Medicine and Health Sciences Commons^™

Development Of A Lung Cancer-Specific Model For Support Group Interest, Laura Testerman

Loma Linda University Electronic Theses, Dissertations & Projects

Despite high levels of both emotional and physical distress and desire for utilization of support group services, lung cancer patients rarely participate in these supportive services. Lung cancer survivors’ interest in and use of supportive psychosocial services remains poorly understood, and Internet-based services may be of particular benefit to this population. The Behavioral Model for Vulnerable Populations, which emphasizes Predisposing (i.e., demographic as well as attitudes about support services), Enabling (i.e., accessibility of services), and Illness (i.e., need for services based on health) factors, was applied to the prediction of survivors’ behavioral intention to participate in face-to-face support groups (F2F) …

Client/Therapist Feedback And The Role Of The Alliance On Psychotherapy Outcomes, Elizabeth Preston Cisneros

Loma Linda University Electronic Theses, Dissertations & Projects

Through a system of patient-focused outcomes research which has employed a quality assurance system for tracking client progress in therapy, there has been consistent evidence that utilizing the system to identify those who are not responding to treatment and warning their therapist about the client’s risk significantly improves client outcomes in psychotherapy. Although outcomes have been improved, significant proportions of clients have treatment failures or see no improvement in therapy. Moreover, feedback to therapists appears to be most effective in improving outcomes for the minority of clients who are already at risk of treatment failure.

Attempts to augment the feedback …

Diagnosing And Treating Adhd: Discipline Differences, Lisa Marie Lliteras

Loma Linda University Electronic Theses, Dissertations & Projects

According to Barkley (2005), attention deficit hyperactivity disorder (ADHD) is one of the most common reasons children are referred to mental health workers in the United States and is now one of the most prevalent psychiatric disorders associated with childhood. The diagnostic criteria and labels for ADHD have changed over the last several decades, and with each change the prevalence rate for ADHD has increased (Wolraich & Baumgaertel, 1997). This increase in the prevalence of ADHD has led to a need for clinicians from different disciplines to assess and treat ADHD. As such, several guidelines from professional associations have been …

Somebody To Lean On: How Lean Principles Promote Exemplary Professional Practice., Angela Agee Adn, Rn, Cmsrn, Laura Baker Rn, Kim Korner Mba, Bsn, Rn, Ne-Bc, Maria Mcnally Bsn, Rn, Cmsrn, Lee Bowman Bsn, Rn, Jennifer Murray Adn, Rn

Patient Care Services / Nursing

No abstract provided.

Prevalence, Knowledge And Care Patterns For Gastro-Oesophageal Reflux Disease In United States Minority Populations., Elaine Yuen, Martha Romney, Richard W. Toner, Nicole M. Cobb, Philip O. Katz, Maya Spodik, Neil I. Goldfarb

College of Population Health Faculty Papers

BACKGROUND: While there is evidence of ethnic variation in the prevalence of gastro-oesophageal reflux disease (GERD) symptoms, few population-based studies examine GERD symptom prevalence amongst the growing Hispanic minority in the US as well as Asians in the West. AIM: To examine the prevalence, awareness and care patterns for GERD across different ethnic groups.

METHODS: A population-based, cross-sectional survey was fielded in English, Chinese and Spanish that assessed self-reported GERD prevalence, awareness and care patterns in four ethnic groups (Caucasian, African American, Asian, Hispanic).

RESULTS: A total of 1172 subjects were included for analysis: 34.6% experienced GERD symptoms at least …

Improving Immunization Rates In The Clinic And In The Community, Karlen E. (Beth) Luthy, Arlene M. Sperhac, Sandra A. Faux, Joseph K. Miner

Faculty Publications

Over the past decade, the United States haas had tremendous success in achieving very high immunization compliance rates among children, sometimes as high as 91%. However, despite progress toward controlling the spread of communicable disease through immunizations, more than 2.1 million children nationwide are not adequately immunized. Even among US children who are adequately immunized, only about half of them actually received their immunization on time.

Postpartum Depression And Culture: Pesado Corazon, Lynn Clark Callister, Renea L. Beckstrand, Cheryl A. Corbett

Faculty Publications

The purpose of this article is to describe what the -literature has shown about postpartum depression (PPD) in culturally diverse women. The majority of qualitative studies done with women identified as -having PPD have been conducted with Western -women, with the second largest group focusing on Chinese women. This article reviews the qualitative studies in the literature and discusses how the management of PPD in technocentric and ethnokinship cultures differs. Social support has been shown to be significantly related to fewer symptoms of PPD, and culturally prescribed practices may or may not be -cultural mediators in decreasing the incidence of …

Imminent Epidemic Of Diabetes Mellitus In Pakistan: Issues And Challenges For Health Care Providers, Waris Qidwai, Tabinda Ashfaq

Department of Family Medicine

No abstract provided.

