Medicine and Health Sciences Commons^™

The 'Golden Hour': A Geospatial Analysis Of Travel Time To Public Emergency Departments In Kenya, Tushara Surapaneni, Nancy Kinyua, Benjamin Wachira

Emergency Medicine, East Africa

Introduction In Kenya and many other low- and middle-income countries, prehospital care systems are underdeveloped or entirely non-existent, leaving emergency departments (EDs) as the primary point of care for medical emergencies. The aim of this cross-sectional observational study was to use a geographic information system (GIS) to comprehensively analyse access to public EDs in Kenya within 1-hour and 2-hour travel times.

Methods Using open-source GIS software, population, land cover, elevation and road network data were analysed to create maps of 1-hour and 2-hour travel time catchment areas around public EDs in Kenya. Travel time analysis was calculated using AccessMod with …

Differential Effects Of Neighborhood Ambient Pm2.5 Exposure And Social Vulnerability On Cancer-Related Systemic Inflammation By Race In A Large Health Care System Population From 2000 To 2020, Benjamin A. Rybicki, Zihan Lin, Amber L. Pearson

Biological, Geological, and Environmental Faculty Publications

BackgroundThe environment can impact cancer risk both directly, such as through the air we breathe, and indirectly, through the neighborhoods we live in. These risk factors often work in concert but can have disparate effects.MethodsTo understand how air pollution, as measured by ambient particulate matter 2.5 (PM2.5) levels and neighborhood disadvantage based on a geographically assigned social vulnerability index (SVI), may act together to impact cancer risk, we used 2000-2020 statewide cohort data from a large health system based in metropolitan Detroit, MI, USA (n = 245,438). Systemic inflammation was used as a surrogate indicator of cancer risk among study …

Pharmacokinetic Profiles Of Sertraline In Pregnancy As A Predictor Of Postpartum Depressive Symptoms, Sílvia M. Illamola, Zachary N. Stowe, Marc L. Kalin, Michael D. Evans, Catherine M.T. Sherwin, Maged M. Costantine, D. Jeffrey Newport, James C. Ritchie, Angela K. Birnbaum

Pediatrics Faculty Publications

Aim: To characterize pharmacokinetic changes of sertraline and its metabolite during pregnancy and postpartum, and their relationship to maternal postpartum depressive symptoms. Methods: This was a prospective observational, longitudinal study of pregnant women with a major depressive disorder treated with sertraline (N = 185 women, 205 pregnancies). Women were enrolled at <16 weeks' gestation and followed at 4-8 week intervals throughout pregnancy and the first postpartum year. Baseline measures included structured clinical interviews and demographic information. Drug and metabolite concentrations and psychometric measures (study outcomes) (ie, Hamilton Rating Scale for depression - 17 item, Beck Depression Inventory, Edinburgh Postnatal Depression Scale [EPDS], Clinical Global Impression [CGI]) were measured at follow-up visits. Serum sertraline and N-desmethylsertraline exposure were reported asstandardized 24-h concentration-to-dose (C/D) and parent to metabolite (P/M) ratios. Linear mixed-effects and latent trajectory models were used to characterize longitudinal patterns in concentration measures across pregnancy and postpartum, and their association with study outcomes. Results: Mean 24-h C/D ratios showed high variability throughout pregnancy and postpartuM.T.hat were characterized by three trajectories for sertraline and five for N-desmethylsertraline and P/M ratio corresponding to different sertraline pharmacokinetic profiles. At postpartum, sertraline drug exposure was inversely associated with higher EPDS score (P < .05), while N-desmethylsertraline exposure was associated with higher scores for all measured depression scales (P < .001). Higher P/M ratios had higher CGI scores (P < .05) postpartum. Conclusion: Sertraline pharmacokinetic profiles varied across pregnant women and were associated with postpartum depressive symptoms. The use of therapeutic monitoring may provide clinical insight that can be useful for identifying patients with a potential toward depressive symptoms.

