Medicine and Health Sciences Commons^™

Evidence-Based Practice Approach Over Three Visits In The Management Of A Patient With Tibio-Femoral Osteoarthritis: A Case Study, Sjaan R. Gomersall, Maureen P. Mcevoy

Internet Journal of Allied Health Sciences and Practice

Supervised training is essential for developing an evidence-based practice (EBP) approach for future health care clinicians. While the skills associated with asking a research question, accessing databases for best research evidence (BRE), and appraising this evidence can be taught in the classroom, the day-to-day application into patient management needs to be taught, and there is a lack of best practice models for this. This case study of a patient with osteoarthritis of the knee demonstrates over a series of three clinic visits how EBP can be used as a framework for guiding assessment and management from the perspective of a …

Regulation Of The Mazef Toxin-Antitoxin Module In Staphylococcus Aureus And Its Impact On Sigb Expression, Niles P. Donegan, Ambrose L. Cheung

Dartmouth Scholarship

In Staphylococcus aureus, the sigB operon codes for the alternative sigma factor σ^Band its regulators that enable the bacteria to rapidly respond to environmental stresses via redirection of transcriptional priorities. However, a full model of σ^Bregulation in S. aureus has not yet emerged. Earlier data has suggested that mazEF, a toxin-antitoxin (TA) module immediately upstream of the sigB operon, was transcribed with the sigB operon. Here we demonstrate that the promoter P_mazE upstream of mazEF is essential for full σ^B activity and that instead of utilizing autorepression typical of TA systems, sigB …

Drug Abuse Treatment Beyond Prison Walls, Carl Leukefeld, Carrie B. Oser, Jennifer Havens, Michele Staton Tindall, Jennifer Mooney, Jamieson B. Duvall, Hannah Knudsen

Behavioral Science Faculty Publications

The period surrounding release from prison is a critical time for parolees, bearing the potential for a drug-free and crime-free life in the community but also high risks for recidivism and relapse to drugs. The authors describe two projects. The first illustrates the use of a formal Delphi process to elicit and combine the expertise of treatment providers, researchers, corrections personnel, and other stakeholders in a set of statewide guidelines for facilitating re-entry. The second project is a six-session intervention to enable women to protect themselves against acquiring or transmitting HIV in their intimate relationships.

Impact Of Poor Quality Of Life On Adolescents In Rural Kentucky: A Brief Report, Hatim A. Omar, Søren Ventegodt, Joav Merrick

Pediatrics Faculty Publications

In many rural areas in Kentucky, adolescents lack the basic assets for a good quality of life, such as having caring adults, a safe place and useful activities after school. Methods: Analysis of data from middle and high school students referred to a comprehensive school based health promotion center (SBHPC). Results: From august 2006 to February 2008, a total of 382 students (200 female, 182 male, aged 12-18 years) were referred to the SBHPC for help. Only two (0.5%) students had two parents living with them and 12 (3.1%) had safe, organized after school activities. 19.9% of the total were …

Use Of Instructional Video To Prepare Parents For Learning Infant Cardiopulmonary Resuscitation, Timothy S. Brannon, Lisa A. White, Julie N. Kilcrease, Lashawn D. Richard, Jana G. Spillers, Cynthia L. Phelps

Faculty, Staff and Student Publications

Parents of premature infants often receive infant cardiopulmonary resuscitation (CPR) training prior to discharge from the hospital, but one study showed that 27.5% of parents could not demonstrate adequate CPR skills after completing an instructor-led class. We hypothesized that parents who viewed an instructional video on infant CPR before attending the class would perform better on a standardized skills test than parents who attended the class with no preparation. Parents randomized to the intervention (video) group viewed the video within 48 hours of the CPR class. Parents in the control group attended the class with no special preparation. All parents …

Cases Of Subconjunctival Hemorrhage After A Joy Ride, Roomasa Channa, Sana Shoukat Memon, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

No abstract provided.

