Medicine and Health Sciences Commons^™

Parental And Carer Responses To Angelman Syndrome And Prader-Willi Syndrome, Allyson K. Thomson

Theses: Doctorates and Masters

The research project undertaken as part of this thesis was designed to assess family stress levels and the use of coping strategies among the carers of people with an intellectual disability caused by Angelman syndrome (AS) or Prader-Willi syndrome (PWS). Both syndromes are genomic imprinting disorders that arise from disruptions in genes located within human chromosome 15q11-q13. Although the disease phenotypes are quite distinct, the genetic mechanisms involved are common to both syndromes but involve paternally-derived mutations in PWS as opposed to maternal mutations in AS. Previous investigations in Western Australia (WA) indicated that people with AS and PWS experience …

Defining The Phenotypes Of Sickle Cell Disease., Samir K. Ballas

Department of Medicine Faculty Papers

The sickle cell gene is pleiotropic in nature. Although it is a single gene mutation, it has multiple phenotypic expressions that constitute the complications of sickle cell disease. The frequency and severity of these complications vary considerably both latitudinally in patients and longitudinally in the same patient over time. Thus, complications that occur in childhood may disappear, persist or get worse with age. Dactylitis and stroke, for example, occur mostly in childhood, whereas leg ulcers and renal failure typically occur in adults. It is essential that the phenotypic manifestations of sickle cell disease be defined accurately so that communication among …

Update On Pain Management In Sickle Cell Disease., Samir K Ballas

Department of Medicine Faculty Papers

Acute pain is the hallmark of sickle cell disease and is the most common cause of hospital admissions. Tissue damage due to vaso-occlusion releases numerous inflammatory mediators that initiate the transmission of painful stimuli that culminate in the perception of pain. The acute sickle cell painful crisis evolves along four phases. Each phase is coupled with changes in certain markers of the disease. Hospital readmission occurs within 1 week in about 16% of discharged patients and within 1 month in about 50% of discharged patients. Failure to treat acute pain aggressively may lead to chronic pain syndrome which, in turn, …

What Modifiable Risk Factors Lead To Strokes In Our Part Of The World?, Maria Khan, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Research Diary: A Tool For Scaffolding, Marion Engin

All Works

Diaries have long been seen as tools for reflection in learning languages, and learning about teaching. Despite this recognition of the importance of narratives in diary writing, little attention has been paid to the role of research diaries in the process of learning about research, and learning how to be a researcher. During the author's own research into the construction of teaching knowledge by pre-service trainees, she became aware that her research diary was scaffolding her own construction of research knowledge. In this article the author discusses the role of a research diary based on a socio-cultural theory of learning. …

An Examination Of The Relationship Between Positive Psychological Functioning And Depression, John Forbes

Theses: Doctorates and Masters

With unipolar depression one of the most disabling illnesses in the world, it is important to appropriately conceptualise this disorder in order to inform research, diagnosis, and treatment. While many psychological theories of depression include constructs of polarity, most research and diagnostic criteria have focused on a single dimension that concentrates on the presence of negative symptomatology. This is reflective of an illness model of mental health that predominantly considers the presence of negative symptoms in terms of mood, cognitions, behaviours, and overall functioning. Nevertheless, there is strong research evidence indicating that positive and negative aspects of psychological functioning are …

Happiness And Related Factors Of Managing Directors In Industrial Plants In Bangkok, J Wattanasup, R. Kalayasiri

Chulalongkorn Medical Journal

Objective : To study levels of happiness and related factors of managing directors in industrial plants in Bangkok. Participants : Four hundred and thirty-one subjects from industrial plants in Bangkok. Methods : Levels of happiness were obtained by using the Thai Mental Health Indicators-66 (TMHI-66). Demographic, work, and social data were also collected. Managing directors with different levels of happiness were compared with respect to their demographic, work, and social variables by using chi-square tests. Then, the variables that were statistically significantly associated with the level of happiness in the initial analysis were analyzed by using multiple logistic regression analysis. …

Quality Of Life Of Pregnant Women Who Decide To Terminate Their Pregnancy, N Rattanaprasop, C. Nimnuan