สิ่งแวดล้อมกับสุขภาพของเด็ก, นวลจันทร์ ปราบพาล

Chulalongkorn Medical Journal

No abstract provided.

Impact Of Obesity On Respiratory System In Children, S. Sritippayawan

Chulalongkorn Medical Journal

ภาวะอ้วนในเด็กเป็นปัญหาที่พบมากขึ้นในปัจจุบัน ทำให้เกิดภาวะแทรกซ้อนในหลายๆ ระบบของร่างกายรวมทั้งระบบหายใจ ความผิดปกติทางระบบหายใจเป็นผลมาจากการสะสมของเนื้อเยื่อไขมันตามอวัยวะต่างๆ ที่เกี่ยวข้องกับการหายใจ เช่น ผนังทรวงอก ผนังหน้าท้อง ทางเดินหายใจ และกะบังลม ทำให้ความยืดหยุ่นของผนังทรวงอกและปอดลดลง ปริมาตรความจุปอดและความสามารถในการออกกำลังกายลดลง นอกจากนี้ไขมันที่สะสมอยู่บริเวณทางเดินหายใจส่วนต้นและลำคอยังทำให้ทางเดินหายใจตีบแคบโดยเฉพาะอย่างยิ่งในขณะหลับ เกิดภาวะ obstructive sleep apneaและ obesity hypoventilation syndrome ทั้งหมดนี้ทำให้เด็กอ้วนเสี่ยงต่อการเกิดภาวะออกซิเจนในเลือดต่ำหรือมีคาร์บอนไดออกไซด์ในเลือดสูงและเกิดภาวะหายใจล้มเหลวตามมาได้ โดยเฉพาะอย่างยิ่งหากมีการติดเชื้อในระบบหายใจหรือภายหลังได้รับยานอนหลับหรือยาสลบเพื่อทำการผ่าตัดนอกจากนี้ ยังพบว่า การที่มีระดับออกซิเจนในเลือดต่ำหรือคาร์บอนไดออกไซด์ในเลือดสูงแบบเรื้อรังร่วมกับภาวะ leptin resistance ซึ่งพบได้ในเด็กอ้วนจะทำให้เด็กเหล่านี้มีการตอบสนองทางระบบหายใจน้อยกว่าปกติต่อภาวะขาดออกซิเจนหรือคาร์บอนไดออกไซด์ในเลือดคั่ง ทำให้ภาวะดังกล่าวรุนแรงมากยิ่งขึ้น ซึ่งหากไม่ได้รับการดูแลรักษาก็จะนำไปสู่ภาวะการหายใจล้มเหลวหรือเกิดภาวะแทรกซ้อนทางระบบหัวใจและหลอดเลือดตามมาได้ นอกจากนี้ สารเคมีที่หลั่งจากเนื้อเยื่อไขมันยังมีผลทำให้เกิดการอักเสบในระบบหายใจ และอาจเกี่ยวข้องกับการเกิดโรคหืดและภาวะหลอดลมไวเกินในเด็กเหล่านี้ การดูแลทางด้านโภชนาการและส่งเสริมการออกกำลังกายอาจช่วยให้สมรรถภาพปอดดีขึ้นและลดการเกิดภาวะแทรกซ้อนต่างๆ เหล่านี้ได้.

Antibiotic Drug Use For The Treatment Of Transrectal Ultrasound Guide Core Biopsy Of Prostate With Sepsis (Trus-Sepsis), T Hathaivasiwong, A. Santi-Ngamkun

Chulalongkorn Medical Journal

Objectives : To study the effectiveness of antibiotic drug use for the treatment of sepsis after transrectal ultrasound guide core biopsy of prostate (TRUS-Bx). Methods : This was a retrospective study from January 2004 to December 2008 of all men who received TRUS-Bx at the Department of Urology, King Chulalongkorn Memorial Hospital, for the elevation of prostatic specific antigen (PSA > 4.0 ng/ml) or abnormal digital rectal examination (DRE). A total of 1,246 patients underwent TRUS-Bx developed fever that required hospitalization for antibiotic treatment; 27 patients (2.17%). We excluded 11 patients from the study because no organism was identified from their …

