Medicine and Health Sciences Commons^™

The Relationship Between Service Utilization And Medicaid Enrollees’ Trust In Health Care Providers, Huey Jen Chen

Mental Health Law & Policy Faculty Publications

Based on findings from 1990 National Co-morbidity Survey, it is estimated that nearly 20% of the U.S. population is affected by mental disorders during a given year. Approximately 5.4% of adults are considered to have a serious mental illness that interferes with their social function, and half of them suffer from severe and persistent mental illness (SMI). Mental illness imposes a high socioeconomic burden that is second only to cardiovascular disease (Kessler, Berglund, Zhao et al., 1996; Kessler, McGonagle, Zhao et al., 1994).

Among individuals with SMI, 40% do not seek any treatment from either general medical or specialty mental …

Triad Girls’ Group Treatment Manual, Michelle Levasseur, Colleen Clark

Mental Health Law & Policy Faculty Publications

No abstract provided.

The Art Of Practicing Scientific Medicine, Waris Qidwai

Department of Family Medicine

No abstract provided.

Utilization Of Services Of Homeopathic Practitioners Among Patients In Karachi, Pakistan, Waris Qidwai

Department of Family Medicine

BACKGROUND: The practice of homeopathy is becoming very popular. There is a need to study and understand as to why this is happening and to raise debate on the issue.
METHODS: The study was conducted on patients, visiting the Family Practice Centre, The Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the utilization of the services of homeopathic practitioners. The ethical requirements for conducting the study were met.
RESULTS: Three hundred and eighty-seven patients were surveyed. The study population included more women then men, with average age of 32.6 years. …

Use Of Home Remedies Among Patients Presenting To Family Physicians, Waris Qidwai, Sr Alim, Rh Dhanani, S Jehangir, A Nasrullah, A Raza

Department of Family Medicine

No abstract provided.

Use Of Folk Remedies Among Patients In Karachi, Pakistan, Waris Qidwai, Sr Alim, Rh Dhanani, S Jehangir, A Nasrullah, A Raza

Department of Family Medicine

BACKGROUND: The concept that food is medicine is being practiced in certain parts of the world, with positive outcomes on health of the population. We have such practice in Pakistan but it needs to be brought in line with the available scientific evidence.
METHODS: The study was conducted on 270 patients, visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the use of folk remedies for medicinal uses.
RESULTS: Substantial use of folk remedies for different medical conditions has been documented. The remedies included cinnamon, ginger, …

Reproductive Health Services In Kwazulu Natal, South Africa: A Situation Analysis Study Focusing On Hiv/Aids Services, Lewis Ndhlovu, Catherine Searle, Robert A. Miller, Andrew A. Fisher, Ester Snyman, Nancy L. Sloan

HIV and AIDS

This Horizons report examines the readiness of reproductive health services in South Africa, which are primarily geared to women, to deliver HIV and AIDS treatment, care, and prevention services. The goal of the study was to obtain information from a representative sample of provincial health care facilities offering reproductive health services in KwaZulu Natal to meet the growing demand for HIV/AIDS-related services. Ninety-eight hospitals, community health centers, and clinics participated in the situation analysis that identified gaps in service delivery and determined priorities for service integration. Results of the study were presented to a large audience of Department of Health, …

Empowering Communities To Respond To Hiv/Aids: Ndola Demonstration Project On Maternal And Child Health: Operations Research Final Report, Hope Humana, Linkages, National Food And Nutrition Commission, Ndola District Health Management Team, Horizons Program, Zambia Integrated Health Project

HIV and AIDS

A pre–post intervention study conducted in Zambia by Horizons and local NGOs and governmental organizations demonstrated that HIV voluntary counseling and testing (VCT) and infant feeding counseling (IFC) to mothers attending maternal and child health (MCH) clinics are vital components of any mother-to-child transmission (MTCT) reduction strategy, whether or not antiretrovirals (ARVs) are available. These interventions enable mothers to make informed and healthy decisions. Data from the Ndola Demonstration Project yielded encouraging results from efforts to improve the capacity of mothers to make informed decisions about their own health and the health of their infant. The interventions succeeded in raising …

Personality Profiles Of Iditasport Ultra-Marathon Participants, Kristin J. Stuempfle, Sherri Lind Hughes, H. Samuel Case, Deborah S. Evans

Health Sciences Faculty Publications

Each February, competitors convene in Big Lake, Alaska, to participate in the “Iditasport Human Powered Ultra-Marathon”. Who would attempt this challenging race? Personality might be one factor predicting participation. Iditasport represents a unique athletic event with a distinctive social and psychological climate that might be reflected in the personalities of the participants in many ways. This study was designed to identify the personality profile of Iditasport athletes when compared to normative populations and to explore differences between athletes competing in different race divisions.