Discovery And Scoring Of Protein Interaction Subnetworks Discriminative Of Late Stage Human Colon Cancer, Rod K. Nibbe, Sanford Markowitz, Lois Myeroff, Rob M. Ewing, Mark R. Chance

Faculty Scholarship

We used a systems biology approach to identify and score protein interaction subnetworks whose activity patterns are discriminative of late stage human colorectal cancer (CRC) versus control in colonic tissue. We conducted two gel-based proteomics experiments to identify significantly changing proteins between normal and late stage tumor tissues obtained from an adequately sized cohort of human patients. A total of 67 proteins identified by these experiments was used to seed a search for proteinprotein interaction subnetworks. A scoring scheme based on mutual information, calculated using gene expression data as a proxy for subnetwork activity, was developed to score the targets …

Assessment Of Knowledge & Practice Of Contraceptives In Females Of Reproductive Age Group At A Tertiary Care Hospital, Nabeela Fazal Babar, Mahmood Ahmed, Muhammad Babar Khan, Muhammad Wasif Khan

Department of Surgery Docs

Abstract

Objectives: To assess the knowledge & practice of contraceptives in females of reproductive age group.
Study Design: Cross sectional descriptive.
Place and Duration of Study: OPD of Fauji Foundation Hospital from February 2008 – September 2008.
Subjects and Method: 339 Females of age b/w of 15 – 49 years attending OPD of Fauji Foundation Hospital were included in study. A structured questionnaire was used to collect data.
Results: Eighty eight percent of the females in our study sample were familiar with one or more methods of contraception (72.7%were familiar with combined oral contraceptive pill (COCP), 60.7% were aware of …

Immediate Effect Of Heel-Pain Orthosis And An Augmented Low-Dye Taping On Plantar Pressures And Pain In Subjects With Plantar Fasciitis, Tracy Andus

Human Movement Studies & Special Education Theses & Dissertations

Research has been done investigating plantar pressures and pain in subjects with pathologies after the application of orthoses and arch taping. To date, however, no study has been conducted investigating plantar pressures and pain in subjects with plantar fasciitis after the application of the augmented low-dye taping (ALD) in comparison to a heel-pain orthosis (HPO). Therefore, the purpose of this study was to determine the effects of the ALD in comparison to a HPO on pain, peak plantar pressure (PPP), and mean plantar pressure (MPP) under multiple areas of the foot in subjects with plantar fasciitis while walking and jogging. …

The Effects Of Isolated Hamstring Fatigue On Jump Landing In Healthy Recreational Athletes, Kristen Anne Phillips

Human Movement Studies & Special Education Theses & Dissertations

The musculature of the lower extremity provides dynamic stability during daily and athletic tasks. In landing tasks, the lower extremity absorbs forces and reduces excessive stresses and motions that are placed upon the body. Neuromuscular fatigue has been linked to an increase in injury and altered kinematics during jump landing tasks. The purpose of this study was to analyze the effects of hamstring fatigue on knee and hip kinematics pre and post hamstrings fatigue while landing from a box drop of 30cm height, during the stop-jump phase. The study aimed to quantify the kinematic data of the hip and knee …

Long-Term Survival After Multidisciplinary Management Of Resected Pancreatic Adenocarcinoma, Matthew H G Katz, Huamin Wang, Jason B Fleming, Charlotte C Sun, Rosa F Hwang, Robert A Wolff, Gauri Varadhachary, James L Abbruzzese, Christopher H Crane, Sunil Krishnan, Jean-Nicolas Vauthey, Eddie K Abdalla, Jeffrey E Lee, Peter W T Pisters, Douglas B Evans

Faculty, Staff and Student Publications

INTRODUCTION: Actual 5-year survival rates of 10-18% have been reported for patients with resected pancreatic adenocarcinoma (PC), but the use of multimodality therapy was uncommon in these series. We evaluated long-term survival and patterns of recurrence in patients treated for PC with contemporary staging and multimodality therapy.

METHODS: We analyzed 329 consecutive patients with PC evaluated between 1990 and 2002 who underwent resection. Each received a multidisciplinary evaluation and a standard operative approach. Pre- or postoperative chemotherapy and/or chemoradiation were routine. Surgical specimens of 5-year survivors were re-reviewed. A multivariate model of factors associated with long-term survival was constructed.

