Medicine and Health Sciences Commons^™

Relationship Between Stress Burden And Perceived Support Among Elderly Male Spousal Caregivers, Stephanie Fitzsimmons Sexton

Walden Dissertations and Doctoral Studies

As older couples age, often one partner becomes more competent and able to care for the other, in which case they are able to remain in their homes. In one township in the northeastern United States, the caregiving role had a significant effect on the lives of elderly men who care for their wives. The purpose of this quantitative project study was to determine the relationship between perceived stress burden and perceived level of social support services and between perceived stress burden and use of support services by elderly male spousal caregivers residing in active adult communities. Watson's theory of …

Evaluation Of Vaccination Policies Among Utah Pediatric Clinic Employees, Tia Peterson

Theses and Dissertations

Introduction: Pediatric health care settings are high risk environments for spreading communicable and vaccine preventable diseases from health care workers to susceptible patients. Methods: All managers of pediatric clinics operating in the state of Utah were included. Participants were invited to complete a two-page questionnaire regarding their clinic vaccination policies. Results: Half (n = 23, 50%) of Utah pediatric outpatient clinics recommend employee vaccinations, although employee refusal is allowed without consequence. Of all adult vaccines, influenza was most often included as part of the employee vaccination policy. Some clinics required unvaccinated employees to wear masks in the event of illness, …

Coenzyme Q10, Sean M. Blumhardt

Graduate Student Theses, Dissertations, & Professional Papers

Blumhardt, Sean, M.A., May 2015, Exercise Science

Coenzyme Q10

Committee Chair: Dr. Steven Gaskill

Coenzyme Q10 (CoQ10) is a strong antioxidant and a key component of energy production in the electron transport chain. CoQ10 levels decrease with both age and cardiac disease in plasma and myocardium. After plasma CoQ10 concentrations decrease, dietary changes are generally unable to reestablish normal levels. CoQ10 supplementation is an inexpensive and safe therapy is able to reduce or prevent damage to cell membranes and vasculature by buffering reactive oxidative species. CoQ10 supplementation can decrease blood pressure in hypertensive patients as well as increase cardiac function …

A Phenomenological Inquiry Into The Low Rates Of Influenza Vaccination Among Older African Americans, Delia Roxanne Howson-Santana

Walden Dissertations and Doctoral Studies

Influenza vaccination is recommended for persons with high-risk health conditions such as chronic diseases to prevent flu-related complications and death. African Americans 65 years and older have consistently been reported to have the lowest influenza vaccination rates compared to all other racial groups, despite having higher rates of chronic diseases. A review of the literature indicated that there is a dearth of qualitative studies examining the grounds for these low rates. In this study, 15 African Americans 65 years and older were interviewed to explore the factors that contribute to low rates of flu vaccination among this racial group. Research …

Optimum Number Of Procedures Required To Achieve Procedural Skills Competency In Internal Medicine Residents, M. Tariq, Nizar Bhulani, Asif Jafferani, Quratulain Naeem, Syed Ahsan Ali, Afaq Motiwala, Jan Van Dalen, Saeed Hamid

Section of Internal Medicine

Background: Procedural skills training forms an essential, yet difficult to assess, component of an Internal Medicine Residency Program. We report the development of process of documentation and assessment of procedural skills training.
Method: An explanatory sequential mixed methods design was adopted where both quantitative and qualitative information was collected sequentially. A survey was conducted within the Department of Internal Medicine at The Aga Khan University Hospital, Karachi, Pakistan to determine the optimum number of procedures needed to be performed by residents at each year of residency. Respondents included both faculty and the residents in the Department. Thereafter, all responses …

Biginelli Synthesis And Characterization Of Potentially Anti-Proliferative Dihydropyrimidinone Thione Analogs, Timothy K. Summers

Theses and Dissertations

No abstract provided.

