Medicine and Health Sciences Commons^™

The Trust In Health Care Organizations By Health Sciences Students, Hermecender Walton-Williams

MUSC Theses and Dissertations

Trust in health care is important for the achievement of better health outcomes. This dissertation examined trust in health care of health sciences students using the Multidimensional Trust in Health Care Systems Scale (MTHCSS). The three main elements of trust within health care were examined: Health care providers, health care institutions and health care payers.

Nursing Managers' Perceptions, Knowledge And Commitment To Shared Governance, Jeanine M. Rundquist

Regis University Student Publications (comprehensive collection)

No abstract provided.

What's Happening: July 28, 2014, Maine Medical Center

What's Happening

No abstract provided.

Alternating Current And Infrared Produce An Onset-Free Reversible Nerve Block, Emilie H. Lothet, Kevin L. Kilgore, Niloy Bhadra, Narendra Bhadra, Tina Vrabec, Yves T. Wang, Michael W. Jenkins, Hillel J. Chiel

Faculty Scholarship

Nerve block can eliminate spasms and chronic pain. Kilohertz frequency alternating current (KHFAC) produces a safe and reversible nerve block. However, KHFAC-induced nerve block is associated with an undesirable onset response. Optical inhibition using infrared (IR) laser light can produce nerve block without an onset response, but heats nerves. Combining KHFAC with IR inhibition [alternating current and infrared (ACIR)] produces a rapidly reversible nerve block without an onset response. ACIR can be used to rapidly and reversibly provide onset-free nerve block in the unmyelinated nerves of the marine mollusk Aplysia californica and may have significant advantages over either modality alone. …

Incidence And Predictors Of Permanent Pacemaker Implantation After Valve Surgery – A Single Center Experience, Justin L. Guthier Do, Bilal Ayub Md, Yassir Nawaz Md, Hassam Saif Md, Robert F. Malacoff Md, Facc, Michael J. Weiss Mph, Theodore G. Phillips Md, James K. Wu Md, Raymond L. Singer Md, Sanjay M. Mehta Md, Gary W. Szydlowski Md, Ronald S. Freudenberger Md

Department of Medicine

No abstract provided.

Policy Impact Assessment: The “Reasonable Break Time” Provision Of The Patient Protection And Affordable Care Act, Merritt Juliano

21st Century Social Justice

Breastfeeding continues to be the most optimal source of nutrition for infants under 6 months of age, and has been associated with a wide variety of infant and maternal health benefits, including protection against certain illnesses and diseases. Most health organizations recommend exclusive breastfeeding for at least the first 6 months post-birth. Despite these recommendations, breastfeeding women, especially those in lower socioeconomic groups face many challenges in our society. Moreover, maternal employment stands as a significant barrier to successful breastfeeding durations. To counter these problems, Section 4207 of the Patient Protection and Affordable Care Act [ACA] was enacted to offer …

The Importance Of Access To Benefits Under The Family Medical Leave Act For Low-Income Families For Bonding And Attachment Facilitation With A Fragile Infant And The Role Of The Social Worker, Theresa Stewart Moran

21st Century Social Justice

Lack of universal family leave discriminates against low-income families with infants who require care in the Neonatal Intensive Care Unit. Birth complications tend to occur more frequently in families living with low socioeconomic status, placing a disproportionate burden on an already vulnerable population. Parents in this group tend to be employed in jobs that do not include the benefit of parental leave. Considering that attachment relationships form as the result of bonding transactions during a critical time in development, limiting contact curtails secure attachment. This, combined with other risk factors, increase the odds of lifelong negative outcomes. Family leave policy …

Medical School Watercooler Newsletter - July 27, 2014, Lindsey Lyle

Watercooler Newsletter

This is the July 27, 2014 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Medical Students Prepare for Board Exams
• Dr. Lynn Batten to Conduct Heart Screening Event for Athletes
• USA Resident Selected as Vice Chair of AMA Resident and Fellow Section
• USA President Holds Town Hall Meetings

Expanding The Role Of Pharmacology Tutors Through The Use Of Online Quizzes, Melinda E. Lull, Nicole E. Moore, Matthew Stryker, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Objectives: Pharmacology tutors have been available each semester for the past two years, but have been under-utilized by the student population. The primary objective of this study was to use innovative methods to increase the use of tutors in pharmacology courses.

The Use Of Student Development Workshops To Supplement The Traditional Pharmacy Curriculum, Melinda E. Lull, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Objectives: Preparing students to be successful in the classroom and as practitioners requires more than didactic education. The objectives of this study were to develop and assess a series of student development workshops aimed at addressing supplementary professional and academic needs of pharmacy students.