Body Composition Relates Poorly To Performance In Ncaa Division Iii Football Players, Kristin J. Stuempfle, Frank I. Katch, David F. Petrie

Health Sciences Faculty Publications

We assessed body composition (height, body mass, body mass index, body fat by densitometry, fat mass, fat-free mass, and lean/fat ratio) and performance (10- and 40-yd sprints, pro shuttle run, vertical jump, sit and reach, and bench press) in 77 National Collegiate Athletic Association Division III football players. Data were analyzed by position and playing status. Significant differences (p less than or equal to 0.05) were found between positions for all body composition measurements and all performance tests except the sit and reach. Starters outperformed nonstarters in all performance tests except the 10-yd sprint and sit and reach ( …

Selective Expression Of Beta Tubulin Isotypes In Gerbil Vestibular Sensory Epithelia And Neurons, Brian Perry, Heather Jensen Smith, Richard F. Ludueña, Richard Hallworth

Journal Articles: Eppley Institute

The seven mammalian isotypes of beta tubulin are strikingly similar in amino acid sequence. The differences in isotypic sequence, although small, are nonetheless conserved in evolution, which suggests that they may confer distinct functional roles. If so, such roles should be reflected in the selective expression of isotypes by cell type, or even in the sorting of isotypes to within-cell pools. Hair cells of the vestibular sensory epithelia each possess a kinocilium, a microtubule-based organelle that could represent a distinct microtubule compartment, separate from the extensive microtubule network in the soma. The afferent neurons that innervate the vestibular sensory epithelia …

Cell Type-Specific Reduction Of Beta Tubulin Isotypes Synthesized In The Developing Gerbil Organ Of Corti, Heather Jensen Smith, Jonquille Eley, Peter S. Steyger, Richard F. Ludueña, Richard Hallworth

Journal Articles: Eppley Institute

There are seven isotypic forms of the microtubule protein beta tubulin in mammals, but not all isotypes are synthesized in every cell type. In the adult organ of Corti, each of the five major cell types synthesizes a different subset of isotypes. Inner hair cells synthesize only betaI and betaII tubulin, while outer hair cells make betaI and betaIV tubulin. Only betaII and betaIV tubulin are found in inner and outer pillar cells, while betaI, betaII, and betaIV tubulin are present in Deiters cells, and betaI, betaII and betaIII tubulin are found in organ of Corti dendrites. During post-natal organ …

Platelets Stimulate Fibroblast-Mediated Contraction Of Collagen Gels, Ulrika Zagai, Karin Fredriksson, Stephen I. Rennard, Joachim Lundahl, C. Magnus Sköld

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Platelets are thought to play a role in a variety of inflammatory conditions in the lung, some of which may lead to fibrosis. In the current study we tested the hypothesis that whole platelets and platelet lysate can mediate remodelling of extracellular matrix in vitro by affecting fibroblast-mediated contraction of a collagen gel. We also sought to determine to what extent platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta) contribute to this effect.

METHODS: Washed platelets, isolated from healthy blood donors, and platelet lysate (freezing and thawing), were cast together with human lung fibroblasts in three-dimensional collagen gels. …

Bekm-1 Is A Herg-Specific Toxin That Shares The Structure With Chtx But The Mechanism Of Action With Ergtx1, Mei Zhang, Yuliya V. Korolkova, Jie Liu, Min Jiang, Eugene V. Grishin, Gea-Ny Tseng

Physiology and Biophysics Publications and Presentations

ABSTRACT

Peptide toxins with disulfide-stabilized structures have been used as molecular calipers to probe the outer vestibule structure of K channels. We want to apply this approach to the human ether-a-go-go-related gene (HERG) channel, whose outer vestibule is unique in structure and function among voltage-gated K channels. Our focus here is BeKm-1, a HERG-specific peptide toxin that can suppress HERG in the low nM concentration range. Although BeKm-1 shares the three-dimensional scaffold with the well-studied charybdotoxin, the two use different mechanisms in suppressing currents through their target K channels. BeKm-1 binds near, but not inside, the HERG pore, and it …

Renovascular Hypertension: Factors Affecting The Outcome Following Surgical Revascularisation, Malik Anas Rabbani, Alia Zaidi, Syed Sohail Ali, Bushra Anas, Asmooni Younus, Syed Mansoor Shah

Section of Nephrology

This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan to evaluate factors that affect outcome following revascularisation in patients with renovascular hypertension. We included all the patients diagnosed to have renovascular hypertension, confirmed by renal angiography, between July 1997 and September 2000. Of the total 15 patients, nine were males and six were females. Eleven patients received venous grafts, three received polytetraflouroethyline (PTFE) grafts while one patient underwent angioplasty and stenting. All were followed-up for a period of nine months (median) with the range from 2 to 84 months. A total of 33.3% of the study patients …

