Medicine and Health Sciences Commons^™

How Does The Use Of Telemonitoring In Adult Patients With Uncontrolled Hypertension Improve Blood Pressure Control? An Integrative Review, Lucie Bakop

Doctoral Dissertations and Projects

Hypertension is an evolving problem worldwide and it constitutes a great risk for cardiovascular diseases. Despite the research and new drugs on the market to manage high blood pressure, hypertension remains the leading cause of disability-adjusted life and death worldwide. With many people suffering from hypertension around the world, and the burden of uncontrolled hypertension, it is imperative to find an intervention that can improve blood pressure control. To better target uncontrolled hypertension, the conventional method of management of high blood pressure based on in-person visits has shown some limitations and it must be combined with a contemporary approach that …

Association Between Serum Vitamin D And Irritable Bowel Syndrome Symptoms In A Sample Of Adults, Myriam Abboud, Suzan Haidar, Nadine Mahboub, Dimitrios Papandreou, Fatme Al Anouti, Rana Rizk

All Works

Vitamin D may be associated with irritable bowel syndrome (IBS) pathways. This cross-sectional study evaluated the associations between serum Vitamin D and IBS symptoms in a sample of Lebanese adults. Participants (n = 230; mean (SD) age: 43.36 (16.05) years, 62.9% females) were adults, free of diseases affecting Vitamin D metabolism, and recruited from a large university and the surrounding community. Serum Vitamin D (25-hydroxyvitamin D) was assessed using an automated chemiluminescence micro-particle immunoassay kit. The Birmingham IBS Symptom Questionnaire total scale, and pain, constipation, and diarrhea subscales were used to study IBS symptoms. Four linear regression analyses were performed, …

How Did The Dietary Habits Of Patients With Chronic Medical Conditions Change During Covid-19?, Sahil K. Patel, Adarsh Gupta

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

CONTEXT: Previous studies have examined the changes in the dietary habits of general populations during the COVID-19 pandemic but have not focused on specific populations such as those with chronic medical conditions (CMCs). Prior to major vaccination efforts, 96.1% of deaths were attributed to patients with preexisting CMCs, thus it is important to examine how this population has endured changes.

OBJECTIVES: The purpose of this study was to identify differences in dietary habits, lifestyle habits, and food attitudes between those with CMCs compared to the populations without chronic medical conditions (non-CMCs) since the beginning of the COVID-19 pandemic.

METHODS: An …

The Impact Of Covid-19 On Physical (In)Activity Behavior In 10 Arab Countries., Haleama Al Sabbah, Zainab Taha, Radwan Qasrawi, Enas A Assaf, Leila Cheikh Ismail, Ayesha S Al Dhaheri, Maha Hoteit, Ayoub Al-Jawaldeh, Reema Tayyem, Hiba Bawadi, Majid Alkhalaf, Khlood Bookari, Iman Kamel, Somaia Dashti, Sabika Allehdan, Tariq A Alalwan, Fadwa Hammouh, Mostafa I Waly, Diala Abu Al-Halawa, Rania Mansour, Allam Abu Farha, The Regional Corona Cooking Survey Group ( The Regional Corona Cooking Survey Group (

All Works

Insufficient physical activity is considered a strong risk factor associated with non-communicable diseases. This study aimed to assess the impact of COVID-19 on physical (in)activity behavior in 10 Arab countries before and during the lockdown. A cross-sectional study using a validated online survey was launched originally in 38 different countries. The Eastern Mediterranean regional data related to the 10 Arabic countries that participated in the survey were selected for analysis in this study. A total of 12,433 participants were included in this analysis. The mean age of the participants was 30.3 (SD, 11.7) years. Descriptive and regression analyses were conducted …

Estimating The Pre- And Post-Diagnosis Costs Of Tuberculosis For Adults In Pakistan: Household Economic Impact And Costs Mitigating Strategies, Shama Razzaq, Aysha Zahidie, Zafar Fatmi

Community Health Sciences

Background: Despite free tuberculosis (TB) care in Pakistan, patients still have to bear high costs, which push them into poverty. This study estimated the pre- and post-diagnosis costs households bear for TB care, and investigated coping mechanisms among adults ≥ 18 years in Karachi, Pakistan.
Methods: We conducted a cross-sectional study comprising of 516 TB patients identified with completion of at least one month intensive treatment from four public sector health facilities from two institutes in Karachi, Pakistan. A standardized questionnaire to estimate patient's costs was administered. The study outcomes were direct medical and non-medical costs, and indirect costs. The …

The Effects Of Resistance Training On Physical Fitness And Neuromotor-Cognitive Functions In Adults With Down Syndrome, Emily M. Post, William J. Kraemer, Madison L. Kackley, Lydia K. Caldwell, Jeff S. Volek, Barbara N. Sanchez, Brian C. Focht, Robert U. Newton, Keijo Häkkinen, Carl M. Maresh

Health and Sport Sciences Faculty Scholarship

Adults with Down syndrome are an underserved population at high risk for a host of different pathologies from aging and lack of activity.