Effect Of Symptom Self-Management Program On Psychotic Relapse For Patients With Chronic Schizophrenia, S Stithyudhakarn, J. Yunibhand, S. Thanasilp

Chulalongkorn Medical Journal

Introduction : Relapse is common in schizophrenia. Therefore, schizophrenia patients are vulnerable groups which require special attention. The relapse can cause patients' distress and result in re-admission in psychiatric hospitals. A symptom self-management program (SSMP) has been developed to improve the patients' self-management ability to decrease early symptoms of psychotic relapse. Objective : To evaluate the effect of SSMP on psychotic relapse in patients with chronic schizophrenia. Setting : An out-patient clinic of a psychiatric hospital. Research design : Randomized control trial. Patients : There were eligible 80 patients with chronic schizophrenia who participated in this study. Methods : The …

Prevalence And Mortality Rate Of Severe Cutaneous Adverse Reactions At Siriraj Hospital, S Limkobpaiboon, D. Panomvanna Na Ayudhya, N Dhana, K. Jongjarearnprasert

Chulalongkorn Medical Journal

Introduction : Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and drug hypersensitivity syndrome (HSS) are severe cutaneous adverse reactions (SCAR) that is mostly related to drugs. Although incidence is rare, it has significant impact on patient's well being because of its high mortality rates. Objective : To investigate the causative drugs, prevalence and mortality rates related to SCAR, which were from drug exposure during 2003 - 2007. Setting : Siriraj Hospital, Bangkok. Research design : A retrospective study Patients : Patients who were diagnosed to be SJS, TEN and HSS were included. Method : Five years retrospective data, 2003 - …

Hypertension In The Young, A Chanakul, T. Deekajorndech

Chulalongkorn Medical Journal

Hypertension in childhood and adolescent is increasing and it is not a benign condition. Obesity and other lifestyle factors, such as physical inactivity, increased-intake of high calories and high salt food, are major determinants for this trend. Body mass index, hypertension, left ventricular hypertrophy and early coronary disease appear to be a correlation in adolescence. There are the evidences that high blood pressure can be tracked from childhood into adulthood, increasing the risks of coronary heart disease, stroke and end-stage renal disease. The early identification, proper evaluation and appropriate management of hypertension in children can reduce the associated long-term morbidity …

Distinct Macrophage Subpopulations Regulate Viral Encephalitis But Not Viral Clearance In The Cns, Christina D. Steel, Woong-Ki Kim, Larry Sanford, Laurie Wellman, Sandra Burnett, Nico Van Rooijen, Rochard P. Ciavarra

Biological Sciences Faculty Publications

Intranasal application of vesicular stomatitis virus (VSV) induces acute encephalitis characterized by a pronounced myeloid and T cell infiltrate. The role of distinct phagocytic populations on VSV encephalitis was therefore examined in this study. Ablation of peripheral macrophages did not impair VSV encephalitis or viral clearance from the brain, whereas, depletion of splenic marginal dendritic cells impaired this response and enhanced morbidity/mortality. Selective depletion of brain perivascular macrophages also suppressed this response without altering viral clearance. Thus, two anatomically distinct phagocytic populations regulate VSV encephalitis in a non-redundant fashion although neither population is essential for viral clearance in the CNS. …

Activation Of Endothelial Cell, Coagulation And Fibrinolysisin Children With Beta- And Alpha-Thalassemia, D Sosothikul, Y Kittikalayawong, C Bupachart, P. Seksarn

Chulalongkorn Medical Journal

Introduction : Thromboembolic complications due to hypercoagulable states arecommon in thalassemic patients, mostly adults. The change in theendothelial cell from resting to procoagulant state could be associatedwith expression of adhesion molecules and selectins. Subsequently,endothelial cell injury can alter hemostasis by promoting fibrin-clotformation.Objective : To determine plasma levels of endothelial, coagulation and fibrinolysismarkers (soluble intercellular adhesion molecules (sICAM-1), vascularendothelial growth factor (VEGF), soluble endothelial selectin (sESelectin),factor VIII activity (FVIII: C) and D-dimer) in children withthalassemia.Design/Methods : This is a cross sectional study. Plasma samples from 120 childrenwith thalassemia (30 with non-splenectomized alpha-thalassemia (NSA),65 with non-splenectomized beta-thalassemia major (NSB) and 25 withsplenectomized …

Health-Risk Behaviors Relate To Health Problems On Annual Health Check-Up, K Kongsomboon, S. Loetthiraphan

