Medicine and Health Sciences Commons^™

Alcohol And Environmental Justice: The Density Of Liquor Stores And Bars In Urban Neighborhoods In The United States, John Romley, Deborah Cohen, Jeanne Ringel, Roland Sturm

Roland Sturm

Objective: This study had two purposes: (1) to characterize the density of liquor stores and bars that individuals face according to race, economic status, and age in the urban United States and (2) to assess alternative measures of retailer density based on the road network and population. Method: We used census data on business counts and sociodemographic characteristics to compute the densities facing individuals in 9,361 urban zip codes. Results: Blacks face higher densities of liquor stores than do whites. The density of liquor stores is greater among nonwhites in lower-income areas than among whites in lower- and higher-income areas …

Identifying Methods Nurse Managers Can Implement To Foster A Supportive Environment For Staff Where Disruptive Behavior Exists, Kathleen Leavitt

Critical and Creative Thinking Capstones Collection

We can all imagine the ideal work environment, where you are respected, empowered, and provided with the resources to perform to the best of your ability everyday. Your skills would be acknowledged and the challenging work that is accomplished each day would be appreciated by peers, team members, and managers. However, in my work environment, an operating room, a phenomenon called "disruptive behavior" often interrupts the ability of achieving this desired state. Initially I was focused on this behavior being displayed by physicians but was awakened to the fact that they are not the only offenders and that many caregivers …

Annual Report, 2006-2007, David B. Nash

College of Population Health Annual Reports

No abstract provided.

A Psuedo-Mass Of Shoulder Girdle Due To Spinal Accessory Nerve Injury After Neck Lymph Node Biopsy: A Casereport, Yen-Nung Lin, Jing-Hwa Wey, Mei-Chun Huang, Kwang-Hwa Chang, Chun-Chieh Chiu

Rehabilitation Practice and Science

Shoulder problems such as pain, weakness, limited range of motion and palpable mass are common complaints in PM&R clinic. This casereport describes a less common but not rare condition: iatrogenic accessory nerve injury after neck lymph node biopsy. The patient in this study presented symptoms of shoulder girdle pain and weakness and also complained of a ”hard palpated mass” over her shoulder girdle.A 49-year-old female complained of gradually worsening left shoulder pain accompanied by weakness and limited range of motion in her left shoulder for many months. She had sought medical advice for many times and rotator cuff pathology was …

A Novel Runx2 Missense Mutation Predicted To Disrupt Dna Binding Causes Cleidocranial Dysplasia In A Large Chinese Family With Hyperplastic Nails, Shaohua Tang, Qiyu Xu, Xueqin Xu, Jicheng Du, Xuemei Yang, Yusheng Jiang, Xiaoqin Wang, Nancy Speck, Taosheng Huang

Dartmouth Scholarship

Background: Cleidocranial dysplasia (CCD) is a dominantly inherited disease characterized by hypoplastic or absent clavicles, large fontanels, dental dysplasia, and delayed skeletal development. The purpose of this study is to investigate the genetic basis of Chinese family with CCD.

Methods: Here, a large Chinese family with CCD and hyperplastic nails was recruited. The clinical features displayed a significant intrafamilial variation. We sequenced the coding region of the RUNX2 gene for the mutation and phenotype analysis.

Results: The family carries a c.T407C (p.L136P) mutation in the DNA- and CBFβ-binding Runt domain of RUNX2. Based on the crystal structure, we predict this …

Argininosuccinic Acidemia: A Casereport, Chih-Wei Lin, Huey-Jen Lay, I-Ju Chen

Rehabilitation Practice and Science

Urea cycle disorder (UCD) is one of inborn error diseases. Citrullinemia is the most common disease (1/57000) among them, followed by argininosuccinic acidemia (ASA) (1/70000). The common characteristic of UCD is hyperammonemia induced by the abnormal liver function. Common symptoms at the onset of diseases include altered consciousness, respiratory insufficiency and seizures. Developmental delay, mental retardation, cerebral palsy, and learning disability are common findings in long-term follow-ups. In this report, we give an account of a patient with ASA. Besides the aforementioned symptoms and long-term sequelae, this patient also has the problem of ataxia. However, the patient's conditions and developments …