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission With Inter- And Intra-Group Structural And Behavioural Heterogeneous Syringe-Sharing Networks (5), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model incorporates structural heterogeneity through a three-group interaction framework and behavioural heterogeneity through group-specific syringe-sharing rates with additional intra-group variability. The syringe-sharing population in the model is divided into core, inner, and outer circle groups representing individuals with high, moderate, and low levels of syringe-sharing interaction intensity, respectively. In addition to differences in the number of daily interaction opportunities across groups, agents in each group are assigned syringe-sharing probabilities that vary at the individual level around their …

《香港多重照顧者面對的挑戰》研究報告, Chak Kwan, Dickson Chan, Meng Soi, Florence Fong, Hiu Wai, Avery Li, Ka Chung, Tom Kwong

APIAS Research Report 研究報告

本研究以質性訪談方式，探討香港「多重照顧者」在日常生活中面對的主要困難及採用的應對策略，並就未來政策及服務提出建議。在本研究中，多重照顧者是指同時需要照顧兩名或以上家庭成員（例如長者、配偶、子女或其他親屬），而其中一名為殘疾或長期病患者。本研究共訪問了45位多重照顧者，結果顯示他們長期承受多方面的壓力，包括時間貧乏、情緒困擾、財政壓力及使用服務困難，影響他們的身心健康、人際關係及職業發展。

就照顧歷程而言，多數受訪者已持續提供照顧，需在工作、家庭與多位照顧對象之間不斷拉鋸，出現「永遠做不完」的感受。在主觀感受上，多重照顧者普遍視照顧為理所當然的責任，但同時感到沉重壓力。他們主要依靠家人分工、嚴密的時間管理、降低對家務與個人生活質素的期望，以及有限度使用社會服務來勉強維持照顧安排。然而，服務分散、申請程序繁複、輪候時間長及資訊不足，使他們難以獲得及時和合適的支援服務。

研究建議有多個方面，包括(1)推行個案經理制度、(2)建立常規化和科學化的照顧者意見收集機制、(3)調整照顧者津貼申請門檻與金額、(4)建立照顧者友善工作環境、(5)優先發展具策略性的「一站式支援」及喘息資源，以及(6)將「多重照顧者」納入長期規劃與制度設計。

Co-Occurring Vocal Symptoms In Speech-Language Pathologists: A Survey Study, Dawn M. Stanley

Journal of Human Services: Training, Research, and Practice

Vocal symptoms among speech-language pathologists (SLPs) are often overlooked in occupational voice research. In a profession where voice is the primary tool, SLPs usually neglect the instrument they ask others to protect. Vocal symptoms may arise due to high vocal demands in clinical and educational settings. Despite their expertise in communication disorders, SLPs remain an understudied population in vocal health. This study surveyed 202 SLPs to examine the experiences of vocal symptoms during clinical practice. Results indicated that SLPs reported co-occurrences of vocal effort and vocal fatigue 29 (22%) which can interfere with vocal quality when treating patients.

Issue 17: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth Mls, Stephanie Subart Pharmd

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 17

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics: 

• Management of Uncomplicated Gram-Negative Bacteremia
• Complicated Urinary Tract Infection Guidelines Update
• Ketamine vs Etomidate for RSI
• STORM-PE 
• Lung Ultrasound–Guided Weaning
•  D-Dimer for Pulmonary Embolism
• Extubation Failure
•  A Multimodal, physiology-Driven approach to pleural effusions
• Dexmedetomidine for Hyperactive …

Ten-Year Pathology-Based Cancer Registry At A Tertiary Referral Hospital In Kenya (2015–2024): Distribution Of Cancers And Completeness Of Pathology Reporting, Brian Ayara, Samuel Mukono, Rodney Adam, Shahin Sayed

Pathology, East Africa

Background Population-based cancer registries remain limited in low- and middle-income countries (LMICs). In Kenya, their coverage is below the 20% threshold recommended by the International Agency for Research on Cancer. Pathology-based registries can provide complementary data in such contexts. This study describes the distribution of cancers diagnosed at a tertiary referral hospital in Nairobi over ten years, and evaluates the completeness of pathology reporting for selected cancers using College of American Pathologists (CAP) protocols.