Factors Contributing To Attitudes Towards Disciplinary Parenting Styles, Amanda Marshall

Theses and Dissertations

The debate on whether or not corporal punishment is an acceptable method of discipline for children has been continuously researched and has consistently shown that the use of corporal punishment has a multitude of negative consequences on children (Gershoff, 2013). The present study aims to understand the factors which may contribute to the persistence of these supportive attitudes towards corporal punishment and abuse. The results of this study reveal that the age an individual becomes a parent/guardian is negatively correlated with their support for corporal punishment and acceptance of physical abuse. Strong correlations were also found between acceptance of abuse …

Best Practices For Improving Flow And Care Of Pediatric Patients In The Emergency Department., Isabel Barata, Kathleen M. Brown, Laura Fitzmaurice, Elizabeth Stone Griffin, Sally K. Snow, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee, Gregory P. Conners, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine

Manuscripts, Articles, Book Chapters and Other Papers

This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.

Patient- And Family-Centered Care Of Children In The Emergency Department., Nanette Dudley, Alice Ackerman, Kathleen M. Brown, Sally K. Snow, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee., Gregory P. Conners

Manuscripts, Articles, Book Chapters and Other Papers

Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in a mutually beneficial partnership among patients, families, and health care professionals. Providing patient- and family-centered care to children in the emergency department setting presents many opportunities and challenges. This revised technical report draws on previously published policy statements and reports, reviews the current literature, and describes the present state of practice and research regarding patient- and family-centered care for children in the emergency department setting as well as some of the complexities of providing such care.

Use Of Low-Dose Ketamine For Pain Management In An Emergency Department, Joseph Ladd, Winifred Pardo

All Publications

Background/Purpose: In the emergency department (ED), many barriers exist to pain management. Non-steroidal anti-inflammatory drugs and acetaminophen often cannot provide enough relief, while opioid analgesics are hindered by side effects, dependency, and tolerance. A non-competitive NMDA receptor antagonist, ketamine has historically been used for sedation and anesthesia in rural settings or in those with limited resources. Ketamine's unique safety profile and variety of dosage forms indicate its potential role in pain management. An evaluation was conducted of ketamine's use in low doses to treat pain in an emergency department with the third-greatest annual census in Miami-Dade county.

Methodology: A retroactive …

Exploring Social Networking Technologies As Tools For Hiv Prevention For Men Who Have Sex With Men, Jorge Ramallo, Thomas Kidder, Tashuna Albritton, Gary Blick, John Pachankis, Valen Grandeleski, Trace Kershaw

Publications and Research

Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social …

Promoting Colorectal Cancer Screening Among Haitian Americans, Steven S. Coughlin, Erica I. Lubetkin, Jennifer L. Hay, Renald Raphael, Selina A. Smith

Publications and Research

Background

Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns.

Methods

In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research.

Results

Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of …

Impact Of Pharmacist-Driven Transition Of Care Program In A Community Hospital, Felicia Seiler, Ana Lopez-Samblas, Maria Rojo-Carlo, Abby Marrero, Aixa Rey

All Publications

No abstract provided.

Impact Of Pharmacy Patient Education Programs On Medication Related Hcahps Scores, Ana Lopez-Samblas, Maria Rojo-Carlo, Aixa Rey, Maria Perez Arias

All Publications

No abstract provided.

Ethanol At Low Concentrations Protects Glomerular Podocytes Through Alcohol Dehydrogenase And 20-Hete., Ellen T. Mccarthy, Jianping Zhou, Ryan Eckert, David Genochio, Rishi Sharma, Olurinde Oni, Alok De, Tarak Srivastava, Ram Sharma, Virginia J. Savin, Mukut Sharma

