Medicine and Health Sciences Commons^™

Integrating A System Approach To Identify And Manage Aggressive Behaviors In Adult Males With Severe Mental Illness In A Psychiatric Hospital, Mitzie Alford-Jenkins

Doctoral Projects

Aggressive behaviors exhibited by patients with a serious mental illness (SMI) hospitalized in inpatient psychiatric hospitals are a challenging safety problem. Early identification of aggressive behaviors is vital to helping nursing staff develop proactive interventions that focus on prevention. Structured risk assessments identify the level of risk and allow for early interventions.

The purpose of the doctoral capstone project was to: (a) provide education to nursing staff on implementing a structured risk assessment tool in order to identify risk for imminent aggression, manage risk for imminent aggression, and record aggressive behaviors among adult males with severe mental illness (SMI); (b) …

Effects Of Antihistamines On The Function Of Human Alpha-7 Nicotinic Acetylcholine Receptors, Seyedeh Soha Khanian

Theses

The effect of histamine H1 receptor (H1R) antagonists (antihistamines), namely, promethazine (PMZ), orphenadrine (ORP), chlorpheniramine (CLP), pyrilamine (PYR), diphenhydramine (DPH), cetirizine (CTZ), and triprolidine (TRP) were tested on the function of the cloned α₇subunit of the human nicotinic acetylcholine receptor (α₇-nAChR) expressed in Xenopus oocytes using the two-electrode voltage-clamp technique. Antihistamines inhibited the α₇-nAChR in the order of PYR > CLP > TRP > PMZ > ORP ≥ DPH ≥ CTZ. Among antihistamines, PYR showed the highest reversible inhibition of acetylcholine (100 µM) - induced current with IC₅₀ value of 6.2 µM. In contrast, the standard H2-H4R …

Discours, Paroles Et Liens À L’Autre Dans Les Groupes Thérapeutiques. Ce N’Est Pas La Fin D’Un Génocide Qui Clôt Un Génocide., Marie-Odile Godard

Présence Francophone: Revue internationale de langue et de littérature

Psychologists and psychoanalysts distinguish between testimony, or personal accounts, and discourse, a fixed societal account. Because genocide, for the survivor, is not a subject of study, we must not only look at the various discourses concerning the genocide, but at their effect on the survivors. We describe how the post-G-Gacaca therapy groups, established to help survivors who had participated in Gacaca assemblies, demonstrated how expression is only effective when it is directed at someone and this person agrees to hear it and be affected by it.

A Case Report Of Joubert Syndrome In Adult Presenting With Seizures, Ramla Nayaib Hashmi, Umm Ul Kiram

Pakistan Journal of Neurological Sciences (PJNS)

Joubert syndrome (JS) is rare autosomal recessive condition characterized by hypotonia, ataxia, psychomotor delay, and variable occurrence of oculomotor apraxia and neonatal breathing abnormalitie,intellectual disability, and specific mid-hindbrain malformation (“molar tooth sign”, MTS) We reportthe case of Joubert syndrome in a 32 years old female patient presenting with intellectual impairment, breathing abnormal breathing patterns like tachypnea followed by apnea ataxia, and seizures. She was diagnosed on the basis of Magnetic Resonance Imaging (MRI) and clinical features. JoubertSyndrome should be considered in all patients presenting with hypotonia, ataxia, nystagmus, breathing abnormalities and developmental delay. Its neuroimaging hallmarks include molar tooth sign …

Effectiveness Of Stretching Of The Flexor Retinaculum With Ultrasonic Therapy In The Management Of Carpal Tunnel Syndrome, Waqar Ahmed Awan, Muhammad Naveed Babur, Misha Ansari, Maria Liaqat

Pakistan Journal of Neurological Sciences (PJNS)

Aims & Objective: The objective of study was to compare the effectiveness of manual stretching of the flexor retinaculum with or without ultrasonic therapy. Methods: The study was started by selecting the 50 patients from the out patients department of Al-nafees Hospital AlipurFarash and National institute of Rehabilitation Medicine Islamabad with history of carpal tunnel syndrome. The 25 patients in experimental group were treated with manual stretching of flexor retinaculum and ultrasound and 25 patients of control group were treated with manual stretching of flexor retinaculum. Every session was started by assessment of improvement of the symptoms in each patient. …

