Medicine and Health Sciences Commons^™

Response To And Recovery From Endotracheal Suctioning In Preterm Infants Using Routine Versus Four-Handed Care, Sharon Cone

Theses and Dissertations

Neonatal Intensive Care Units have experienced profound advances in technology and treatment modalities over the last two decades. Infants born at the edge of viability are now surviving despite prolonged hospitalizations. These infants born preterm are prone to a high degree of stress from life sustaining and routine interventions. Much focus has been directed toward addressing noxious environmental factors such as noise, light, and infectious disease; however, little has been done to examine the stress experienced by the professional caregiver who work in these environments. Environmental press theory, which focuses on the interplay between human beings and their surroundings, is …

Jean-Martin Charcot - Neurologist By Avocation, Nephrologist By Yearning, Gary Eknoyan

Houston History of Medicine Lectures (2006-2012)

In an age of medical advances and specialization, Jean-Martin Charcot (1825-1893) helped found the discipline of neurology and in 1882 was appointed the first professor of Diseases of the Nervous System in France. As an investigator with broad interests and vast knowledge Charcot contributed to several other disciplines. An early mentor and dominant figure in Charcot's formative years was Pierre Rayer (1793-1867), famous for his seminal contributions to the study of the kidney, who gifted Charcot with his passion for clinical pathological correlations and likely a yearning for the study of kidney diseases. Famous for the clarity and incisiveness of …

Components Of The Indirect Effect In Vaccine Trials: Identification Of Contagion And Infectiousness Effects, Tyler J. Vanderweele, Eric J. Tchetgen, M. Elizabeth Halloran

COBRA Preprint Series

Vaccination of one person may prevent the infection of another either because (i) the vaccine prevents the first from being infected and from infecting the second or because (ii) even if the first person is infected, the vaccine may render the infection less infectious. We might refer to the first of these mechanisms as a contagion effect and the second as an infectiousness effect. In this paper, for the simple setting of a randomized vaccine trial with households of size two, we use counterfactual theory under interference to provide formal definitions of a contagion effect and an infectiousness effect. Using …

On The Definition Of A Confounder, Tyler J. Vanderweele, Ilya Shpitser

COBRA Preprint Series

The causal inference literature has provided a clear formal definition of confounding expressed in terms of counterfactual independence. The causal inference literature has not, however, produced a clear formal definition of a confounder, as it has given priority to the concept of confounding over that of a confounder. We consider a number of candidate definitions arising from various more informal statements made in the literature. We consider the properties satisfied by each candidate definition, principally focusing on (i) whether under the candidate definition control for all "confounders" suffices to control for "confounding" and (ii) whether each confounder in some context …

Caring For A Preterm Infant During The First Six Months Post Nicu Discharge: A Mother’S Perspective, Lois Phillips-Pula

Theses and Dissertations

Overview There are numerous studies in the current literature focusing on the intense emotions experienced by parents, following the birth of a preterm infant, (i.e., born prior to 37 weeks gestational age [GA]). Research findings have helped us understand the fear and anxiety they feel while attempting to navigate the neonatal intensive care unit (NICU) environment. What happens in those early weeks and months at home after discharge, however, is surprisingly absent from the literature. It is well known that preterm infants are readmitted to the hospital during the first few months after discharge at a rate of 10% - …

Leadership Rounding: Improving Frontline Nurse Satisfaction, Erin Bashaw

Doctor of Nursing Practice (DNP) Projects

The amount of time nurse managers and senior leadership spend with frontline or bedside staff impacts their ability to empower, engage and retain staff. Improving nurse satisfaction in relationship to teamwork, perception of senior leadership and attitude about direct management should be a priority of all organizations. Leaders that recognize the power of an intergenerational and interdisciplinary workforce will be influential for dynamic change and visionary development. Advancing overall teamwork as a nursing department, developing a better rapport with senior leadership and improving the relationship between direct management and front-line nurses is in the best interest of patient care.