Unusual Presentations Of Wegener's Granulomatosis: Pitfalls In Early Diagnosis, Syed Mansoor Ahmed Shah, Malik Anas Rabbani, Ambreen Gul, Aasim Ahmad

Section of Nephrology

Wegener's Granulomatosis (WG) is a disorder characterized by necrotizing granulomatous vasculitis that primarily affects the upper and lower respiratory tracts and the kidneys. Although the cause is unknown, there is strong evidence that this is an autoimmune disease and immunosuppressive therapy with cyclophosphamide and corticosteroids efficiently relieves the symptoms and, prevents relapses. We report on four cases of WG that presented with unusual features. The first patient presented with vague joint pain, blackish discoloration of the skin and leg ulcers. The second patient presented as fever of unknown origin and gingival hyperplasia. The third patient presented with hearing loss while …

Aids, Orphans, And Development In Sub-Saharan Africa: A Review Of The Dilemma Of Public Health And Development, Joe Lugalla

Institute for Educational Development, East Africa

HIV/AIDS is having devastating consequences on families, young children, and other vulnerable social groups. In this paper, I review the impact of HIV/AIDS on families and development in sub-Saharan Africa. I begin by showing the magnitude of the problem and the factors that have led to rapid spread of HIV/AIDS in this sub-continent. I discuss gender inequality, poverty, social inequality, and globalization, and show how these facilitate the rapid spread of the epidemic. I show how AIDS is creating a mass of orphans on the one hand, and how it is impacting development and creating new public health contradictions on …

An Extended Hierarchical Task Analysis For Error Prediction In Medical Devices, Phillip H. Chung, Jiajie Zhang, Todd R. Johnson, Vimla L. Patel

Faculty, Staff and Student Publications

This paper introduces an extended hierarchical task analysis (HTA) methodology devised to evaluate and compare user interfaces on volumetric infusion pumps. The pumps were studied along the dimensions of overall usability and propensity for generating human error. With HTA as our framework, we analyzed six pumps on a variety of common tasks using Norman’s Action theory. The introduced method of evaluation divides the problem space between the external world of the device interface and the user’s internal cognitive world, allowing for predictions of potential user errors at the human-device level. In this paper, one detailed analysis is provided as an …

Rigorously Assessing Whether The Data Backs The Back School, David T. Vinh, Craig W. Johnson, Cynthia L. Phelps

Faculty, Staff and Student Publications

A rigorous between-subjects methodology employing independent random samples and having broad clinical applicability was designed and implemented to evaluate the effectiveness of back safety and patient transfer training interventions for both hospital nurses and nursing assistants. Effects upon self-efficacy, cognitive, and affective measures are assessed for each of three back safety procedures. The design solves the problem of obtaining randomly assigned independent controls where all experimental subjects must participate in the training interventions.

The Physician's Perception Of Medical Error And Its Application To The Development Of An Educational Training Tool, Johnny E. Bates, Cynthia Phelps, Craig W. Johnson

Faculty, Staff and Student Publications

It is becoming clear that if we are to impact the rate of medical errors it will have to be done at the practicing physician level. The purpose of this project was to survey the attitude of physicians in Alabama concerning their perception of medical error, and to obtain their thoughts and desires for medical education in the area of medical errors. The information will be used in the development of a physician education program.

Randomized Comparisons Among Health Informatics Students Identify Hypertutorial Features As Improving Web-Based Instruction, Craig W. Johnson, Yan Xing, Lan Yang

Faculty, Staff and Student Publications

Hypertutorials optimize five features - presentation, learner control, practice, feedback, and elaborative learning resources. Previous research showed graduate students significantly and overwhelmingly preferred Web-based hypertutorials to conventional "Book-on-the-Web" statistics or research design lessons. The current report shows that the source of hypertutorials' superiority in student evaluations of instruction lies in their hypertutorial features. Randomized comparisons between the two methodologies were conducted in two successive iterations of a graduate level health informatics research design and evaluation course. The two versions contained the same text and graphics, but differed in the presence or absence of hypertutorial features: Elaborative learning resources, practice, feedback, …

Encouraging Adolescents Toward Mental Health Careers Via Website Biographies, Irmi U. Willcockson, Prabhu R. Shankar, Cynthia L. Phelps, Craig W. Johnson

Faculty, Staff and Student Publications

This project designed, developed, implemented and is currently evaluating the effectiveness of an interactive, multi-media website designed to encourage adolescents to consider careers in mental health. This Web-based learning environment features biographies of mental health scientists. Evaluation is conducted in a systematic, structured way using cognitive achievement, usability (ease of use), and affective scales (e.g., fun to use) as outcome measures

How To Teach The Eight Multiple Intelligences Developed By Howard Gardner In An Elementary Classroom, Sarah Lyle

Graduate Research Papers

This project consists of research that supports Howard Gardner's multiple intelligence theory. Definitions for each type of intelligence and specific examples of people who might exhibit each type of intelligence are included in the introduction. Several strategies for teachers to use on a daily basis as well as a curriculum development for early elementary aged students are included in this project.