The Burden Of Dysphagia And Chest Infection In Acute Ischemic Stroke In A Tertiary Care Hospital Of Islamabad Capital Territory, Rao Suhail, Shahzad Ahmed, Sumaira Nabi, Mansoor Iqbal

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is the foremost cause of severe neurologic disability in adults and is associated with a variety of complications. Dysphagia complicates acute ischemic strokes (AIS) in 42% cases and is more evident during the first week after ischemic stroke. Chest infection complicates AIS in 32% of the cases and 89% of these cases are due to dysphagia. Videofluoroscopy is the gold standard for swallowing assessment but due to non availability, bedside swallowing assessment is a more handytool. Methods: From August 2013 to February 2014151 patients were enrolled according to the set criteria.Each patient was assessed for dysphagia according to the …

Diagnostic Issues And Clinical Spectrum Of Childhood Degenerative Brain Diseases, Tipu Sultan, Ashfa Ameer Khan, Muhammad Arshad Khawaja, Zia Ur Rahman, Ahsan Waheed Rathore

Pakistan Journal of Neurological Sciences (PJNS)

To find out the spectrum of clinical presentation and typesof neurodegenerative disorders of childhoodin tertiary care child neurology centre of Pakistan. To find out the role of brain imaging in the diagnosis of degenerative brain disorders in children. Methods: It will bea retrospective, descriptive study conducted at department of paediatric neurology,The Children’s Hospital, Institute of child health, Lahore, Pakistanfrom January 1st,2004 to December 31,2013 (10 years). A total of 22,737 patients were admitted in the Paediatric Neurology department in the above said period. Out of them 366 children fulfilled the inclusion criteria. History, clinical examination and relevant investigations were evaluated …

Stiff Person Syndrome: A Diagnostic And Management Challenge, Zoya Sajjad, Anam Abrar, Zafar Ullah, Aasim Rehman, Wasim Tariq, Arsalan Ahmad

Pakistan Journal of Neurological Sciences (PJNS)

Stiff person syndrome (SPS) is a rare neurological disorder characterized by progressive muscle stiffness and rigidity, mostly involving axial muscles, resulting in functional disability. It is associated with elevated anti- Glutamic acid decarboxylase (GAD) antibody levels. Electromyography findings are often diagnostic. We present a case of a 48 years old male, who presented with progressive stiffness and rigidity of axial muscles and limbs. His EMG was consistent with SPS. Anti GAD antibodies were markedly elevated. He was treated with rituximab and has improved significantly. SPS is a difficult diagnosis, usually under diagnosed due to lack of awareness among medical community. …

Gender Based Differences In Diabetic Peripheral Neuropathy, Athar Javed, Ahmad Furqan, Mohsin Zaheer, Naeem Kasuri

Pakistan Journal of Neurological Sciences (PJNS)

Diabetic peripheral neuropathy (DPN) is one of the common complications of diabetes mellitus. Aim: To find out gender based differences in frequency of DM, age at diagnosis of DM and subsequent onset of DPN, duration of DM and DPN and electrophysiological patterns. Methodology: On the basis of non-probability purposive sampling, a cross sectional study was conducted at Neurology department, Mayo Hospital, Lahore. Patients fulfilling the ADA criteria for DM, and DPN were included in the study. Data was analyzed using SPSS 16 version. Results: A total of 125 patients were included in the study with 57/125 (45.6%) males and 68/125 …

Comparison Between Greulich-Pyle And Girdany-Golden Methods For Estimating Skeletal Age Of Children In Pakistan, Muhammad Awais, Naila Nadeem, Yousuf Husen, Abdul Rehman, Madiha Beg, Yasir Jamil Khattak

Department of Radiology

Objective: To compare Greulich-Pyle (GP) and Girdany-Golden (GG) methods for estimation of Skeletal Age (SA) in children referred to a tertiary care hospital in Karachi, Pakistan.STUDY Design: Cross-sectional study.PLACE AND DURATION OF STUDY: Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan, from July 2010 to June 2012.METHODOLOGY: Children up to the age of 18 years, who had undergone X-ray for the evaluation of trauma were included. Each X-ray was interpreted using both methods by two consultant paediatric radiologists having at least 10 years experience, who were blinded to the actual Chronologic Age (CA) of children.Results: A total of …

Regulation Of C-Reactive Protein Gene Expression And Function, Avinash N. Thirumalai

Electronic Theses and Dissertations

Human C-reactive protein (CRP) is the prototypic acute phase protein whose serum concentration increases rapidly during inflammation. CRP is also associated with atherosclerosis; it is deposited at lesion sites where it may interact with modified lipoproteins. There are 2 major questions regarding CRP: 1. How is the serum concentration of CRP regulated? 2. What are the functions of CRP in atherosclerosis?

