales for the company. SCM costs are higher in India than they are in other areas of the world, amounting to 13% of India's GDP. The purpose of this study was to explore SCM strategies Indian business leaders in the pharmaceutical industry have used to reduce the high costs associated with SCM. This study used a single case study research design and …

Enhanced Osseous Integration Of Human Trabecular Allografts Following Surface Modification With Bioactive Lipids, Tiffany Wang, Jack Krieger, Cynthia Huang, Anusuya Das, Michael P. Francis, Roy Ogle, Edward Botchwey

School of Medical Diagnostics & Translational Sciences Publications

In this study, we used extracellular matrix (ECM) gels and human bone allograft as matrix vehicles to deliver the sphingolipid growth factor FTY720 to rodent models of tibial fracture and a critical-sized cranial defect. We show that FTY720 released from injectable ECM gels may accelerate callous formation and resolution and bone volume in a mouse tibial fracture model. We then show that FTY720 binds directly to human trabecular allograft bone and releases over 1 week in vitro. Rat critical-sized cranial defects treated with FTY720-coated grafts show increases in vascularization and bone deposition, with histological and micro-computed topography (microCT) evidence of …

Terpenes And Flavonoids From Salvia Apiana And Their Affinities To Cannabinoid And Opioid Receptors, Taylor Hayes

Honors Theses

Salvia apiana (white sage, Lamiacae family) plant is native to southern California and parts of Mexico. Some Native American tribes local to this region consider S. apiana to be sacred and burn the leaves as incense for purification ceremonies. The plant has been used to treat sore throats, coughs, chest colds, upper respiratory infections, and poison oak rashes. Native Americans widely used this plant in traditional Chumash healing. Infusion of the leaves is used as a diaphoretic and diuretic. The aqueous ethanolic extract of S. apiana showed moderate activity towards the CB1 receptor (58.3% displacement). The extract was fractionated on …

Exploration In The Effectiveness Of Solid Lipid Nanoparticle Formulations In Enhancing Ocular Delivery Of Win 55, 212 In The Management Of Glaucoma, Emily Ann Nesbit

Honors Theses

Glaucoma is a progressive and degenerative ocular disease which, without proper treatment, can result in permanent blindness. Due to a complex organization of lipophilic and hydrophilic ocular membranes, topical delivery of therapeutic agents has also proved to be a challenging task. Cannabinoids, such as Δ9-Tetrahydrocannabinol (THC), have intraocular pressure (IOP) lowering and neuroprotective capabilities. Due to the unfavorable physiochemical characteristics of these molecules, delivery into the eye through a topical route is very difficult. Previous research has shown that prodrug derivatization and formulations such as solid lipid nanoparticles (SLNs) improve the physiochemical characteristics and ocular bioavailability of such molecules. WIN …

Variability In Antibacterial Chemical Defenses In Caribbean Sponges Of The Genus Aplysina, Savannah Stockton

Honors Theses

Coral reefs represent one of the most diverse ecosystems on earth, providing habitat for at least 25% of all marine species. Coral ecosystems are faced with many stressors, both physical and biological, that are causing their continuing decline. Understanding the impacts of these stressors, and the resilience of coral reefs, is important to the long-term survival of these critical ecosystems. As a major constituent of marine communities, sponges are an important phylum contributing to the ecology of coral reefs. Like other components of coral reef habitats, sponges also face a wide variety of biological stressors including pathogens, predators, and competitors. …

Identification Of Inhibitors Of Fxii, Alexandra C. Bensel

Honors Theses

Hereditary angioedema is characterized by recurrent swelling of the extremities, larynx, and gastrointestinal tract. While type I and type II hereditary angioedema result from a C1-inhibitor deficiency, a new variant of the disease, type III hereditary angioedema, was recently discovered in individuals with functioning levels of the C1-inhibitor. Ongoing research has postulated that increased activity of factor XII is responsible for this new form of hereditary angioedema because it causes overproduction of bradykinin. The purpose of the experiment was to identify inhibitors of factor XII. One hundred and seventy six molecules were screened through a dose response using Human Factor …

Evaluation Of The Prevalence And Treatment Trends Of Diabetic Peripheral Neuropathy Among Patients With Diabetes In A Rural Population, Lauren Daigle