Chulalongkorn Medical Journal

Objective : To study the quality of life (QOL) and related factors of pregnant women who decided to terminate their pregnancy. Design : Cross-sectional descriptive study. Setting : A private clinic in Bangkok. Materials and Methods : One hundred and forty-one women who decided to terminate their pregnancy took part. Demographic data were collected using self-complete questionnaire. The WHOQOL- BREF-THAI questionnaire was used to determine QOL. Result : The QOL score of women who terminated pregnancy was quite low in every dimension especially in mental health. Using reference value; about one-fifth had poor QOL-mental health and one-fourth had poor QOL- …

Accuracy Of Computed Tomography In Diagnosing Malignancy In Solitary Pulmonary Lesions, Imaad-Ur-Rehman, Wasim Memon, Yousuf Husen, Waseem Akhtar, Raafay Sophie, Muhammad Akbar Baig

Department of Radiology

OBJECTIVE: To evaluate accuracy of Computed Tomography (CT) for diagnosing malignancy in solitary pulmonary lesions (SPLs).

METHODS: A prospective cross-sectional study was conducted from 20-01-2007 to 30-06-2008 at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty-three patients with solitary pulmonary lesions (SPLs) seen in prior chest x-rays or chest CT scans were referred to radiology department for CT guided biopsy. CT scan was performed for each patient prior to biopsy and CT evaluation of the SPLs was performed followed by CT guided Biopsy. Histopathological diagnosis of the lesion was taken as the gold standard.

RESULTS: CT was found …

Aggressive Embryonal Rhabdomyosarcoma Presenting As Schwanoma : A Case Report, Mohammad Sohail Awan, Montasir Junaid, Zain A. Sobani

Department of Radiology

Rhabdomyosarcomas (RMS) are thought to arise from pluripotent muscle cell precursors intended to form the bodyís future striated muscle. Due to the wide distribution of striated muscle across the body these tumors may appear anywhere and cause symptoms accordingly. Presenting symptoms are highly variable and based on the tumor size and location making clinical diagnosis difficult. The diagnosis of RMS is based on histological examination; however they express varying cytologic pictures representing the different stages of rhabdomyoblasts and their development into skeletal muscle presenting pictures from highly to poorly differentiated neoplasms. Therefore their histological diagnosis also requires the use of …

Modulation Of Myocardial Mitochondrial Mechanisms During Severe Polymicrobial Sepsis In The Rat, M. Chopra, H. B. Golden, S. Mullapudi, W. Dowhan, D. E. Dostal, Avadhesh C. Sharma

PCOM Scholarly Papers

Background: We tested the hypothesis that 5-Hydroxydecanoic acid (5HD), a putative mitoKATP channel blocker, will reverse sepsis-induced cardiodynamic and adult rat ventricular myocyte (ARVM) contractile dysfunction, restore mitochondrial membrane permeability alterations and improve survival. Methodology/Principal Findings: Male Sprague-Dawley rats (350-400 g) were made septic using 400 mg/kg cecal inoculum, ip. Sham animals received 5% dextrose water, ip. The Voltage Dependent Anion Channels (VDAC1), Bax and cytochrome C levels were determined in isolated single ARVMs obtained from sham and septic rat heart. Mitochondria and cytosolic fractions were isolated from ARVMs treated with norepinephrine (NE, 10 µmoles) in the presence/absence of 5HD …

Relationships Between High-Stakes Clinical Skills Exam Scores And Program Director Global Competency Ratings Of First-Year Pediatric Residents, E. E. Langenau, G. Pugliano, W. L. Roberts

PCOM Scholarly Papers

Background: Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA), residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP) program directors' annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE), also assess competency in several clinical domains. Objective: The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics andCOMLEX-USALevel 2-PE scores from2005 to 2009. Methods: The sample included all 94 …

A Computational Framework For Proteome-Wide Pursuit And Prediction Of Metalloproteins Using Icp-Ms And Ms/Ms Data, W. Andrew Lancaster, Jeremy L. Praissman, Farris L. Poole, Aleksandar Cvetkovic, Angeli Lal Menon, Joseph W. Scott, Francis E. Jenney, Michael P. Thorgersen, Ewa Kalisiak, Junefredo V. Apon, Sunia A. Trauger, Gary Siuzdak, John A. Tainer, Michael W. W. Adams