Our first aim was to determine the role of the constitutively expressed transcription factor Oct-1 in regulating CRP gene expression. We found that Oct-1 overexpression inhibited (IL-6+IL-1β)- induced CRP gene expression; maximal inhibition required the binding of Oct-1 to …

Focusing On Drug Versus Disease Mechanisms And On Clinical Subgrouping To Advance Personalised Medicine In Psychiatry, Jose De Leon

Psychiatry Faculty Publications

Personalised medicine has finally been featured in psychiatric journals, but psychiatrists have mainly focused on the promise of using disease mechanisms to personalise treatment. Psychiatric disorders such as schizophrenia and depression are not diseases, in the medical sense, and are probably more like syndromes. Instead of spending much time and effort focusing on the mechanisms of diseases that may instead be syndromes, the author believes that psychiatrists should (1) learn more about personalising prescription via drug mechanisms, a pharmacological approach to personalised medicine; and (2) reconsider prior attempts by traditional clinical psychopharmacologists to use sophisticated clinical approaches that try to …

On The Symbolism Of The White Coat, David A. Nash

Oral Health Science Faculty Publications

The white coat ceremony has become an academic ritual in the health professions: a ceremony that signals a transformation of status from ordinary student to that of one studying to become a health professional. While donning the white coat is a sign of a changed role, the white coat is also a powerful symbol of transformation. White is a symbol of purity, and the white coat symbolizes the purity of purpose being affirmed in becoming a health professional. Dentistry is afforded the status of a learned profession as a result of the power dentists possess over patients seeking care; this …

Relationship Between Age And Pre-End Stage Renal Disease Care In Elderly Hemodialysis Patients, Rubette Harford Phd, Msn, Rn

Dissertations

Purpose: The primary purpose of this dissertation was to examine the relationship between age and receipt of three components of pre-end stage renal disease care prior to first initiation of hemodialysis, and to explore the implications of differences in interpretation of funding policies for dialysis services in Puerto Rico and the U.S. mainland. Background: The growing burden of chronic kidney disease (CKD) is a national public health concern, particularly within the aged population. It is estimated that more than 25 million Americans are living with some level of kidney disease, with an increasing prevalence noted with increasing age (Coresh et …

Ahr-Related Activities In A Creosote-Adapted Population Of Adult Atlantic Killifish, Fundulus Heteroclitus, Two Decades Post-Epa Superfund Status, Josephine Wojdylo

All Dissertations

Atlantic killifish, Fundulus heteroclitus, have adapted to, or at least developed a level of resistance to creosote-based polycyclic aromatic hydrocarbons (PAHs) found at the Atlantic Wood (AW) superfund site in the southern branch of the Elizabeth River, VA USA. Historically, 90+% of the mummichogs at this site have hepatic lesions of varying severity, and 30+% of these fish have tumors of various origin. Many xenobiotics, including select PAHs found at the Atlantic Wood site, are ligands for the aryl hydrocarbon receptor (AhR), which is a promiscuous ligand-dependent transcription factor involved in developmental regulation, environmental sensing, and induction of a suite …

The Scoop, Vol. 1 Issue 9, December 2014, Health Sciences Library

Volume 1

Latest news and events from the Health Sciences Library in our monthly newsletter for December 2014.

Long-Acting Antituberculous Therapeutic Nanoparticles Target Macrophage Endosomes., Benson J. Edagwa, Dongwei Guo, Pavan Puligujja, Han Chen, Joellyn Mcmillan, Xinming Liu, Howard Gendelman, Prabagaran Narayanasamy

Journal Articles: Pharmacology & Experimental Neuroscience

Eradication of Mycobacterium tuberculosis (MTB) infection requires daily administration of combinations of rifampin (RIF), isoniazid [isonicotinylhydrazine (INH)], pyrazinamide, and ethambutol, among other drug therapies. To facilitate and optimize MTB therapeutic selections, a mononuclear phagocyte (MP; monocyte, macrophage, and dendritic cell)-targeted drug delivery strategy was developed. Long-acting nanoformulations of RIF and an INH derivative, pentenyl-INH (INHP), were prepared, and their physicochemical properties were evaluated. This included the evaluation of MP particle uptake and retention, cell viability, and antimicrobial efficacy. Drug levels reached 6 μg/10(6) cells in human monocyte-derived macrophages (MDMs) for nanoparticle treatments compared with 0.1 μg/10(6) cells for native drugs. …