Exercise Training May Enhance Functional Capacity And Improve Heart Rate Impairment In Coronary Artery Disease Patients With Chronotropic Incompetence, Chen-Jung Hsu, Ssu-Yuan Chen, Ching Lan, Der-Sheng Han, Jin-Shin Lai

Rehabilitation Practice and Science

This study investigated whether coronary artery disease patients with chronotropic incompetence (CI) can significantly improve their functional capacity after exercise training. Forty-two men (mean age: 55.3±9.3yr) underwent coronary revascularization and without beta-blockade participated in a threemonth outpatient exercise training program. Patients were separated into a CI group (n=18) and a non-CI group (n=24) based on whether they could reach 85% of the age-predicted peak heart rate (HR). Chronotropic incompetence was defined as failure to achieve 85% of the age-predicted maximal HR. Bicycle exercise workouts were conducted three times weekly. The exercise duration was 30 minutes per session included 5 minutes …

Effects Of A Lateral Wedged Insole In Patients With Medial Compartment Osteoarthritis Of The Knee, Li-Wei Chou, Mu-Jung Kao, Pey-Yu Yang, Nai-Hsin Meng, Sui-Foon Lo, Hong-Wen Wu, Horng-Chaung Hsu

Rehabilitation Practice and Science

Background: Medial compartment osteoarthritis (OA) of the knee is one of the most prevalent and disabling chronic conditions affecting older adults. This study assesses the efficacy of an inserted lateral wedged insole for the conservative treatment of medial compartment knee OA.Methods: Thirteen outpatients (9 females and 4 males with a mean age of 71.0 and a standard deviation of 5.5) with medial compartment knee OA were prospectively treated with an inserted lateral wedged insole with an elevation of 12 mm for three months. The baseline and three-month visual analog scale (VAS) scores for subjective knee pain and the remission score …

Exploring The Relationship Between Body Build And Pressure Under The Ischial Tuberosity, Li-Ru Chen, Kuo-Hu Chen, Chia Lee, Ming-Shin Wang, Ting-Chang Chen, Cheng-Hsun Hsieh

Rehabilitation Practice and Science

Pressure ulcers usually occur over the ischial tuberosity of the people bound in wheelchairs. The objective of the study is to make a comparison between age, genders, and different factors of body build, including height, weight, body mass index, body fat percentage, waist circumference, buttock circumference, and mid-upper arm circumference, on their influences upon pressure under the ischial tuberosity.This experiment is a cross-sectional comparison study. We recruited 38 participants, including twenty-five males and thirteen females aged from 24 to 57. Our results showed that there were no differences on pressure under the ischial tuberosity among people of different age and …

Bilateral Putaminal Hemorrhage In A Young Female: A Casereport, Ke-Vin Chang, Wen-Shiang Chen, Huey-Wen Liang

Rehabilitation Practice and Science

Background: The etiology of spontaneous intracerebral hemorrhage (ICH) in young adults may include causative factors such as vascular abnormality, hypertension, anticoagulant therapy, brain tumor, and others. Hypertension is the most common cause of ICH in young adults in Taiwan. Simultaneous or multiple intracerebral hemorrhages are uncommon, and symmetrical distribution is even rarer. Most cases reported in the literature are in the elderly.Case: We report the case of a 29 years old female with a history of hypertension and elevated blood pressure, who presented with an acute onset of right side limb weakness. Results: Brain computed tomography (CT) showed hemorrhage in …

Rehabilitation Of Transtibial Amputation Caused By Necrotizing Soft Tissue Infections: A Casereport, Shih-Kun Chang, Wai-Keung Lee, Huei-Yu Lo, Yau-Wai Wai, Won-Jean Lin, Kien-Jung Wang

