Medicine and Health Sciences Commons^™

Proteomics And Phosphoproteomics Of Brain: (1) Analyses Of The Pink1 Knockout Model Of Parkinson Disease; (2) Insights Into The Progression Of Alzheimer Disease; And (3) The Naked Mole-Rat Model Of Salubrious Aging, Judy C. Triplett

Theses and Dissertations--Chemistry

Proteomics is the field of science in which proteins produced by an organism (the proteome) are identified. The level of a particular protein can vary with time and the influence of cellular stressors. The study of phosphoproteomics is vital because tyrosine, serine and threonine phosphorylation modulate protein structure and function and is a crucial regulator of cellular signaling pathways. Dysregulation of protein and phosphorylation levels has been reported in multiple neurodegenerative disorders including Parkinson disease (PD) and Alzheimer disease (AD).

PINK1 is a mitochondrial serine/threonine kinase that polices mitochondrial integrity. Mutations in this protein are associated with familial early-onset PD. …

Can Consumers Perceive A Difference In Quality When Comparing Whole-Grain Gluten-Free Baked Goods To Refined Gluten-Free Baked Goods At Varying Flour Levels, Jenna R. Carlson

Masters Theses

The prevalence of celiac disease and gluten intolerances has increased drastically in the last few decades, accounting for 1 in 100 individuals, or about 1% of Americans (Mager, Qiao, & Turner, 2012). The only treatment for celiac disease or any other gluten intolerance is the gluten-free diet. The gluten-free diet can lack many essential nutrients. The purpose of this research was to identify if consumers could perceive a difference in quality when comparing whole-grain gluten-free baked goods to refined gluten-free baked goods at varying flour levels of 20%, 50%, and 100%.

The researcher-developed Carlson Acceptability of Gluten-Free Baked Goods Survey …

An Exploration Of College Student Experiences Regarding Healthy Eating At A Midsized Midwestern University: A Qualitative Approach, E. Jordan Stayer

Masters Theses

This study was an exploration of the experiences college students have while eating in on-campus dining centers at a midsized, Midwest, public university. The present study examined college students' (n = 7) experiences of eating in the dining centers with a campus meal plan. Participants were asked a series of questions regarding their individual beliefs, their surrounding environment, and their physical behaviors while dining.

The study concluded that dining habits are very personal to each and every human being in the world. At the higher education level, because each student brings with them a completely different taste, desire, and …

Factors Supporting And Inhibiting Adherence To Hiv Medication Regimen In Women: A Qualitative Analysis Of Patient Interviews., Oluwakemi Fagbami, Adetokunbo Oluwasanjo, Carrie Fitzpatrick, Rebecca Fairchild, Ann Shin, Anthony Donato

Reading Hospital Internal Medicine Residency

Adherence to antiretroviral therapy reduces morbidity and mortality; however rates of non-adherence are variable among women for unclear reasons. This study was a single-center qualitative analysis of interviews with 18 female HIV-positive non-adherent patients (defined by virologic failure) to explore psychosocial factors impacting adherence. Factors identified were categorized as promoting, inhibiting or having no effect on adherence. Three themes, characterized as social factors, illness factors and other societal pressures, were identified. Medical systems support, family support and compliance for children were most commonly identified as promoting adherence, while psychiatric comorbidities, lack of medical systems support and side effects were identified …

The Effect Of Δ9-Tetrahydrocannabinol, Cannabidiol, Menthol And Propofol On 5-Hydroxytryptamine Yype 3 Receptors--A Computational Approach, Andreas C. Schilbach, Tatiana Prytkova, Keun-Hang Susan Yang

Mathematics, Physics, and Computer Science Faculty Articles and Research

This study investigates the function of 5-HT type 3 (5- HT3) receptors using a computational approach.

Job Stress Among Female Residents During Postgraduate Training At A University Hospital In Karachi, Pakistan, Madiha Hashmi, Fauzia A. Khan, Khan S, Ali S. K

Department of Anaesthesia

Background: Postgraduate medical training is a stressful experience for both male and female doctors but previous studies have shown that stress might be more prevalent amongst female residents. Since women make up 70-80% of medical graduates in Pakistan we conducted this study to determine the prevalence of stress among female residents during postgraduate training and identify the most common stressors.

