Medicine and Health Sciences Commons^™

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Faculty Articles

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Public Health Emergency Preparedness Terminology: Using An Interactive Game To Introduce Complex Words And Definitions, Julie Gleason-Comstock, Tim Spannaus, Ellen Marks, Deborah Charbonneau, Alicia Streater

Michigan Journal of Public Health

Objectives. An educational reinforcement exercise, using a bingo game, introduced students to challenging public health emergency preparedness terminology in order to pilot test the use of a game as an efficient method of learning a new vocabulary and definitions. Knowledge of the language of emergency preparedness and a fast and fun way to stay current could contribute to better coordination among public health personnel and their community partners. Methods. A bingo game, developed using Macromedia Flash and XML files, and delivered within the Blackboard™ Course Management System was tested with first year medical students in a library orientation, and graduate …

Clinical Case Mix And Other Challenges To Detroit's Medicaid-Dependent Nursing Homes, Richard L. Douglass, William Lavery, Paul Bridgewater, Gloria Long, Joyce Blair

Michigan Journal of Public Health

Nursing homes that care for the poor in Detroit are frequently dependent upon Medicaid as their principal source of revenue. These facilities face numerous challenges because they face limited resources for maintenance of facilities, staff and administrative supports, and other normal costs. They lack the kinds of support that are provided in-kind, or by more generous sources of revenue and are often characterized as institutions of poor quality; yet nearly 70% of the nation’s Medicaid-recipient elderly nursing home patients are in for-profit facilities that are sustained largely on Medicaid funding. These facilities are often sources of care for underserved minority …

Ethical Dilemmas In Publishing A Journal Of Public Health Practice, Harry Perlstadt

Michigan Journal of Public Health

No abstract provided.

Letters To Mjph, Patricia D. Mail

Michigan Journal of Public Health

No abstract provided.

John B. Waller, Jr, Drph: A Celebration Of Life In Public Health A Tribute In The Michigan Journal Of Public Health

Michigan Journal of Public Health

No abstract provided.

Fulminant Hepatic Failure Bridged To Liver Transplantation With Molecular Adsorbent Recirculating System: A Single Center Experience, Cataldo Doria Md, Lucio Mandala Md, Victor L. Scott Md, Salvatore Gruttadauria Md, Ignazio R. Marino Md

Department of Surgery Faculty Papers

Purpose: We herein describe the clinical course of a consecutive series of fulminant hepatic failure patients treated with molecular adsorbent recirculating system, a cell-free albumin dialysis technique. From November 2000 to September 2002, 7 adult patients age 22-61 (median 41), one male (14.2%), and 6 females (85.7%), affected by fulminant hepatic failure, underwent 7 courses (1 to 5 session each, six hours in duration) of extracorporeal support using the molecular adsorbent recirculating system technique. Pre and post treatment blood glucose, liver function tests, ammonia, arterial lactate, electrolytes, hemodynamic parameters, arterial blood gases, liver histology, Glasgow Coma Scale, and coagulation studies, …

Enhanced Disease Surveillance Through Private Health Care Sector Cooperation In Karachi, Pakistan: Experience From A Vaccine Trial, M. Imran Khan, Shah Muhammad Sahito, Mohammad Javed Khan, Shafi Mohammad Wassan, Abdul Wahab Shaikh, Ashok Kumari Maheshwari, Camilo J. Acosta, Claudia M. Galindo, Rion Leon Ochia, Shahid Rasool, Sheeraz Peerwan, Mahesh K. Puri, Mohammad Ali, Afia Zafar, Rumina Hasan, Lorenz Von Seidlein, John D. Clemens, Shaikh Qamaruddin Nizami, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

INTRODUCTION: In research projects such as vaccine trials, accurate and complete surveillance of all outcomes of interest is critical. In less developed countries where the private sector is the major health-care provider, the private sector must be included in surveillance systems in order to capture all disease of interest. This, however, poses enormous challenges in practice. The process and outcome of recruiting private practice clinics for surveillance in a vaccine trial are described.
METHODS: The project started in January 2002 in two urban squatter settlements of Karachi, Pakistan. At the suggestion of private practitioners, a phlebotomy team was …

Living With Globalization: A Menace Or A Chance?, Fauziah Rabbani, Babar T Shaikh, Sarah Wamala

Community Health Sciences

No abstract provided.

