Medicine and Health Sciences Commons^™

Development Of Cytotoxic Natural Killer Cells For Ovarian Cancer Treatment, Veethika Pandey

Electronic Theses and Dissertations

Ovarian cancer is a leading cause of gynecological malignancy. Cytoreductive surgery and frontline platinum/taxane-based chemotherapy provides good initial efficacy in the treatment, but poor long-term patient survival. This is mainly caused by tumor relapse due to intraperitoneal spreading and ineffective alternate therapies to treat these resistant tumors. The challenge in the field is to develop strategies that would prove effective in these patients and extend overall survival. Over the years, various treatments have been developed for the treatment of cancer amongst which, adoptive cell immunotherapy has shown promising results. But despite the efficacy seen in the clinic, there are concerns …

Gene Expression Changes Reflect Clinical Response In A Placebo-Controlled Randomized Trial Of Abatacept In Patients With Diffuse Cutaneous Systemic Sclerosis, Eliza F. Chakravarty, Viktor Martyanov, David Fiorentino, Tammara A. Wood, David J. Haddon, Justin A. Jarrell, Paul Utz, Mark Genovese, Michael Whitfield, Lorinda Chung

Dartmouth Scholarship

Systemic sclerosis is an autoimmune disease characterized by inflammation and fibrosis of the skin and internal organs. We sought to assess the clinical and molecular effects associated with response to intravenous abatacept in patients with diffuse cutaneous systemic.

Is Conflict A Factor In A Population's Quality Of Life? A Comparative Study Of University Students In The Palestinian Territories And Jordan, Yara Asi

Electronic Theses and Dissertations

As nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken in an effort to understand how long-term conflict manifests itself in noncombatant populations. However, existing studies focus primarily on indicators within the …

Accreditation As An Organizational Response: Exploring The Influence Of Leadership And Institutional And Task Environments On The Accreditation Process In Communication Sciences And Disorders Programs, Jeffrey Charles Adams

Theses and Dissertations

Influences on the accreditation process in communication sciences and disorder (CSD) programs were examined using a cross case comparative qualitative analysis among four successfully accredited academic departments in the southern United States. Program chairs, CSD administrators, clinic directors and faculty were interviewed. Four institutional sites were selected for the case studies based upon the outcome of the program’s most recent accreditation site visit, the date of the accreditation site visit, number of available faculty, and institutional type. The four institutions included one master’s granting private institution, one master’s granting (larger) program, one doctoral/research medical university, and one doctoral/research university (very …

Medical Versus Surgical Methods Of Early Abortion: Protocol For A Systematic Review And Environmental Scan Of Patient Decision Aids, Kyla Z. Donnelly, Rachel Thompson

Dartmouth Scholarship

Introduction: Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II).

Methods and analysis: For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating …

Quantitative Spatial Frequency Fluorescence Imaging In The Sub-Diffusive Domain For Image-Guided Glioma Resection, Mira Sibai, Israel Veilleux, Jonathan T. Elliott, Frederic Leblond, Brian Wilson

Dartmouth Scholarship

Intraoperative 5- aminolevulinic acid induced-Protoporphyrin IX (PpIX) fluorescence guidance enables maximum safe resection of glioblastomas by providing surgeons with real-time tumor optical contrast. However, visual assessment of PpIX fluorescence is subjective and limited by the distorting effects of light attenuation and tissue autofluorescence. We have previously shown that non-invasive point measurements of absolute PpIX concentration identifies residual tumor that is otherwise non-detectable. Here, we extend this approach to wide-field quantitative fluorescence imaging by implementing spatial frequency domain imaging to recover tissue optical properties across the field-of-view in phantoms and ex vivo tissue.