Methods We conducted a retrospective review of all histologically confirmed cancers at the Aga Khan University Hospital, Nairobi, from 2015 to 2024. Data were extracted from …

Benefits, Challenges, And The Way Forward: Medical Specialists' Perception On Family Physician Integration In Healthcare System In Tanzania, Juvenalius Anselm, Roselyter Riang’A, Neelam Ismail, Davis Rubagumya, Jesca Munishi, Sumayyah Saudin, Lynn Moshi, Willbroad Kyejo, Nancy Matillya

Family Medicine, East Africa

Background Family medicine provides comprehensive care by integrating biomedical, behavioral, and social sciences. While established in some sub-Saharan countries, it remains new and unintegrated in Tanzania’s public health system. Its integration is vital for healthcare reform to enhance patient care and system quality.This study aimed to understand the perceptions of medical specialists regarding the integration of family physicians into the Tanzanian healthcare system.

Methods A descriptive qualitative study was conducted through in-depth interviews with ten medical specialists from Aga Khan Hospital and Muhimbili National Hospital in Dar es Salaam. Thematic analysis was employed in this study.

Results Integration of family …

Mental Wellbeing Of Family Caregivers Of People Living With Mental Illness In Kenya: Who Cares? A Cross-Sectional Study, Norah Obungu, Fleur Meijer, Stanley Luchters

Family Medicine, East Africa

Background Although about 60% of patients with chronic mental health disorders in sub-Saharan Africa live with their relatives, burden amongst family caregivers has not been studied much. The aim of this study was to evaluate the prevalence and factors associated with caregiver burden among family caregivers of patients with chronic mental illness attending two psychiatric care facilities in Nairobi, Kenya.

Methods A cross-sectional study was conducted among 284 systematically sampled participants who completed a socio-demographic questionnaire and the Zarit Burden Interview. Moderate to severe burden was defined as a ZBI score > 41. Independent associations were examined using bivariable and multivariable …

In Vitro Pharmacological Evaluation Of Novel Cmpi Derivatives As Selective Positive Allosteric Modulators Of The Alpha4 Beta2 Nicotinic Acetylcholine Receptor, Josue Gaona, Nataly Sanchez, Wilder Felix, Nathalia Menegasso, Brisa Cea, Ganesh Thakur, Ayman K. Hamouda

School of Medicine Student Publications and Presentations

Nicotinic acetylcholine receptors (nAChRs) contribute to the pathogenesis of neurodegenerative diseases such as Parkinson’s disease (PD), where degeneration of dopaminergic and cholinergic neurons disrupts neurotransmission. The (α4)₃(β2)₂ nAChR subtype is expressed on affected neuronal populations and represents a promising therapeutic target. Positive allosteric modulators (PAMs) may enhance receptor function while preserving endogenous signaling. We evaluated chemical derivatives of CMPI [3-(2-chlorophenyl)-5-(5-methyl-1-(piperidin-4-yl)-1H-pyrazol-4-yl)isoxazol] as selective PAMs of (α4)₃(β2)₂ nAChRs. Two-electrode voltage-clamp recordings were performed in Xenopus laevis oocytes expressing defined receptor stoichiometries to assess potentiation and generate dose–response curves. Cytotoxicity was assessed in HEK cells using the MTT assay. Substitutions at the pyrazole …

An Exploratory Bayesian Network Analysis Of Weight And Feeding Outcomes In 6-Month-Old Infants With Complex Congenital Heart Disease, Amy Delaney, Mary Taylor, Julie Ann Lavoie, Roger Brown, Karen Pridhame

Speech Pathology and Audiology Faculty Research and Publications

Purpose: We aimed to explore with a Bayesian network how clinically important factors related to feeding infants with complex congenital heart disease (CCHD) are associated with each other and influence feeding outcomes. Our goal was to raise questions for further study.

Method: This descriptive study included data from 19 infants on severity of neonatal illness, early oral-motor (OM) and swallowing skills, feeding patterns, liquid and solid intake, and weight-for-age at 2 and 6 months. Bayesian network analysis was used to estimate the conditional probabilities of these variables in relation to each other and predict the 6-month weight-for-age z score and …

Ai Agent For Healthcare Education, Sudhanshu Tarale

Shelby Hall Graduate Research Forum Presentations

No abstract provided.

