Medicine and Health Sciences Commons^™

Lipid Management Of Patients With Probable Familial Hypercholesterolemia By A Nurse Practitioner, Carla Weidner

Doctor of Nursing Practice (DNP) Program

Heart disease remains the number one killer of Americans. Patient’s high cholesterol numbers are a major risk factor for the development of heart disease. Studies performed by the Centers for Disease Control (CDC) and the U.S. Department of Health and Human Services (DHHS) have recognized this as an area in need of improvement. Strategies for improvement of patients’ serum cholesterol and adherence to the recommended therapies have been explored. The purpose of this evidence based project is to compare cholesterol management outcomes in patients cared for by a nurse practitioner, with lipid management certification, to patients cared for by their …

The Retrospective Evaluation Of The Effectiveness Of Implementing Standard Of Care Best Practices On Fear Of Hypoglycemia (Foh) In Insulin Requiring Diabetics, Melissa Laporte

Doctor of Nursing Practice (DNP) Program

The population of individuals with diabetes is expected to rise along with a rise in the use of insulin therapy to control hyperglycemia and prevent diabetic complications. Insulin therapy is implicated as one of the leading causes of hypoglycemia, a potentially life-threatening adverse drug event. Hypoglycemia is recognized by patients and clinicians as the greatest barrier to achieving adequate glycemic control and it causes physical, psychosocial, financial, and safety concerns for individuals, their families, communities and health care systems. Hypoglycemia often causes insulin requiring diabetics to develop a fear of hypoglycemia, a complex phenomenon that manifests as avoidance of hypoglycemia …

Kinematic And Kinetic Effects Of Alterations In Lumbar Lordosis In People With Tight Hamstrings, Dema Assaf

Theses and Dissertations (ETD)

The etiology of nonspecific low back pain is sparsely understood. To better understand the contributing factors to nonspecific low back pain, there are often common concurrent pathologies that are investigated to determine their functional relationship to low back pain. One such pathology, investigated further in this thesis, is tight hamstrings. Specifically, the effect of hamstring length on pelvic position during gait and activities of daily living under normal and altered spinal position were investigated as part of this study in a motion analysis lab.

First, a marker validation study was conducted to ensure the accuracy of sagittal spinal measures of …

Ethical Documentation At The End Of Life, James T. Pathoulas

Lindmark Fellowship in Ethics

Patient autonomy is a basic tenet of ethical decision making in medicine. Individuals who are unable to participate in decision making at the end of life present a unique challenge to delivering ethical patient-­centered care. To ensure patient autonomy is upheld, providers are encouraged to use healthcare directives to guide clinical decision-­making. Healthcare directives are designed to uphold patient autonomy by indicating the desired scope of care at the end of life. While a particular type of healthcare directive, the advance care directive, is widely accepted, there are two common issues concerning its use: interpretation and accessibility. Issues with advance …

Mental Health Clinical Managers And Their Multicultural Leadership Practices, Christie Marie Melonson

Theses & Dissertations

There is a general recognition that the United States has historically failed to provide adequate mental health services to ethnic minorities. The American Counseling Association has mandated multicultural competence of counseling professionals in today’s context of dramatic demographic change. Despite numerous studies on practitioners, organizations, models, and interventions geared toward minorities, disparities in access, usage, and outcomes in still exist. Simultaneously, counseling fields have emphasized leadership development as a key factor in improving services, yet training or research on leadership remains scarce. In response to these conditions, this basic interpretive qualitative study focused on exploring clinical managers’ perceptions of their …

Pentoxifylline As An Adjunct To Antimicrobial Therapy To Reduce Length Of Stay In Infants With Sepsis, Philip J. Yinger

Yale School of Medicine Physician Associate Program Theses

Context: Neonatal sepsis is associated with prolonged hospital stay and increased morbidity and mortality despite appropriate antimicrobial therapy. There are discordant results in the existing literature regarding the association between adjunctive pentoxifylline therapy and duration of stay or mortality.

Hypothesis: We hypothesize that among preterm infants with blood culture-confirmed sepsis who are treated with pentoxifylline plus appropriate antimicrobial therapy, as compared to infants treated with placebo plus appropriate antimicrobial therapy, median duration of stay in the neonatal intensive care unit will be significantly reduced.