Methodology: All female residents enrolled in postgraduate training programmes at the Aga Khan University meeting the inclusion criteria were recruited and informed written consent was obtained. Job Stress Inventory (JSI) was used to identify symptoms and sources of job stress. …

Perioperative And Acute Care Transesophageal Echocardiography (Toe), Madiha Hashmi

Department of Anaesthesia

In Pakistan perioperative transoesophageal echocardiography (TOE) during cardiac surgery is available in a few centers with reliance on cardiologists and cardiac technicians and its use in noncardiac surgery and intensive care units is very limited. In view of the increasing popularity of TOE based on obvious benefits this review is presented with an aim to evaluate the current indications and potential benefits of using TOE during anesthesia for cardiac and non-cardiac surgery and the intensive care units and compare TOE with pulmonary artery catheter (PAC) and transthoracic echocardiography (TTE) as an hemodynamic monitor in the acute care setting.

Developing Local Guidelines For Management Of Sepsis In Adults: Sepsis Guidelines For Pakistan (Sgp), Madiha Hashmi, Fazal Hameed Khan, Sarwar Zubairi, S. Tipu Sultan, Saeeda Haider, Sadqa Aftab, Javed Husain, Anwar Ul Haq, Zahid Akhtar Rao, Amin Khuwaja, Syed Farjad Sultan, Zunairah Rais, Roohina Baloch, Naseem Salahuddin, Aslam Khan, Faisal Sultan, Kamran Chima, Amjad Ali, Gohar Ali

Department of Anaesthesia

Background: The purpose of developing ‘Sepsis Guidelines for Pakistan’ (SGP) is to provide clinicians practicing in local hospitals with a framework to aid timely recognition and management of adult patients in sepsis by adopting evidence-based recommendations of Surviving Sepsis Campaign (SSC) tailored to available resources. These recommendations are not meant to replace the SSC Guidelines.
Methodology: SGP is an initiative of Pakistan Society of Critical Care Medicine (PSCCM). Four key decision points to be addressed in the guidelines were identified by a thirteen member multidisciplinary committee i.e., grading the hospitals in the country, recognition of sepsis and associated organ dysfunction, …

Human Rights In The New Global Strategy., Jyoti Sanghera, Lynn Gentile, Imma Guerras-Delgado, Lucinda O’Hanlon, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The Global Strategy for Women’s and Children’s Health (2010), with its emphasis on participatory decision making processes, non-discrimination, and accountability, affirmed the importance of human rights. Despite important gains following its launch women, children, and adolescents continue to experience serious violations of their health and health related human rights, including discrimination in access to quality healthcare. A human rights based approach must thus be fully integrated throughout the Global Strategy.

The right to health is recognised by several legal tools and treaties relating to human rights, including the International Covenant on Economic, Social and Cultural Rights; the Convention on the …

Women’S Health Priorities And Interventions, Marleen Temmerman, Rajat Khosla, Laura Laski, Zoe Mathews, Lale Say

Obstetrics and Gynaecology, East Africa

Over the past decades, governments have taken steps towards improving women’s health in line with commitments made in key international summits. Progress has been made in reducing maternal mortality,1 which accelerated with the launch of the United Nations secretary general’s Global Strategy for Women’s and Children’s Health in 2010. Use of maternal healthcare and family planning has increased in some countries.2 Progress has also been seen on two determinants of women’s health—school enrolment rates for girls and political participation of women—but not for others such as gender based violence.3

However, societies are still failing women in relation to health, especially …

How To Assess Success Of Treatment When Using Multiple Doses: The Case Of Misoprostol For Medical Abortion., Armando H. Seuc, Iqbal H. Shah, Moazzam Ali, Claudia Diaz-Olavarrieta, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The assessment of treatment success in clinical trials when multiple (repeated) doses (courses) are involved is quite common, for example, in the case of infertility treatment with assisted reproductive technology (ART), and medical abortion using misoprostol alone or in combination with mifepristone. Under these or similar circumstances, most researchers assess success using binomial proportions after a certain number of consecutive doses, and some have used survival analysis. In this paper we discuss the main problems in using binomial proportions to summarize (the overall) efficacy after two or more consecutive doses of the relevant treatment, particularly for the case of …

Global Estimates Of The Prevalence And Incidence Of Four Curable Sexually Transmitted Infections In 2012 Based On Systematic Review And Global Reporting, Lori Newman, Jane Rowley, Stephen Vander Hoorn, Nalinka Saman Wijesooriya, Magnus Unemo, Nicola Low, Gretchen Stevens, Sami Gottlieb, James Kiarie, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and incidence of four curable STIs: chlamydia, gonorrhoea, trichomoniasis and syphilis.