Eeg Features And Rotterdam Head Ct Score Predict Early Favorable Outcome In Pediatric Severe Tbi, Xuexin Lu

Presentations

INTRODUCTION Accurate prognostication after pediatric severe TBI (sTBI) remains challenging. We examined the utility of continuous EEG (cEEG) and Rotterdam head CT score in predicting short-term favorable outcome. METHODS 7-yr (01/2018-12/2024) retrospective study of children aged 1.5-18 yrs admitted to our PICU with sTBI and receiving cEEG monitoring per institutional protocol. Early favorable outcome was defined as Pediatric Cerebral Performance Category scale 1-3 at PICU discharge. cEEG features (background, sleep architecture, reactivity, and seizure) during the 1st 12-hrs of monitoring and initial Rotterdam head CT scores were recorded. Demographics, GCS score, pupillary reactivity, injury severity score (ISS), clinical seizure, cardiac …

Oral Ferrous Sulphate Supplementation Has Greater Efficacy, But Lower Tolerance Than Iron (Iii)-Hydroxide Polymaltose Complexes In Exercising Women With Low Iron Stores, Alannah Ka Mckay, Sophie Broome, Nicolin Tee, Kin Lui Yim, Marc Sim, Peter Peeling, Louise M. Burke

Research outputs 2022 to 2026

Background & Aims: Iron deficiency (ID) is a global health condition that predominately affects women. Although oral iron supplementation is an effective treatment strategy for this issue, gastrointestinal complaints are common, and if persistent, may lead to poor compliance. The efficacy of different iron formulations which claim to improve tolerance is unclear. This study assessed the efficacy and tolerability of ferrous sulphate (FS) and iron (III)-hydroxide polymaltose complex (IPC) supplementation in three different cohorts of women.. Methods: This study implemented a 12-week, single-blind, randomized controlled trial. Eligible participants had a serum ferritin concentration of <50 μg/L and met specific inclusion criteria to be enrolled to either the athlete, pre-menopausal or post-menopausal groups. Participants were randomized to receive FS (equivalent to 105 mg elemental iron) plus sodium ascorbate or IPC (equivalent to 100 mg elemental iron) daily. Venous blood samples were collected at baseline, 4-, 8- and 12-weeks of supplementation. A daily questionnaire was completed throughout the study period, documenting supplement tolerance (number and severity of symptoms), exercise load, menstrual characteristics, and supplement compliance. Results: Fifty-seven participants completed the intervention with a compliance rate of 94.9 % [range: 74.8-100 %]. A significant interaction between supplement and time was evident for ferritin (p < 0.001), where FS increased after 12 weeks (+109 %; p < 0.001) but no change was evident in IPC (+7 %; p = 0.727). No differences were detected between cohorts (p > 0.05). The IPC group had a …

Assessing Liver And Iron Markers In Steady State Pediatric Scd Patients To Ascertain The Hepatic Consequences Of Hemotransfusion: A Case-Control Study In Ghana, John Agyemang Sah, Stephen Twumasi, Allwell Adofo Ayirebi, Benedict Sackey, Enoch Odame Anto, Richard Vikpebah Duneeh, Ebenezer Senu, Veronica Barnor, David Boakye, Daniel Nii Martey Antonio, Wina Ivy Ofori Boadu

Research outputs 2022 to 2026

Background and Aims: Between 200,000 and 300,000 children with sickle cell disease (SCD) are born in Africa every year, with 75%–80% of these children living in sub-Saharan Africa. In newborns with SCD, significant iron accumulations may develop because of their increased risk of requiring multiple blood transfusions. This study aimed to assess the hepatic effects of hemotransfusion in pediatric SCD patients in steady state by measuring liver and iron markers. Methods: This case-control research enrolled 120 children with SCD and 60 children without SCD from the Asokwa Children's Hospital Sickle Cell Clinic and Child Welfare Clinic. Participants’ sociodemographic information, history …

Measuring Plantar Flexor Voluntary Activation And Maximal Voluntary Contraction In A Portable, Seated Method: A Validity And Reliability Study, Molly E. Coventry, Andrea B. Mosler, Paola T. Chivers, Brady D. Green, Ebonie K. Rio, Myles C. Murphy