Methods: We propose a multicenter, double-blind, placebo-controlled, parallel-group randomized controlled trial to investigate …

Development Of An Indirect Elisa, Blocking Elisa, Fluorescent Microsphere Immunoassay And Fluorescent Focus Neutralization Assay For Serologic Evaluation Of Exposure To North American Strains Of Porcine Epidemic Diarrhea Virus, Faten Okda, Xiaodong Liu, Aaron Singrey, Travis Clement, Julie Nelson, Jane Christopher-Hennings, Eric A. Nelson, Steven Lawson

Veterinary and Biomedical Sciences Faculty Publications

Recent, severe outbreaks of porcine epidemic diarrhea virus (PEDV) in Asia and North America highlight the need for well-validated diagnostic tests for the identification of PEDV infected animals and evaluation of their immune status to this virus. PEDV was first detected in the U.S. in May 2013 and spread rapidly across the country. Some serological assays for PEDV have been previously described, but few were readily available in the U.S. Several U.S. laboratories quickly developed indirect fluorescent antibody (IFA) assays for the detection of antibodies to PEDV in swine serum, indicating prior exposure. However, the IFA has several disadvantages, including …

Practical Pearl: Lead Poisoning - August 2015, Hillary Branch Md

Pediatrics Practical Pearls: Referral Guidelines for Common Problems

No abstract provided.

Standardization Of The Experimental Autoimmune Myasthenia Gravis (Eamg) Model By Immunization Of Rats With Torpedo Californica Acetylcholine Receptors- Recommendations For Methods And Experimental Designs., Mario Losen, Pilar Martinez-Martinez, Peter C. Molenaar, Konstantinos Lazaridis, Socrates Tzartos, Talma Brenner, Rui-Sheng Duan, Jie Luo, Jon Lindstrom, Linda Kusner

Pharmacology and Physiology Faculty Publications

Myasthenia gravis (MG) with antibodies against the acetylcholine receptor (AChR) is characterized by a chronic, fatigable weakness of voluntary muscles. The production of autoantibodies involves the dysregulation of T cells which provide the environment for the development of autoreactive B cells. The symptoms are caused by destruction of the postsynaptic membrane and degradation of the AChR by IgG autoantibodies, predominantly of the G1 and G3 subclasses. Active immunization of animals with AChR from mammalian muscles, AChR from Torpedo or Electrophorus electric organs, and recombinant or synthetic AChR fragments generates a chronic model of MG, termed experimental autoimmune myasthenia gravis (EAMG). …

Magnetic Resonance Microscopy Of Renal And Biliary Abnormalities In Excised Tissues From A Mouse Model Of Autosomal Recessive Polycystic Kidney Disease., Choong H Lee, Amber K O'Connor, Chaozhe Yang, Joshua M Tate, Trenton R Schoeb, Jeremy J Flint, Stephen J Blackband, Lisa M. Guay-Woodford

Pediatrics Faculty Publications

Polycystic kidney disease (PKD) is transmitted as either an autosomal dominant or recessive trait and is a major cause of renal failure and liver fibrosis. The cpk mouse model of autosomal recessive PKD (ARPKD) has been extensively characterized using standard histopathological techniques after euthanasia. In the current study, we sought to validate magnetic resonance microscopy (MRM) as a robust tool for assessing the ARPKD phenotype. We used MRM to evaluate the liver and kidney of wild-type and cpk animals at resolutions <100 >μm and generated three-dimensional (3D) renderings for pathological evaluation. Our study demonstrates that MRM is an excellent method for …

Change In Overactive Bladder Symptoms After Surgery For Stress Urinary Incontinence In Women, Halina Zyczynski, Michael E Albo, Howard B Goldman, Clifford Y Wai, Larry T Sirls, Linda Brubaker, Peggy Norton, R E Varner, Maude Carmel, Hae-Young Kim

NYMC Faculty Publications

OBJECTIVE: To assess change in overactive bladder (OAB) symptoms up to 5 years after surgery and to identify associated predictors of change from baseline.