Optimal Duration Of Holter Recordings: Is There Additional Yield From 48 Versus 24 Hours?, Amanda Trang, Md, Behzad B. Pavri, Md

Department of Medicine Faculty Papers

INTRODUCTION

• Holter monitors are often used for evaluation of palpitations, syncope, heart rate, and detection of arrhythmias
• The duration of a typical Holter recording is either 24 or 48 hours
• Little research has been targeted at determining the ideal duration of monitoring
• We examined the yield of 24 versus 48 hours of Holter monitoring

Nut Midline Carcinoma In A Pregnant Woman, Jill N. D'Souza, Md, David M. Cognetti, Md, Ryan N. Heffelfinger, Md, James J. Evans, Md, Madalina Tuluc, Md, Jurij R. Bilyk, Marc R. Rosen, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

NUT midline carcinoma is a rare, highly aggressive tumor that involves midline structures, particularly in the head, neck and mediastinum. It is characterized by NUT gene translocations on chromosome 15. It typically impacts teenagers or young adults, and has a fulminant course leading to death in less than a year in most cases despite aggressive chemoradiotherapy. Due to its location, this tumor is frequently considered inoperable. We present a case of a sinonasal NUT midline carcinoma with orbital invasion discovered during the workup of sinusitis in a young, pregnant woman. The tumor was managed with definitive excision to negative margins …

Cervical Spine Osteomyelitis After Esophageal Dilation In Patients With A History Of Laryngectomy Or Pharyngectomy And Pharyngeal Irradiation, Richard A. Goldman, Md, Jill N. D'Souza, Md, Adam J. Luginbuhl, Md, Joshua E. Heller, Md, Joseph M. Curry, Md, David M. Cognetti, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Dysphagia is a common sequela of the treatment of head and neck cancer and is frequently managed with esophageal dilation in patients with dysphagia secondary to hypopharyngeal stenosis. Reported complications of esophageal dilation include bleeding, esophageal perforation, and mediastinitis. We examine four cases of cervical spine osteomyelitis presenting as a delayed complication of esophageal dilation for hypopharyngeal stenosis in patients with a history of laryngectomy or pharyngectomy and radiation with or without chemotherapy. The history of head and neck surgery and radiation in these patients further complicates the management of the cervical spine osteomyelitis.

Lineage-Specific Interface Proteins Match Up The Cell Cycle And Differentiation In Embryo Stem Cells, Angela Re, Christopher T. Workman, Levi Waldron, Alessandro Quattrone, Søren Brunak

Publications and Research

The shortage of molecular information on cell cycle changes along embryonic stem cell (ESC) differentiation prompts an in silico approach, which may provide a novel way to identify candidate genes or mechanisms acting in coordinating the two programs. We analyzed germ layer specific gene expression changes during the cell cycle and ESC differentiation by combining four human cell cycle transcriptome profiles with thirteen in vitro human ESC differentiation studies. To detect cross-talk mechanisms we then integrated the transcriptome data that displayed differential regulation with protein interaction data. A new class of non-transcriptionally regulated genes was identified, encoding proteins which interact …

Transition From An M1 To A Mixed Neuroinflammatory Phenotype Increases Amyloid Deposition In App/Ps1 Transgenic Mice, Erica M. Weekman, Tiffany L. Sudduth, Erin L. Abner, Gabriel J. Popa, Michael D. Mendenhall, Holly M. Brothers, Kaitlyn Braun, Abigail Greenstein, Donna M. Wilcock

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: The polarization to different neuroinflammatory phenotypes has been described in early Alzheimer's disease, yet the impact of these phenotypes on amyloid-beta (Aβ) pathology remains unknown. Short-term studies show that induction of an M1 neuroinflammatory phenotype reduces Aβ, but long-term studies have not been performed that track the neuroinflammatory phenotype.

METHODS: Wild-type and APP/PS1 transgenic mice aged 3 to 4 months received a bilateral intracranial injection of adeno-associated viral (AAV) vectors expressing IFNγ or green fluorescent protein in the frontal cortex and hippocampus. Mice were sacrificed 4 or 6 months post-injection. ELISA measurements were used for IFNγ protein levels and …

Conference Learnings, Anne Brown Rn, Cpan, Chtp, Carol Wang Rn, Bsn, Miriam Turnbach Rn, Chtp

Patient Care Services / Nursing

No abstract provided.

Low Zinc Levels Is Associated With Increased Inflammatory Activity But Not With Atherosclerosis, Arteriosclerosis Or Endothelial Dysfunction Among The Very Elderly, Ehimen Aneni, Khurram Nasir

All Publications

BACKGROUND:

Reduced zinc intake has been related to atherogenesis and arteriosclerosis. We verified this assumption in very old individuals, which are particularly prone to both zinc deficiency and structural and functional changes in the arterial wall.