Research outputs 2022 to 2026

Background: Voluntary activation testing quantifies the ability of the motor nervous system to produce maximal force. Laboratory assessment of ankle plantar flexor voluntary activation is common, but field testing in practical settings is limited by equipment portability. We aimed to compare plantar flexor voluntary activation and maximal voluntary contraction (MVC) using a portable device with a standardised laboratory method and evaluate the test–retest reliability of the portable protocol. Methods: We performed a pseudo-randomised, crossover design. Participants completed two protocols: (1) portable force plate testing and (2) a laboratory-based isokinetic dynamometer. Voluntary activation was assessed using twitch interpolation via tibial nerve …

The Relationships Between Social Network Size, Loneliness And Personality In Individuals Living With A Neurological Condition: An Exploratory Study, Isabella Branson, Kate Turner, Mitchell Turner, Manja Laws, Leah Dempsey, Simon Laws, Mandy Stanley, Johnny Lo, Travis Cruickshank

Research outputs 2022 to 2026

Background: People living with a neurological condition often report having smaller social networks and less frequent social contact, leading to greater loneliness and worse quality of life. This study explored the relationships between personality traits, social network size (SNS) and perceived loneliness in this population. Methods: Sixty-eight individuals diagnosed with a neurological condition participated in this study. Perceived loneliness was assessed using the UCLA Loneliness Scale – Version 3, SNS was evaluated by the Social Network Index and personality traits were examined using the NEO Factor Five Inventory. Path analysis was conducted to determine if loneliness was negatively associated with …

Work Challenges And Cancer-Related Cognitive Impairment: Level Of Education Accounts For Unmet Needs Beyond Cognitive Impairment Severity, Darren Haywood, Susan L. Rossell, Ashley Henneghan, Frank D. Baughman, Jennifer Haywood, Evan Dauer, Annika Hegde, Ahmed A. Moustafa, Nicolas H. Hart

Research outputs 2022 to 2026

Purpose: Cancer-related cognitive impairment (CRCI) can impact cancer survivors’ return to work and occupational functioning for many years following the completion of cancer treatment. Understanding the characteristics of CRCI-related occupational difficulties and unmet supportive care needs is critical for the development of effective interventions. Within occupational roles, a higher level of education is typically associated with greater cognitive load and different demands. The objective of this study was to examine whether the level of education accounted for CRCI-related (a) occupational difficulties and (b) occupational unmet supportive care needs, beyond the contributions of perceived cognitive functioning and employment level. Methods: A …

Essential Role Of Cd63 In Maintaining Corneal Epithelial Identity In The Human Limbus, Yuzuru Sasamoto, Kosei Suzuki, Shinri Sato, Catherine A.A. Lee, Gabrielle Martin, Bruce R. Ksander, Markus H. Frank, Natasha Y. Frank

Research outputs 2022 to 2026

Purpose: Building on the identification of ABCB5 as a marker of limbal stem cells (LSCs), this study examines CD63, a newly identified molecule co-expressed with ABCB5 in limbal epithelial cells, to define its role in maintaining corneal epithelial cell identity. Methods: RNA sequencing (RNA-seq) was performed on flow cytometry–sorted Abcb5-positive and Abcb5-negative murine corneal epithelial cells. CD63 expression in human corneal tissue was assessed by immunostaining. CD63 was silenced in cultured human limbal epithelial cells using siRNA-mediated knockdown and resulting molecular and cellular changes were analyzed by qRT-PCR, flow cytometry, RNA-seq, Western blotting, and cell proliferation assays. Results: RNA-seq analysis …

Effect Of A 6-Week Structured Exercise Intervention On Tnf-Α During The Chronic Recovery Phase Of A Burn Injury Compared To Regular Daily Activities: A Pilot Randomised Cross-Over Trial, Tyler Jerome Osborne, Grant Rowe, Dale W. Edgar, Mark Fear, Fiona M. Wood, Timothy Fairchild, Brook Galna, Pippa Kenworthy, Brad Wall