Waldenstrom's Macroglobulinemia Terminating In Acute Myeloid Leukemia, Safoorah Khalid, Salman Adil, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Waldenstrom's macroglobulinemia (WM) is a rare condition, accounting for approximately 2% of haematologic malignancies. The most common causes of death in these patients are progression of the malignant lymphoproliferative process, infection and cardiac failure. Acute leukemia is a rare event in the clinical course of WM. A number of case reports have documented the development of terminal acute leukemia in patients with WM following prolonged chemotherapy.

Extra Pulmonary Uptake Of Tc-99m-Maa Perfusion Lung Scan As A Result Of Right To Left Intra Cardiac Shunt, Riffat Hussain, Maseeh-Uz-Zaman, Sohail Abrar Khan, M Nadeem Ahmad

Department of Pathology and Laboratory Medicine

Extra pulmonary accumulation of Tc-99m-macroaggregate of albumin (MAA) is rarely seen on perfusion lung scan, and has been reported in less than 4% of a study population of nearly 380 patients1. It occurs when the agent bypasses the lungs due to a right to left (R-L) cardiac or pulmonary shunt, when it is shunted to the portal vein before reaching the right atrium and ventricle of the heart, and when the agent is degraded to a submicron particle size.2 When a pharmaceutical problem is excluded, extra-pulmonary uptake implies unusual hemodynamics with a shunt.

Pharmaceutical Research: Paradox, Challenge Or Dilemma?, Abdul Latif Sheikh

Community Health Sciences

A great deal of pharmaceutical research is nowadays carried out in developing countries such as Pakistan. Is it, however, beneficial for the country and the participants, often the poorly educated and illiterate? Pharmaceutical research in Pakistan can bring benefits to both patients and country. Promotion of good clinical practice and the development of national guidelines are advocated. Government and industry both have a role to play to maintain the right balance.

Private Drug Sellers Education In Improving Prescribing Practices, Waris Qidwai, Mukesh Kumar Krishanani, Saman Hashmi, Rubina Abu Ali

Department of Family Medicine

OBJECTIVE: To determine the education of private drug sellers as an intervention tool in promoting rational use of medicines for diarrhoea at private drug outlets in a rural setting.
PLACE AND DURATION OF STUDY: The study was conducted at Mithi, Tharparkar in rural Sindh in August 2005.
PATIENTS AND METHODS: Diarrhea was selected to study drug-prescribing habit of private drug sellers. Evidence-based guidelines for control of diarrhea were developed along with simulation cases and keys. In phase-1, simulators were sent to 6 private drug sellers and their prescription was noted. After phase-1, 3 private drug sellers were educated …

Low Blood Pressure Syndrome: A Myth Or A Reality? Results Of A Patient's Survey At A Teaching Hospital In Karachi, Waris Qidwai, Bheesham Tara Chand

Department of Family Medicine

Objective: To study patient’s knowledge, perceptions attitude and practice with regard to low blood pressure.
Design: A Questionnaire-based survey.
Settings: Family Practice Center, Aga Khan University Hospital, Karachi, Pakistan, in June 2004.
Main outcome measures: Low blood pressure is a disease, causes and treatment of low blood pressure, patient ever suffered from low blood pressure, low blood pressure can be diagnosed with BP apparatus, without apparatus and stress can cause low blood pressure.
Results: A 110 patients were interviewed. Majority of the subjects were educated young married men, well placed socio-economically. A majority (73%) of the …

Psychological Stress Among Family Practice Patients Visiting A Teaching Hospital In Karachi, Waris Qidwai, Malika Kassamali

Department of Family Medicine

Objective: To study psychological stress among family practice patients to highlight its importance.
Design: A cross sectional study. Setting: Family Practice Center of Aga Khan University Hospital, Karachi - Pakistan, in July 2003. Patients and Methods: Family practice patients were interviewed without using any systematic randomization. A questionnaire was developed that included data on demographic profile of the patient and questions on patient perceptions whether they were in stress or not, the degree of stress if perceived to be present and its causes including need to seek medical help. They were simultaneously administered a stress screening questionnaire that …

Castleman's Disease -- A Rare Disease Of Lymph Nodes, Mohammad Zakiullah, Zafaruddin Khan, Riaz Qureshi, Suhail Muzaffar

Department of Family Medicine

Castleman's disease is a rare disorder of unknown etiology and different clinical manifestations, occurring in young adults (usually prior to age 30 years). In this case report we present one such case who was a 16 years old male with abdominal pain, weight loss, cervical lymph adenopathy and hepatosplenomegaly. Lymph node biopsy revealed hyaline-vascular type of Castleman's disease. He was put on chemotherapy but was lost to follow-up.