Can Computer Assisted Diagnosis (Cad) Be Used As A Screening Tool In The Detection Of Pulmonary Nodules When Using 64-Slice Multidetector Computed Tomography?, Zishan Haider, Muhammad Idris, W. Memon, Nazia Kashif, Sidra Idris, Zafar Sajjad, Saeed Akram

Department of Radiology

Objectives:To evaluate (1) whether or not the addition of computer-assisted diagnosis (CAD) to 64-slice multidetector computed tomography (CT) can be used as a screening tool for detection of pulmonary nodules in routine CT chest examinations and (2) whether or not to advocate the incorporation of CAD as a screening tool into our daily practice. Materials And

Methods:

A retrospective cross-sectional analysis of 109 consecutive Patients who had all undergone routine contrast-enhanced CT chest examinations for indications other than lung cancer at the Radiology Department of Aga Khan University Hospital, Karachi, between November 2010 and January 2011. All examinations were …

Effect Of Duration And Amplitude Of Direct Current When Lidocaine Is Delivered By Iontophoresis, Susan A. Saliba, Courtney L. Teeter-Heyl, Patrick O. Mckeon, Christopher D. Ingeroll, Ethan N. Saliba

Physical Therapy Faculty Publications

Dosage for the galvanic stimulation for iontophoresis varies. Clinicians manipulate the duration or the amplitude of the current, but it is not known which is more effective. We compared the anesthetic effect of lidocaine HCL (2%) by manipulating the current parameters on 21 healthy volunteers (age: 21.2 ± 4.2, height 170.7 ± 10.2 cm, mass 82.1 ± 19.2 kg). Three conditions were administered in a random order using a Phoresor II^® with 2 mL, 2% lidocaine HCL in an iontophoresis electrode. (1) HASD (40 mA_*min): High amplitude (4 mA), short duration (10 min); (2) LALD (40 mA.min): …

Fluctuations And Instantons In Complex Landscapes: From Ligand Unbinding To Proton Transfer, Justin Elenewski

Theses and Dissertations

Biophysical entities are complex systems systems with strong environmental coupling, dominated by fluctuations on a hierarchy of timescales. These properties confound simulation of ligand binding and catalysis, inflating the scale of the problem to one tractable only with a considerable outlay of resources. In an attempt to ameliorate this restriction, several techniques are developed to accelerate biomolecular simulations while collaterally lending physical insight. The first segment of this dissertation is concerned with directed simulations of ligand binding in a model system. Using the serum retinol binding protein as a prototype, the potential of mean force associated with ligand binding is …

Long-Term Effects Of Changes In Cardiorespiratory Fitness And Body Mass Index On All-Cause And Cardiovascular Disease Mortality In Men: The Aerobics Center Longitudinal Study, Duck-Chul Lee, Xuemei Sui, Enrique G. Artero, I-Min Lee, Timothy S. Church, Paul A. Mcauley, Fatima C. Stanford, Harold W. Kohl Iii, Steven N. Blair

Faculty Publications

Background - The combined associations of changes in cardiorespiratory fitness and body mass index (BMI) with mortality remain controversial and uncertain.

Methods and Results - We examined the independent and combined associations of changes in fitness and BMI with all-cause and cardiovascular disease (CVD) mortality in 14,345 men (mean age 44 years) with at least 2 medical examinations. Fitness, in metabolic equivalents (METs), was estimated from a maximal treadmill test. BMI was calculated using measured weight and height. Changes in fitness and BMI between the baseline and last examinations over 6.3 years were classified into loss, stable, or gain groups. …

A Bridge To One World: An Indigenous Wisdom-Based Approach To Designing A Transcultural Patient Family Advisory Council, Julie Lundberg

Theses and Graduate Projects

As health care organizations face increasing challenges to accommodate diverse patient populations amid growing concerns of persistent health disparities, there is urgent need to better understand and listen to diverse, unique patient experiences. This paper describes the design and implementation of a transcultural Patient Family Advisory Council (PFAC) as a concrete step towards ensuring that the voices of culturally diverse patients and families are effectively engaged to improve the patient experience at a large, Midwestern healthcare organization. Storytelling, ritual and dialogue provide a wisdom-based approach to the design of a Bridge to One World practice model grounded in Leininger's Culture …

Care Of Self: How Reiki Is Used By Nurses To Reduce Stress On An Acute Care Unit, Leann Olson

