Medicine and Health Sciences Commons^™

Community Health News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Luque Reviews Practice Models

Examining Caregiver Appraisal Of Functional Capacity In Family Members With Dementia, Catherine Verrier Piersol

Theses and Dissertations

The vast majority of persons with Alzheimer’s disease and related dementias live at home and are cared for by families or close friends/neighbors. An essential element to daily care decisions is the caregiver’s appraisal of function in the family member with dementia. This dissertation comprises three separate papers exploring caregiver appraisal of functional capacity, using secondary data from a study conducted at Thomas Jefferson University of 88 patient-caregiver dyads, funded by the Alzheimer’s Association (L. Gitlin, PhD, principal investigator; Grant # IIRG-07-28686). The caregivers were primarily female (88.6%), white (77.3%), and spouses (55.7%), with a mean age of 65.8. All …

Open-Source Collaboration For Global Health: Science And Practice, Ariel Pablos-Méndez, Michael Klag, Lynn R. Goldman

Environmental and Occupational Health Faculty Publications

No abstract provided.

Development And Pilot Implementation Of A Locally Developed Trauma Registry: Lessons Learnt In A Low-Income Country, Amber Mehmood, Junaid Abdul Razzak, Sarah Kabir, Ellen J. Mackenzie, Adnan A. Hyder

Department of Emergency Medicine

Background

Trauma registries (TRs) play an integral role in the assessment of trauma care quality. TRs are still uncommon in developing countries owing to awareness and cost. We present a case study of development and pilot implementation of “Karachi Trauma Registry” (KITR), using existing medical records at a tertiary-care hospital of Karachi, Pakistan to present results of initial data and describe its process of implementation.

Methods

KITR is a locally developed, customized, electronic trauma registry based on open source software designed by local software developers in Karachi. Data for KITR was collected from November 2010 to January 2011. All patients …

Causes Of Death In Surgically Treated Patients With Type A Aortic Dissection - A Ten Year Review, James K. Wu Md, Eilizabeth Depaolo Bs, Theodore G. Phillips Md, Timothy S. Misselbeck

Department of Surgery

No abstract provided.

Health Risk Assessments Of Waste Combustion Emissions Using Surrogate Analyte Models, Michael A . Schmidt

Theses and Dissertations

Exposure assessments of open burn pits are often complicated by a lack of sampling equipment and resources. This research investigated the hypothesis of carbon dioxide (CO₂) as a viable surrogate for particulate matter with diameter ≤ 2.5 μm (PM2.5). Large-scale solid waste combustion tests resulted in linear trends between mean PM2.5 and CO₂ (R2 = 0.964 - 0.989). This pilot study demonstrates the feasibility of using CO₂ as a surrogate of PM2.5 concentration as CO₂ sensors potentially provide a cost-effective solution for monitoring in lieu of expensive PM instruments. It also indicates the potential reduction …

Mentoring Nursing Students In An Underserved Diverse Community, Wendover, Ut, Dr. Karen Miller

Journal of Undergraduate Research

Nursing students were required to complete 120 clinical hours in Wendover over a 4 week period. This required 4 trips to Wendover, UT and 4 overnight accommodations. The students rotated through several clinical sites including Anna Smith Elementary, Wendover High School, Toole Public Health Department and the Wendover Community Health Center. At each clinical site, students were paired with members of the community to facilitate learning. BYU students had daily contact with school nurses, teachers and administrators to assist in understanding their role and completing their assignments. At the elementary school, teachers helped BYU students to prepare and teach developmentally …

Using Bayesian Networks To Discover Relations Between Genes, Environment, And Disease, Chengwei Su, Angeline Andrew, Margaret R. Karagas, Mark E. Borsuk

Dartmouth Scholarship

We review the applicability of Bayesian networks (BNs) for discovering relations between genes, environment, and disease. By translating probabilistic dependencies among variables into graphical models and vice versa, BNs provide a comprehensible and modular framework for representing complex systems. We first describe the Bayesian network approach and its applicability to understanding the genetic and environmental basis of disease. We then describe a variety of algorithms for learning the structure of a network from observational data. Because of their relevance to real-world applications, the topics of missing data and causal interpretation are emphasized. The BN approach is then exemplified through application …

Bapineuzumab Alters Aβ Composition: Implications For The Amyloid Cascade Hypothesis And Anti-Amyloid Immunotherapy, Alex E. Roher, David H. Cribbs, Ronald C. Kim, Chera L. Maarouf, Charisse M. Whiteside, Tyler A. Kokjohn, Ian D. Daugs, Elizabeth Head, Carolyn Liebsack, Geidy Serrano, Christine Belden, Marwan N. Sabbagh, Thomas G. Beach