Pathway Efficiency And Relative Age In The Australian Football League Talent Pathway, Ashley Cripps, Luke S. Hopper, Christopher Joyce, James Veale

Health Sciences Papers and Journal Articles

Sporting bodies invest substantial resources into the identification and development of talented junior athletes. However, low retention of junior athletes into senior competition has been reported. One mechanism affecting retention may be selections biased by relative age. This study examined the pathway involvement and birth distribution of athletes (n=2519) selected into the Australian Football League Talent Pathway, over six seasons. Only half of athletes selected into professional teams had any involvement in the talent pathway. Birth distributions at every pathway stage were biased towards relatively older athletes, with relatively older athletes more likely to be de-selected as the pathway progressed. …

The Role Of A Highly Conserved Eubacterial Ribosomal Protein In Translation Quality Control, Anusha Naganathan

Electronic Theses and Dissertations

The process of decoding is the most crucial determinant of the quality of protein synthesis. Ribosomal protein L9 was first implicated in decoding fidelity when a mutant version of L9 was found to increase the translation of a T4 phage gene. Later studies confirmed that the absence of L9 leads to increased translational bypassing, frameshifting, and stop codon readthrough. L9 is part of the large subunit of the prokaryotic ribosome and is located more than 90 Å from the site of decoding, making it difficult to envision how it might affect decoding and reading frame maintenance. Twenty years after the …

Impact Of Interruption Frequency On Nurses' Performance, Satisfaction, And Cognition During Patient-Controlled Analgesia Use In The Simulated Setting, Kristi Campoe

Electronic Theses and Dissertations

Problem: Interruption during medication administration is a significant patient safety concern within health care, especially during the administration of high risk medications in nursing. Patient-controlled analgesia (PCA) devices are frequently associated with adverse events and have a four-fold increased risk of patient injury compared to non-PCA related adverse events. While the nature and frequency of interruptions have been established for nurses* medication processes, the impact of interruption frequency on nurses* PCA interaction has not been fully measured or described. Purpose: The purposes of this study were to quantify the impact of interruption frequency on registered nurses* (RN) performance, satisfaction, and …

Proteomic Analysis Delineates The Signaling Networks Of Plasmodium Falciparum, Brittany Pease

Electronic Theses and Dissertations

Malaria is a life-threatening disease caused by Plasmodium parasites that are spread through the bites of infected mosquito vectors. It is a worldwide pandemic that threatens 3.4 billion people annually. Currently, there are only a few validated Plasmodium drug targets, while drug resistance continues to rise. This marks the urgency for the development of novel parasite-specific therapeutics. Plasmodium falciparum diverges from the paradigm of the eukaryotic cell cycle by undergoing multiple rounds of DNA replication and nuclear division without cytokinesis. A better understanding of the molecular switches that coordinate the progression of the parasite through the intraerythrocytic developmental stages will …

Family Care Giver Knowledge, Patient Illness Characteristics, And Unplanned Hospital Admissions In Older Adults With Cancer, Patricia Geddie

Electronic Theses and Dissertations

Unplanned hospital admissions (UHA) in older adult populations are a recurring problem in older adults with cancer. Older adults comprise approximately 60% of cancer diagnoses and receive the majority of cancer treatment. However, little is known about why older adults under treatment for cancer experience a high number of unplanned hospital admissions. A review of the literature provided few study findings and a gap in the current knowledge was identified regarding the factors associated with unplanned hospital admissions in older adults under treatment for cancer. A conceptual framework based on the literature and this researcher's clinical experienced guided this study. …

Nurse Managers, Work Environment Factors And Workplace Bullying, Joy Parchment

Electronic Theses and Dissertations

The purpose of this dissertation is to explore relationships between authentic leadership style, global social power, job demand, job control, and workplace bullying of nurse managers in acute care settings across the United States. Over 30 years of workplace bullying research exists. Consequences are linked to intent to leave, turnover, and harmful emotional and physical effects. Published studies identifying nurse managers as targets of workplace bullying and work environment factors that contribute to nurse managers being recipients of workplace bullying either, downward from their leaders, horizontally from their nurse manager peers, and upwards from their clinical nurses were not identified. …

Therapeutic Horseback Riding With Military Veterans: Perspectives Of Riders, Instructors, And Volunteers, Leslie Lafleur

Antioch University Dissertations & Theses

Statistics reveal that over 353,000 military members have been diagnosed with PTSD and/or TBI resulting from war-related activities. With the rising number of war stress injuries, there have not been enough psychotherapeutic services to meet the current demand for the care of returning veterans from Iraq and Afghanistan. Although some intervention strategies have been deemed successful, the current standards of care (e.g., exposure therapy, cognitive therapy) are limited by training inadequacies, accessibility, and outcomes (e.g., retention, early drop out, resistance, non-responsiveness). Furthermore, it is unclear whether these treatments are efficacious in addressing the unique symptom presentations of this population. The …