Rehabilitation Practice and Science

Necrotizing soft tissue infections is an infrequent disease. Although many studies and casereports have been presented in recent years, none have described the impact of this disease on prosthetic fitting, ambulation training, and rehabilitation for patients with transtibial amputation.A 50 year-old man suffered from left transtibial amputation and received operation of split thickness skin grafts due to necrotizing soft tissue infections. He was trained to overcome the following problems: 1. Poor endurance, cardiopulmonary function and muscle strength of bilateral lower limbs. 2. The loss of dorsiflexion in the right ankle that resulted from excision of the anterior tibialis muscle. 3. …

Self-Assessment Examination For Residents In Physical Medicine And Rehabilitation: First Experience In Taiwan, I-Nan Lien, Tyng-Guey Wang, Shin-Liang Pan, Rai-Chi Chan

Rehabilitation Practice and Science

Objective: The national Self-Assessment Examination (SAE) for residents has been held in the United States for many years. However, no similar test has been held by any medical specialty association in Taiwan. The first national SAE in Physical Medicine and Rehabilitation (PM & R) aimed to provide a benchmark for residents and medical institutes.Material and Methods: The written questions of the Certification Examination 2005 of the Taiwan Board of PM & R were used in the SAE for residents. Participants were first to third year residents in PM & R from various medical institutes and candidates for the board examination …

Medical Service Needs Of Special Education Students In Chiayi County, Taiwan, Shu-Yi Wang, Yuh-Chin Jean

Rehabilitation Practice and Science

The Buddist Tzu Chi Dalin Hospital was responsible for providing medical services to special education students of Chiayi County in 2004. We evaluated the cognitive skills, activities of daily living, language skills, and gross and fine motor functions of 160 disabled students, 113 male and 47 female. Students with mental retardation were the most frequent, followed by students with dyslalia, then autism, and attention deficit and hyperactivity disorder. A needs assessment revealed that 155, 132, and 107 students fed, dressed, and bathed themselves independently, respectively. Ninety-three students had a language disorder, 75 students had fine motor impairment, and 52 students …

Bone Mineral Density In Subjects With Cerebral Palsy: A Preliminary Study In Taiwan, Hsin-Chi Wu, Ming-Chuan Lin, Yi-Shiung Horng, Hong-Yi Chen, Kwang-Hwa Chang

Rehabilitation Practice and Science

Objective: Children with cerebral palsy (CP) have complicated disabilities, and also have the tendency to suffer from osteoporotic fractures. The aim of this study was to explore the bone mineral density (BMD) and to estimate the fracture rate in Taiwanese CP subjects.Materials and methods: To study the BMD and its related factors in 28 Taiwanese CP subjects (16 males, 12 females; age range, 2-24 years; mean age, 9.8 years), we evaluated their BMD in the lumbar spine (LS-BMD) with dual energy x-ray absorptiometry, clinical characteristics, biochemical bone metabolism-related factors, and nutritional status. The fracture rate was evaluated during a three-year …

Botulinum Toxin Type A Treatment For Drooling In Taiwanese Children With Cerebral Palsy: Three Casereports, Yu-Ching Lin, I-Ling Lin, Yu-Te Chiu, Jeng-Yi Shieh

Rehabilitation Practice and Science

Botulinum toxin is a promising treatment option for the management of drooling in patients with cerebral palsy. However, the effect of botulinum toxin type A in treating drooling of Taiwanese children with cerebral palsy has not been reported thus far. We injected single dose botulinum toxin into bilateral parotid glands of three children with cerebral palsy, and followed the results over a 9-month period. Drooling improved in all three patients without significant adverse effects during follow up. There were individual differences in terms of efficacy and duration of effect. Two patients had longer duration of effect than that reported in …

Choreoathetosis As Side Effect Of Gabapentin Therapy In A Patient With Spontaneous Spinal Epidural Hematoma: A Casereport, Min-Hsin Lai, Tzu-Yun Wang, Tsung-Ying Li, Cheng-Chiang Chang, Shin-Tsu Chang