PCOM Scholarly Papers

BACKGROUND: Metal-containing proteins comprise a diverse and sizable category within the proteomes of organisms, ranging from proteins that use metals to catalyze reactions to proteins in which metals play key structural roles. Unfortunately, reliably predicting that a protein will contain a specific metal from its amino acid sequence is not currently possible. We recently developed a generally-applicable experimental technique for finding metalloproteins on a genome-wide scale. Applying this metal-directed protein purification approach (ICP-MS and MS/MS based) to the prototypical microbe Pyrococcus furiosus conclusively demonstrated the extent and diversity of the uncharacterized portion of microbial metalloproteomes since a majority of the …

Constructing A Critical Path For Product Development, Commercialization, And Access, Martha Brady

HIV and AIDS

This brief discusses the Council's health technologies development and the product development path from conceptualization to market. It defines the steps in the Critical Path Framework, and examines activities at the preclinical and clinical stage.

Migration And Hiv In India: Study Of Select Districts, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Alka Narang, Umesh Chawla

HIV and AIDS

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

"Knowing Myself First": Feasibility Of Self-Testing Among Health Workers In Kenya, Sam Kalibala, Waimar Tun, William Muraah, Peter Cherutich, Erick Oweya, Patricia Oluoch

HIV and AIDS

Report of a study exploring the feasibility and acceptability of free HIV home self-testing among health workers in Kenya, within the range of other HIV testing options available.

Facilitating Regulatory Approval Of Multipurpose Prevention Technologies For Sexual And Reproductive Health, Martha Brady

HIV and AIDS

This brief describes multipurpose prevention technologies (MPTs) that address women's sexual and reproductive health (SRH) needs, and how to go about facilitating regulatory approval of this technology. It outlines a strategic framework to examine current regulatory guidance, as well a product development pathway to bring MPTs to market.

What Regulatory Guidance Exists For Multipurpose Prevention Technologies (Mpts)? A Review Of Key Guidance Documents And Their Applicability To Mpts, Martha Brady, Heeyoung Park

HIV and AIDS

This brief reviews regulatory guidance documents and how they may apply to multi-purpose technologies (MPTs). It examines guidance documents from the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The brief concludes by anticipating increased interactions with US regulatory agencies in hopes of finding new regulatory pathways that address MPTs specifically.

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Swaziland, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Swaziland, led by Population Services International, in partnership with Jhpiego, Marie Stopes International, and the Population Council. The study assesses participants' comprehension of the circumcision process, the informed consent process, as well as the affect of male circumcision counseling on their experience.

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Zambia, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Zambia, led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International, and the Population Council. The objectives of the study were to assess male circumcision clients' comprehension of the informed consent process, examine social norms and practices regarding informed consent for adolescents, compare clients' expectations and experiences, and make additional recommendations for improving the informed consent process.

Hiv Integrated Biological And Behavioural Surveillance Survey (Ibbss) 2010, Federal Ministry Of Health

HIV and AIDS

This report by the Nigerian Federal Ministry of Health highlights the findings of an integrated biological and behavioral surveillance survey (IBBSS) in Nigeria among groups whose behaviors or occupations often place them at higher risk of contracting sexually transmitted infections, including HIV. The main objectives of the study were to assess the knowledge and beliefs of high-risk groups about STI and HIV, determine the prevalence of HIV infection among these groups, and obtain data that will permit identification of trends over time. Since the 2007 IBBSS survey report, a considerable number of interventions have commenced among the study groups.