Theses and Graduate Projects

As the nursing shortage escalates and patient acuity levels continue to rise, nurses can expect to experience increased stress and burnout. Indeed, studies show that job dissatisfaction among nurses today is widespread. Finding ways to reduce the stress, improve job satisfaction, and retention is important not only for nurses, nursing units, and organizations, but also for patients. This paper describes a nursing practice model that was developed to reduce stress and burnout among nurses in an acute care unit of a large urban hospital. The model uses the energy therapy of Reiki and is guided by Martha Rogers' Science of …

Creating A Healing Environment In The Intensive Care Unit, Elissa Egbers

Theses and Graduate Projects

The intensive care unit (ICU) can be a very stressful environment. Patients are critically ill and require constant monitoring. Indeed, high tech care in the ICU environment includes multiple factors that may impair the patient's ability to sleep and rest. The purpose of this paper is to describe a practice model that is conducive to patient healing in an intensive care unit in a large urban hospital. This practice model is significant to patients, families, and nursing staff and is based on Florence Nightingale's Environmental Model of Nursing and her thirteen canons. This paper describes the potential implementation of the …

Identifying Modulators Of The Development Of Acute Functional Tolerance To Ethanol In Caenorhabditis Elegans., Ka-Po Leung

Theses and Dissertations

Alcohol abuse is a problem in our society. There are few treatments available, in part due to the unclear molecular mechanisms of ethanol’s effects. Human studies indicate that there is a genetic component influencing disease susceptibility, and that an individual’s initial response to alcohol can predict their development of addiction. We have taken a forward genetics approach to study one component of initial response, acute functional tolerance (AFT), in Caenorhabditis elegans. We identified bet11, a mutation that causes animals to be defective in the development of AFT. Genetic analysis suggested that the gene that bet11 disrupts participates in a synthetic …

Living With Hiv: Views Through The Blog, Linda Eastham

Theses and Dissertations

The purpose of this qualitative descriptive study was to develop a greater clarity of how HIV infected individuals live and work within the sphere of HIV infection as represented through unsolicited, personal narratives posted on blogs. Existing, single author, personal blogs were identified via a search engine. Blogs were defined as the blog author's postings and all responses, whether written by the blog author or a reader respondent. Inclusion and exclusion criteria were developed to respect indicators of bloggers' intentions for privacy, e.g., blogs which required a password were excluded. A total of 14 blogs met inclusion criteria. Actions to …

Medical School Watercooler Newsletter - December 4, 2011, Lindsey Lyle

Watercooler Newsletter

This is the December 4, 2011 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler

Contents Include

• USA College of Medicine Welcomes Dr. Jarrod Fortwendel

• Support for Grieving Loved Ones During the Holidays

• USAMC Cookbook Proceeds To Benefit Patients

• Reminder: December Med School Café

• Holiday Toy Drive A Success

Disparate Degrees Of Hypervariable Loop Flexibility Control T Cell Receptor Cross-Reactivity, Specificity, And Binding Mechanism, Daniel R. Scott, Oleg Y. Borbulevych, Kurt H. Piepenbrink, Steven A. Corcelli, Brian M. Baker

Food for Health: Publications

αβ T cell receptors recognize multiple antigenic peptides bound and presented by major histocompatibility complex molecules. TCR cross-reactivity has been attributed in part to flexibility of the complementarity-determining region loops, yet there have been limited direct studies of loop dynamics to determine the extent of its role. Here we studied the flexibility of the binding loops of the αβ TCR A6 utilizing crystallographic, spectroscopic, and computational methods. A significant role for flexibility in binding and cross-reactivity was indicated only for the CDR3α and CDR3β hypervariable loops. Examination of the energy landscapes of these two loops indicated that CDR3β possesses a …

Best Practice Considerations For Arriving At A State Entity Or Agency, Institute For Public Health And Justice, Status Offenders

Policy & Position Papers

No abstract provided.