RESULTS: …

The Effect Of Semantic Set Size On Word Learning By Preschool Children, Holly L. Storkel, Suzanne M. Adlof

Faculty Publications

Purpose - The purpose was to determine whether semantic set size, a measure of the number of semantic neighbors, influenced word learning, and whether the influence of semantic set size was broad, showing effects on multiple measures both during and after learning.

Method - Thirty-six preschool children were exposed to 10 nonobjects, varying in semantic set size, paired with 10 nonwords, controlling phonotactic probability and neighborhood density. Nonobject-nonword pairs were presented in a game format. Learning was measured in naming and referent identification tasks administered before, during, and 1 week after training.

Results - Results showed no differences in naming …

Adult And Child Semantic Neighbors Of The Kroll And Potter (1984) Nonobjects, Holly L. Storkel, Suzanne M. Adlof

Faculty Publications

Purpose - The purpose was to determine the number of semantic neighbors, namely semantic set size, for 88 nonobjects (J. F. Kroll & M. C. Potter, 1984) and determine how semantic set size related to other measures and age.

Method - Data were collected from 82 adults and 92 preschool children in a discrete association task. The nonobjects were presented via computer, and participants reported the first word that came to mind that was meaningfully related to the nonobject. Words reported by two or more participants were considered semantic neighbors. The strength of each neighbor was computed as the …

Pick1 Deficiency Causes Male Infertility In Mice By Disrupting Acrosome Formation, Nan (Tori) Xiao, Chuen Kam, Chong Shen, Wenying Jin, Junqi Wang, Kwong Man Lee, Liwen Jiang, Jun Xia

All Dugoni School of Dentistry Faculty Articles

Protein interacting with C kinase 1 (PICK1) is a peripheral membrane protein involved in protein trafficking, a function that has been well characterized in neurons. Here, we report that male mice deficient in PICK1 are infertile and have a phenotype resembling the human disease globozoospermia. The primary defect in the testes of Pick1-knockout mice was fragmentation of acrosomes in the early stages of spermiogenesis. This fragmentation was followed by defects in nuclear elongation and mitochondrial sheath formation, leading to round-headed sperm, reduced sperm count, and severely impaired sperm motility. We found that PICK1 interacted with Golgi-associated PDZ- and coiled-coil motif-containing …

Spectrum Of Tamoxifen Associated Endometrial Pathology In Breast Cancer Patients, Asim Qureshi, Farhan Bukhari, Shahid Pervez

Department of Pathology and Laboratory Medicine

The objective of the study was to determine the incidence and type of endometrial abnormalities in long-term users of tamoxifen with breast cancer. All patients with a diagnosis of Oestrogen Receptor positive breast cancer on Tamoxifen therapy who had also undergone endometrial biopsy for abnormal bleeding or other symptoms were included. Among the 37 cases that had long-term follow up available, 21(57%) had evidence of endometrial pathology. There were seven cases of simple hyperplasia and thirteen of endometrial polyp. Only one case of endometrial carcinoma was seen. These findings support the association between prolonged tamoxifen therapy and endometrial pathology of …

Evaluation Of Suspected Renal Colic Patients With Unenhanced Low-Dose Multi-Detector Computed Tomography, N. Twahirwa, J. Rees

Imaging & Diagnostic Radiology, East Africa

Objectives: To determine the proportion of correctly diagnosed ureteric calculi and alternate diagnoses using unenhanced low dose multidetector CT KUB.

Design: Descriptive – prospective study.

Setting: Aga Khan University Hospital, Nairobi between November 2006 and October 2007.

Subjects: One hundred and four patients underwent low dose multi-detector computed tomography (MDCT) KUB.