METHODS:

Subjects (n = 201, 80-102 years) with uneventful cardiovascular history and who were not in use of anti-inflammatory treatments in the last 30-days were enrolled. Daily intake of zinc, lipid profile, plasma C-reactive protein (CRP), plasma zinc, flow-mediated dilation (FMD), carotid ultrasonography and cardiac computed tomography were obtained. Young's Elastic Modulus, Stiffness Index and Artery Compliance were calculated.

RESULTS:

There was no significant …

The Repetitive Behavior Spectrum In Autism And Obsessive Compulsive Disorder: From Helpful To Harmful, Robert H. Rice

Nursing Faculty/Staff Publications

Systematic study comparing repetitive behaviors in autism with those observed in obsessive compulsive disorder (OCD) and other Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition-Text Revision (DSM-IV-TR) diagnoses is lacking despite its diagnostic and treatment significance. This research examines repetitive behaviors in a sample of children and adults diagnosed with an autism spectrum disorder (ASD), (OCD), or both. Data were collected from three participant pools; clinic clients, parents/caregivers, and therapists; in order to test the psychometric properties of questions for assessing the functional characteristics of repetitive thoughts and behavior (i.e., stereotypy, compulsion, obsession, perseveration, preoccupation). Exploratory factor analyses revealed …

The Semen Microbiome And Its Relationship With Local Immunology And Viral Load In Hiv Infection, Cindy M. Liu, Brendan J.W. Osborne, Bruce A. Hungate, Kamnoosh Shahabi, Sanja Huibner, Richard Lester, Michael G. Dwan, Colin Kovacs, Tania L. Contente-Cuomo, Erika Benko, Maliha Aziz, Lance B. Price

Environmental and Occupational Health Faculty Publications

Semen is a major vector for HIV transmission, but the semen HIV RNA viral load (VL) only correlates moderately with the blood VL. Viral shedding can be enhanced by genital infections and associated inflammation, but it can also occur in the absence of classical pathogens. Thus, we hypothesized that a dysregulated semen microbiome correlates with local HIV shedding. We analyzed semen samples from 49 men who have sex with men (MSM), including 22 HIV-uninfected and 27 HIV-infected men, at baseline and after starting antiretroviral therapy (ART) using 16S rRNA gene-based pyrosequencing and quantitative PCR. We studied the relationship of semen …

Metagenomic Identification Of A Novel Salt Tolerance Gene From The Human Gut Microbiome Which Encodes A Membrane Protein With Homology To A Brp/Blh-Family Beta-Carotene 15,15'-Monooxygenase, Eamonn P. Culligan, Roy D. Sleator, Julian R. Marchesi, Colin Hill

Department of Biological Sciences Publications

The human gut microbiome consists of at least 3 million non-redundant genes, 150 times that of the core human genome. Herein, we report the identification and characterisation of a novel stress tolerance gene from the human gut metagenome. The locus, assigned brpA, encodes a membrane protein with homology to a brp/blh-family β-carotene monooxygenase. Cloning and heterologous expression of brpA in Escherichia coli confers a significant salt tolerance phenotype. Furthermore, when cultured in the presence of exogenous β-carotene, cell pellets adopt a red/orange pigmentation indicating the incorporation of carotenoids in the cell membrane.

A Spatial Analysis Of Functional Outcomes And Quality Of Life Outcomes After Pediatric Injury, Nathaniel Bell, Sami Kruse, Richard K. Simons, Mariana Brussoni

Faculty Publications

BACKGROUND:

Changes in health-related quality of life (HRQoL) are more regularly being monitored during the first year after injury. Monitoring changes in HRQoL using spatial cluster analysis can potentially identify concentrations of geographic areas with injury survivors with similar outcomes, thereby improving how interventions are delivered or in how outcomes are evaluated.

METHODS:

We used a spatial scan statistic designed for oridinal data to test two different spatial cluster analysis of very low, low, high, and very high HRQoL scores. Our study was based on HRQoL scores returned by children treated for injury at British Columbia Children's Hospital and discharged …

Structured Light Scatteroscopy, Venkataramanan Krishnaswamy, Jonathan T. Elliott, David M. Mcclatchy, Richard J. Barth Jr., Wendy A. Wells, Brian W. Pogue, Keith D. Paulsen

Dartmouth Scholarship

A new imaging approach, structured light scatteroscopy (SLS), is demonstrated, which offers rapid wide-field imaging of microscopic morphological variations in bulk tissue surfaces. Elastic scattering of light offers exquisite sensitivity to ultrastructural changes at multiple size scales ranging from nanometers to millimeters, but in bulk tissues the confounding effects of molecular absorption and strong multiple scattering of light often lead to a dramatic reduction in scatter contrast and specificity. It is demonstrated that the SLS using structured high spatial frequency illumination and detection to probe the tissue achieves direct, absorption-independent, high-resolution maps of the scattering response. The scattering response is …