Manuscripts, Articles, Book Chapters and Other Papers

Clinical studies suggest cardiovascular and renal benefits of ingesting small amounts of ethanol. Effects of ethanol, role of alcohol dehydrogenase (ADH) or of 20-hydroxyeicosatetraenoic acid (20-HETE) in podocytes of the glomerular filtration barrier have not been reported. We found that mouse podocytes at baseline generate 20-HETE and express ADH but not CYP2e1. Ethanol at high concentrations altered the actin cytoskeleton, induced CYP2e1, increased superoxide production and inhibited ADH gene expression. Ethanol at low concentrations upregulated the expression of ADH and CYP4a12a. 20-HETE, an arachidonic acid metabolite generated by CYP4a12a, blocked the ethanol-induced cytoskeletal derangement and superoxide generation. Ethanol at high …

Immunohistochemical Expression Of Matrix Metalloprotease-2 And Matrix Metalloprotease-9 In The Disks Of Patients With Temporomandibular Joint Dysfunction, Luis Eduardo Almeida, Karina Caporal, Viviane Ambros, Marina Azevedo, Lucia Noronha, Rosy Leonardi, Paula C. Trevilatto

School of Dentistry Faculty Research and Publications

Purpose

Matrix metalloproteases (MMPs) are tissue-remodeling enzymes that function during the remodeling process, such as in immune-inflammatory diseases. Metalloprotease-2 (MMP-2) and metalloprotease-9 (MMP-9) are gelatinases that degrade several types of extracellular matrix collagen. It is hypothesized that in temporomandibular joint (TMJ) dysfunction, MMP-2 and MMP-9 expression levels may be elevated. Therefore, the objective of this study is to determine the association of MMP-2 and MMP-9 expression with temporomandibular joint dysfunction using an immunohistochemical approach to evaluate the joint disk.

Material and Methods

A total of 45 human temporomandibular joint samples were collected, with 36 samples in the test group (patients …

Alternative Therapy For Sickle Cell Disease, Huda Alsultan

Graduate Research Papers

Sickle cell disease can lead to serious complications, such as stroke, acute chest syndrome, pulmonary hypertension, organ damage, blindness, skin ulcers, gallstones and priapism. Additionally, patients with sickle cell disease usually have several pain crises during the year, which means they have to be admitted to the hospital a couple days or weeks in order to treat these crises by pain relievers through IV line or veins. This necessitates quite often that the patient would be absent from their jobs or schools. Frequent absences may cause people with sickle cell disease to experience stress which in turn leads to a …

Pacap And Cocaine Reinstatement: A Neuropeptide Expressed By Corticostriatal Neurons That Regulates Nucleus Accumbens Astrocytes, Linghai Kong, E. Hess, Brian Maunze, Matthew M. Hurley, Khadijah Makky, Sujean Choi, John R. Mantsch, David A. Baker

Biomedical Sciences Faculty Research and Publications

Drug addiction involves heightened relapse vulnerability arising from persistent drug-induced neuro-adaptations, including a) hypofrontality which is thought to reflect reduced firing of cortical afferents to the nucleus accumbens (NAcc) and b) altered glutamate homeostasis in NAcc that likely involves reduced glutamate release and uptake by astrocytes. An important question is whether these forms of pathological plasticity are functionally linked such that reduced corticostriatal firing may result in aberrant regulation of astrocytes in the NAcc. To begin to evaluate this possibility, we first determined whether neurons regulate system xc- (Sxc) activity, a mechanism of non-vesicular glutamate release by astrocytes. We found …

Regulation Of System XC- By Pharmacological Manipulation Of Cellular Thiols, Rebecca Albano, Nicholas J. Raddatz, Julie Hjelmhaug, David A. Baker, Doug Lobner

Biomedical Sciences Faculty Research and Publications

The cystine/glutamate exchanger (system x_c^-) mediates the transport of cystine into the cell in exchange for glutamate. By releasing glutamate, system x_c^- can potentially cause excitotoxicity. However, through providing cystine to the cell, it regulates the levels of cellular glutathione (GSH), the main endogenous intracellular antioxidant, and may protect cells against oxidative stress. We tested two different compounds that deplete primary cortical cultures containing both neurons and astrocytes of intracellular GSH, L-buthionine-sulfoximine (L-BSO), and diethyl maleate (DEM). Both compounds caused significant concentration and time dependent decreases in intracellular GSH levels. However; DEM caused an increase …

Is Regenerative Injection Therapy (Prolotherapy) Effective At Reducing Pain Associated With Knee Osteoarthritis?, Ashley Aloi

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is regenerative injection therapy (prolotherapy) effective at reducing pain associated with knee osteoarthritis?”