Honors Theses

Evidence for adherence to the American Diabetes Association's (ADA) screening and treatment guidelines for various health complications of diabetes in rural populations is limited. The ADA recommends annual foot and eye exams and supports the use of the Semmes-Weinstein monofilament (SWM) to detect signs of diabetic peripheral neuropathy (DPN). This study evaluated the prevalence and treatment trends of DPN among patients with diabetes in a rural population. Fifty-two individuals over the age of 18, with known Type 1 or Type 2 diabetes mellitus, were recruited to participate. Participants were asked to respond to a 29-item, multiple choice and freeform question …

Initiation And Retention In Couples Outpatient Treatment For Parents With Drug And Alcohol Use Disorders, Abbly L. Braitman, Michelle L. Kelley

Psychology Faculty Publications

The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy. Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported …

The Pharmaceutical Industry's Effect On Rheumatologists' Patterns Of Care, Frank Bailey

Walden Dissertations and Doctoral Studies

Drug makers have developed numerous techniques to influence treatment choices. Almost no information exists regarding the pharmaceutical industry's influence on rheumatologists and how these pressures could affect patient care. This phenomenological research, conducted within the framework of social exchange theory, explored the lived experiences of rheumatologists regarding their interactions with agents of the pharmaceutical industry. A researcher-designed interview protocol was used to gather feedback from 10 rheumatologists regarding how interactions with agents of the pharmaceutical industry made them feel. Using horizonalization, meaningful statements made by rheumatologists were condensed into specific themes and patterns, which provided a composite summary of their …

Novel Spoxazomicins Derived From Streptomyces Sp. Rm-14−6 Attenuate Ethanol Induced Cytotoxicity In Vitro, Meredith A. Saunders

Theses and Dissertations--Psychology

An estimated 13.9% of Americans currently meet criteria for an alcohol use disorder. Ultimately, chronic alcohol use may result in neurological deficits, with up to 85% of alcoholics exhibiting signs of cognitive decline. However, biochemical and behavioral factors contributing to this decline have remained elusive. Our ongoing research program encompasses a multi-tiered screening of a natural product library and validation process to provide novel information about mechanisms underlying these deficits and to identify novel chemical scaffolds to be exploited in the development of pharmacological treatments for alcohol use disorders in a rodent organotypic hippocampal slice culture mode. Experiment 1 sought …

High-Throughput Sequencing-Based Approaches For The Identification And Development Of Molecular Targets For Cancer Therapy, David Joel Oliver

Theses and Dissertations

Effective cancer treatment depends on the development of therapeutics that efficiently eliminate the disease without significant reduction to quality of life. Targeted therapeutics achieve these goals, but their long-term efficacy is limited by the ability of cancers to become resistant to these therapies over time. The identification of new therapeutic targets is crucial for the future of cancer treatment. In this work we present functional identification and characterization of novel targets for cancer therapy.

Loss-of-function screens are a well-founded approach for the functional identification of new therapeutic targets, and, in combination with high-throughput sequencing technology, can now be performed at …

Roles Of Nitric Oxide On Epithelial To Mesenchymal Transition And Cancer Stem Cell Phenotypes In Anoikis-Resistant Lung Cancer Cells, Phattrakorn Powan

Chulalongkorn University Theses and Dissertations (Chula ETD)

The interconversion between epithelial and mesenchymal is proposed to be a key machinery responsible for metastasis-related deaths. Likewise, cancer stem cells (CSCs) have been proposed to be a key driver of tumor metastasis. The gaseous biological mediator nitric oxide (NO) is also reported to mediate metastasis. However, the linkage between the three events and their control mechanisms under detachment condition are unclear. Since an increase of E-cadherin was frequently found in mesenchymal to epithelial transition (MET) process, we used anoikis resistance H460 lung cancer cells (AR_H460) and a 3D tumor spheroid assay and other CSC-indicating assays to investigate the role …

Probing Allosteric, Partial Inhibition Of Thrombin Using Novel Anticoagulants, Stephen S. Verespy Iii

Theses and Dissertations

Thrombin is the key protease that regulates hemostasis; the delicate balance between procoagulation and anticoagulation of blood. In clotting disorders, like deep vein thrombosis or pulmonary embolism, procoagulation is up-regulated, but propagation of clotting can be inhibited with drugs targeting the proteases involved, like thrombin. Such drugs however, have serious side effects (e.g., excessive bleeding) and some require monitoring during the course of treatment. The reason for these side effects is the mechanism by which the drugs’ act. The two major mechanisms are direct orthosteric and indirect allosteric inhibition, which will completely abolish the protease’s activity. Herein we sought an …