Sanders-Brown Center on Aging Faculty Publications

The characteristic neuropathological changes associated with Alzheimer's disease (AD) and other lines of evidence support the amyloid cascade hypothesis. Viewing amyloid deposits as the prime instigator of dementia has now led to clinical trials of multiple strategies to remove or prevent their formation. We performed neuropathological and biochemical assessments of 3 subjects treated with bapineuzumab infusions. Histological analyses were conducted to quantify amyloid plaque densities, Braak stages and the extent of cerebral amyloid angiopathy (CAA). Amyloid-β (Aβ) species in frontal and temporal lobe samples were quantified by ELISA. Western blots of amyloid-β precursor protein (AβPP) and its C-terminal (CT) fragments …

Urgent Aeromedical Evacuation Network Capacity Planning, Scott C. Finkbeiner

Theses and Dissertations

Aeromedical Evacuation (AE) has been steadily utilized during Operation Iraqi Freedom and Operation Enduring Freedom. AE is a global enterprise. The current structure of AE is facing changes as forces scale down from operations in Iraq and Afghanistan. AE will, however, continue to be important in its domestic use in the continental USA (CONUS). Current practice is to pull aircraft (e.g. C-17, C-130 or KC-135) from their normal operations to meet Urgent and Priority patient needs when local alternatives are infeasible. An alternative to the current system would be having a centralized "bed-down" location for AE operations that would house …

Traumatic Brain Injury Recovery Care: Demand Forecasting, Staffing, And Treatment Planning, Mitchell R. Kieffer

Theses and Dissertations

Improvised Explosive Device attacks have skyrocketed since the start of the War on Terror. Many troops wounded by these tactics receive long-lasting unseen wounds including Traumatic Brain Injury (TBI). TBI sufferers are treated along with other casualties. This has created an increasing, and varying, demand for ongoing post operative recovery care for troops returning from deployments. Diagnosis and treatment for TBI wounded troops is costly. This thesis is motivated by the recognition that budgets are constrained yet quality of care should not be compromised. Additive Holtz-Winters smoothing is used to forecast overall patient care demand, a regression based on queueing …

Aids: An Overview, Loretta Mclaughlin

New England Journal of Public Policy

"We stand nakedly in front of a very serious pandemic, as mortal as any pandemic there ever has been," said Halfdan Mahler, director-general of the World Health Organization (WHO). "I don't know of any greater killer than AIDS, not to speak of its psychological, social and economic maiming. Everything is getting worse and worse with AIDS and all of us have been underestimating it, and I in particular. We're running scared. I cannot imagine a worse health problem in this century." When asked to compare AIDS to other epidemics, such as smallpox, that have infected and killed over the course …

Spectral Detection Of Acute Mental Stress With Vis-Swir Hyperspectral Imagery, Elizabeth K. Norvell

Theses and Dissertations

The ability to identify a stressed person is becoming an important aspect across different work environments. Especially in higher-stress career fields, such as first responders and air traffic controllers, mental stress can inhibit a person's ability to accomplish their job. A person's efficiency and psychological state in the work environment can be impeded due to poor mental health. Stress can result in harmful effects on the body, both physically and mentally, including depression, lack of sleep, and fatigue, which can lead to reduced work productivity. Research is being conducted to detect stress in workload-intensive environments. This thesis implements an imaging …

De-Branching Of The Aortic Arch During Thoracic Endovascular Aortic Repair, James K. Wu Md, Caitlin O'Connor Bs, Timothy S. Misselbeck, Theodore G. Phillips Md

Department of Surgery

No abstract provided.

Emotional Distress In Patients Newly Diagnosed With Late Stage Cancers, Mei Bai, Elizabeth Ercolano, Mark Lazenby, Tony Ma, Ruth Mccorkle

Nursing Faculty Works

No abstract provided.

Increased Brain White Matter Axial Diffusivity Associated With Fatigue, Pain And Hyperalgesia In Gulf War Illness, Rakib U. Rayhan, Benson W. Stevens, Christian R. Timbol, Oluwatoyin Adewuyi, Brian Walitt, John Vanmeter, James N. Baraniuk

Medicine Faculty Publications

Background

Gulf War exposures in 1990 and 1991 have caused 25% to 30% of deployed personnel to develop a syndrome of chronic fatigue, pain, hyperalgesia, cognitive and affective dysfunction.