Rehabilitation Practice and Science

Spontaneous spinal epidural hematoma (SSEH) is attributed to a spinal epidural hematoma which is not caused by incidental, traumatic, or iatrogenic (for example, lumbar puncture) procedures. SSEH is an uncommon condition causing spinal cord lesion and subsequent neurologic deficits. Spinal cord pathology is often followed by neuropathic pain which may be treated with a combination of drug regimens, such as gabapentin, tricyclic antidepressants, topic lidocaine, opioids and serotoninnorepinephrine reuptake inhibitor. We present a case of SSEH with neuropathic pain that was treated with gabapentin, morphine and imipramine. The patient developed choreoathetosis temporally related to adjunctive therapy with gabapentin at dosages …

Report On The U.S. Summit: "Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management", Janice L. Clarke

College of Population Health Faculty Papers

On Tuesday, July 17, 2007 in Washington, DC, Intel Corporation assembled a group of the nation’s most respected health leaders to discuss the issues surrounding chronic care and an aging population and explore solutions to these highly complex and increasingly urgent challenges for the US health care system. The highlevel summit, hosted by Intel Chairman Craig Barrett, was held in the auditorium of the National Museum for Women in the Arts and attended, either in person or via the simultaneous webcast, by presidents, chairmen, and executive directors of influential organizations including the National Business Coalition on Health, the National Medical …

Low Back Pain Due To Infective Discitis: A Casereport, Hung Chi Lin, Chin-Liang Liu, The-Chen Wang, Mu-Jung Kao

Rehabilitation Practice and Science

Infective discitis accompanying low back pain is uncommon. In general, risk factors for infective discitis include an age greater than 50 years, a history of cancer, unexplained weight loss, pain that lasts more than 1 month, a history of intravenous drug abuse, presence of a urinary tract infection or other infections, diabetes mellitus, and recent invasive procedures. The presence of an elevated erythrocyte sedimentation rate (ESR) and a C-reactive protein (CRP) level have proven to be reliable laboratory criteria consistent with infective discitis. Moreover, magnetic resonance (MR) imaging findings have been shown to have a good sensitivity for infective discitis. …

Antiphospholipid Antibody Syndrome With Chronic Subdural Hemorrhage: A Casereport, Yun-Fu Chou, Wei-Jang Yen, Chia-Hui Dai, Ta-Shen Kuan, Chang-Zern Hong

Rehabilitation Practice and Science

Patients who suffer antiphosphlipid antibody syndrome may have two kinds of antibodies, Anticardiolipin and Lupus anticoagulant. These antibodies may increase the risk of ischemic stroke and cerebral ischemia. However, the incidence of cerebral bleeding is relative rare. As a result, patients with antiphosphlipid syndrome often take oral anticoagulants for a long-term period to prevent ischemic stroke attack.We report a female patient who was diagnosed antiphosphlipid antibody syndrome in 1998, and took oral anticoagulants for a long period to restrain the symptom of thrombosis. The INR(International Normalized Ratio)value has been kept between 1.5 to 2.0 by controlling the dosage of oral …

Power Spectrum Analysis Of Heart Rate Variability In Full-Term And Preterm Neonates, Tsui-Fen Yang, Nien-Tzu Kao, Rai-Chi Chan, Terry-Bj Kuo, Shu-Jen Chen

Rehabilitation Practice and Science

Objective: Prematurely born infants have been believed to be neurologically less mature than full-term neonates. The purpose of this study was to investigate the regulation and maturation of autonomic nervous systems, in both full-term and preterm neonates of different conceptional ages.Methods: One hundred and thirteen infants, both clinically and neurologically healthy and with conceptional ages of between 33 and 42 weeks, were enrolled in the study. Power spectrum analyses of heart rate variability were performed under standard conditions when the subjects were in a sleeping state. Results: Conceptional age did exert a significant influence over heart rate variability. There was …

Effects Of Residence On Physical Fitness Among Adults In Taiwan, Jih-Rong Lin, Yin-Chou Lin, Cheng-Hsiu Lai, Chia-Hua Kuo, Shih-Wei Chou, Alice M. K. Wong