Study Design: Review of all English language primary studies published in 2012 and 2013.

Data Sources: One randomized control trial, one randomized crossover study and one single-arm uncontrolled study were found using PubMed and Ebscohost.

Outcomes Measured: Clinical outcome for all three articles was measured using the Western Ontario McMaster University Osteoarthritis Index (WOMAC); which specifically focuses on quality of life, function, and pain reduction after the use of prolotherapy versus the saline …

Is Rabeprazole A Safe Treatment For Gastroesophageal Reflux Disease In Children Ages 1-16 Years?, Sarah Applegarth

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of the selective EBM review is to determine whether or not Rabeprazole is a safe treatment for GERD in children less than sixteen years old.

Study Design: Review of three randomized controlled studies. All three studies were published in English between 2007-2013.

Data Sources: Three randomized, un-blinded, controlled studies found using Medline and PubMed

Outcomes Measured: Each trial measured the adverse events that occurred with the use of Rabeprazole for the treatment of GERD in children less than sixteen years of age. This was done by using subjective reporting of treatment-emergent adverse events (TEAE’s). Differences in the …

Is Collagenase Clostridium Histolyticum A Safe And Effective Treatment For Adult Patients With Dupuytren’S Contracture?, Heather N. Bailey

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not collagenase clostridium histolyticum is a safe and effective treatment for adult patients with Dupuytren’s contracture.

STUDY DESIGN: Review of two double-blind, placebo-controlled randomized controlled trials and one cross-sectional study. All of these studies are published in English between 2009-2013.

DATA SOURCES: Two double-blind, placebo-controlled randomized controlled trials and one cross-sectional study found using PubMed.

OUTCOMES MEASURED: Each randomized controlled trial measured the ability to meet the primary end point and all secondary endpoints, percent decrease in degree of contracture, increase in range of motion, patient satisfaction, …

How Safe And Effective Is Tryptophan In Improving Sleep In Healthy Individuals With Mild Sleep Disorders?, Genevieve Asante-Odame

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not tryptophan is effective in improving sleep in healthy individuals with mild sleep disorders.

STUDY DESIGN: Systematic review of three published, randomized controlled trials (double-blind, placebo-controlled) between 2005-2010, all English language.

DATA SOURCES: Three randomized controlled trials published between 2005 and 2010 were found using PubMed/MEDLINE and Cochrane databases.

OUTCOMES MEASURED: Improved sleep quality and duration of sleep, which were measured using sleep diaries and sleep study questionnaires.

RESULTS: The first study, Cubero et al showed that administration of diet containing high levels of tryptophan reflected more …

Is Yoga Effective In Reducing Fibromyalgia-­Related Symptoms In Women With Fibromyalgia?, Molly R. Beckmann

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not yoga is effective in reducing fibromyalgia-related symptoms in women with fibromyalgia.

Study Design: Review of two published double blind, randomized controlled trials published in 2010 and one before-after study published in 2012 were used for this review and selected based on their relevance to the clinical question

Data Source: Studies were found using PubMed, AMED, and CINAHL Plus.