METHODS: This is a secondary analysis of data from three multicenter urinary incontinence (UI) surgical trials of women with stress-predominant mixed UI assigned to Burch colposuspension, autologous fascial sling, or retropubic or transobturator midurethral slings. The primary outcome was improvement of 70% or greater from baseline in symptoms measured by the Urinary Distress Inventory-Irritative subscale. Surgical groups were compared within respective trials. Generalized linear models were fit using 1-year and up to 5-year data.

RESULTS: Significant …

Missing Data Frequency And Correlates In Two Randomized Surgical Trials For Urinary Incontinence In Women, Linda Brubaker, Heather J Litman, Hae-Young Kim, Philippe Zimmern, Keisha Dyer, John W Kusek, Holly E Richter, Anne Stoddard

NYMC Faculty Publications

INTRODUCTION AND HYPOTHESIS: Missing data is frequently observed in clinical trials; high rates of missing data may jeopardize trial outcome validity.

PURPOSE: We determined the rates of missing data over time, by type of data collected and compared demographic and clinical factors associated with missing data among women who participated in two large randomized clinical trials of surgery for stress urinary incontinence, the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr) and the Trial of Midurethral Sling (TOMUS).

METHODS: The proportions of subjects who attended and missed each follow-up visit were calculated. The chi-squared test, Fisher's exact test and t test …

Shoulder External Rotator Eccentric Training For Subacromial Pain Syndrome, Eric Chaconas

Physical Therapy Collection

Background and Purpose: Rotator cuff weakness has been associated with subacromial pain syndrome (SAPS). The purpose of this study was to determine the effect of eccentric training, isolated to the shoulder external rotators, on strength, strength ratios, range of motion, upper quarter balance, pain, perceived function and global change.

Methods: Forty-Four participants, 19 females (mean age 46), with greater than 3 months of shoulder pain were randomized into two groups. The experimental group performed an external rotator eccentric training exercise (ETER) for three sets of 15 and a scapular retraction exercise, with a resistance band, for 2 sets of 10, …

Temporal And Spatial Changes In The Pattern Of Iba1 And Cd68 Staining In The Rat Brain Following Severe Traumatic Brain Injury, Debbie Smith, Diane Brooks, Eric Wohlgehagen, Thomas Rau, David Poulsen

Biomedical and Pharmaceutical Sciences Faculty Publications

We have previously demonstrated that acute treatment with low dose methamphetamine is neuroprotectivein a rat model of severe traumatic brain injury (TBI). Using gene expression analysis, we further showed that methamphetamine treatment significantly reduced the expression of proinflammatory genes after severe TBI. Therefore, to further investigate the potential effects of methamphetamine treatment on the neuroinflammatory response, we examined immunofluorescent staining of Iba1 and CD68, two marker of neuroinflammation, in the rat lateral fluid percussion injury model of severe TBI. In this study, we observed temporal and spatial alterations in the pattern of Iba1 and CD68 labeling within two weeks after …

A Brief Overview Of Amblyaudia, Raelynn Lamminen, Daniel Houlihan

Psychology Department Publications

Amblyaudia, a recent subcategory of auditory processing disorder, is characterized by asymmetrical auditory processing of an individual’s ears. Amblyaudia can result in speech comprehension difficulties, reading difficulties, information processing deficits, and inattention. These difficulties can be mistakenly attributed to Attention Deficit Hyperactivity Disorder (ADHD), Specific Learning Disorders (SLD), depression, anxiety disorders, and communication disorders. Unfortunately, traditional hearing tests do not place the two ears in competition and cannot detect asymmetry. Therefore, students who exhibit these difficulties and have normal performance on traditional hearing tests should be also evaluated for amblyaudia with dichotic listening tests. Amblyaudia can be addressed through dichotic …

Extended Followup Of A Cohort Of Chromium Production Workers, Herman Jones Gibb, Peter St. John Lees, Jing Wang, Keri O'Leary

Epidemiology Faculty Publications

Background

The current study evaluates the mortality of 2,354 workers first employed at a Baltimore chromate production plant between 1950 and 1974.

Methods

The National Death Index (NDI Plus) was used to determine vital status and cause of death. Cumulative chromium (VI) exposure and nasal and skin irritation were evaluated as risk factors for lung cancer mortality.

Results

There are 91,186 person-years of observation and 217 lung cancer deaths. Cumulative chromium (VI) exposure, nasal irritation, nasal perforation, nasal ulceration, and other forms of irritation (e.g., skin irritation) were associated with lung cancer mortality.