Results: Ninety (47 males and 43 females with age range of 17 - 79 years, mean 40 years) were included in the statistical analysis while 14 were excluded. Eighteen out of ninety (20%) were classified as definitely having ureteric calculi on the composite reference. Among the 18, 17 were …

Gambling Interacts With Trauma To Predict Alexithymia Scores Among College Students, Tara K. Cossel, María José Herrera, Dennis E. Mcchargue

Department of Psychology: Presentations

Gambling is fairly common among college age students, with estimates ranging from 15% (Kerber, 2005) to 42% (LaBrie, Shaffer, LaPlante, & Wechslet, 2003). Furthermore, gambling among college students is associated with a variety of negative consequences, particularly for men (Engwall, Hunter, & Steinberg, 2004). Despite this, less is known about psychological factors linking gambling among college age students. In a recent study conducted among college students, the relationship between pathological gambling and psychological variables (e.g., alexithymia) was examined. Findings indicate that psychological variables like alexithymia might be a noteworthy risk factor to problem gambling (Parker, Wood, Bond, & Shaughnessy, 2005). …

Cancer Of The Penis: Case Report, D. K. Kiptoon, P. M. Ngugi, F. S. Rana

Pathology, East Africa

Two patients with penile carcinoma are presented after management at a district hospital in Kenya. Both had undergone ritual circumcision as teenagers and presented late. HR was a 73 year old who presented with a fungating penile mass for which a partial penectomy was performed after wedge biopsy confirmed malignancy. He thereafter declined to have the surgical specimen sent for histology and took the amputated stump for burial in his compound to avoid bad omen. GK was 25 years old and presented with a fungating mass and underwent partial penectomy after a histological diagnosis was made. He absconded from follow-up …

Soil Zinc Content, Groundwater Usage, And Prostate Cancer Incidence In South Carolina, Sara E. Wagner, James B. Burch, Jim Hussey, Tom Temples, Susan Bolick-Aldrich, Catishia Mosley-Broughton, Yuan Liu, James R. Hébert

Faculty Publications

Background

Prostate cancer (PrCA) incidence in South Carolina (SC) exceeds the national average, particularly among African Americans (AAs). Though data are limited, low environmental zinc exposures and down-regulation of prostatic zinc transporter proteins among AAs may explain, in part, the racial PrCA disparity.

Methods

Age-adjusted PrCA rates were calculated by census tract. Demographic data were obtained from the 1990 census. Hazardous waste site locations and soil zinc concentrations were obtained from existing federal and state databases. A geographic information system and Poisson regression were used to test the hypothesis that census tracts with reduced soil zinc concentrations, elevated groundwater use, …

Gst Polymorphism And Excretion Of Heterocyclic Aromatic Amine And Isothiocyanate Metabolites After Brassica Consumption, Susan E. Steck, James R. Hébert

Faculty Publications

Brassica vegetable intake has been associated with decreased risk and well-done meat intake has been associated with increased risk of cancers at multiple organ sites in epidemiologic studies. Experimental studies suggest a role of modulation of phase I and phase II metabolizing enzymes as one mechanism for these associations. Heterocyclic aromatic amines (HAAs) are carcinogens formed in meat that has been cooked to well-done and at high temperatures. Phase I metabolizing enzymes catalyze the activation of HAAs, and phase II metabolizing enzymes serve to detoxify the active carcinogens. The glutathione S-transferase (GSTs) are a family of phase II metabolizing enzymes …

Pah-Dna Adducts, Cigarette Smoking, Gst Polymorphisms, And Breast Cancer Risk, Kathleen M. Mccarty, Regina M. Santella, Susan E. Steck, Rebecca J. Cleveland, Jiyoung Ahn, Christine B. Ambrosone, Kari North, Sharon K. Sagiv, Sybil M. Eng, Susan L. Teitelbaum, Alfred I. Neugut, Marilie D. Gammon

Faculty Publications

BACKGROUND: Polycyclic aromatic hydrocarbon (PAHs) may increase breast cancer risk, and the association may be modified by inherited differences in deactivation of PAH intermediates by glutathione S-transferases (GSTs). Few breast cancer studies have investigated the joint effects of multiple GSTs and a PAH biomarker.