A Model For A Haitian Comprehensive Community Mental Health Center: An Accounting, Corey Gifford

Antioch University Dissertations & Theses

Haiti is the poorest country in the Western hemisphere. Mental health resources are minimal and in need of further development. The goal of this dissertation project was to develop a model for a comprehensive outpatient Community Mental Health Center (CMHC) in Port-au-Prince, Haiti. It was both critical and essential that the development of a CMHC be considered within the sociopolitical and economic context of Haiti. As such, this project first examined relevant information regarding Haitian geography, poverty, government, and culture. Within this context, the impact of the 2010 earthquake was considered. This context was then used to consider relevant literature, …

Loneliness And Perceived Stigmatization Among Older Adults Enrolled In Opiate Substitution Treatment Programs And The Utilization Of Mental Health Services, Jennifer B. Armstrong

Antioch University Dissertations & Theses

Little research has examined the role that loneliness and perceived stigmatization play in the decision to seek mental health services among older adults enrolled in opiate substitution treatment. Researchers studying this at-risk population have called for more studies to examine services that can be implemented within current opiate substitution treatment settings. This study advances research in the field by utilizing standardized self-report measures to examine the relationship between loneliness, perceived stigmatization, and the impact of said variables on the utilization of available mental health services among older adults enrolled in opiate substitution treatment programs. Ninety-four 50-71-year-old adults from an opiate …

Evaluation Of Linear And Nonlinear Postural Stability Measurements Following Concussion, Kelsey Evans

College of Graduate Studies: Theses & Dissertations

Sport related concussions affect nearly 1.6 to 3.8 million athletes annually in the United States. A large number of these athletes suffer from postural instability following concussion. Postural control assessment has become a recommended tool to determine readiness to return to play. Measurement of postural control through the use of center of pressure (CoP) variables may provide a sensitive evaluation following concussion and throughout recovery. Purpose: To evaluate a unipedal and bipedal quiet stance protocol consisting of linear and nonlinear CoP measurements with varying durations in a concussed population throughout recovery. Methods: Thirteen NCAA Division I Collegiate Football players (age: …

Flipping The Classroom To Teach Population Health: Increasing The Relevance., Vicki Simpson, Elizabeth Richards

School of Nursing Faculty Publications

In recent years, there have been multiple calls to enhance the population health and health promotion aspects of nursing programs. Further impetus has been provided by passage of the Affordable Care Act in 2010 with its focus on prevention. The need to develop students who can critically think and apply knowledge learned is crucial to the development of nurses who can integrate and apply the concepts of population-focused practice in society and a healthcare system undergoing transformation. This coupled with the ever changing needs of learners requires a different approach to content delivery and presentation. Flipped classroom courses, with an …

Impact Of A Community-Based Perinatal And Newborn Preventive Care Package On Perinatal And Neonatal Mortality In A Remote Mountainous District In Northern Pakistan, Zahid Memon, Gul N Khan, Sajid Bashir Soofi, Imam Y Baig, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: There is limited evidence from community-based interventions to guide the development of effective maternal, perinatal and newborn care practices and services in developing countries. We evaluated the impact of a low-cost package of community-based interventions implemented through government sector lady health workers (LHWs) and community health workers (CHWs) of a NGO namely Aga Khan Health Services on perinatal and neonatal outcomes in a sub-population of the remote mountainous district of Gilgit, Northern Pakistan.
Methods: The package was evaluated using quasi experimental design included promotion of antenatal care, adequate nutrition, skilled delivery and healthy newborn care practices. Control areas …

Validity And Usability Of A Professional Association’S Web-Based Knowledge Translation Portal: American Physical Therapy Association’S Ptnow.Org, Judith E. Deutsch, Wendy Romney, Jan Reynolds, Tara Jo Manal

All PTHMS Faculty Publications

Background: PTNow.org is an evidence-based, on-line portal created by a professional membership association to promote use of evidence in practice and to help decrease unwarranted variation in practice. The site contains synthesis documents designed to promote efficient clinical reasoning. These documents were written and peer-reviewed by teams of content experts and master clinicians. The purpose of this paper is to report on the content and construct validity as well as usability of the site. Methods: Physical therapist participants used clinical summaries (available in 3 formats--as a full summary with hyperlinks, "quick takes" with hyperlinks, and a portable two-page version) on …