A Qualitative Study Evaluating Bedside Reporting And The Impact On Nurse Satisfaction And Communication Barriers With Washington Regional Medical Center, Win Szeto, Sarah Wren, Molly Milborn

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Nursing care occurs on a continuum that involves transferring the responsibility of a patient’s care from one nurse to another during shift change. Hand-off reports are a vital part of the communication cycle to ensure safe and effective care. Studies have shown bedside reporting increases patient and nurse satisfaction as well as the nurse-patient relationship (Agency for Healthcare Research and Quality, 2013b). The aim of this study was to educate nurses on the importance of bedside reporting and to implement a standardized hand-off. This study was evaluated through two measures. The first measure involved a survey/interview on nurses' perception before …

Data Sources Regarding The Nonmedical Use Of Pharmaceutical Opioids In The United States, Teresa D. Schmidt, Amanuel Zimam, Alexandra Nielsen, Wayne Wakeland

Complex Systems Faculty Publications and Presentations

Objective—Recent increases in the nonmedical use of pharmaceutical opioids and the adverse outcomes associated with them have stimulated a large amount of research and data collection on this public health problem. Systematic organization of the available data sources is needed to facilitate ongoing research, analysis, and evaluation. This work offers a systematic categorization of data sources regarding the nonmedical use of pharmaceutical opioids in the United States.

Methods—A list of keywords regarding the nonmedical use of pharmaceutical opioids was used to conduct systematic searches in PubMed®. Filtration of search results generated 92 peer-reviewed academic articles, published between January 1995 and …

Named Entity Recognition In Chinese Clinical Text, Jianbo Lei

Dissertations and Theses (Open Access)

Objective: Named entity recognition (NER) is one of the fundamental tasks in natural language processing (NLP). In the medical domain, there have been a number of studies on NER in English clinical notes; however, very limited NER research has been done on clinical notes written in Chinese. The goal of this study is to develop corpora, methods, and systems for NER in Chinese clinical text.

Materials and methods: To study entities in Chinese clinical text, we started with building annotated clinical corpora in Chinese. We developed an NER annotation guideline in Chinese by extending the one used in the 2010 …

Saturated Free Fatty Acids Induce Cholangiocyte Lipoapoptosis, Sathish Kumar Natarajan, Sally A. Ingham, Ashley M. Mohr, Cody J. Wehrkamp, Anuttoma Ray, Sohini Roy, Sophie C. Cazanave, Mary A. Smith, Justin L. Mott

Journal Articles: Biochemistry & Molecular Biology

Recent studies have identified a cholestatic variant of nonalcoholic fatty liver disease (NAFLD) with portal inflammation and ductular reaction. Based on reports of biliary damage, as well as increased circulating free fatty acids (FFAs) in NAFLD, we hypothesized the involvement of cholangiocyte lipoapoptosis as a mechanism of cellular injury. Here, we demonstrate that the saturated FFAs palmitate and stearate induced robust and rapid cell death in cholangiocytes. Palmitate and stearate induced cholangiocyte lipoapoptosis in a concentration-dependent manner in multiple cholangiocyte-derived cell lines. The mechanism of lipoapoptosis relied on the activation of caspase 3/7 activity. There was also a significant up-regulation …

A Combined Therapeutic Regimen Of Buspirone And Environmental Enrichment Is More Efficacrious Than Either Alone In Enhancing Spatial Learning In Brain-Injured Rats, Christina M. Monaco, Kory M. Gebhardt, Sarah M. Chlebowski, Kaitlyn E. Shaw, Jeffrey P. Cheng

PCOM Scholarly Works

Abstract Buspirone, a 5-HT1A receptor agonist, and environmental enrichment (EE) enhance cognition and reduce histopathology after traumatic brain injury (TBI) in adult rats, but have not been fully evaluated after pediatric TBI, which is the leading cause of death in children. Hence, the aims of this study were to assess the efficacy of buspirone alone (Experiment 1) and in combination with EE (Experiment 2) in TBI postnatal day-17 male rats. The hypothesis was that both therapies would confer cognitive and histological benefits when provided singly, but their combination would be more efficacious. Anesthetized rats received a cortical impact or sham …