OBJECTIVE: We estimated the breast cancer risk associated with multiple polymorphisms in the GST gene (GSTA1, GSTM1, GSTP1, and GSTT1) and the interaction with PAH-DNA adducts and cigarette smoke.

METHODS: We conducted unconditional logistic regression using data from a population-based sample of women (cases/controls, respectively): GST polymorphisms were genotyped using …

A Human Capital Approach To Reduce Health Disparities, Saundra H. Glover, Sudha Xirasagar, Yunho Jeon, Keith T. Elder, Crystal N. Piper, Harris Pastides

Faculty Publications

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research.

Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), …

The Dynamics Of Income And Neighborhood Context For Population Health: Do Long Term Measures Of Socioeconomic Status Explain More Of The Black/White Health Disparity Than Single-Point-In-Time Measures?, D. Phuong Do

Faculty Publications

Socioeconomic status, though a robust and strong predictor of health, has generally been unable to fully explain the health gap between blacks and whites in the Untied States. However, at both the individual and neighborhood levels, socioeconomic status is often treated as a static factor with only single-point-in-time measurements. These cross-sectional measures fail to account for possible heterogeneous histories within groups who may share similar characteristics at a given point in time. As such, ignoring the dynamic nature of socioeconomic status may lead to the underestimation of its importance in explaining health and racial health disparities.

In this study, I …

Cardiorespiratory Fitness And Digestive Cancer Mortality: Findings From The Aerobics Center Longitudinal Study (Acls), J. Brent Peel, Xuemei Sui, Charles E. Matthews, Swann Arp Adams, James R. Hébert, James W. Hardin, Timothy S. Church, Steven N. Blair

Faculty Publications

Although higher levels of physical activity are inversely associated with risk of colon cancer, few prospective studies have evaluated overall digestive system cancer mortality in relation to cardiorespiratory fitness (CRF). The authors examined this association among 38,801 men aged 20−88 years and who performed a maximal treadmill exercise test at baseline in the Aerobics Center Longitudinal Study (Dallas, Texas) during 1974−2003. Mortality was assessed over 29 years of follow-up (1974−2003). 283 digestive system cancer deaths occurred during a mean 17-year of observation. Age-adjusted mortality rates per 10,000 person-yrs according to low, moderate, and high CRF groups were 6.8, 4.0, and …

Associated Symptoms In The Ten Days Before Diagnosis Of Kawasaki Disease., Annette L. Baker, Minmin Lu, L Luann Minich, Andrew M. Atz, Gloria L. Klein, Rosalind Korsin, Linda Lambert, Jennifer S. Li, Wilbert Mason, Elizabeth Radojewski, Victoria L. Vetter, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To describe common associated symptoms within the 10 days before diagnosis in subjects enrolled in the Pediatric Heart Network's trial of steroid therapy in Kawasaki disease (KD).

STUDY DESIGN: Patients with acute KD were enrolled between days 4 and 10 of illness at 8 centers between 2002 and 2004. We defined common associated symptoms as those occurring in >or=10% of patients. Principal clinical criteria for KD were not included in this analysis.

RESULTS: Among 198 patients, irritability was reported in 98 (50%), vomiting in 88 (44%), decreased food/fluid intake in 73 (37%), cough in 55 (28%), diarrhea in 52 …

Heme Oxygenase Activity And Hemoglobin Neurotoxicity Are Attenuated By Inhibitors Of The Mek/Erk Pathway., Jing Chen-Roetling, Zhi Li, Mai Chen, Olatilewa O. Awe, Raymond F. Regan

Department of Emergency Medicine Faculty Papers

Hemoglobin breakdown produces an iron-dependent neuronal injury after experimental CNS hemorrhage that may be attenuated by heme oxygenase (HO) inhibitors. The HO enzymes are phosphoproteins that are activated by phosphorylation in vitro. While testing the effect of kinase inhibitors in cortical cell cultures, we observed that HO activity was consistently decreased by the MEK inhibitor U0126. The present study tested the hypothesis that MEK/ERK pathway inhibitors reduce HO activity and neuronal vulnerability to hemoglobin. The MEK inhibitors U0126 and SL327 and the ERK inhibitor FR180204 reduced baseline culture HO activity by 35-50%, without altering the activity of recombinant HO-1 or …