Methods and Findings: WHO’s 2012 estimates were based upon literature reviews of prevalence data from 2005 through 2012 among general populations for genitourinary infection with chlamydia, gonorrhoea, and trichomoniasis, and nationally reported data on syphilis seroprevalence among antenatal care attendees. Data were standardized for laboratory test type, geography, age, and high risk subpopulations, and combined using a Bayesian meta-analytic approach. …

Commentary: Actions To End Violence Against Women: A Multi-Sector Approach, Claudia García-Moreno, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

No abstract provided.

Low-Grade Serous Carcinoma – The Clinical Challenge, Khadija Warfa, Martin Kobel, Prafull Ghatage, Gregg Nelson

Obstetrics and Gynaecology, East Africa

Low-grade serous carcinoma is one of the five major histological types of ovarian carcinoma associated with a specific biology. We reviewed three cases from our institution to demonstrate the variable clinical course and provide a brief review on this disease entity.

Assessing Predictors Of Contraceptive Use And Demand For Family Planning Services In Underserved Areas Of Punjab Province In Pakistan: Results Of A Cross-Sectional Baseline Survey, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Waqas Hameed, Omar Farooq Khan, Ghazunfer Abbas, Marleen Temmerman, Erik Munroe

Obstetrics and Gynaecology, East Africa

Background: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed.

Method: A cross-sectional baseline household survey …

Implementation Of Point-Of-Care Diagnostics Leads To Variable Uptake Of Syphilis, Anemia And Cd4+ T-Cell Count Testing In Rural Maternal And Child Health Clinics, Caroline De Schacht, Carlota Lucas, Nádia Sitoe, Rhoderick Machekano, Patrina Chongo, Marleen Temmerman, Ocean Tobaiwa, Laura Guay, Seble Kassaye, Ilesh V. Jani

Obstetrics and Gynaecology, East Africa

Introduction: Anemia, syphilis and HIV are high burden diseases among pregnant women in sub-Saharan Africa. A quasi-experimental study was conducted in four health facilities in Southern Mozambique to evaluate the effect of point-of-care technologies for hemoglobin quantification, syphilis testing and CD4+ T-cell enumeration performed within maternal and child health services on testing and treatment coverage, and assessing acceptability by health workers.

Methods: Demographic and testing data on women attending first antenatal care services were extracted from existing records, before (2011; n = 865) and after (2012; n = 808) introduction of point-of-care testing. Study outcomes per health facility were compared …

Couple Based Family Planning Education: Changes In Male Involvement And Contraceptive Use Among Married Couples In Jimma Zone, Ethiopia, Tizta Tilahun, Gily Coene, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Background: Family planning contributes substantially in achieving the Millennium Development Goals. Recently,male involvement has gained considerable attention in family planning programs but the implementation thereof remains a challenge. In that context, our study aimed at measuring the effect of a six-month-long family planning education program on male involvement in family planning, as well as on couples’ contraceptive practice.

Methods: We conducted a quasi-experimental research among 811 married couples in Jimma Zone, southwest Ethiopia. Our study consisted of an intervention and a control group for comparative purpose; and surveyed before and after the implementation of the intervention. The intervention consisted of …

A Cross Sectional Comparison Of Postnatal Care Quality In Facilities Participating In A Maternal Health Voucher Program Versus Non-Voucher Facilities In Kenya, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Francis Obare, Rebecca Njuki, Marleen Temmerman, Ben Bellows

Obstetrics and Gynaecology, East Africa

Background: Health service fees constitute substantial barriers for women seeking childbirth and postnatal care. In an effort to reduce health inequities, the government of Kenya in 2006 introduced the output-based approach (OBA), or voucher programme, to increase poor women’s access to quality Safe Motherhood services including postnatal care. To help improve service quality, OBA programmes purchase services on behalf of the poor and marginalised, with provider reimbursements for verified services. Kenya’s programme accredited health facilities in three districts as well as in two informal Nairobi settlements.