Cytokine Variations And Mood Disorders: Influence Of Social Stressors And Social Support, Marie-Claude Audet, Robyn J. Mcquaid, Zul Merali, Hymie Anisman

Brain and Mind Institute

Stressful events have been implicated in the evolution of mood disorders. In addition to brain neurotransmitters and growth factors, the view has been offered that these disorders might be provoked by the activation of the inflammatory immune system as well as by de novo changes of inflammatory cytokines within the brain. The present review describes the impact of social stressors in animals and in humans on behavioral changes reminiscent of depressive states as well as on cytokine functioning. Social stressors increase pro-inflammatory cytokines in circulation as well as in brain regions that have been associated with depression, varying with the …

Notes From The Director, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Motivational Interviewing To Enhance Weight Loss And Eating Self-Efficacy In Overweight And Obese Adults, Theresa K. Buchanan Dr.

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Greater than six in ten adults in the United States are overweight or obese which can lead to cardiovascular disease, Type II Diabetes, joint injury and some forms of cancer, costing billions of healthcare dollars each year. Weight loss is difficult, as is maintaining weight loss. The purpose of this project is to investigate if use of the evidenced based (EB) intervention, motivational interviewing (MI), will enhance weight loss and eating self-efficacy (ESE) in overweight and obese adults seeking weight loss at a weight loss clinic over the course of eight weeks. Participants who received MI in addition to current …

Top 10 Medicinal Plants And Their Groundbreaking Impact On Modern Medicine, Jordan N. Patterson, Joan Marie Lausier

Senior Honors Projects

This paper describes ten plants that having been groundbreaking drugs in the past century that were all derived from plants. I chose to do my project on this topic because of my family’s history with natural medicine. In 1999 my mother was diagnosed with Bile Duct cancer and the doctors gave her only a couple of weeks to live. The doctors recommended chemotherapy and radiation, but the results seemed negative for the situation. After some extensive research, my parents found St. Georges Medicinal Wellness Center located in the tiny village of Bad Aibling, Germany. This hospital along with offering traditional …

Social Support From The Athletic Trainer And Symptoms Of Depression And Anxiety At Return To Play, Jingzhen Yang, Julie T. Schaefer, Ni Zhang, Tracey Covassin, Kele Ding, Erin Heiden

Faculty Research, Scholarly, and Creative Activity

No abstract provided.

Andreas Vesalius (1514-1564)–An Unfinished Life, Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The fame of Andreas Vesalius (1514-1564) rests on his anatomy text, De humani corporis fabrica, regarded as a seminal book in modern medicine. It was compiled while he taught anatomy at Padua, 1537-1543. Some of his findings challenged Galen’s writings of the 2c AD, and caused De fabrica to be rejected immediately by classically trained anatomists. At age 29, Vesalius abandoned his studies and over the next two decades served as physician to Emperor Charles V of the Holy Roman Empire (HRE) and later to King Philip II of Spain in Madrid. In 1564, he sought to resume teaching anatomy …

Hospital Discharge Decision Modeling For Mental Health Inpatients, Peiwen Duan

Industrial Engineering Undergraduate Honors Theses

This research addresses the issue of unnecessary treatment and late discharge for mental health inpatients. In this thesis, a dynamic decision model is proposed to determine the optimal timing to discharge a patient from hospital that considers both the impacts of over-treatment and not enough treatment on patients recovery. We measure the reward of making the discharge decisions in terms of hospitalization cost and readmission cost. The objective is to minimize the total expected cost for patients and provides hospital care providers with theoretical methods to assist them to make a better decision about discharge planning and management.

Acanthamoeba Spp. As Reservoirs For Transmission Of Norovirus, Tun-Yun Hsueh

Graduate Theses and Dissertations

Human noroviruses (HuNoV) are the most common cause of foodborne disease outbreaks in the United States and the most common food commodities implicated in HuNoV outbreaks are leafy greens; however, the vehicle of transmission and point of contamination are often unknown. Here, we hypothesize that common free-living amoebae (FLA) ubiquitous in the environment may act as reservoirs of HuNoV and facilitate the transmission of these pathogens to fresh produce. The objective of this research was to first evaluate the interaction/association between HuNoV surrogates and Acanthamoeba by incubating them together and analyzing virus titer associated with amoeba through an 8 day …