Healthcare Acquired Infection Risk And Toothbrush Contamination In The Icu., Michelle Frazelle

Theses and Dissertations

Healthcare acquired infections (HAIs) are a complex and multi-factorial problem associated with high morbidity, mortality, and cost. Toothbrushes (TBs) may be at risk for contamination with potential pathogenic microorganisms (PPMs) from the patient care environment or autoinnoculation from the patient. We focused on three PPMs: multiply resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), and Acinetobacter. Specific aims were to (1) describe environmental factors associated with TB contamination in the ICU; (2) describe the relationship between TB contamination and oral colonization in critically ill adults.

Understanding Mothers Of Late Preterm Infants, Brenda Baker

Theses and Dissertations

The experience of becoming a mother is a personal and social experience influenced by individual characteristics, friends and family, and the infant. The journey to become a mother encompasses concepts of maternal competence and responsiveness. The purpose of this study was to examine maternal competence and responsiveness to the infant in mothers of late preterm infants compared to mothers of full term infants. The conceptual model for this work was based on the work of Reva Rubin describing maternal identity and role development. Maternal competence and responsiveness are components of maternal role and are influenced by social support, maternal self-esteem, …

Bevacizumab Effect On Topotecan Pharmacokinetics In A Murine Orthotopic Rhabdomyosarcoma Xenograft Model, Zaifang Huang

Theses and Dissertations (ETD)

Increasing evidence suggests that inhibition of vascular endothelial growth factor (VEGF) can transiently normalize tumor vasculature, thereby improving delivery of systemic chemotherapy. Bevacizumab (BEV), an anti-VEGF antibody, has been shown to transiently normalize tumor vasculature by increasing tumor vessel maturity, decreasing tumor vessel permeability, and increasing tumor oxygenation in an Rh30 orthotopic rhabdomyosarcoma xenograft model. However, the effects of BEV on the pharmacokinetics of TPT and the antitumor activity of TPT have not been evaluated. This study aimed to investigate the effect of BEV on TPT systemic and tumoral pharmacokinetics and to determine how these changes affect the efficacy of …

Neuronal Growth Cone Retraction Relies Upon Proneurotrophin Receptor Signaling Through Rac, Richard E. Mains, Betty A. Eipper

UCHC Articles - Research

Growth of axons and dendrites is a dynamic process that involves guidance molecules, adhesion proteins, and neurotrophic factors. Although neurite extension during development has been extensively studied, the intracellular mechanisms that mediate neurite retraction are poorly understood. Here, we show that the proneurotrophin, proNGF, induces acute collapse of growth cones of cultured hippocampal neurons. This retraction is initiated by an interaction between p75^NTR and the sortilin family member, SorCS2 (sortilin-related VPS10 domain containing receptor 2). Binding of proNGF to the p75^NTR-SorCS2 complex induced growth cone retraction by initiating the dissociation of the guanine-nucleotide exchange factor Trio from …

Muscle-Fiber Type And Blood Oxidative Stress After Eccentric Exercise, John Quindry, Lindsey Miller, Graham Mcginnis, Megan Irwin, Charles Dumke, Meir Magal, N, Travis Triplett, Jeffrey Mcbride, Zea Urbiztondo

Integrative Physiology and Athletic Training Faculty Publications

Acute strength exercise elicits a transient oxidative stress, but the factors underlying the magnitude of this response remain unknown. The purpose of this investigation was to determine whether muscle-fiber type relates to the magnitude of blood oxidative stress after eccentric muscle activity. Eleven college-age men performed 3 sets of 50 eccentric knee-extensions. Blood samples taken pre-, post-, and 24, 48, 72, and 96 hr postexercise were assayed for comparison of muscle damage and oxidative-stress biomarkers including protein carbonyls (PCs). Vastus lateralis muscle biopsies were assayed for relative percentage of slow-and fast-twitch muscle fibers. There was a mixed fiber composition (Type …

The Overtraining Syndrome In Endurance Athletes; A Guide For Coaches And Athletic Trainers For Prevention And Treatment, Shannon M. Hughes

Graduate Theses

Training may be the most vital aspect of competition for serious athletes. The goal of training is to improve athletic performance by improving physiological performance, but there are instances when training can push an athlete physiologically beyond the threshold of tolerance. Most coaches and athletic trainers are aware that overtraining leads to physical injury when little recovery time is allowed, but what is still unclear is how overtraining affects the emotional and psychological stability of the athlete. The purpose of this guide is to educate coaches, athletic trainers, and even athletes, on the methods to potentially avoid overtraining, to recognize …

Chhs December 2011 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health And Human Services, Western Kentucky University

College of Health & Human Services Publications

No abstract provided.

