Medicine and Health Sciences Commons^™

Vaccinating Vulnerable Populations, Paula B. Mcnabb

Theses and Graduate Projects

Influenza vaccination rates for all minority groups in Minnesota are lower than rates for Caucasians of all age groups. Since 2006, a collaborative partnership called Minnesota Immunization Networking Initiative (MINI) has provided free influenza vaccinations in convenient and trusted community settings throughout the Twin Cities metropolitan area of Minnesota in an attempt to address this health disparity. The literature highlights a number of barriers that negatively influence individuals' choices regarding acceptance of influenza vaccination but also highlights motivators, facilitators and processes that positively impact these decisions. Thirteen focus group interviews were conducted with individuals from the Ethiopian, Latino, Native American …

Nursing Bedside Shift Report: A Best Care Practice, Heather Gleason

Theses and Graduate Projects

For healthcare organizations, patient safety and satisfaction are major priorities and are impacted by many different professional disciplines. Nurses can influence this greatly through the relationships built with patients and the information provided to them regarding care while in the hospital. Communication errors are the leading cause of sentinel events for patients, reiterating the importance of having a safe transfer of care between nurses at shift change. Bedside shift report not only creates transparency of patient information but results in improved patient safety and hospital satisfaction scores. Completing nursing shift report at the bedside promotes patients' and families' contribution to …

Social Cognitive Factors Associated With Verbal Bullying And Defending, Heather L. Carroll

Wayne State University Dissertations

The purpose of the study was to examine defending and verbal bullying and the role of social cognitive variables, including empathy, values, moral disengagement, and efficacy among middle school students. Middle school students (n=282) in grades 6 through 8 in an urban public school district in Michigan participated in the study. Data were collected using a self-report survey format during the 2013-2014 school year. Social cognitive variables were analyzed by grade and gender. Results indicated a statistically significant main effect for gender. Female students reported significantly higher scores for empathy, self-transcendence values and openness to change values, in comparison to …

Resolving Ethical Dilemma: An Application Of A Theoretical Model, Lubna Ghazal, Zulekha Saleem, Gulzar Amlani

School of Nursing & Midwifery

Human error can occur in any profession. Medical errors most commonly occur in a health care system, which may delay patient’s recovery and produce harm to patients. However, when a medical error occurs, it is challenging to inform the incident to patients and their family. Health care professionals follow a professional code of ethics to do well and not harm patients. Historically, many of these errors were not disclosed to patients but the trend for more open disclosure of medical errors to patients and their families is a mutually beneficial and welcomed change.

Regional Dust Storm Modeling For Health Services: The Case Of Valley Fever, William A. Sprigg, Slobodan Nickovic, John N. Galgiani, Goran Pejanovic, Slavo Petkovic, Mirjam Vujadinovic, Ana Vukovic, Milan Dacic, Scott Dibiase, Anup K. Prasad, Hesham El-Askary

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

On 5 July 2011, a massive dust storm struck Phoenix, Arizona (USA), raising concerns for increased cases of valley fever (coccidioidomycosis, or, cocci). A quasi-operational experimental airborne dust forecast system predicted the event and provides model output for continuing analysis in collaboration with public health and air quality communities. An objective of this collaboration was to see if a signal in cases of valley fever in the region could be detected and traced to the storm - an American haboob. To better understand the atmospheric life cycle of cocci spores, the DREAM dust model (also herein, NMME-DREAM) was modified to …

Flipping The Global Health Challenge To The Classroom, Cristina Redko

Population and Public Health Sciences Faculty Publications

Much of the debate concerning global health education remains focused on building effective training programs. This paper emphasizes the development of teaching strategies specific to global health education. Inspired by the active learning process of “flipped classrooms” where critical thinking happens in the classroom and fact finding happens outside, this paper describes the experience of bringing the real global health challenge of high maternal mortality in Somaliland directly into the North American classroom in a public health graduate program.

The Likelihood Of Khat Chewing Serving As A Neglected And Reverse ‘Gateway’ To Tobacco Use Among Uk Adult Male Khat Chewers: A Cross Sectional Study, Saba Kassim, Nikki Lynn Rogers, Kelly Leach

Population and Public Health Sciences Faculty Publications

Background

Chewing khat leaves is often accompanied by tobacco use. We assessed aspects of tobacco use and explored factors associated with tobacco use patterns (frequency of use per week) among khat chewers who used tobacco only when chewing khat (“simultaneous tobacco and khat users”, STKU).