Methods: Postnatal care quality in voucher health facilities (n = 21) accredited in 2006 …

Induced Abortion In 30 Chinese Provinces In 2013: A Cross-Sectional Survey, Shangchun Wu, Marleen Temmerman, Kun Wang, Shuchen Wang, Jiong Li, Wei-Hong Zhang

Obstetrics and Gynaecology, East Africa

Background: Galloping economic growth and reform in China in the past 30 years has led to dramatic social changes. Attitudes towards sex and sexual behaviour have changed, and premarital sex has become more acceptable. The methods of contraception have changed, and the use of highly effective or long-acting contraceptive methods tends to be decreasing, especially in urban areas. Abortion is commonly used to end unintended pregnancy. The aim of this study was to survey the current situation of induced abortions in selected hospitals in 30 provinces in China.

Methods: This cross-sectional study was conducted in 295 randomly selected hospitals in …

Quality At The Centre Of Universal Health Coverage, Howard L. Sobel, Dale Huntington, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The last decade of the MDG era witnessed substantial focus on reaching the bottom economic quintiles in low and middle income countries. However, the inordinate focus on reducing financial risk burden and increasing coverage without sufficient focus on expanding quality of services may account for slow progress of the MDGs in many countries. Human Resources for Health underlie quality and service delivery improvements, yet remains under-addressed in many national strategies to achieve Universal Health Coverage. Without adequate investments in improving and expanding health professional education, making and sustaining gains will be unlikely. The transition from the Millennium Development Goals (MDG) …

Determinants Of Method Switching Among Social Franchise Clients Who Discontinued The Use Of Intrauterine Contraceptive Device, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Wajahat Hussain, Ghulam Mustafa, Muhammad Ishaque, Safdar Ali, Aftab Ahmed, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Introduction: Women who do not switch to alternatemethods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.

Methods: The data used for this study comes from a larger cross-sectional survey conducted in nine

(9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who …

The Perceptions Of The Preparedness Of Medical Graduates To Take On Internship Responsibilities In Low Resource Hospitals In Kenya, Patricia Muthaura, Tashmin Khamis

Obstetrics and Gynaecology, East Africa

The Aga Khan University is developing an Undergraduate Medical Education (UGME) curriculum for implementation in East Africa in 2016, which aims to serve the health needs of the populations there. Pilot focus group discussions of recent interns were conducted at the Aga Khan University Hospital, Nairobi to find out: (1) If Kenyan medical students are adequately prepared for their roles as interns in low resource hospitals upon graduation from medical schools; (2) The likely clinical conditions that interns will face in low resource hospitals in Kenya; and (3) How might the UGME curriculum best prepare interns for their roles in …

Perceptions Of The Preparedness Of Medical Graduates For Internship Responsibilities In District Hospitals In Kenya: A Qualitative Study, Patricia Muthaura, Tashmin Khamis, Mushtaq Ahmed, Syeda Ra’Ana Hussain

Obstetrics and Gynaecology, East Africa

Background: Aga Khan University is developing its undergraduate medical education curriculum for East Africa. In Kenya, a 1 year internship is mandatory for medical graduates’ registration as practitioners. The majority of approved internship training sites are at district hospitals. The purposes of this study were to determine: (1) whether recent Kenyan medical graduates are prepared for their roles as interns in district hospitals upon graduation from medical school; (2) what working and training conditions and social support interns are likely to face in district hospital; and (3) what aspects of the undergraduate curriculum need to be addressed to overcome perceived …

Prognostic Indications Of Elevated Mct4 And Cd147 Across Cancer Types: A Meta-Analysis, Cory D Bovenzi, James Hamilton, Md, Patrick Tassone, Md, Pgy-3, Jennifer Johnson, David Cognetti, Adam J. Luginbuhl, William M. Keane, Tingting Zhan, Madalina Tuluc, Voichita Bar-Ad, Ubaldo E. Martinez-Outshoorn, Md, Joseph M. Curry

Department of Medical Oncology Faculty Papers

No abstract provided.