Gestation Length, Mode Of Delivery And Neonatal Line Thickness Variation, CléMent Zanolli, Luca Bondioli, Franz Manni, Paola Rossi, Roberto Macchiarelli

Human Biology Open Access Pre-Prints

The transition from an intra- to extra-uterine environment leaves its mark in deciduous teeth (and first permanent molars) as an accentuated enamel incremental ring called the neonatal line (NL). This prominent microfeature separates the enamel formed during intrauterine life from that formed after leaving the womb. However, while the physical structure of this scar is well known, the bases of its formation are still a matter of investigation. In particular, besides the influence of the birth-related abrupt environmental and dietary changes and the role played by physiological factors such as hypocalcaemia, it has been suggested a direct relationship between NL …

How Does The Rural Food Environment Affect Rural Childhood Obesity?, David Hartley Phd, Mha, Nathaniel J. Anderson Ms, Mph, Kimberley Fox Mph, Jennifer D. Lenardson Mhs

Population Health

Objective: Assess the impact of the rural food environment on the eating behaviors and BMI of rural low-income children. Method: Statewide (Maine, 2009) household survey of parents of children on Medicaid (n=1722), oversampled in six rural communities, resulting in n=272 for six target communities. Food environment measured using modified Nutrition Environment Measures Survey in Stores (NEMS-S) for 46 retail food outlets. Multi-variate analysis assessed factors affecting home food environment, child's eating behavior and BMI. Results: Home food behaviors (how often: family eats together, child eats breakfast, vegetables served) and parent food consumption were significantly associated with children's healthy eating behaviors. …

Inhibition Of Cysteine Protease By Platinum (Ii) Diamine Complexes, Chaitanya Rapolu

Masters Theses & Specialist Projects

Chemotherapy is the first line of treatment used in cancer. Chemotherapy drugs such as cisplatin, carboplatin and oxaliplatin are used in treatment. Cisplatin enters the cell through copper transporter CTR1 by passive diffusion and bind to DNA and proteins. Cisplatin is found to inhibit several enzymes targeting cysteine, histidine and methionine residues, which are expected to be responsible for its anticancer activity. A better understanding of how the size and shape and leaving ligands of platinum complexes affect cysteine protease, papain enzyme are studied. This could give new ways to optimize anticancer activity. The activity of papain enzyme was measured …

Caring, Interaction, And Active Teaching Strategies: Factors That Contribute To The Success Of The Associate Degree Nursing Student, Penelope Sue Logsdon

Dissertations

This exploratory study examined successful associate degree nursing students’ perceptions regarding the importance of caring by the nursing faculty, nursing faculty/student interaction, and faculty use of active teaching strategies. Participants completed a researcher developed survey instrument that measured both the importance and frequency of the caring, interaction, and active teaching strategies. The survey instrument measured six demographic factors and 30 statements regarding caring, interaction, and active teaching. Participants rated the statements for both importance and frequency on a four-point Likert scale. Five community and technical college associate degree nursing programs participated in the research with a total of 270 successful …

A Non-Invasive Assay For Monitoring Stress Responses: A Comparison Between Wild And Captive-Reared Rainbowfish (Melanoteania Duboulayi), Amina Zuberi, Sinan Ali, Culum Brown

Aquaculture Collection

The stress response of wild and captive reared rainbowfish (Melanoteania duboulayi) following chasing by a simulated predator was examined. Cortisol release rate was monitored using a flow through system by measuring water borne hormone levels. Tests using known cortisol concentrations revealed that the technique yielded 95% of the cortisol present in the water. Cortisol release rates increased several fold in both populations after being chased but peaked at different time periods. Wild fish showed a typical stress response with release rate rising to (2.29±0.22 ng g⁻¹ h⁻¹) 2 h after exposure followed by rapid recovery. The captive-reared …