Methods

A sample of 204 male khat chewers was recruited during random visits to khat outlets. Data collected included socio-demographic items, tobacco use and khat chewing behaviours. Both psychological and physical dependence on khat were assessed using the Severity of Psychological Dependence on Khat (SDS-Khat) Scale, the Diagnostic Statistical Manual IV (DSM-IV) and adapted items …

Conversion Of Autoimmune Hypothyroidism To Hyperthyroidism, Saira Furqan, Naeem-Ul Haque, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Graves' disease and Hashimoto's thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice.

Case Presentation: We are reporting three cases of middle aged Asian females who presented with classical symptoms of hypothyroidism and the investigations showed elevated thyroid stimulating hormone with positive thyroid antibodies. Diagnosis of autoimmune hypothyroidism was made and thyroxine replacement therapy …

Pituitary Stalk Interruption Syndrome Presenting As Short Stature: A Case Report, Nanik Ram, Syed Ahsan Ali, Syed Zubair Hussain

Section of Diabetes, Endocrinology and Metabolism

Introduction: Pituitary stalk interruption syndrome is a rare congenital abnormality of the pituitary that is responsible for anterior pituitary deficiency. It is characterized by a classic triad of interrupted pituitary stalk, absent or ectopic posterior pituitary, and anterior pituitary hypoplasia or aplasia. Clinical presentation varies according to age. In adults it presents as short stature and anterior pituitary deficiency. Without early diagnosis and treatment, mortality and morbidity in these patients is high. Early diagnosis and treatment of this rare disease can prevent permanent short statue of the patient. We report the first case of pituitary stalk interruption syndrome from …

Preablation Stimulated Thyroglobulin/Tsh Ratio As A Predictor Of Successful I(131)Remnant Ablation In Patients With Differentiated Thyroid Cancer Following Total Thyroidectomy, Syed Zubair Hussain, Maseeh Uz Zaman, Sarwar Malik, Nanik Ram, Ali Asghar, Unaib Rabbani, Nida Aftab, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background. About 90% of thyroid cancers are differentiated thyroid cancers. Standard treatment is total thyroidectomy followed by radioactive I(131)remnant ablation and TSH suppression with thyroxine. Unsuccessful ablation drastically affects the prognosis of patients with DTC particularly high risk individuals; therefore, identifying the factors that affect the success of ablation is important in the management of patients with DTC. sTg is a good predictor of successful ablation in DTC. Its levels can be influenced by tumor staging and TSH values, as well as other factors. Therefore, we did this study using TSH to correct the predictive value of sTg in …

Computational Multimedia For Video Self Modeling, Ju Shen

Theses and Dissertations--Computer Science

Video self modeling (VSM) is a behavioral intervention technique in which a learner models a target behavior by watching a video of oneself. This is the idea behind the psychological theory of self-efficacy - you can learn or model to perform certain tasks because you see yourself doing it, which provides the most ideal form of behavior modeling. The effectiveness of VSM has been demonstrated for many different types of disabilities and behavioral problems ranging from stuttering, inappropriate social behaviors, autism, selective mutism to sports training. However, there is an inherent difficulty associated with the production of VSM material. Prolonged …

Writing To Cope: Meaning Making For Professionals Caring For The Cancer Patient, Nicole Saint-Louis

Publications and Research

This paper will focus on the use of narrative or writing as an opportunity to bear witness, honor and work through the grief and loss professional caregivers experience in their oncology practice. The discussion includes, meaning making, narrative theory, narrative therapy and the growing literature of narrative medicine. Sample narratives will be shared to elucidate how writing can assist with the pain, loss and grief professional caregivers experience in the care of those coping with death and dying.

Role Of Complementary And Alternative Medicine In Controlling Dyslipidemia, Waris Qidwai, Firdous Jahan, Kashmira Nanji

Department of Family Medicine

No abstract provided.