Chulalongkorn Medical Journal

Background : Annual health check-up is an important process to evaluate health status and identify health risk behaviors i.e. cigarette smoking, sleep deprivation, alcoholic drinking, inadequate exercise, eating unhealthy foods, and unsafe driving. Objective : To determine the effect of gender, age group, and health-risk behaviors on health problems. Design : Cross-sectional analytic study Materials and Methods : Data were collected from 412 persons who went to Her Royal Highness (HRH) Princess Maha Chakri Sirindhorn Medical Center for their routine health check-up from November, 2007 to December, 2008. The authors used logistic regression and simple linear regression for multivariate analysis …

Mid Aortic Syndrome : An Unusual Cause Of Childhood Hypertension, A Chanakul, P. Rianthavorn

Chulalongkorn Medical Journal

Mid aortic syndrome (MAS) is characterized by an extensive narrowing of the abdominal aorta, with involvement of the renal and visceral arterial branches. Angiography is the gold standard for the diagnosis of MAS. However, computed tomography angiography (CTA) can effectively determine the location and the extent of the stenosis. Medical management of MAS generally means a lifelong, combination of multiple classes of antihypertensive medications. Surgical correction such as aortoaortic bypass with renal revascularization remains the definitive treatment of the idiopathic MAS. Moreover, the surgery can provide tissues for histological examination to arrive at the definite diagnosis of MAS. We reported …

Body Image Satisfaction And Related Factors In Postpartum Women At King Chulalongkorn Memorial Hospital, P Kitranun, S. Suppapitiporn

Chulalongkorn Medical Journal

In postpartum women, their body shape has extensively changed. Body image has positive and negative effect including self confidence, self esteem and may lead to mental health problem. Understanding the body image satisfaction and its related factors may be beneficial for helping postpartum women to develop appropriate satisfaction in their body image.

ย่อวารสาร, N/A

Chulalongkorn Medical Journal

No abstract provided.

Safety Net Activities Of Independent Rural Health Clinics, David Hartley Phd, Mha, John A. Gale Ms, Al Leighton Ba, Stuart Bratesman Mpp

Rural Health Clinics

Rural Health Clinics (RHCs) are an important part of the rural health care infrastructure as they provide a wide range of primary care services to the rural residents of 45 states. Since RHCs are located in underserved rural areas and serve vulnerable populations, many consider them safety net providers. In this paper we explore whether and to what extent independent RHCs are serving a safety net role, or have the capacity to serve that role. We address this question through a telephone survey of 392 randomly selected independent RHCs. Response rate for the survey was 93%. We investigated whether and …

Prediction And Testing Of Biological Networks Underlying Intestinal Cancer, Vishal N. Patel, Gurkan Bebek, Mark R. Chance

Faculty Scholarship

Colorectal cancer progresses through an accumulation of somatic mutations, some of which reside in so-called "driver" genes that provide a growth advantage to the tumor. To identify points of intersection between driver gene pathways, we implemented a network analysis framework using protein interactions to predict likely connections - both precedented and novel - between key driver genes in cancer. We applied the framework to find significant connections between two genes, Apc and Cdkn1a (p21), known to be synergistic in tumorigenesis in mouse models. We then assessed the functional coherence of the resulting Apc-Cdkn1a network by engineering in vivo single node …

Effects Of Hypothyroidism On Cell Proliferation And Neuroblasts In The Hippocampal Dentate Gyrus In A Rat Model Of Type 2 Diabetes, Sun Shin Yi, In Koo Hwang, Ji Won Choi, Moo-Ho Won, Je Kyung Seong, Yeo Sung Yoon

Biomedical Sciences Faculty Research and Publications

We observed how the hypothyroid state affects diabetic states and modifies cell proliferation and neuroblast differentiation in the hippocampal dentate gyrus (DG). For this, 0.03% methimazole, an anti-thyroid drug, was administered to 7-week-old, pre-diabetic Zucker diabetic fatty (ZDF) rats by drinking water for 5 weeks, and the animals were sacrificed at 12 weeks of age. At this age, corticosterone levels were significantly increased in the ZDF rats compared to those in the control (Zucker lean control, ZLC) rats. Methimazole (methi) treatment in the ZDF rats (ZDF-methi rats) significantly decreased corticosterone levels and diabetes-induced hypertrophy of adrenal glands. In the DG, …

Noninvasive Fluorescence Monitoring Of Protoporphyrin Ix Production And Clinical Outcomes In Actinic Keratoses Following Short-Contact Application Of 5-Aminolevulinate, Christine B. Warren, Sara Lohser, Lauren C. Wene, Brian W. Pogue, Philip Bailin, Edward Maytin