Purpose: To examine the effects of a 10-week resistance training program on measures of motor behavior, cognitive function, mood, and physical fitness.

Methods: Participants (n = 11) were men and women clinically diagnosed with Down syndrome (age: 25.8 ± 6.4 years; height: 151.5 ± 8.3 cm; weight: 67.5 ± 13.0 kg; IQ: 58.3 ± 19.7 units). After familiarization of testing procedures, subjects performed The Arizona Cognitive Test Battery for Down Syndrome, TGMD-2, lower and upper body …

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.

Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith

Master of Occupational Therapy Student Critically Appraised Topics

For this project, we created a critically appraised topic to study the effects of early mobilization on length of hospital stay in COVID-19 patients in the ICU.

Implementation Of 3-Minute Diabetic Foot Exam For At Risk Diabetic Patients In Urban Primary Care Setting, Suzana Alvarez

DNP Projects

Background: Healthcare providers manage chronic health concerns by reducing the risk of diabetic complications among their patient population. In 2017, diabetes was the seventh leading cause of death in the United States and Connecticut. In Connecticut, there are 19,500 newly diagnosed diabetics and four Connecticut cities have higher occurrence of diabetes: Waterbury, New Britain, Hartford, and Bridgeport. Bridgeport Primary Care (BPC) had no policy or procedure in place to require the providers to complete a routine diabetic foot exam. The aim of this project was to promote and implement a tool to assist the BPC providers in evaluating adult …

Association Of Trauma Center Designation With Postdischarge Survival Among Older Adults With Injuries, Molly P. Jarman, Ginger Jin, Joel S. Weissman, Arlene S. Ash, Jennifer Tjia, Ali Salim, Adil Haider, Zara Cooper

Section of General Surgery

Importance: Trauma centers improve outcomes for young patients with serious injuries. However, most injury-related hospital admissions and deaths occur in older adults, and it is not clear whether trauma center care provides the same benefit in this population.
Objective: To examine whether 30- and 365-day mortality of injured older adults is associated with the treating hospital's trauma center level.
Design, setting, and participants: This prospective, population-based cohort study used Medicare claims data from January 1, 2013, to December 31, 2016, for all fee-for-service Medicare beneficiaries 66 years or older with inpatient admission for traumatic injury in 2014 to 2015. Data …

Effect Of Computer-Assisted Cognitive Behavior Therapy Vs Usual Care On Depression Among Adults In Primary Care: A Randomized Clinical Trial, Jesse H. Wright, Jesse J. Owen, Tracy D. Eells, Becky F. Antle, Laura B. Bishop, Renee Girdler, Lesley M. Harris, R. Brent Wright, Michael J. Wells, Rangaraj Gopalraj, Michael E. Pendleton, Shehzad Ali

Counseling Psychology: Faculty Scholarship

Importance Depression is a common disorder that may go untreated or receive suboptimal care in primary care settings. Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression.

Objectives To evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.

Design, Setting, …

Serious Mental Illness And Mental Health Treatment Utilization Among Adults Residing In Non-Metropolitan And Metropolitan Counties, Tyrone F. Borders, Timothy Williams

Rural & Underserved Health Research Center Publications

Key Findings

The past year prevalence of serious mental illness (SMI) was significantly higher among non-metropolitan than metropolitan (5.90% vs. 5.18%, P < .03) adults.

Only 67.58% of non-metropolitan and 64.29% of metropolitan adults with SMI received any mental health (MH) treatment in the past year.

Additional analyses revealed the following non-metropolitan/metropolitan treatment differences:

• A higher percentage of non-metropolitan than metropolitan adults with SMI received only medication for MH treatment (24.50% vs. 18.53%, P < .02).
• A higher percentage of metropolitan than non-metropolitan adults with SMI received inpatient, outpatient, and medication (5.42% vs. 2.63%, P < .02).
• A significantly higher percentage of non-metropolitan than metropolitan adults with …

Measurement Characteristics And Correlates Of Hiv-Related Stigma Among Adults Living With Hiv: A Cross-Sectional Study From Coastal Kenya, Stanley W. Wanjala, Moses Nyongesa, Paul Mwangi, Agnes M. Mutua, Stanley Luchters, Charles R J C Newton, Amina Abubakar

Institute for Human Development

Objective We studied the psychometric properties of the 12-item short version of the Berger HIV stigma scale and assessed the correlates of HIV-related stigma among adults living with HIV on the Kenyan coast.

Design Cross-sectional study.

Setting Comprehensive Care and Research Centre in the Kilifi County Hospital.

Participants Adults living with HIV on combination antiretroviral therapy were recruited and interviewed between February and April 2018 (n=450).

Main outcome measures HIV-related stigma.