Coming Out, Coming Together, Coming Around: An Interpretative Phenomenological Analysis Of Families' Experiences Adjusting To A Young Family Member's Disclosure Of Non-Heterosexuality, Denise M. Fournier Rodriguez

Department of Family Therapy Dissertations and Applied Clinical Projects

Young people who identify as lesbian, gay, or bisexual (LGB) are disclosing their sexual identity--or coming out--at progressively younger ages, making it more important than ever for the general population to understand, tolerate, and accept diversity in sexual identity. This study was designed to fill the gap in the existing literature about how the coming out process affects LGB young people's families of origin. Three LGB young people participated in the study, along with a member of each of their families. The researcher conducted semi-structured interviews with each of the participants, as well as a conjoint interview with each of …

Living With Uncertainty: The Impact On Breast Cancer Survivors And Their Intimate Partners, Kimberley Dockery

Department of Family Therapy Dissertations and Applied Clinical Projects

This study explored the lived experiences of breast cancer survivors and their intimate partners. The research was informed by a social constructionist framework and phenomenological method of inquiry. While the body of literature on the physical, psychological, and social health of breast cancer survivors is growing, only a few studies have focused solely on the lived experience of survivorship and the uncertainty of recurrence. This study sought to explore the construction of meaning in the couples' context and experiences of surviving breast cancer. The present study examined how breast cancer survivors make meaning of their survivorship in context of living …

Examining A Link Between Paraquat, Alpha-Synuclein Fibrillation And Neurodegeneration: A Review, Nikhil Ailaney

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Parkinson’s disease is a chronic and progressive motor system disorder that is caused by the degeneration of dopaminergic neurons in the central nervous system. At the molecular level, Parkinson’s disease works by decreasing the concentrations of the neurotransmitter dopamine, a chemical messenger involved in motor messaging, within the central nervous system. Low levels of dopamine in the central nervous system causes motor system dysfunction because the insufficient levels of dopamine lead to an inability for neurons to successfully transmit motor messages. At the organismal level, Parkinson’s disease causes tremors, Bradykinesia, and rigidity. These symptoms ultimately lead to a diminished quality …

Understanding Nicotine Addition: Dependency As A Result Of Maladaptive Brain Structure, Nate Thomas

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Nicotine addiction is the most prevalent, destructive dependency found in our culture. Despite its well-documented damaging health risks, nicotine use is still widely accepted and could be conceptualized as a social epidemic. Much of this acceptance may stem from nicotine’s lack of debilitating cognitive effects, as compared to those of other abused drugs. However, what may reign dominantly over nicotine’s legality is simple cultural precedent: tobacco has never been illegal and holds a place in human history. Therefore, attempting to alter this would prove highly unpopular and unsuccessful. This macroscopic irrationality, a blind favor for cultural precedents, parallels the irrational …

Identification Of A Treatment-Resistant, Ketamine-Sensitive Genetic Line In The Chick Anxiety-Depression Model, Stephen Walter White

Electronic Theses and Dissertations

Approximately 60% of Major Depressive Disorder (MDD) patients do not respond to FDA-approved antidepressants. Introducing effective pharmacotherapies for this treatment-resistant population is hindered by the lack of pre-clinical screening assays that accurately model the clinical features of TRD. The purpose of this research was to screen representatives of different classes FDA-approved antidepressants and one novel antidepressant in two genetic lines of domestic fowl chicks that have previously been identified as stress-vulnerable and stress-resilient in the chick anxiety depression model. Separate groups of socially raised Black Australorp (stress-vulnerable) and Production Red (stress-resilient) chicks were administered the tricyclic antidepressant imipramine (0-20 mg/kg), …

Revolution, Reform, And Reticent Voices: The Effects Of Nicaragua's Dynamic Health System On Medical Professionals, James E. Gardner

Browse All Undergraduate research

The views of health professionals are an important and often overlooked aspect of changes in health policy. This paper examines the impact of healthcare reform on the medical professionals of Nicaragua over the last 40 years. First, the historical context of Nicaraguan healthcare is discussed. This history is presented as both an outgrowth of and a reaction to Nicaragua’s changing political environment. The changes in health policy over this time period are then examined through the lens of medical professionals. Several sub-topics are investigated including the relationship between perceptions of health professionals and political ideology, the inability of the younger …