Methods

Gulf War veterans (n = 31) and sedentary veteran and civilian controls (n = 20) completed fMRI scans for diffusion tensor imaging. A combination of dolorimetry, subjective reports of pain and fatigue were correlated to white matter diffusivity properties to identify tracts associated with symptom constructs.

Results

Gulf War Illness subjects had significantly correlated fatigue, pain, hyperalgesia, and increased axial diffusivity in the right inferior fronto-occipital fasciculus. ROC …

Infective Endocarditis In The U.S., 1998–2009: A Nationwide Study, David H. Bor, Steffie Woolhandler, Rachel Nardin, David Brusch, David U. Himmelstein

Publications and Research

Background
Previous studies based on local case series estimated the annual incidence of endocarditis in the U.S. at about 4 per 100,000 population. Small-scale studies elsewhere have reported similar incidence rates. However, no nationally-representative population-based studies have verified these estimates.

Methods and Findings
Using the 1998–2009 Nationwide Inpatient Sample, which provides diagnoses from about 8 million U.S. hospitalizations annually, we examined endocarditis hospitalizations, bacteriology, co-morbidities, outcomes and costs. Hospital admissions for endocarditis rose from 25,511 in 1998 to 38, 976 in 2009 (12.7 per 100,000 population in 2009). The age-adjusted endocarditis admission rate increased 2.4% annually. The proportion of patients …

Examining Mainecare’S Coverage Options Under The Affordable Care Act, Erika C. Ziller Phd, Trish Riley

Population Health & Health Policy

The Affordable Care Act (ACA) was designed to achieve nearly universal access to health coverage in the United States—in part by standardizing Medicaid eligibility across the country so that each state’s program would cover individuals with incomes below 138% of the federal poverty level (FPL), or $15,856 for an individual and $32,499 for a family of four in 2013 (see Figure 1).i However, in June 2012, the U.S. Supreme Court determined that states could not be required to broaden Medicaid and retained the decision as a state option. States that choose to participate may do so by amending their state …

Intervention With Children With Autism: The Effect Of Using A Robot On Participation In Reciprocal Play, Shereen Ririe

Theses and Dissertations

The current study was part of a larger work investigating the effects of intervention incorporating a robot on the social engagement behaviors of children with autism. The larger study implemented a single-subject, multiple-baseline research design in which four children with autism participated in baseline sessions, traditional intervention, intervention including a robot, and follow-up sessions. The current study focused on the participant's responses to directives from the clinician and the parent during collaborative activities that included the robot. Children's responses were analyzed to determine if they responded to directives without assistance, responded with hand-over-hand assistance, or did not comply. Sessions were …

Effects Of Syntactic Complexity On Speech Motor Performance, Kelsey Lewis Boyce

Theses and Dissertations

This study evaluated the possible influence of linguistic demands on speech motor control by measuring articulatory movement stability during conditions of increasing grammatical complexity. There were 60 participants in three age groups: 20-30 years, 40-50 years, and 60-70 years, with equal numbers of men and women in each group. These speakers produced 10 repetitions of five different sentence or phrase conditions. These five conditions included two baseline measurements and three sentences of varying complexity. Each complexity condition had an MLU count of 23, word length of 17, syllable length of 25, and contained the phrase open boxes of pompoms. …

Test-Retest Reliability Of Speech Recognition Threshold Material In Individuals With A Wide Range Of Hearing Abilities, Karin Leola Caswell

Theses and Dissertations

The purpose of this study was to evaluate an updated list of digitally recorded Speech Recognition Threshold (SRT) materials for test-retest reliability. Chipman (2003) identified 33 psychometrically equated spondaic words that are frequently occurring in English today. These digitally recorded words were used to determine the SRT of 40 participants using the American Speech-Language Hearing Association guidelines. The participants were between the ages of 19 and 83 years and presented with hearing impairment ranging from normal to severe. The individual's pure-tone averages classified 16 participants with normal hearing to slight loss, 12 participants with mild loss, and 12 participants with …

Cd4 And Cd8 T Cells Directly Recognize Murine Gammaherpesvirus 68-Immortalized Cells And Prevent Tumor Outgrowth, Xiaozhan Liang, Rebecca L. Crepeau, Weijun Zhang, Samuel H. Speck, Edward J. Usherwood

Dartmouth Scholarship

There has been extensive research regarding T cell recognition of Epstein-Barr virus-transformed cells; however, less is known regarding the recognition of B cells immortalized by gamma-2 herpesviruses. Here we show that B cells immortalized by murine gammaherpesvirus 68 (MHV-68, γHV-68) can be controlled by either CD4 or CD8 T cells in vivo. We present evidence for the direct recognition of infected B cells by CD4 and CD8 T cells. These data will help in the development of immunotherapeutic approaches combating gamma-2 herpesvirus-related disease.