Rehabilitation Practice and Science

Health-related physical fitness can be assessed using four principal attributes: body composition; muscular strength and endurance; flexibility; and cardiorespiratory endurance. Factors such as the lifestyle behaviors or dietetic habits can affect physical fitness. The aim of this study is to investigate the differences in physical fitness among adults residing in different areas of Taiwan. The study was conducted between April and November 2002. In total, 19638 subjects aged 18-65 years were recruited and divided into the following three groups: (1) urban group (subjects living in Taipei and Kaohsiung City); (2) rural group (subjects living in Yunlin County, Chiayi County, Chiayi …

Autonomic Dysreflexia In Ankylosing Spondylitis With Double Spinal Cord Injuries: A Casereport, Shu-Chun Huang, Wun-Jhong Tsai, Shih-Wei Chou, Chin-Man Wang, Alice M. K. Wong

Rehabilitation Practice and Science

This 54-year-old man underlying ankylosing spondylitis suffered from double spinal cord injuries with traumatic C6/7 dislocation and a neglected L1 vertebral body fracture which progressed to transverse fracture three weeks after the injury, acting as a powerful precipitant to autonomic dysreflexia. The dysreflexic symptoms happened at least three times when he practiced sitting during mat exercise and ameliorated soon by virtue of lying down. Compared with the previous record checked three weeks ago, neurologic examination revealed alteration of sensory level and loss of deep anal sensation. The patient received L1 laminectomy as well as T12 and L2 transpedicle screws fixation, …

Bickerstaff's Brainstem Encephalitis Combined With Guillain-Barré Syndrome: A Casereport, Yi-Ping Cheng, Jo-Tong Chen, Ta-Shen Kuan

Rehabilitation Practice and Science

Bickerstaff's brainstem encephalitis is a post-infectious brainstem inflammatory disorder of unknown etiology. The characteristic symptoms include: acute ophthalmoplegia with diplopia, ataxia, disturbed consciousness, and extensor plantar response. In this report we describe a 33-year-old woman with Bickerstaff's brainstem encephalitis combined with Guillain-Barré syndrome that presented 25 days after a Cesarean section. After five treatments with plasmapheresis and intravenous immunoglobin for 5 days, the patient's muscle strength recovered to MRC 4/5. The ophthalmoplegia and bilateral extensor plantar responses also disappeared. The patient then was transferred to the PM&R department for persistent slurred speech, ataxia, and diplopia. The rehabilitation program included training …

Mice Deficient In Involucrin, Envoplakin, And Periplakin Have A Defective Epidermal Barrier., Lisa M Sevilla, Rachida Nachat, Karen R Groot, John F Klement, Jouni Uitto, Philippe Djian, Arto Määttä, Fiona M Watt

Department of Dermatology and Cutaneous Biology Faculty Papers

The cornified envelope is assembled from transglutaminase cross-linked proteins and lipids in the outermost epidermal layers and is essential for skin barrier function. Involucrin, envoplakin, and periplakin form the protein scaffold on which the envelope assembles. To examine their combined function, we generated mice deficient in all three genes. The triple knockouts have delayed embryonic barrier formation and postnatal hyperkeratosis (abnormal accumulation of cornified cells) resulting from impaired desquamation. Cornified envelopes form but are ultrastructurally abnormal, with reduced lipid content and decreased mechanical integrity. Expression of proteases is reduced and the protease inhibitor, serpina1b, is highly upregulated, resulting in defective …

Computer Alert System That Promotes Patient Safety By Identifying Possible Contraindications Of Prescribed Physical Agents, Hong-Nan Shih, Jing-Hwa Wey, Chun-Chieh Chiu, Po-Wei Lin, Tsan-Hon Liou, Chi-Hsien Chen

Rehabilitation Practice and Science

This study investigated and analyzed the prevalence of contraindications that can co-exist with a prescribed physical agent. To prevent likely complications, this study implemented a computer warning system, which prompts physiatrists to possible contraindications. Once a physical agent is prescribed, the system automatically reviewarticles the ICD-9 codes in the patients’ medical chart. Two pre-established databases are used in the warning system: one contains contraindications for each physical agent and the other has possible contraindications for each selected ICD-9 code. By cross-referencing between ICD-9 codes in a patient's chart and the two databases, the warning system was able to identify possible …