The Influence Of Participating In An International Clinical Experience During Baccalaureate Nursing Education On Interprofessional Collaboration And Teamwork For New Registered Nurses, Sherylyn Watson

Nursing Faculty Publications

An increased focus on interprofessional collaboration and teamwork in the healthcare professions had placed demands on nursing education to identify evidence based instructional strategies that bolster the interprofessional competency in prelicensure nursing education. One approach in addressing the call was to explore current educational opportunities for their effectiveness in developing interprofessional collaboration and teamwork. The popular trend in nursing education was to offer international clinical experiences that provide nursing care to impoverished people of developing countries. The current literature on these experiences had primarily focused on short-term outcomes that demonstrate personal growth of the individual, exposing opportunity for research concentrating …

Sex-Specific Genetic Effects In Physical Activity: Results From A Quantitative Genetic Analysis, Vincent P. Diego, Raquel Nichele De Chaves, John Blangero, Daniel Santos, Thayse Natacha Gomes, Fernanda Karina Dos Santos, Rui Garganta, Peter T. Katzmarzyk, José Ar Maia

School of Medicine Publications

Background: The objective of this study is to present a model to estimate sex-specific genetic effects on physical activity (PA) levels and sedentary behaviour (SB) using three generation families.

Methods: The sample consisted of 100 families covering three generations from Portugal. PA and SB were assessed via the International Physical Activity Questionnaire short form (IPAQ-SF). Sex-specific effects were assessed by genotype-by-sex interaction (GSI) models and sex-specific heritabilities. GSI effects and heterogeneity were tested in the residual environmental variance. SPSS 17 and SOLAR v. 4.1 were used in all computations.

Results: The genetic component for PA and SB domains varied from …

Application And Histology-Driven Refinement Of Active Contour Models To Functional Region And Nerve Delineation: Towards A Digital Brainstem Atlas, Nimal Patel, Sharmin Sultana, Tanweer Rashid, Dean Krusienski, Michel A. Audette

Electrical & Computer Engineering Faculty Publications

This paper presents a methodology for the digital formatting of a printed atlas of the brainstem and the delineation of cranial nerves from this digital atlas. It also describes on-going work on the 3D resampling and refinement of the 2D functional regions and nerve contours. In MRI-based anatomical modeling for neurosurgery planning and simulation, the complexity of the functional anatomy entails a digital atlas approach, rather than less descriptive voxel or surface-based approaches. However, there is an insufficiency of descriptive digital atlases, in particular of the brainstem. Our approach proceeds from a series of numbered, contour-based sketches coinciding with slices …

An O'Neill Institute Briefing Paper: Ebola, The World Health Organization, And Beyond: Toward A Framework For Global Health Security, Lawrence O. Gostin, Eric A. Friedman, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic has demonstrated that the world remains ill-prepared to respond to infectious disease outbreaks. A host of institutions are now reviewing what went wrong, and new institutions are being considered, including an African Centers for Disease Control and Prevention and World Bank-initiated Pandemic Emergency Facility. The World Health Organization itself failed in one of its core functions by allowing a preventable infectious disease to spiral out of control in the world’s poorest region. The 68th World Health Assembly (WHA), held in May 2015, provided an opportunity for the Organization to reflect on what went wrong and …

Indonesia Has It Backward: It's Not E-Cigarettes That's The Problem But Smoking, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Indonesia has announced it will be banning e-cigarettes. But that would do nothing to reduce smoking, which should be the main target of those interested in reducing tobacco use deaths and harms. Rather than ban e-cigarettes, it makes more sense to regulate them effectively so that they can serve as a useful anti-smoking tool. The availability of e-cigarettes to smokers can also make much more aggressive anti-smoking strategies more practically and politically viable-–perhaps even paving the way for banning cigarettes, instead.