Design And Structure-Activity Relationship Of Small Molecule C-Terminal Binding Protein (Ctbp) Inhibitors And Investigation Of The Scope Of Palladium Multi-Walled Carbon Nanotubes (Pd-Mwcnt) Catalyst In C–H Activation Reactions, Sudha Korwar

Theses and Dissertations

C-terminal binding proteins (CtBPs) are transcriptional co-repressors involved in developmental processes, and also implicated in a number of breast, ovarian, colon cancers, and resistance against cancer chemotherapy. CtBP is a validated novel potential anti-cancer target. In this project we sought to develop potent and selective small-molecule inhibitors of CtBP. Using a combination of classical medicinal chemistry and modern computational approaches, we designed a potent inhibitor HIPP (hydroxyimino-3-phenylpropanoic acid) that showed an IC₅₀ of 0.24 μM against recombinant CtBP. Further elucidation of the structure-activity relationship (SAR) of HIPP led to the design of more potent inhibitors 3-Cl HIPP (CtBP IC …

Sulfated Dehydropolymer Of Caffeic Acid For Repair Of Lung Damage And Emphysema, Tien M. Truong

Theses and Dissertations

The complex pathobiologic mechanisms of emphysema are not fully understood, leaving this deadly disease without effective pharmacotherapy for a cure. This project hypothesized that the sulfated dehydropolymer of caffeic acid (CDSO3) exhibits Fe²⁺ chelation-based hypoxia inducible factor-1a (HIF-1a) up-regulatory protective activities against in vitro emphysematous cell death and for in vivo reversal of emphysema induced with SU5416, a vascular endothelial growth factor blocker.

Using in vitro chromogenic competitive inhibition assays, CDSO3 was shown to chelate Fe²⁺ (IC₅₀ of 23 µM), but not Fe³⁺ ions. The trypan blue exclusion and lactate

dehydrogenase assays were then employed to …

Quantitative Analysis Of 5-Chloro-2-Methoxy-N-[2-(4-Sulfamoylphenyl)Ethyl]Benzamide (Glyburide Analogue, Ga) In Mouse Plasma And Whole Blood Using A Micro-Extraction And Liquid Chromatography-Tandem Mass Spectrometry, Ankit Zalavadia

Theses and Dissertations

Pharmacokinetic evaluation of 5-chloro-2-methoxy-N-[2-(4- sulfamoylphenyl)ethyl]benzamide in mouse plasma demanded for a suitable bioanalytical method. No reported bioanalytical method exists to-date that can quantify concentration of this compound in any biological matrix. The purpose of this study was 1) to develop and validate a new bioanalytical method using a micro-extraction and LC-MS/MS to quantify the target analyte in mouse plasma and 2) to partially validate the method in whole blood. A bioanalytical method was developed and validated in both matrices for a linear concentration range of 2-1000 ng/ml. For both matrices, the reverse predicted concentration of calibration standards (-8.95% to 12.16% …

Resource Utilization And Costs Associated With Off-Label Use Of Atypical Antipsychotics In An Adult Population, Della Varghese

Theses and Dissertations

Introduction: Atypical Antipsychotics (AAPs) are approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia and bipolar disorder. AAPs are commonly used off-label to treat depression, post-traumatic stress disorder and neuropsychiatric symptoms in dementia due to lack of alternative treatment options and treatment resistance. Concerns for off-label use arise since AAPs increase the risk of cardiovascular events and death. The objectives were 1) describe patterns of RU and costs among off-label AAPs users in a nationally representative population 2) identify prevalence of off-label use in the Medicare population 3) compare RU and costs between off-label AAPs …

Curcumin/Melatonin Hybrids As Neuroprotective Agents For Alzheimer's Disease, John Saathoff

Theses and Dissertations

Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the leading cause of dementia, affecting ~5.2 million Americans. Current FDA approved medications provide mainly symptomatic relief and there are no agents available to delay or cure this disease. Multiple factors such as amyloid-β aggregates, dyshomeostasis of biometals, oxidative stress, and neuroinflammation have been implicated in the development of AD. Even though significant advances have been made in understanding the mechanisms leading to AD, the exact etiology still remains elusive. Given AD’s multifactorial nature, a multifunctional strategy of small molecule design would help to identify novel chemical templates. Recently our lab …

Exploring The Concept Of Human Oct3 Inhibitors As A Novel Class Of Antidepressants, Kavita A. Iyer

Theses and Dissertations

The Dukat laboratory developed 2-amino-6-chloro-3,4-dihydroquinazoline (A6CDQ) as a 5-HT₃ receptor ligand. A6CDQ and one of its positional isomers, the 7-chloro analog A7CDQ, produced antidepressant-like effects in the mouse tail suspension test (TST). We investigated and systematically ruled out a solely 5-HT₃ receptor or hSERT mediated mechanism of antidepressant-like effect for both A6CDQ and A7CDQ.