Research outputs 2022 to 2026

Background: Burn injury induces a prolonged inflammatory response that may contribute to long-term metabolic dysfunction. Exercise is known to reduce inflammation in various clinical populations; however, its effect on chronic post-burn inflammation remains unclear. This crossover trial investigated the impact of a 6-week exercise intervention on tumour necrosis factor-alpha (TNF-α) in adults with non-severe burns sustained more than one year prior. Methods: Twenty-one participants were randomised to complete either a 6-week exercise program or a control period first, separated by a 4-week washout. The exercise program comprised three supervised sessions per week of combined resistance and cardiovascular training. Primary (TNF-α) …

Participatory Action Research (Par) In Designing A Supplementary Animated Teaching Resource To Support Learning Cervical Assessment, Michelle Gray, Shelley Stuart, Melanie Welfare

Research outputs 2022 to 2026

Aim: To create an education resource that assists students to understand the movement of the cervix during labour from a posterior retroverted position to a central location, cervical effacement, dilatation of the cervix and descent of the fetal skull. Background: Learning about anatomy and physiology in relation to cervical effacement and dilatation are abstract concepts that are difficult to understand from reading alone. Diagrams are of little assistance however 3D animation has the potential to improve students learning experiences. Design: Participatory Action Research (PAR) using the 7 C's Feekery Framework approach was adopted. Participants became coresearchers in conceptualising the learning …

Physical Fitness And Executive Functions In Early Childhood: A Systematic Review Of Recent Evidence, Nemanja Lakicevic, Marko Manojlovic, Elena Chichinina, Apollinaria Chursina, Kristina Tarasova, Ewan Thomas, Yuming Zhong, Antonino Bianco, Patrik Drid

Research outputs 2022 to 2026

Background Optimizing physical fitness (PF) and developing executive functions (EFs) is of great importance in preschool children. The link between PF, obtained through repetitive physical activity, and EFs is gaining increasing attention in recent years and we sought to systematically search the literature on the relationship between PF and EFs in preschool children published in the last five years. Methods Web of Science, Scopus, and PubMed were databases searched for the relevant literature. Original studies written in English and published in peer-reviewed journals including healthy children aged 3–6 years who were simultaneously tested for PF and EFs were considered eligible. …

Clinical Insights Into The Management Of Sleep Disturbances Within Cancer Care: A Qualitative Analysis, Sam Adams, Timothy D. Clay, Mitchell Turner, Christopher Kueh, Kelly Moes, Travis Cruickshank

Research outputs 2022 to 2026

Purpose: The present study aimed to gain a deeper understanding of how oncology healthcare professionals’ (HCPs) manage sleep disturbances. Methods: Semi-structured interviews were conducted with 10 oncology HCPs (medical oncologists, oncology nurse practitioners, clinical nurse consultants) working in metropolitan Perth, Western Australia. Reflexive thematic analysis was used to understand oncology HCPs’ perspectives on treating sleep disturbances, explore challenges and barriers to their management, as well as opportunities for improvement. Results: Four main themes were developed: (1) sleep disturbances are underreported and underassessed, (2) poor sleep can be difficult to manage, (3) limited capacity to address sleep issues, and (4) opportunities …

Optimizing Agility Training In Team Sport Players—The Role Of Perception-Action Coupling: A Systematic Review With Multi-Level Meta-Analysis, Zhiwei Zhao, Yuhang Liu, Kai Xu

Research outputs 2022 to 2026

Agility, characterized by rapid whole-body movement in response to external stimuli, is a key performance determinant in team sports owing to its reliance on perception-action coupling. Despite its importance, existing evidence on training effects is disproportionately focused on change-of-direction ability, overlooking the perceptual-cognitive demands of true agility. This systematic review therefore sought to quantify the effects of agility-specific training, examine moderators and establish dose-response model in team-sport players, while accounting for perception-action coupling. Following PRISMA 2020 guidelines, systematic searches were conducted in Web of Science, Scopus and PubMed for peer-reviewed English-language studies. Risk of bias was appraised using a modified …

Pleural Metastases From Acral Lentiginous Melanoma Diagnosed By Medical Thoracoscopy, Ad Rian Chong, Khai Lip Ng, Nai-Chien Huan, Nur Husna Mohd Aminudin, Fazilah Hassan, Kasuma Mohamed Nordin