Identification Of Seventh-Day Adventist Health Core Convictions : Alignment With Current Healthcare Practice, Randall L. Haffner

Dissertations

Purpose. The prevailing literature suggests that organizations can sustain their vitality and longevity by preserving their core ideology. The purpose of this study is to define and articulate the core convictions of Seventh-day Adventist healthcare and then investigate how the leaders' and employees' cognitive understandings, behaviors, and affective attachments align at Florida Hospital in Orlando, Florida.

Method. This two-phased sequential exploratory study utilizes qualitative research to define the core convictions of Seventh-day Adventist healthcare through historical literature review, analysis of official Church publications, four commissioned scholarly papers, and one-on-one interviews with seasoned healthcare administrators. These findings are then used to …

Calibrating The Wealth And Health Of Nations: Trade, Health, And Foreign Policy After The Wto's First Decade, David P. Fidler

Articles by Maurer Faculty

One of the most important themes to emerge from the relationship between trade and health in the first ten year's of the WTO's existence is the challenge of achieving policy coherence. This task is a foreign policy challenge for WTO Members, which requires looking at the relationship between trade and health against the backdrop of the making and implementing of foreign policy. Policy coherence has generally become a major concern for foreign policymakers because post-Cold War trends, such as accelerating globalization, seriously challenge traditional foreign policy assumptions, practices, and institutions. Part of this new context for foreign policy involves the …

Alliances, The University Of New Mexico Health Sciences Center

Alliances

The University of New Mexico Health Sciences Center magazine.

Enrolled Nurses' Attitudes, Subjective Norms, Intentions And Behaviour Related To Independent Medication Administration, Donna Sayers

Theses : Honours

The purpose of this quantitative descriptive research study was to investigate Enrolled Nurses' attitudes, intentions and behaviour in relation to independent medication administration (IMA). This research was necessary as a significant number of Enrolled Nurses (ENs) are now able to administer medications up to Schedule Four level, without supervision when they have completed a medication administration programme (MAP). This change in the scope of practice for the EN will eventually be introduced nationally as recommended by the National Review of Nursing Education (2002). Anecdotal reports suggest that IMA is causing concern for the EN but little or no research has …

Nurses' Decision Making Processes Regarding Indwelling Catheter Insertion And Removal, Helen Hull

Theses : Honours

Urinary catheterisation remains a common procedure conducted by nurses often as a result of autonomous decision making. This research aimed to identify and describe the lived experience of nurses' decision making processes regarding the insertion and removal of urinary catheters. The research was believed to be important as there is a myriad of literature on what is best practice but very little on what is actually taking place in nursing practice. A qualitative phenomenological study design was chosen, where nurse participants were interviewed using open-ended questions. Descriptive phenomenology was the chosen method which follows in Heidegerr's tradition that allowed nurses …

Sex Differentiation And Sexually Dimorphic Disease, Emily A. Jefferson

Theses : Honours

Sexual dimorphism of the central nervous system is a still widely debated and an area of much research. Conclusive evidence that anatomical and physiological differences in the CNS exist has been reported by post-mortem studies and magnetic resonance imaging (MRI). This present study seeks to contribute to the understanding of the differences in the brain between genders and to ascertain reasons as to why the literature is so varied. A number of structures such as the cerebral cortex, hypothalamic nuclei and the amygdala have proven to be significantly larger within males as opposed to females. The nuclei of the hypothalamus …

Exploring The Notion Of Emotional Attachment In Orford's Model Of Addiction : Review, And A Step Towards Operationalising Orford's Concept Of Strong Attachment In Addiction : A Qualitative Study, Kate E. Baily

Theses : Honours

Orford's (2001) notion that a strong emotional attachment to an object (drug) or activity (gambling) is a central component of addiction has received little empirical attention. The published research on attachment to inanimate objects was reviewed and led to the following conclusions. First, attachment theory has been validly applied to people's relationships with inanimate objects. Second, researchers have developed technologies (e.g., psychological measures, operational definitions) to enable empirical research in this area. Third, this research is in its early phases, but has produced reliable standardised measures of people's emotional attachment to brands. Further research is needed to operationalise Orford's (2001) …

Effect Of A Paediatric Incentive Spacer And Reinforcement Of Inhalation Technique Training In Preschool Children, Jasminka Murdzoska