Conclusion

Cumulative chromium (VI) exposure was a …

Children Display Adult-Like Kinetic Pattern In The Time Domain But Not In The Frequency Domain While Walking With Ankle Load, Jianhua Wu, Toyin Ajisafe, Matthew Beerse, Huaqing Liang

Physical Therapy Faculty Research

While external load is added during locomotion, humans increase the activation of extensors during stance and suppress the initiation of flexors during swing. External load at the ankles, rather than on the waist or thigh, elicits higher activities from ankle extensors, and increases stride length and decreases cadence in adults. Spatiotemporal and kinematic patterns become adult-like in children aged 5-8 years. However, little is known if children show adult like kinetic patterns while walking with external load This study aimed to investigate differences in kinetic patterns between children and adults while walking with external ankle load using both time and …

Walking Pattern In Children With And Without Down Syndrome Via A Force-Driven Harmonic Oscillator Model, Jianhua Wu, Matthew Beerse, Toyin Ajisafe, Huaqing Liang

Physical Therapy Faculty Research

Children with Down syndrome (DS) display poorer kinematic and kinetic patterns of walking than typically developing ( TD) children. However, little is known on neuromuscular control in children with DS during locomotion. A force driven harmonic oscillator (FDHO) model sheds light on general muscular activation with respect to the gravitational load of the thigh-shank-foot system. The K/G ratio derived from this model represents a scaling between the elastic restoring torque from muscles and soft tissues and the gravitational torque from the weight of the leg during walking. The K/G ratio has shown different muscular function in infant walkers and children …

Soldiers Returning From Deployment: A Qualitative Study Regarding Exposure, Coping, And Reintegration, Lisa A. Brenner, Lisa M. Betthauser, Nazanin Bahraini, Jaimie L. Lusk, Heidi Terrio, Ann I. Scher, Karen A. Schwab

Graduate School of Professional Psychology: Student Scholarship

Purpose/Objective: The purpose of this study was to qualitatively explore exposure to deployment-related physical and/or emotional trauma and associated symptoms among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) soldiers. Interviews also focused on in-theater- and reintegration-related experiences. Research Method/Design: OEF/OIF soldiers (N = 103) participated in semistructured interviews, and a qualitative descriptive methodology was used to analyze the data. Results: Themes were identified regarding (a) common experiences related to emotional and physical traumas and associated symptoms and strategies for coping and making meaning of experiences and (b) how combat and reintegration experiences affected soldiers’ senses of self, relationships with others, …

Differences In Muscle Activation While Gripping A Sandbag Versus An Olympic Weightlifting Bar 2015, Todd Luther

Master's Theses

The purpose of this study was to compare the myoelectric activity of the extensor carpi ulnaris, flexor carpi ulnaris, flexor carpi radialis, and opponens pollicis muscles while gripping a 50 lb Olympic weightlifting bar to the myoelectric activity of the same muscles while gripping a sandbag of the same weight. Myoelectric activity was measured as the average root mean square (RMS) of the surface electromyography (sEMG) values. The hypothesis was that gripping a sandbag would result in greater muscle activation of the extensor carpi ulnaris, flexor carpi ulnaris, flexor carpi radialis, and opponens pollicis muscles than gripping an Olympic weightlifting …

Code Status Discussions, Kelly A. Rabah

Obstetrics and Gynecology Faculty Publications

The 2 most Important Take-aways:

• Have the conversation early

• Fully disclose risks, benefits and alternatives

Chhs August 2015 E-Newsletter,, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Variation In Brain Morphology Of Intertidal Gobies: A Comparison Of Methodologies Used To Quantitatively Assess Brain Volumes In Fish, Gemma E. White, Culum Brown

Veterinary Science and Medicine Collection

When correlating brain size and structure with behavioural and environmental characteristics, a range of techniques can be utilised. This study used gobiid fishes to quantitatively compare brain volumes obtained via three different methods; these included the commonly used techniques of histology and approximating brain volume to an idealised ellipsoid, and the recently established technique of X-ray micro-computed tomography (micro-CT). It was found that all three methods differed significantly from one another in their volume estimates for most brain lobes. The ellipsoid method was prone to over- or under-estimation of lobe size, histology caused shrinkage in the telencephalon, and although micro-CT …