The role of organic cation transporter 3 (OCT3) as an alternative mechanism in the regulation of neurotransmitters including serotonin (5-HT) and the therapeutic potential of targeting hOCT3 to achieve antidepressant effects has been established. By virtue of possessing protonatable nitrogen atoms, 2-aminodihyroquinazolines could potentially …

Medication Assisted Treatment And The Three Legged Stool: Medical Providers, Chemical Dependency Professionals, And Clients, Steven Matt Magrath

Antioch University Dissertations & Theses

Opioid dependence has reached epidemic levels in the United States and around the world. With the increased prescribing of opioid pharmaceuticals and the influx of inexpensive heroin, the health care cost to society has topped $72.5 billion annually (Murphy et al., 2016). Opioid overdose deaths have now surpassed motor vehicle deaths and have tripled since 1990. In some age groups opioid overdose is the leading cause of death. This study seeks to analyze the only field that directly treats this primary brain disease: medication assisted treatment for opioid dependence. The three primary participants in this partnership include: (a) doctors and …

An Analysis Of Psychologist Postdoctoral Psychopharmacology Training Materials For Critiques Of Neurobiological Hypotheses Of Depression's Etiology, Critical Analyses Of The Dsm's Rigor, And For Consumer/Survivor/Ex-Patient Content., Chris William Nicholas Rowe

Antioch University Dissertations & Theses

There is widespread agreement that neurobiology plays a role in psychological distress and that psychiatric diagnosis and associated psychopharmacological interventions can be helpful. However, there are also unresolved issues surrounding the limits of empirical support for current diagnostic criteria, shortcomings in neurobiological explanations of psychopathology, and unanswered questions about the mechanism, safety, and efficacy of psychiatric medications. This has implications for treatment errors which can precipitate negative socio-economic and health consequences, particularly for vulnerable groups like the Consumer/Survivor/Ex-Patient (c/s/x) population. It is for these reasons that the training psychologists receive to prescribe should, in addition to integrating the critiques of …

Guidance For The Practical Management Of The Heparin Anticoagulants In The Treatment Of Venous Thromboembolism., Maureen A. Smythe, Jennifer Priziola, Paul P. Dobesh, Diane Wirth, Adam Cuker, Ann K. Wittkowsky

Journal Articles: Pharmacy Practice

Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. Despite the changing landscape of VTE treatment with the introduction of the new direct oral anticoagulants many uncertainties remain regarding the optimal use of traditional parenteral agents. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. This specific chapter addresses the practical management of heparins including low molecular weight heparins and fondaparinux. For each anticoagulant a list of the most common practice related questions were created. Each question was addressed using a …

Social Problems, Biomedical Answers? How Causes Of Social Problems Affect Choice Of Solutions, Bianca C. Dreyer

Theses and Dissertations (Comprehensive)

With rapid advances in behavioural genetics, scientists are identifying an increasing array of genetic influences on human behaviour. Public misconceptions about the function of genes often lead to the oversimplification of the role of genes in behaviour (Dar-Nimrod & Heine, 2011). To date, no study has systematically investigated whether simply learning about genetic causes of behaviour affects people’s preferred solutions to problematic behaviours. The present research program includes three studies that were designed to examine the psychological effects of exposure to genetic etiology for problematic behaviour, in particular aggression, and investigated how this information influences endorsement of solutions, rating of …

Effects Of Hiv And Drugs Of Abuse On The Blood-Brain Barrier, Gopika Hari

UROP Posters

Despite effective systemic therapy, HIV-1 infection within the brain results in neuronal degradation and neurocognitive dysfunction. This neurocognitive dysfunction is worsened in the setting of opiate abuse. The central nervous system (CNS) is protected by the blood-brain barrier (BBB), a selective barrier regulating the passage of substances from peripheral circulation into the CNS. The BBB is composed of microvascular endothelial cells encased by basal lamina, pericytes, and perivascular astrocyte endfeet. Intracellular junctional complexes comprising of adherens and tight junctions are located between the endothelial cells and form tight barrier, preventing traffic of compounds between cells (paracellular flux). Clinical and in …