Bladder Management And Urologic Outcome In Patients With Chronic Spinal Cord Lesions, Je-Kuei Yang, Su-Ju Tsai, I-Chun Chen, Liu-Ing Bih

Rehabilitation Practice and Science

Between February and September 2004, 73 patients with spinal cord lesions of greater than 2 years duration were enrolled in this study. A chart reviewarticle was conducted to record the manner in which the patients' bladder management, previous urologic complications, and any corresponding treatments and effects. Among the patients, 55 were male and 18 were female, with an average age of 29.3±12.1 and 32.0±13.0 years, respectively. The mean duration of the patients' injuries was 9.5±6.9 years in men, and 7.0±4.5 years in women, respectively.Group Ⅰ included 8 patients (11.0%) who had indwelling catheters since the time of their injury and …

Intensive Cardiopulmonary Rehabilitation Program For Patients With Severe Heart Failure And Acute Stroke: A Report Of Two Cases, Chyi-Yann Wang, Jue-Long Wang, Ai-Lun Yang, Ko-Long Lin

Rehabilitation Practice and Science

Cardiovascular disease is a major factor restricting successful outcomes after stroke rehabilitation. While neurological recovery after stroke has been extensively investigated, cardiovascular adaptations to physical activities poststroke have received little attention. Severe heart failure patients have been well known for limitation of ambulation, but the influence over acute poststroke patients have rarely been investigated. Exercise testing has become a mainstay for the prognostic assessment of patients with heart failure. Various studies have shown that patients with impaired exercise capacity, as measured by low peak oxygen consumption (Vo2), have an unfavorable outcome, independent of other parameters. Whether parameters from submaximal test …

Hereditary Neuropathy With Liability To Pressure Palsies: A Report Of Two Cases, Chu-Hsu Lin, Long-Sun Ro, Hung-Chih Hsu, Wei-Chi Hsieh, Chih-Jung Lin, Jian-Der Lee

Rehabilitation Practice and Science

Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal-dominant disorder characterized by self-limited, recurrent compressive mononeuropathies at common entrapment sites precipitated by trivial injuries. This disorder typically develops in early adulthood. Electrodiagnostic studies revealed diffuse mild demyelinating neuropathies with entrapment over common entrapment sites. Nerve biopsies frequently show segmental demyelination and thickening of the myelin sheath which is mostly caused by 1.5 Mb deletion of the 17p 11.2 site containing the peripheral myelin protein 22 (PMP22) gene on the 17(superscript th) chromosome. This report describes the clinical features, electrodiagnostic studies, and genetic studies of a Taiwanese family. Among …

Analysis Of Hospitalization-Related Factors Among Nursing Home Residents: A Preliminary Report, I-Chun Chen, May-Lien Liu, Cheng-Hsiu Lin

Rehabilitation Practice and Science

There are increasing numbers of elderly people spending the last years of their lives in a nursing home (NH) or other long-term care institution, mostly because of physical and/or mental disabilities. NH residents may have a variety of acute illnesses; hospitalization is an important treatment option for the frail NH resident owing to the insufficient resources of NHs. The purpose of this study is to investigate the cause of hospitalization, and to analyze the correlation between the NH residents’ characteristics and hospitalization.Residents staying in the participating NH for more than one year were recruited into this study, and from September …

Epidemiology And Associated Factors Related To Congenital Muscular Torticollis In A Taiwan Regional Hospital, Miao-Ming Chen, Sung-Kai Lin, Chuan-Fa Hsieh, Hsiu-Hsi Chen

Rehabilitation Practice and Science

Introduction: Congenital muscular torticollis (CMT) is the common disease among newborn. The diagnosis of CMT was based on clinical presentation and physical examination, typically. In 1900, ultrasonography for the CMT had first been described and it had been found to be a more sensitive diagnostic tool. However, such data was scarcely in Taiwan.Purpose: To measure the incidence of CMT in Taiwan and identify associated factors in order to provide evidence for a possible etiology for CMT. Methods: We used of CMT sonography of 1021 newborns at Li-Shin hospital. Sonographic studies of the bilateral sternocleidomastoid muscle (SCM) were performed on all …