Laparoscopic Treatment Of Pancreatic Pseudocysts In Children., Suzanne M. Yoder, Steven Rothenberg, Kuojen Tsao, Mark L. Wulkan, Todd A. Ponsky, Shawn D. St Peter, Daniel J. Ostlie, Timothy D. Kane

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Pancreatic pseudocysts are problematic sequelae of pancreatitis or pancreatic trauma causing persistent abdominal pain, nausea, and gastric outlet obstruction. Due to the low volume of disease in children, there is scant information in the literature on the operative management of pseudocysts with minimally invasive techniques. We conducted a multi-institutional review to illustrate several technical variations utilized in achieving laparoscopic cystgastrostomy in the pediatric population.

METHODS: A retrospective review was conducted of all patients who underwent laparoscopic cystgastrostomy in five institutions. Patient data, operative techniques, and postoperative course were analyzed.

RESULTS: There were 13 patients with a mean age of …

Prevention Of Mother-To-Child Transmission (Pmtct) Of Hiv In The Sub-Saharan Africa Region With A Focus On Uganda, Emily K. Franks

Senior Honors Theses

With the rise of the HIV/AIDS epidemic in the past thirty years, people of all ages, infants to elderly alike, all over the world, suffer from its adverse effects. Even an unborn baby in-utero can contract this virulent infection by means of mother-to-child transmission (MTCT) (Sweeney, 2005). Infants and children diseased in this way comprise 90% of the estimated 800,000 new cases of HIV in children seen each year, but the region hit hardest, however, is Sub-Saharan Africa, with the country of Uganda historically having the highest incident rate for a time (Stringer, E.M., et al. 2008). Therefore, the purpose …

Volume 02, Joseph A. Mann, Kathryn J. Greenly, Scott E. Jenkins, Andrew E. Puckette, Daniel M. Honey, Jeffery P. Ravenhorst, Jamie Elizabeth Mesrobian, Thomas Scott, Jay Crowell, Sarah Spangenberg, Amy S. Eason, Kenny Wolfe, Liz Hale, Rachel Bouchard, Will Semonco, Carley York, Ryan Higgenbothom, Adrienne Heinbaugh, Melissa Dorton, Madeline Hunter, June Ashmore, Clark Barkley, Jay Haley

Incite: The Journal of Undergraduate Scholarship

Introduction from Dean Dr. Charles Ross

Mike's Nite: New Jazz for an Old Instrument by Joseph A. Mann

Investigation of the use of Cucumis Sativus for Remediation Of Chromium from Contaminated Environmental Matrices: An Interdisciplinary Instrumental Analysis Project by Kathryn J. Greenly, Scott E. Jenkins, and Andrew E. Puckette

Development of GC-MS and Chemometric Methods for the Analysis of Accelerants in Arson Cases by Scott Jenkins

Building and Measuring Scalable Computing Systems by Daniel M. Honey and Jeffery P. Ravenhorst

Nomini Hall: A Case Study in the Use of Archival Resources as Guides for Excavation at An Archaeological Site by …

Beliefs And Behaviors Regarding Substance Use And Hiv Risk Among Men Who Have Sex With Men (Msm) In A Mid-Sized U.S. Community, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Martin Hall Mssw, Seana Golder Phd

Brown School Faculty Publications

This paper explores the beliefs and behaviors surrounding substance use and HIV risk among a convenience sample of 98 MSM in a mid-size community located in the central U.S. Several interesting patterns were identified in the descriptive analyses. Multivariate analysis identified two variables, belief that recreational drug use made sexual experiences better and reports that most MSM friends drank alcohol or took recreational drugs that were significant predictors of engagement in substance using behavior. Models accounted for 24% of the variance in drinking behavior and 15% of the variance in drug using behavior. Suggestions for HIV/AIDS prevention and intervention and …