Dartmouth Scholarship

Topical 5-aminolevulinic acid (ALA) is widely used in photodynamic therapy (PDT) of actinic keratoses (AK), a type of premalignant skin lesion. However, the optimal time between ALA application and exposure to light has not been carefully investigated. Our objective is to study the kinetics of protoporphyrin IX (P_pIX) accumulation in AK after short contact ALA and relate this to erythemal responses. Using a noninvasive dosimeter, P_pIX fluorescence measurements (5 replicates) were taken at 20-min intervals for 2 h following ALA application, in 63 AK in 20 patients. Data were analyzed for maximal fluorescent signal obtained, kinetic …

Neural Plasticity And Treatment-Induced Recovery Of Sentence Processing In Agrammatism, Cynthia K. Thompson, Dirk B. Den Ouden, Borna Bonakdarpour, Kyla Garibaldi, Todd B. Parrish

Faculty Publications

This study examined patterns of neural activation associated with treatment-induced improvement of complex sentence production (and comprehension) in six individuals with stroke-induced agrammatic aphasia, taking into account possible alterations in blood flow often associated with stroke, including delayed time-to-peak of the hemodynamic response function (HRF) and hypoperfused tissue. Aphasic participants performed an auditory verification fMRI task, processing object cleft, subject cleft, and simple active sentences, prior to and following a course of Treatment of Underlying Forms (TUR; Thompson et al., 2003), a linguistically based approach for treating aphasic sentence deficits, which targeted objective relative clause constructions. The patients also were …

Pattern Of Drugs Of Abuse Identified In Chemical Samples, Farhan Javed Dar, Aysha Habib Khan, Imran Siddiqui, Farooq Ghani

Department of Pathology and Laboratory Medicine

OBJECTIVE: To determine the pattern of drugs of abuse in urine and blood samples processed at referral laboratory in Pakistan so that information on the type of drugs used can be identified and used for ready reference for future strategy. Study Design: Observational study.

PLACE AND DURATION OF STUDY: Clinical Laboratory of The Aga Khan University Hospital, Karachi, from July 2006 to March 2008. Methodology: Retrospective review of records were done for the common drugs that are used for screening at the Clinical Laboratory include alcohol, amphetamine, barbiturates, benzodiazepines, cannabinoids, cocaine and opiates. Alcohol was tested in blood and others …

Inducible Clindamycin Resistance Due To Expression Of Erm Genes In Staphylococcus Aureus: Report From A Tertiary Care Hospital Karachi, Pakistan, Naima Fasih, Seema Irfan, Afia Zafar, Erum Khan, Rumina Hasan

Department of Pathology and Laboratory Medicine

OBJECTIVE: To assess the frequency of phenotypic expression of inducible resistance of clindamycin due to expression of erm genes, in clinical isolates of Staphylococcus aureus (S. aureus), by double disk diffusion test (D-test).

METHOD: This was a cross sectional study conducted in the clinical laboratory of Aga Khan University Hospital, Karachi. A total of 2432, non duplicate clinical isolates of S. aureus, consisting of 1562 methicillin sensitive S. aureus (MSSA) and 870 methicillin resistant S. aureus (MRSA), were selected from February 2007 to January 2008. One hundred and thirty eight isolates of S. aureus were selected based on discordant resistance …

Identifying Strategies Early Intervention Occupational Therapists Use To Teach Caregivers., Jessica L. Colyvas, L Brook Sawyer, Philippa H. Campbell

Department of Occupational Therapy Faculty Papers

This study investigated early intervention occupational therapists' use of strategies to teach caregivers. A sample of 40 videotapes made by early intervention occupational therapists was randomly selected from an archival videotape data set of provider home visits. The sample included 20 videotapes illustrating traditional services and 20 videotapes illustrating therapists providing participation-based services. Videotapes were rated using the Teaching Caregivers Scale, which rates three variables on 30-s intervals: (1) routine, (2) provider role, and (3) strategies used to teach caregivers during early intervention home visits. Regardless of the model of service, explicit teaching strategies were rarely used during home visits.

Preliminary Studies On Analgesic And Behavioural Activities Of The Homoeopathic Formulations Of Chenopodium Ambrosioides In Experimental Animal Models, E Nsundaram, K Psingh, K Reddy, P Reddy, Ch Raveendar, K.R.J Nair, C Nayak

Indian Journal of Research in Homoeopathy

No abstract provided.

Identification, C Nayak, Vikram Singh, V Siddiqui, Rupali Dixit

Indian Journal of Research in Homoeopathy

No abstract provided.