Test-Retest Reliability In Word Recognition Testing In Subjects With Varying Levels Of Hearing Loss, Meghan Elizabeth Grange

Theses and Dissertations

The purpose of this study was to determine the test-retest reliability of digitally recorded word recognition materials. Word recognition testing is included in a complete audiological evaluation to measure an individual's ability to discriminate what they hear. A phonetically balanced list of 50 monosyllabic words was presented to each participant at four different sensation levels (SL) using the American Speech Language Hearing Association recommended protocol for word recognition score testing. Each participant took a 10 minute break before the test was readministered. Participants included 40 subjects with varying levels of hearing loss, from normal hearing to severe hearing loss. The …

Big Decisions While Facing The Threat Of Huntington's Disease, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

The Net Reclassification Index (Nri): A Misleading Measure Of Prediction Improvement With Miscalibrated Or Overfit Models, Margaret Pepe, Jin Fang, Ziding Feng, Thomas Gerds, Jorgen Hilden

UW Biostatistics Working Paper Series

The Net Reclassification Index (NRI) is a very popular measure for evaluating the improvement in prediction performance gained by adding a marker to a set of baseline predictors. However, the statistical properties of this novel measure have not been explored in depth. We demonstrate the alarming result that the NRI statistic calculated on a large test dataset using risk models derived from a training set is likely to be positive even when the new marker has no predictive information. A related theoretical example is provided in which a miscalibrated risk model that includes an uninformative marker is proven to erroneously …

2013 March 19 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

High-Activity Mutants Of Butyrylcholinesterase For Cocaine Hydrolysis And Method Of Generating The Same, Chang-Guo Zhan, Hoon Cho, Hsin-Hsiung Tai

Pharmaceutical Sciences Faculty Patents

A novel computational method and generation of mutant butyrylcholinesterase for cocaine hydrolysis is provided. The method includes molecular modeling a possible BChE mutant and conducting molecular dynamics simulations and hybrid quantum mechanical/molecular mechanical calculations thereby providing a screening method of possible BChE mutants by predicting which mutant will lead to a more stable transition state for a rate determining step. Site-directed mutagenesis, protein expression, and protein activity is conducted for mutants determined computationally as being good candidates for possible BChE mutants, i.e., ones predicted to have higher catalytic efficiency as compared with wild-type BChE. In addition, mutants A199S/A328W/Y332G, A199S/F227A/A328W/Y332G, A199S/S287G/A328W/Y332G, …

International And Domestic Student Health-Information Seeking And Satisfaction, Stacy Theodora Austin

Dissertations and Theses

This study examines two groups -international and domestic students at Portland State University (PSU) - in terms of their motivations to seek university-health services, and their satisfaction with university-health services. The Theory of Motivated Information Management (W. A. Afifi & Weiner, 2004) served as the foundation for this study to examine the preferences of students in terms of the ways they seek information about their health concerns. Differences in international and domestic students' anxiety, efficacy, and satisfaction with physicians were supported. International students reported more anxiety than domestic students. Domestic students reported being more efficacious than international students when talking …

Advances In Personalized Targeted Treatment Of Metastatic Melanoma And Non-Invasive Tumor Monitoring, Dragana Klinac, Elin S. Gray, Michael Millward, Mel R. Ziman Dr

Research outputs 2013

Despite extensive scientific progress in the melanoma field, treatment of advanced stage melanoma with chemotherapeutics and biotherapeutics has rarely provided response rates higher than 20%. In the past decade, targeted inhibitors have been developed for metastatic melanoma, leading to the advent of more personalized therapies of genetically characterized tumors. Here we review current melanoma treatments and emerging targeted molecular therapies. In particular we discuss the mutant BRAF inhibitors Vemurafenib and Dabrafenib, which markedly inhibit tumor growth and advance patients’ overall survival. However this response is almost inevitably followed by complete tumor relapse due to drug resistance hampering the encouraging initial …

The Effect Of A Robot On Children With Severe Autism During A Song Activity, Michelle Nelson

Theses and Dissertations

This study is a small portion of a larger work examining the effects of low dosage robot use in interactive and social engagement therapy for children with autism. The purpose of this study was to investigate the participation of the subjects during song activities. Four children were used as participants, each receiving a total of 20 play-based treatment sessions targeting engagement and social interaction. The clinician incorporated the robot into these treatment sessions for 10 minute long segments within a 50 minute session. The current study analyzed these 10 minute segments with the robot, coding turn-taking behaviors. Results indicated that, …