Research outputs 2022 to 2026

Acral lentiginous melanoma (ALM) with pleural metastases is rare and under-recognised. We report an 86-year-old woman with progressive dyspnoea and pleuritic chest pain. 18 months ago, she was diagnosed with stage IIC ALM of the right heel, and was treated with wide local excision, but she declined adjuvant therapy. Imaging demonstrated a large left pleural effusion with diffuse pleural thickening, pulmonary mass, and hepatic metastases. Brownish pleural fluid, along with thoracoscopic identification of multiple pigmented nodules, led to a histologically confirmed diagnosis. Talc pleurodesis was performed for symptom control, and best supportive care was pursued. This case highlights the diagnostic …

Reimagining Peer-Led Support In Doctoral Nursing And Midwifery Education: A Collaborative Autoethnographic Case Study, Gideon U. Johnson, Sachini Thennakoon, Mayumi Kumarage, Emy Toutountzis, Lisa Whitehead

Research outputs 2022 to 2026

Aim: To explore how peer-led initiatives can enhance connection, belonging and sustainability within higher degree by research (HDR) nursing and midwifery programmes. Background: HDR study can be an isolating experience, often characterised by fragmented support and limited opportunities for structured peer learning. While institutions provide formal mechanisms for supervision and progress, less attention has been given to student-led approaches that cultivate inclusive scholarly communities and sustained peer engagement. Design: Collaborative autoethnographic case study. Methods: HDR student representatives and academic staff at Edith Cowan University, Australia (2022–2024), reflected collaboratively on the design, implementation and impact of peer-led initiatives, including monthly hybrid …

Mainstreaming Mistrust: The Shift In Us Vaccine Policy Under The Trump Administration, Sanjin Musa, Amy Estlund, Megan A. Berman

Faculty Scholarship

Department of Health and Human Services led by Robert F. Kennedy Jr., represents a significant departure from long-standing public health norms. This commentary explores how historically marginalized anti-vaccine activism has moved into the mainstream of government oversight. Key actions driving this transition include the wholesale replacement of the Advisory Committee on Immunization Practices, the departure of senior CDC officials, and the public questioning of established childhood immunization schedules. Furthermore, the administration has ceased financial support for global health entities like the World Health Organization and Gavi, the Vaccine Alliance, while canceling funding for innovative mRNA vaccine platforms. 

These domestic policy …

Can We Refute A Role For Infections In Alzheimer's Disease Pathogenesis?, Zena K Chatila, Michael R Duggan, Esther Silberberg, Juan Fernandez, Lavinia A Auber, Elizabeth M Bradshaw, Nikki M. Schultek

PCOM Scholarly Works

While a growing body of literature suggests a role for infections in Alzheimer's disease (AD), microbial contributions to AD remains a contentious topic, in part due to challenges in reconciling the positive evidence with studies reporting null findings. Here, we examine the evidence that argues against a role for infections in AD, while offering mechanistic hypotheses that may account for both the negative and positive findings, including dysregulated host immunity and gene-environment interactions of AD-associated genes.

Mentorship Practices And Perceptions Of Nursing Faculty At The Aga Khan University In Uganda: A Qualitative Study, Mary Namuguzi, Sarah Nakaziba, Shamim Namukasa, Carolyne Namukwaya, Dinah Kassaman, Arnold Mwanzu, Jackline Estomihi Kiwelu, Duncan Osuka, Nazahed Mkiramweni, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Background Mentorship of new faculty helps to reduce the challenges associated with their new roles, as some lack knowledge of teaching pedagogies. This study assessed the mentorship experiences regarding practices and perceptions of new nursing and midwifery faculty at the Aga Khan University School of Nursing and Midwifery (SONAM) in Uganda.

Methodology This study used a phenomenological design. Data were collected in semistructured interviews with 11 participants, and data saturation was reached. Data were organized with NVivo 12 Pro and analyzed using framework analysis.

Findings The main themes that emerged were mentorship practices, perceptions about mentorship, and proposed mentorship guidelines. …