Theses : Honours

Incorrect inhaled drug delivery technique is a common problem in paediatric asthma [1-4]. Previously, device technique training has been shown to significantly improve inhaler skills, using subjective methods, namely check-list analysis [5-8]. However, more objective measures are needed to examine more comprehensively the effect of training in preschool children and parents. Resistance to regular asthma therapy is also a frequent problem when attempting to treat young children. Reasoning with young children can be very difficult and parents often have to struggle with their child to achieve compliance [2]. The Funhaler spacer (FH) (Funhaler™; InfaMed, Australia) has been developed in an …

Molecular Epidemiology Of Antibiotic Resistant Salmonella Enterica Strains From Different Animal And Human Sources In Ireland, David George Lee

Theses

In this study, 176 isolates of Salmonella were collected from different laboratories in Ireland. All isolates were confirmed to be of the genus Salmonella by performing bacteriological and biochemical tests. Briefly, all isolates were cultured onto XLD agar after which pure cultures were verified and stocked at this institute. Definitive identification was carried out using the API 20-E system and a separate urease test was also performed on all isolates. After confirmation of the genus, all isolates were prepared for antibiotic susceptibility testing and r-types were determined using sixteen antibiotics. Depending on the antibiotic resistance profiles, isolates were selected for …

A Holistic Self-Identity Model, Jacquelyne R. Joens

Graduate Research Papers

Parents, educators, business leaders, political leaders, and mental health professionals all appreciate the impact positive self-esteem has on a person's ability to strive and grow. Self-esteem is a complex, multifaceted component of human existence. It is possible to identify and observe the result of a healthy self-esteem or even the outcome of a damaged self-esteem, but the term self-esteem may be antiquated and no longer exemplary of a complete picture of self. This paper examines research and attempts to define a multi-dimensional model of self-esteem, a Holistic Self-Identity Model, which will help to bring into focus the concept of self-identity …

Are Residents' Extended Shifts Associated With Adverse Events, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

First paragraph:

Heated debates and controversies surrounding the regulation of medical residents’ work hours have raged for over twenty years. In the wake of Libby Zion’s untimely death in 1984 and resulting recommendations by the Bell Commission, New York State enacted legislation (Code 405.4) governing residents’ working conditions and supervision [1]. Since then, there has been growing interest in regulating residents’ work hours, culminating recently (2003–2004) in national guidelines and legislation on duty-hour restrictions both in the United States and Europe [2,3].

Engendering Student Empathy For Disabled Clients With Urinary Incontinence Through Experiential Learning, Karen A. Karlowicz, Kay L. Palmer

Ellmer School of Nursing Faculty Publications

As part of a rehabilitation clinical course for senior baccalaureate nursing students, a disability-incontinence experiential learning activity is required. The assignment is intended to familiarize students with some of the challenges encountered by a client with mobility problems, including continence management issues using disposable undergarments. Wearing the undergarments dry and wet while being confined to a wheelchair provides insight and promotes empathy for patients with bladder control problems.

Effects Of Gesture+Verbal Treatment For Noun And Verb Retrieval In Aphasia, Anastasia M. Raymer, Floris Singletary, Amy Rodriguez, Maribel Ciampitti, Kenneth M. Heilman, Leslie J. Gonzalez Rothi

Communication Disorders & Special Education Faculty Publications

Links between verbs and gesture knowledge suggest that verb retrieval may be particularly amenable to gesture+verbal training (GVT) in aphasia compared to noun retrieval. This study examines effects of GVT for noun and verb retrieval in nine individuals with aphasia subsequent to left hemisphere stroke. Participants presented an array of noun and verb retrieval deficits, including impairments of semantic and/or phonologic processing. In a single-participant experimental design, we investigated effects of GVT for noun and verb retrieval in two counterbalanced treatment phases. Effects were evaluated in spoken naming and gesture production to pictured objects and actions. Spoken naming improvements associated …

Word-Retrieval Treatment In Aphasia: Effects Of Sentence Context, Anastasia Raymer, Francine Kohen

Communication Disorders & Special Education Faculty Publications

Word-retrieval treatment studies in aphasia have reported the greatest influences on picture naming for trained words. To increase treatment effects to untrained words and sentence contexts, we investigated a sentence-reading treatment hierarchy that moves from errorless to generative production of sentences incorporating target nouns and verbs. In an individual with nonfluent aphasia, treatment resulted in improved picture naming for nouns and verbs and generalized increases in numbers of grammatical sentences and content words following noun therapy. A second individual with fluent aphasia improved little in picture-naming and sentence-generation tasks for both nouns and verbs. This sentence-based word-retrieval training, in which …