Outcomes Measured: All three studies measured improvement of fibromyalgia symptoms based on a variety of well-validated measures, most notably the Fibromyalgia Impact Questionnaire, the Quality of Life Profile …

Is Bitemporal Ect More Effective Than Bifrontal Ect In Reducingthe Symptoms Of Depression In Adults?, Talia M. Brinton

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not bitemporal ECT is more effective than bifrontal ECT in the treatment of adults with major depressive disorder. STUDY DESIGN: Review of three published randomized controlled trials, all English language. All RCTs were published after 1999 and studied patients older than 17 years old. DATA SOURCES: Three randomized control trials were found using PubMED, OVID, and Medline. Articles were selected based on relevance and that the outcomes of the studies mattered to patients. OUTCOME(S) MEASURED: Hamilton Rating Scale for Depression- 24 item completed by practitioner. RESULTS: The …

How Effective Is Acupuncture In Treating Persistent Allergic Rhinitis In Children And Adults?, Diana M. Casallas

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this evidence based medicine review is to determine whether or not acupuncture is effective in treating persistent allergic rhinitis in children and adults. Study design: Review of three published, randomized controlled trials (RCTs) published in 2004, 2007, and 2013. All English language. Data Source: The three randomized controlled trials that used in this review were found using PubMed. Outcome measured: Symptoms of nasal obstruction, rhinorrhea, sneezing and itching were measured with the Total Nasal Symptom Score (TNSS). Other outcomes measured were: Daily rhinitis scores, relief medication scores symptom free days and relief quality of life questionnaire …

Does Far Infrared Therapy Reduce The Incidence Of Arteriovenous Fistula Malfunction In Patients With Renal Disease Undergoing Hemodialysis?, Parker Barrett

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not far infrared therapy reduces the incidence of arteriovenous fistula (AVF) malfunction in patients with renal disease undergoing hemodialysis.

STUDY DESIGN: Review of three primary randomized controlled trial studies published from 2007-2013.

DATA SOURCES: Three peer-reviewed randomized controlled trials studying the effectiveness of far infrared therapy in the preservation of native arteriovenous fistula function in patients with chronic kidney disease requiring hemodialysis. Data searches done in PubMed, CINAHL Plus and EBSCOhost.

OUTCOMES MEASURED: Primary outcome measured was episodes of AVF malfunction due to stenotic complication. …

Is Treatment With Topical Glyceryl Trinitrate Effective In Reducing Elbow Pain In Patients With Lateral Epicondylitis?, Benjamin Chartier

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not treatment with topical glyceryl trinitrate is effective in reducing elbow pain in patients with lateral epicondylitis.

Study Design: Review of two English language randomized controlled trials and one primary study published 2003, 2009, 2011.

Data Sources: Two double blind randomized controlled and one prospective comparison study comparing the effectiveness of gylceryl trinitrate to placebo in the treatment of pain related to lateral epicondylitis, found using PubMed, EBSCOhost, and CINAHL Plus.

Outcome(s) Measured: The outcome studied was patient self-rated elbow pain at rest, pain with activity, pain …

Will The Addition Of Oxaliplatin To 5-Fluorouracil (5fu), And Leucovorin Improve Disease Free Survival Of Patients With Stage Iii Colon Cancer Who Had Surgical Resection Of The Tumor?, Sarah Cotter

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not the addition of oxaliplatin to 5FU and leucovorin will improve disease free survival of patients with stage III colon cancer who had surgical resection of the tumor.

Study Design: Review of three published, double blind randomized control trials in the English language in 2004, 2007, and 2009.

Outcomes Measured: The outcome is disease free survival of colon cancer. It is measured using periodic patient follow-up. History and PE, neuro assessment, liver and kidney function tests, CEA test, CBC, and imaging studies such as colonoscopy or barium …

Is Bevacizumab Effective In Inhibiting The Growth Of Recurrent Pterygium?, Sharon L. De La Cruz

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Bevacizumab is an effective treatment in inhibiting the growth of recurrent pterygium.

Study Design: Review of three published, English language randomized controlled trials published in 2010, 2012, and 2013.

Data Sources: Three randomized controlled trials measuring the efficacy of Bevacizumab to inhibit the growth of recurrent pterygium were found using PubMed and OVID databases.

Outcome(s) Measured: The severity and progression of pterygium recurrence as well as corneal neovascularization were the main outcomes measured. Conjunctival injection, thickness, and size of the fibrovascular tissue were examined in subjects …