The Normative Authority Of The World Health Organization, Lawrence O. Gostin, Devi Sridhar, Daniel Hougendobler

Georgetown Law Faculty Publications and Other Works

The World Health Organization (WHO) was born after the devastation of World War II, as a normative agency endowed with unprecedented constitutional powers. But even as it has achieved stunning successes, such as the eradication of smallpox, it has failed to live up to the exalted expectations of the postwar health and human rights movement e exemplified most recently by its inadequate response to the Ebola epidemic. Our aim is to offer innovative ideas for restoring the Organization to its leadership position by exercising its normative authority, even as it faces a crowded and often chaotic global health architecture. Before …

Nanoparticle Measurement, Control And Characterization: Procedure Applied To Machining Processes And Mechanical Friction, Victor Songmene, Riad Khettabi, Martin Viens, Jules Kouam, Stéphane Hallé, François Morency, Jacques Masounave, Abdelhakim Djebara

Rapports de recherche scientifique

Cliquez ici pour la version française de ce rapport

Alors que les nanotechnologies émergentes ouvrent des voies prometteuses dans plusieurs secteurs d’activité, des études suggèrent que les nanoparticules (NP) qu’elles génèrent pourraient avoir des effets négatifs, notamment sur la santé et sur l’environnement. Celles-ci peuvent être générées lors de la fabrication, de la manutention et de l’assemblage de pièces métalliques ordinaires et de celles à base de nanomatériaux. D’autres activités quotidiennes, telles que le freinage des automobiles, peuvent aussi produire des NP. Il est donc urgent de trouver des moyens de contrôler ces risques. Cependant, les techniques et méthodes usuelles …

Correlation Of Ultrasonographic Small Intestinal Wall Layering With Histology In Normal Dogs, Alexandre Benjamin Le Roux

LSU Master's Theses

Five intestinal layers are commonly described ultrasonographically in dogs. However, current high-frequency endosonography allows the identification of 9 layers in people. The aim of this study was to describe ex vivo small intestinal layering in dogs and correlate ultrasonographic layering with histological layers. Our hypothesis was that, similar to findings in humans, discrepancies exist in thickness and visibility of intestinal layers between histology and ultrasound in dogs. Twelve adult dogs were included in the study. They were euthanized for reasons unrelated to gastrointestinal disease, but extensive medical history was unavailable. Duodenum, jejunum and ileum samples were resected immediately after euthanasia. …

Conditioned Pain Modulation Predicts Exercise-Induced Hypoalgesia In Healthy Adults, Kathy J. Lemley, Sandra K. Hunter, Marie K. Hoeger Bement

Exercise Science Faculty Research and Publications

Introduction: Conditioned pain modulation (CPM) is the concept that pain inhibits pain and has potential rehabilitation implications for exercise prescription. The purpose of this study was to determine whether changes in pressure pain perception after a thermal conditioning stimulus (i.e., CPM) was attenuated with aging and whether CPM predicted pain relief after exercise (exercise-induced hypoalgesia (EIH)) in healthy young and older adults.

Methods: Twenty young (21.9 ± 3.3 yr, 10 men) and 19 older (72.0 ± 4.5 yr, 10 men) adults participated in three sessions: one familiarization and two experimental (EIH and CPM) sessions. Pressure pain perception was assessed using …

Citrate Anticoagulation: Are Blood Donors Donating Bone?, Walter Bialkowski, Roberta Bruhn, Gustaf Edgren, Paula E. Papanek

Exercise Science Faculty Research and Publications

An estimated 2.4 million volunteer apheresis blood donation procedures were performed in the United States in 2010, and increases in the proportion of transfused blood products derived from apheresis blood collections have been consistently reported. Anticoagulation is required during apheresis and is achieved with citrate. Donor exposure to citrate causes an acute physiological response to maintain serum mineral homeostasis. Some data are available on the sequelae of this acute response in the days and weeks following exposure, raising questions about bone mineral density in regular apheresis donors. New research is emerging that addresses the potential long-term health outcomes of repeated …

Domestic Violence Against Women In Bangladesh: A Review Of The Literature And The Gaps To Fill-In By Future Interventions, Anisur Rahman Khan

Khazar Journal of Humanities and Social Sciences

Although Bangladesh maintains inadequate records of the various forms of violence against women, it is clear that domestic violence against women is the most insidious problem for women in Bangladesh. For many Bangladeshi women, home is a place of pain and humiliation and violence is an integral part of everyday life. Domestic violence against women, perpetrated by their husbands, is a multi-faceted problem in Bangladesh. The efforts of the scholars to empirically investigate the problem are inadequate and a lot of issues are yet to be explored. This review is an attempt to present the findings of the major empirical …