Prediction Of Parturition In Holstein Dairy Cattle Using Electronic Data Loggers, M. Titler, M. G. Maquivar, S. Bas, P. J. Rajala-Schultz, E. Gordon, K. Mccullough, P. Federico, G. M. Schuenemann

Physiology Collection

The objective of the present study was to assess the effect of parturition on behavioral activity [steps, standing time, lying time, lying bouts (LB), and duration of LB] 4 d before calving using electronic data loggers. Animals (n = 132) from 3 herds were housed in similar freestall barns using a prepartum pen 21 d before the expected calving date and were moved into a contiguous individual maternity pen for parturition. Electronic data loggers were placed on a hind leg of prepartum heifers (heifers, n = 33) and cows (cows, n = 99) at 7 ± 3 d before the …

Trident - August 2015, Dugoni School Of Dentistry

Trident

The newsletter of the Pacific Orthodontic Alumni Chapter at University of the Pacific, Arthur A. Dugoni School of Dentistry.

Pandemic Of Pregnant Obese Women: Is It Time To Re-Evaluate Antenatal Weight Loss?, Anne Davis

Nutrition Sciences Faculty Publications

The obesity pandemic will afflict future generations without successful prevention, intervention and management. Attention to reducing obesity before, during and after pregnancy is essential for mothers and their offspring. Preconception weight loss is difficult given that many pregnancies are unplanned. Interventions aimed at limiting gestational weight gain have produced minimal maternal and infant outcomes. Therefore, increased research to develop evidence-based clinical practice is needed to adequately care for obese pregnant women especially during antenatal care. This review evaluates the current evidence of obesity interventions during pregnancy various including weight loss for safety and efficacy. Recommendations are provided with the end …

Afm13: A First-In-Class Tetravalent Bispecific Anti-Cd30/Cd16a Antibody For Nk Cell-Mediated Immunotherapy, Jingjing Wu, Jiaping Fu, Mingzhi Zhang, Delong Liu

NYMC Faculty Publications

Monoclonal antibodies against CD20 molecule have been leading the revolution of lymphoma treatment. In addition to monoclonal antibodies against CD20 and CD30, novel agents of immunotherapeutics in clinical development are being developed and are rapidly migrating to clinical application. One area of active development is NK cell activators, such as AFM13. This review will highlight the latest development of AFM13 as the first-in-class tetravalent bispecific anti-CD30/CD16A antibody for NK cell-mediated immunotherapy.

Hippocalcin Response To Calcium: Do Conserved Tryptophans – W30 Or W103 – Matter?, Sunkesula K. Sagar

Graduate School of Biomedical Sciences Theses and Dissertations

Changes in intracellular calcium levels play a very important role in cell signaling, in turn, affecting neuronal functions such as memory, learning and cell death. A class of proteins called Neuronal Calcium Sensor (NCS) proteins serves to modulate the functioning of the neuronal cells in response to changes in calcium levels, and prevent neuronal apoptosis. Structurally, all NCS proteins have 4 calcium-binding EF hand motifs, although EF1 does not bind to calcium in many members. All NCS proteins have an acyl modification at the N- terminus – where a myristoyl group is added post-translationally. Hippocalcin (HPCA) is an NCS protein, …

Public Relations In Government-Based Public Health: Testing Contingency Theory During H1n1 Response, 2009-2010, Terri Lea Sasser

Dissertations

The primary purpose of this study is to describe public relations programs in state and local government-based health departments nationwide. Using the H1N1 communications and public relations activities as a frame, or basis of comparison, this study will further seek to identify if Contingency Theory of public relations may be an apt descriptor of public relations activities during this particular response effort. This study uses Contingency Theory as a theoretical perspective to explain the strategic management of the organization-public relationships and add to the body of knowledge about Contingency Theory of public relations in the field of health communications. Contingency …

Redefining Disease Emergence To Improve Prioritization And Macro-Ecological Analyses, Samantha R. Rosenthal, Richard S. Ostfeld, Stephen T. Mcgarvey, Mark N. Lurie, Katherine F. Smith

Health & Wellness Department Faculty Publications and Research

No abstract provided.