Hyperglycemia-Induced Diaphragm Weakness Is Mediated By Oxidative Stress, Leigh Ann Callahan, Gerald S. Supinski

Internal Medicine Faculty Publications

INTRODUCTION: A major consequence of ICU-acquired weakness (ICUAW) is diaphragm weakness, which prolongs the duration of mechanical ventilation. Hyperglycemia (HG) is a risk factor for ICUAW. However, the mechanisms underlying HG-induced respiratory muscle weakness are not known. Excessive reactive oxygen species (ROS) injure multiple tissues during HG, but only one study suggests that excessive ROS generation may be linked to HG-induced diaphragm weakness. We hypothesized that HG-induced diaphragm dysfunction is mediated by excessive superoxide generation and that administration of a specific superoxide scavenger, polyethylene glycol superoxide dismutase (PEG-SOD), would ameliorate these effects.

METHODS: HG was induced in rats using streptozotocin …

Perceived Barriers Among Pregnant Women Towards Cervical Cancer Screening, Visavilwa Vincent Lamuka

Master of Medicine in Family Medicine

Background: Cervical cancer remains the most common cancer in women in Eastern Africa in general and Tanzania in particular. However, to a large extent cervical cancer is preventable by effective screening programmes as has been demonstrated in many developed countries. Developing countries lack formal national screening programmes. Screening is usually mainly done opportunistically. Objective: To assess the perceived barriers to uptake of cervical cancer screening among pregnant women attending antenatal clinics in two hospitals in Dar es Salaam. Methodology: This was a qualitative study, conducted at two hospitals in Dar es salaam, a government facility (Amana District Hospital) and a …

An Assessment Of Whether Medical Doctors Have The Knowledge That Would Enable Them To Competently Deliver Tobacco Cessation Services, Miriam Miima Khamonya

Master of Medicine in Family Medicine

Background: Tobacco use is the leading cause of preventable morbidity and mortality globally. The international community recognizes this epidemic and compelling evidence exists on the significant contribution of the health care provider in propagating the success of tobacco cessation. The World Health Organization highlights minimal implementation of tobacco control policies by Tanzania despite a rise in tobacco use prevalence. Medical doctors’ competence is a reflection on our commitment to tobacco cessation service delivery. Main Objectives: To assess whether medical doctors have the knowledge that would enable them to competently deliver tobacco cessation services. Specific Objectives 1. To assess medical doctors’ …

Understanding And Managing Complications In Neurosurgery, Raza Sayyed, M Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

It is a well-known surgical maxim that only two types of surgeons do not have surgical complications; those who do not operate, and those who lie. Surgical complications in other words, are unwanted but undeniable part of surgery. There is not one operation with a 0% complication rate and therefore statistically, if a surgeon does not have complications, he probably has not operated enough. Despite their inevitability, complications convey a sense of gravity to the public, health professionals, and the policy makers alike.

Delay In Diagnosis Of Motor Neuron Disease. A Tertiary Care Experience, Hazim Brohi, Naveed Uddin Ahmed, Rajesh Khatri, Ishaq Asghar

Pakistan Journal of Neurological Sciences (PJNS)

Motor Neuron Disease is a progressive neurological disorder with poor prognosis. Inability to correctly recognize the disease, leads to undue agony and diagnostic dilemma. Studies have been done to look at the average duration taken to diagnose the disease from the onset of symptoms. The literature shows that latency from symptom onset to diagnosis range from 10.6–17.5 months. No such study has been conducted in our region. We reviewed 62 patients referred to the neurophysiology lab from year 2009 to 2013 with quarry of MND. Only 40 patients were identified to fulfill the El Escorial criteria for MND. The median …

Assessing Interprofessional Continuing Education And Planning Ahead, Farhan Vakani, Mughis Sheerani

Pakistan Journal of Neurological Sciences (PJNS)