Situation Assessment Of The Hiv Response Among Young People In Zambia, Sam Kalibala, Drosin Mulenga

HIV and AIDS

The main objective of this situational assessment is to compile and synthesize existing recent information on HIV and young people together with the current AIDS response for young people in Zambia—including programs, policies, and key partners—and to document gaps and challenges in the response. The assessment aims to further strengthen this response by all stakeholders including the Government of the Republic of Zambia, the UN, faith-based organizations, civil society organizations, donors, young people, and youth-led organizations. Recommendations include: amending and strengthening laws related to HIV programming for young people and involving them in design and implementation; offering health services, life …

Parent-Child Communication On Sexual And Reproductive Health Matters: Perspectives Of Mothers And Fathers Of Youth In India, Shireen J. Jejeebhoy, K.G. Santhya

Poverty, Gender, and Youth

This report from the Population Council study “Youth in India: Situation and Needs” presents data from in-depth interviews with mothers and fathers of youth in six states of India regarding communication patterns. The content of parent-child—and parent-daughter—communication is typically intended to ensure that young people conform to prevailing social, gender, and relationship norms. This study, one of the first from India to probe parental perspectives, suggests that parents are indeed concerned about their children’s transition into sexual life, but are constrained by traditional norms, lack of information, and limited skills from communicating with and providing them the supportive environment needed …

Day Of Dialogue On Multipurpose Prevention Technologies: Toward Clarity In Nomenclature, Martha Brady, C. Elizabeth Mcgrory

Poverty, Gender, and Youth

The report summarizes a half-day meeting convened by the Population Council to clarify the wide variety of nomenclature and concepts associated with multipurpose prevention technologies (MPTs). The first section outlines where different types of products are reviewed within the FDA and existing processes that could be applied to MPTs. This is followed by a section that reviews what guidance exists and what else may be needed for review of products like MPTs that address two (or more) indications, including those with a single active, two actives, and multiple components. This meeting identified some of the specific opportunities and challenges for …

Female Wages In The Egyptian Textiles And Clothing Industry: Low Pay Or Discrimination?, Amirah El-Haddad

Poverty, Gender, and Youth

This Population Council working paper analyzes data collected from a survey of firms and workers in the textiles and clothing sector in Egypt. These data allow for the explanation of the sector’s gender wage gap by poorer endowments, and relegation of women to low-paying firms and occupations; and by within-firm and within-occupation differential in returns. There is a pay gap in this sector, with men receiving an hourly wage 29 percent higher than that of women, partly because women are concentrated in the lower paid occupations, with a clear glass ceiling in effect, and outright discrimination occurs. The largest of …

Women's Job Search Behavior In The Egyptian Labor Market, Somaya Abdel Mowla

Poverty, Gender, and Youth

This study evaluates the difference between male and female job search behavior in the Egyptian labor market and the changes in this behavior between 1998 and 2006, in order to examine the effect of transition toward a market-oriented economy on job search activity. The paper also investigates the determinants of women’s job search behavior. The results reveal three alarming facts that raise worries about women’s labor force participation and their future labor market outcomes: women were less active job searchers than men, the gender gap in job search has widened, and this gap is even wider when excluding registration in …

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …

National Efforts Toward Fgm-Free Villages In Egypt: The Evidence Of Impact, Ghada Barsoum, Nadia Rifaat, Omaima El-Gibaly, Nihal Elwan, Natalie Forcier

Poverty, Gender, and Youth

This report is a midterm evaluation and documentation of the process and approach of the FGM-Free Village Model implemented in Egypt by the National Council of Childhood and Motherhood with assistance from the Population Council. In a comparison of responses from women and men in intervention groups to those in nonintervention (control) villages, data analysis shows that the program has been successful in changing views and attitudes toward female genital mutilation (FGM). FGM is an entrenched generational practice, and eradicating it in a community requires concerted effort over an extended period of time. This evaluation strongly recommends that efforts be …

Costs Of Marriage—Marriage Transactions In The Developing World, Sajeda Amin, Ashish Bajracharya

Poverty, Gender, and Youth

Over the past two decades the Population Council has amassed a wealth of information on the causes and correlates of child marriage and documented its adverse effects on the well-being of women and girls. In many parts of the developing world, understanding child marriage is central to designing programs that promote healthy transitions to adulthood. Council research also underscores the importance of rituals and practices of marriage exchange around the globe and documents the considerable variation in these practices. Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief No. 35 synthesizes some broad themes that have emerged from research on …