Results 450 participants with a median age of 43 years (IQR=36–50) took part in the study. Of these, 356 (79.1%) were female. Scale reliability and validity were high (alpha=0.80, …

A Preliminary Validation Of The Polish Version Of The Comprehensive Intellectual Humility Scale (Cihs), Zdzisław Kroplewski, Elizabeth J. Krumrei-Mancuso, Grażyna Bielecka, Małgorzata Szcześniak

All Faculty Open Access Publications

Background: In the last few years, empirical research on intellectual humility has grown notably, involving the elaboration of promising measures that provide a different outlook on the construct. Although all of them offer valid, theoretically sound, and meaningful contributions, we selected the 22-item Comprehensive Intellectual Humility Scale (CIHS) by Krumrei-Mancuso and Rouse for validation. The rationale for choosing this questionnaire for Polish validation stands in its multidimensional nature, which enables the study of various nuances of this psychological concept. Methods: The research was carried out with the participation of 260 adults (Study 1) and 210 adults (Study 2). The respondents …

Association Between Periodontal Disease And Oral Cancer Screening Among Us Adults: Nhanes 2011-2014, Shillpa Naavaal, Dina T. Garcia, Xiaoyan Deng, Dipankar Bandyopadhya

Dental Public Health and Policy Publications

Objectives:

To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD.

Materials and Methods:

We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥ 30 years. PD status was classified as no PD, mild/moderate PD, and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral …

Extended Functional Connectivity Of Convergent Structural Alterations Among Individuals With Ptsd: A Neuroimaging Meta-Analysis, Brianna S. Pankey, Michael C. Riedel, Isis Cowan, Jessica E. Bartley, Rosario Pintos Lobo, Lauren D. Hill-Bowen, Taylor Sato, Erica D. Musser, Matthew T. Sutherland, Angela R. Laird

Psychology Faculty Publications

Background: Post-traumatic stress disorder (PTSD) is a debilitating disorder defined by the onset of intrusive, avoidant, negative cognitive or affective, and/or hyperarousal symptoms after witnessing or experiencing a traumatic event. Previous voxel-based morphometry studies have provided insight into structural brain alterations associated with PTSD with notable heterogeneity across these studies. Furthermore, how structural alterations may be associated with brain function, as measured by task-free and task-based functional connectivity, remains to be elucidated.

Methods: Using emergent meta-analytic techniques, we sought to first identify a consensus of structural alterations in PTSD using the anatomical likelihood estimation (ALE) approach. Next, we generated functional …

Satisfaction And Effectiveness Of Opioid Pain Management Among Adults With Cystic Fibrosis: A Mixed Methods Study, Sarah Allgood, Jessica L. Zemlak, Elisabeth Dellon, Siddhartha G. Kapnadak, Jessica Goggin, Noah Lechtzin

College of Nursing Faculty Research and Publications

Background

Chronic pain is common among people living with cystic fibrosis (CF) and associated with worse clinical outcomes. Despite this, little is known about how pain is managed and how opioids are used to treat pain. The purpose of this convergent mixed methods study was to examine self-reported satisfaction and effectiveness of pain management strategies among a sample of adults with CF who are prescribed opioids.

Methods

We developed an online survey querying 4 domains - demographics, pain characteristics, pain communication, and management strategies. This was distributed nationally to adults with CF (n=48) via various online platforms. We obtained quantitative …

Practices Of Vitamin D Supplementation Leading To Vitamin D Toxicity: Experience From A Low-Middle Income Country, Siraj Muneer, Imran Siddiqui, Hafsa Majid, Nawazish Zehra, Lena Jafri, Aysha Habib

Department of Pathology and Laboratory Medicine

Introduction: The trend of prescribing VD preparations for nonspecific body aches and self-medication has increased significantly. The importance of vitamin D toxicity (VDT) has been underestimated and under recognized. This study was done to determine the frequency toxicity (>150 ng/ml) in subjects for 25-hydroxyvitamin D (25OHD) and evaluate the vitamin D (VD) supplements used by these subjects.
Methodology: This descriptive cross-sectional study was conducted at the Section of Chemical Pathology, Aga Khan University Hospital Karachi from April 2020 to March 2021. Subjects with 25OHD toxicity were contacted and information related to history of calcium and VD supplementation were collected. …

Effect Of Tracheostomy Timing On Outcomes In Patients With Traumatic Brain Injury, Talha Mubashir, Hongyin Lai, Emmanuella Oduguwa, Rabail Chaudhry, Julius Balogh, George W Williams, Vahed Maroufy

Journal Articles

Tracheostomy following severe traumatic brain injury (TBI) is common, yet the outcomes associated with tracheostomy timing are unclear. The objective of this study was to assess hospital outcomes of tracheostomy timing in TBI patients. We retrospectively analyzed data from the National Inpatient Sample database of adult patients aged ≥18 years with a primary diagnosis of TBI. Indexed hospitalizations of TBI patients who underwent either percutaneous or surgical tracheostomy between 1995 and 2015 in the United States were included. The interventional groups were 1) early tracheostomy (≤7 days) vs standard tracheostomy (8-14 days), vs late tracheostomy (≥15 days), and 2) tracheostomy …