The purpose of this survey is to check the concept of Interprofessional education (IPE) to continuing education among working physicians.It assessed 150 randomly selected working physicians of the Aga Khan University Hospital. One -best type questionnaire was designed and piloted to check its completion within 90 seconds.Four quick questions were dedicated at C1 & C2 level focused to check the knowledge and understanding of the physicians to IPE. The results showed 100% response rate. Majority (i.e. > 80%) of the respondents were familiar with the term IPE.The next three items tested physicians understanding regarding the IPE ability to improve communication, teamwork, …

Crossed Cerebellar Diaschisis In Partial Status Epilepticus, Sahrish Aieshah Kazi, Rehmani Aniqah Jawad, Rashed Nazir, Shahid Ahmed Shah, Arsalan Ahmad

Pakistan Journal of Neurological Sciences (PJNS)

Crossed cerebellar diaschisis is a phenomena described as decrease in metabolism in the cerebellar hemisphere contralateral to the supratentorial lesion. A 61 year old man presented with status epilepticus. CT Brain showed small acute hemorrhage in left parietal lobe.MRI revealed diffusion restriction in right cerebral and left cerebellar hemispheres with hyperintensities on T2WI and FLAIR. However, CT perfusion was suggestive of increased perfusion in these areas. Periictal EEG showed frequent bursts of higher voltage spike and wave discharges over the right hemisphere. He was treated with IV antiepileptics. But he continued to deteriorate, and expired at 10th day of admission.

Neurostimulation For Refractory Primary Chronic Headache Disorders: A Review, Bindu Yoga, Modar Khalil, Hassan Zafar, Fayyaz Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Headache is the commonest symptom seen in both primary and secondary care. Vast majority are primary i.e. for which no underlying cause has been detected. Tension Headaches, Migraine and Cluster Headaches are the most common primary headache disorders in the population. Although most of the primary headache disorders can be satisfactorily treated with both acute and preventive medications, those that are refractory to conventional treatment pose a great challenge to the headache physician. Moreover some patients are not able to use traditional treatment due to intolerance and co-morbidities. Neurostimulation is a treatment modality that has been used in other neurological …

Exploring The Role And Skill Set Of Physiotherapy Clinical Educators In Work Integrated Learning, Susan Edgar, Joanne Connaughton

Physiotherapy Papers and Journal Articles

Clinical educators are under increasing pressures in the workplace to provide quality education of healthcare students within varying supervision frameworks. Along with facilitating the teaching of clinical skills, clinical educators play a support role for students and so require more than expert clinical abilities in their vital position linking institutions and the healthcare environment. Twelve physiotherapy clinical educators attended one of two focus groups exploring their opinions on the role and skill set of clinical educators in work-integrated learning (WIL).Clinical educators described their role, their skills, challenges they faced supporting the needs of students, as well as future training requirements. …

Gossypiboma Diagnosed Fifteen Years After A Cesarean Section: A Case Report, Abdul Rehman, Noor Ul-Ain Baloch, Muhammad Awais

Department of Biological & Biomedical Sciences

Gossypiboma, a retained surgical sponge, is a rare complication following any surgical procedure and is primarily a result of human error. Such patients often have vague clinical presentations and the diagnosis often comes as a surprise. We present the case of a 40-year-old woman who had a long-standing history of lower abdominal discomfort. She was diagnosed with a gossypiboma fifteen years after a cesarean section. All general physicians, surgeons and radiologists must be aware of this rare but clinically significant entity.

Pharmacological Basis For The Medicinal Use Of Rhus Coriaria In Hyperactive Gut Disorders, Khalid Hussain Janbaz, Arham Shabbir, Hassan Mehmood, Anwarul Hassan Gilani

Department of Biological & Biomedical Sciences

This study was aimed at providing the pharmacological basis for the medicinal use of Rhus coriaria in diarrhea. In mice, the crude of R. coriaria demonstrated antisecretory and antidiarrheal effects against castor oil-induced fluid accumulation and diarrhea at at 100 and 300 mg/kg, respectively, and was found safe up to tested dose of 5 g/kg. In isolated rabbit jejunum, R. coriaria exhibited concentration-dependent (0.01-3.0 mg/mL) relaxation of spontaneous and high K⁺ (80 mM)-induced contractions, similar to verapamil. The Ca⁺⁺ antagonist activity was confirmed when pretreatment of R. coriaria shifted Ca⁺⁺ concentration-response curves to the right with suppression …