Evaluation Of Teacher Ratings To Improve Child Language Screenings In Speech-Language Pathology, Kyomi Dana Gregory

LSU Doctoral Dissertations

The purpose of this study was to examine the validity of teacher ratings for screening children’s language skills. Teacher ratings were measured through the use of two tools, the Children’s Communication Checklist-2 (CCC-2; Bishop, 2006) and the Teacher Rating of Oral Language and Literacy (TROLL; Dickinson, McCabe, & Sprague, 2001). The data for this study were from 77 kindergarteners who lived in rural Louisiana and spoke a non-mainstream dialect of English; 51 were classified as typically developing and 26 as presenting with Specific Language Impairment. Convergent validity was examined by comparing the two teacher rating tools to each other and …

Diffusion Of Innovations Of Videoconference Technology: An Instrumental Case Study Concerning Undergraduate Degree-Seeking Nontraditional Learners, Bruce G. Campbell

Theses and Dissertations

This applied dissertation is an instrumental case study based on diffusion of innovations theory designed to gather student opinions regarding videoconference (VC) technology use in facilitating courses to undergraduate degree-seeking nursing students. The author of diffusion of innovations theory, Rogers (2003), recommended that more qualitative studies be conducted in education. Rogers and Jain (1968) recommended these studies should be conducted from the aspect of “receivers of innovation diffusion” (p.1) to provide feedback instrumental to implementation of technological innovations in academe. Further, Rogers stated that multiple data points should be used during the process of trialing an innovation. Therefore, a current …

Aadej Comm 46 3 2015

AADEJ - The Communicator

The Communicator is the official journal of the American Association of Dental Editors and Journalists (AADEJ). It is published quarterly, distributed digitally via email to members, and posted on the Association's website, AADEJ.org. Each issue includes regular updates from the editorial team and AADEJ board, as well as feature articles on current issues in the field.

Hypothyroidism And The Development Of Hypertension, Kaleb Short

All Graduate Theses, Dissertations, and Other Capstone Projects

Low thyroid hormone (TH) in adulthood is associated with increased risk of cardiovascular disease, including risk of hypertension. The Spontaneously Hypertensive Rat (SHR), exhibits alterations in thyroid function when compared to normotensive controls. Interestingly, inhibiting thyroid gland function before 4 weeks of age prevented hypertension in the SHR, indicating that TH is involved in the etiology of SHR hypertension. However, these studies utilized tail-cuff photoplethysmography (PPG), which is known to have stress-induced artifacts, and did not compare effects in the normotensive parent strain Wistar Kyoto (WKY) rat. Therefore, it is uncertain whether TH is responsible for an elevation in baseline …

"A Compromise To Help The Community": Rural Sexual Assault Nurse Examiner Experiences, Rebecca R. Gonnering

All Graduate Theses, Dissertations, and Other Capstone Projects

Victims of sexual assault require specialized medical care when they report to hospital emergency departments including physical examination, evidence collection, and emotional support. Sexual Assault Nurse Examiners (SANEs) are medical professionals trained to complete the examination and evidence collection in a prompt and sensitive manner. In fact, where SANE programs exist, emergency room waiting times are shorter, evidence collection improves, and revictimization from untrained staff is reduced. Unfortunately, SANEs are not widely available, particularly in rural areas. This lack of trained examiners employed at local hospitals creates a gap in access to proper care, often resulting in long waits as …

The Fertility Problem Inventory And Infertility-Related Stress: A Case Study, Staci Leigh Born

All Graduate Theses, Dissertations, and Other Capstone Projects

More than seven million people of childbearing age in the United States experience infertility. For women, the experience of infertility is stressful. The Fertility Problem Inventory (FPI) has been used to quantitatively measure women's experience of infertility-related stress. However, the construct of infertility-related stress is poorly described in existing literature. The purpose of this case study was understand how women experience the FPI as a measure of infertility-related stress. To address this issue, women who are undergoing infertility treatment completed the FPI and participated in unstructured interviews. Archival documents were also retrieved to corroborate findings and satisfy saturation. Results indicate …