Critically Reflexive Theory: A Proposal For Nursing Education, Jayne Josephsen

Nursing Faculty Publications and Presentations

Nursing is a discipline in transition. As the complexity and acuity of patients increase, nurses are taking on a more comprehensive role in health care leadership and patient outcomes. As the discipline has evolved so has the curricular framework of nursing educational programs, moving from being based on a specific nursing theory, to a general metaparadigm, to the current focus on meeting curricular content standards developed by national accrediting agencies. When considering the skills needed to fully engage in critical thinking and patient advocacy there may be room for an additional curricular focus: that of metacognitive development based on critical …

Correspondence: Protocol-Based Care For Early Septic Shock, Hans-Joachim Priebe, Angel Coz-Yataco, Stephen Trzeciak, Antonio J. Dajer, Derek C. Angus, Donald M. Yealy, John A. Kellum, Craig M. Lilly

Internal Medicine Faculty Publications

No abstract provided.

Maternal And Congenital Toxoplasmosis, Currently Available And Novel Therapies In Horizon, Helieh S. Oz

Internal Medicine Faculty Publications

Over one billion people worldwide are predicted to harbor Toxoplasma infection frequently with unknown lifelong health consequences. Toxoplasmosis is an important cause of foodborne, inflammatory illnesses, as well as congenital abnormalities. Ubiquitous Toxoplasma has a unique tropism for central nervous system with a mind-bugging effect and is transmitted sexually through semen. Currently available therapies are ineffective for persistent chronic disease and congenital toxoplasmosis or have severe side effects which may result in life-threatening complications. There is an urgent need for safe and effective therapies to eliminate or treat this cosmopolitan infectious and inflammatory disease. This investigation discusses pathogenesis of maternal …

Newborn Care: What We Can Learn From The Kangaroo Mother, Donald E. Greydanus, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Methodology And Ontology In Microbiome Research, John E. Huss

Philosophy Faculty Research

Research on the human microbiome has generated a staggering amount of sequence data, revealing variation in microbial diversity at the community, species (or phylotype), and genomic levels. In order to make this complexity more manageable and easier to interpret, new units—the metagenome, core microbiome, and enterotype—have been introduced in the scientific literature. Here, I argue that analytical tools and exploratory statisti- cal methods, coupled with a translational imperative, are the primary drivers of this new ontology. By reducing the dimensionality of variation in the human microbiome, these new units render it more tractable and easier to interpret, and hence serve …

Residential Treatment For Combat-Related Posttraumatic Stress Disorder: Identifying Trajectories Of Change And Predictors Of Treatment Response, Joseph M. Currier, Jason M. Holland, Kent D. Drescher

Psychology Faculty Research

Background

Combat-related posttraumatic stress disorder (PTSD) can be a difficult condition to treat and has been associated with serious medical and economic issues among U.S. military veterans. Distinguishing between treatment responders vs. non-responders in this population has become an important public health priority. This study was conducted to identify pre-treatment characteristics of U.S. veterans with combat-related PTSD that might contribute to favorable and unfavorable responses to high value treatments for this condition.

Method

This study focused on 805 patients who completed a VHA PTSD residential program between 2000 and 2007. These patients completed the PTSD Clinical Checklist at pre-treatment, post-treatment, …

Wide-Field In Vivo Neocortical Calcium Dye Imaging Using A Convection-Enhanced Loading Technique Combined With Simultaneous Multiwavelength Imaging Of Voltage-Sensitive Dyes And Hemodynamic Signals, Hongtao Ma, Samuel Harris, Redi Rahmani, Clay O. Lacefield, Mingrui Zhao, Randy M. Bruno, Jason Berwick, Theodore H. Schwartz

Dartmouth Scholarship

In Vivo calcium imaging is an incredibly powerful technique that provides simultaneous information on fast neuronal events, such as action potentials and subthreshold synaptic activity, as well as slower events that occur in the glia and surrounding neuropil. Bulk-loading methods that involve multiple injections can be used for single-cell as well as wide-field imaging studies. However, multiple injections result in inhomogeneous loading as well as multiple sites of potential cortical injury. We used convection-enhanced delivery to create smooth, continuous loading of a large area of the cortical surface through a solitary injection site and demonstrated the efficacy of the technique …

Global Burden Of Disease Study 2010: Interpretation And Implications For The Neglected Tropical Diseases, Peter J. Hotez, Miriam Alvarado, Maria Gloria Basanez, Ian Bolliger, Et Al.

Faculty, Staff and Students Publications

No abstract provided.