Department Of Radiology-Annual Executive Summary Report-July 1, 2002 To June 30, 2003, Vijay M. Rao, M.D.

Department of Radiology Administrative Documents and Reports

94 page Department of Radiology Annual Executive Summary Report, July 1, 2002 to June 30, 2003, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Renal Cortical Necrosis: A Case Series Of Nine Patients & Review Of Literature, Syed Sohail Ali, Syed Zulfiqar Rizvi, Suhail Muzaffar, Aasim Ahmad, Akhtar Ali, Sheema H. Hassan

Department of Biological & Biomedical Sciences

Background: The purpose of this study is to review cases of renal cortical necrosis (RCN) which we came across during a period of five years, confirmed on needle biopsy specimens, with literature available so far.
Methods: All renal biopsy records between January 1996 to December 2001 at the Aga Khan University Hospital, Karachi, Pakistan were reviewed to identify patients with histologically proven renal cortical necrosis. Seven patients were also referred by the department of Nephrology, Lady Reading Hospital, Peshawar, Pakistan. Patients' medical records were reviewed for demographic, clinical, and follow up data.
Results: There were total of nine patients identified …

Quality Assessment Of A Collaborative Approach For Decreasing Drug-Related Morbidity And Achieving Therapeutic Goals, Brian J. Issetts, Lawrence M. Brown, Stephen W. Schondelmeyer, Lois A. Lenarz

Pharmacy Faculty Articles and Research

Background Collaboration between physicians and pharmacists is one approach to address drug-related morbidity and achieve therapeutic goals. A collaborative practice of pharmaceutical care has been used in the Fairview Clinics System of Minneapolis-St Paul since 1999.

Methods The quality of therapeutic determinations made by pharmacists within this collaborative practice of pharmaceutical care was studied by a 12-member panel of physicians and pharmacists who used randomly selected patient records. This was a quality improvement and care process validation component of a study evaluating the effects of drug therapy management in patients receiving prepaid medical assistance. An implicit review process was used …

Human Cytomegalovirus Chemokine Receptor Us28-Induced Smooth Muscle Cell Migration Is Mediated By Focal Adhesion Kinase And Src, Daniel N. Streblow, Jennifer Totonchy, Patsy Smith, Ryan Melnychuk, Laurel Hall, Dora Pancheva, Martine Smit, Paola Casarosa, David D. Schlaepfer, Jay A. Nelson

Pharmacy Faculty Articles and Research

The human cytomegalovirus-encoded chemokine receptor US28 induces arterial smooth muscle cell (SMC) migration; however, the underlying mechanisms involved in this process are unclear. We have previously shown that US28-mediated SMC migration occurs by a ligand-dependent process that is sensitive to proteintyrosine kinase inhibitors. We demonstrate here that US28 signals through the non-receptor protein-tyrosine kinases Src and focal adhesion kinase (FAK) and that this activity is necessary for US28-mediated SMC migration. In the presence of RANTES (regulated on activation normal T cell expressed and secreted), US28 stimulates the production of a FAK Src kinase complex. Interestingly, Src co-immunoprecipitates with US28 in …

Price Of Pharmaceuticals, Value, R&D, And Intergenerational Equity, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

"A few issues are more debated today than the price of pharmaceuticals. The debate is prompted by the lack of drug access for the world's population, the high expenditures of pharmaceutical companies in marketing and profits, and the need for research and development of new drugs."

Determination Of The Substrate-Docking Site Of Protein Tyrosine Kinase C-Terminal Src Kinase, Sungsoo Lee, Xiaofeng Lin, Nguyen Hai Nam, Keykavous Parang, Gongqin Sun

Pharmacy Faculty Articles and Research

Protein tyrosine kinases (PTK) are key enzymes of mammalian signal transduction. For the fidelity of signal transduction, each PTK phosphorylates only one or a few proteins on specific Tyr residues. Substrate specificity is thought to be mediated by PTK–substrate docking interactions and recognition of the phosphorylation site sequence by the kinase active site. However, a substrate-docking site has not been determined on any PTK. C-terminal Src kinase (Csk) is a PTK that specifically phosphorylates Src family kinases on a C-terminal Tyr. In this study, by sequence alignment and site-specific mutagenesis, we located a substrate-docking site on Csk. Mutations in the …

Carraco, Arthur, 1873-1964 (Sc 1370), Manuscripts & Folklife Archives

Manuscript Collection Finding Aids

Finding aid and scans (Click on "Additional Files" below) for Manuscripts Small Collection 1370. Hospital fee statements received by Arthur Carraco, Carrollton, Kentucky, after treatment at the Kentucky Baptist Hospital, Louisville, Kentucky.