Medicine and Health Sciences Commons^™

The Impact Of Nursing Hours And Hospital And Patient Characteristics On Medicare Hospital Acquired Conditions: A National Pooled Cross-Sectional Secondary Data Model And Analysis, Terry Kahlert Eng

Graduate Doctoral Dissertations

Background: Previous research and quality improvement initiatives have underscored the prevalence of healthcare acquired conditions (HACs) and their associated costs in American hospitals. In response to these findings, in 2008, The Centers for Medicare and Medicaid Services identified 10 condition categories that they would no longer pay for if acquired during hospitalization. The conditions were selected based on high cost, high volume, or both, assigned to a higher paying medical severity diagnostic related group (MS-DRG), and were deemed preventable through application of evidence-based guidelines. The Health Quality Outcomes Model and a Path Model guided the study.

Objective: To quantify the …

Sleep Hygiene Practices: A Cross Cultural Survey Of Sleeping And Dreaming In College Students, Ivan Noe Martinez Salazar

Masters Theses

There is consensus that a sizeable percentage of people in most developed countries do not obtain adequate amounts or quality of sleep. These disruptions in sleep, when chronic and severe, can lead to psychological, behavioral and health consequences. The focus on behavioral and contextual factors that impact sleep has been termed “sleep hygiene”. An on-line anonymous survey collected sociodemographic information, as well as self-reports on sleep, sleep hygiene practices and dreaming across two cultural groups (English & Spanish speaking responders). A total of 204 participants (majority of them college and graduate students) answered the survey. Both cultural groups, English and …

Lower Macular Pigment Optical Density In Foveal-Involved Glaucoma., James Loughman

Articles

Purpose: To evaluate the relationship between macular pigment optical density (MPOD) and structural parameters of the macula and optic nerve head in glaucomatous eyes.

Examining The Relationship Between Anemia, Cognitive Function, And Socioeconomic Status In School-Aged Ecuadorian Children, Angela Chamberlain

Student Works

Background and Objectives: It is estimated that over 40% of children in Ecuador are anemic. Anemia in children can influence physical and cognitive development and have lasting effects on adulthood productivity and quality of life. The objectives of this study were to: (1) evaluate the relationship of anemia and cognitive function, and (2) determine the influence of demographic factors on cognitive function. Population and Setting: The sample consisted of 175 school-aged children between 5 to 11 years old attending a school in a poverty stricken area of Guayaquil, Ecuador. Methods: A descriptive correlational cross sectional design was used to study …

Cultural Beliefs And Understandings Of Cervical Cancer Among Mexican Immigrant Women In Southeast Georgia, John S. Luque, Yelena N. Tarasenko, Jonathan N. Maupin, Moya L. Alfonso, Lisa C. Watson, Claudia Reyes-Garcia, Daron G. Ferris

Health Policy & Management: Faculty Publications (2006-2018)

Rural Mexican immigrant women in the U.S. are infrequently screened and experience health disparities from cervical cancer. We explored cancer-related cultural beliefs in this population. We administered a cross-sectional survey to 39 Mexican immigrant women due for screening. We conducted univariate and bivariate analyses of participants’ characteristics, Pap test history, cancer-related knowledge and beliefs, and cultural consensus analysis about causes of cervical cancer and barriers to screening. For all the cultural consensus tasks, there was consensus (Eigenratios >3:1) among survey participants. Comparing the rankings of risk factor clusters, clusters related to sexual behaviors were ranked more severely than clusters related …

The Case For Family Medicine In Pakistan, Saniya Raghib Sabzwari

Department of Family Medicine

The specialty of Family Medicine enjoys a special position in the medical practice of the West, serving as one of the key primary care specialties. Family physicians act as providers of first contact catering to the medical needs of the entire family in all aspects of preventive, curative and rehabilitative stages of illness and to health maintenance. The growth of this specialty, however, has lagged behind in Pakistan for various reasons. Having both a high burden of communicable and non-communicable diseases in Pakistan; family physicians should form the frontline force in dealing with these health issues. Several success stories of …

The Emotional Experience Of American Indians Receiving Hemodialysis And How It Relates To Treatment Adherence, Anitra M. Warrior

College of Education and Human Sciences: Dissertations, Theses, and Student Research

This study used a phenomenological approach as an attempt to capture the essence of the experience of American Indians with diabetes who are receiving dialysis. The purpose of this study and this approach was to develop an understanding of factors that influence treatment adherence, specifically with mental health concerns. As an additional component of this study, this research also followed an advocacy/participatory approach (Creswell, 2007) in which steps to reform services are provided to the Indian Health Service in support of this marginalized group through a written Agenda for Change.

Participants for this study were recruited from multiple states serving …

Entral Corneal Thickness Changes After Phacoemulsification, Tanveer Anjum Chaudhry, Muhammad Hamza, Wajiha Koomal, Khabir Ahmad

Department of Surgery Docs

Purpose: To determine when the mean central corneal thickness (CCT) returns to normal values after uneventful phacoemulsification. Material and Methods: This was a prospective case series. The study was carried out at the Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi. Eyes scheduled to undergo phacoemulsification during December 2011 – March 2012 were eligible to be included. Eyes with corneal degenerations, dystrophies or high pre-op astigmatism were excluded. A structured proforma was used to collect data on sociodemographics, comorbids, visual acuity, and CCT before surgery and 1 day, 1 week and 1 month after surgery. Changes in …

Intersection Of Career Counseling And Psychosocial Adjustment To Disability For Adults With Acquired Disabilities, Tina M. Anctil Peterman

Counselor Education Faculty Publications and Presentations

This program shares a theoretical and practical approach to career counseling with adults with acquired disabilities. Practitioners must possess a working knowledge of the adjustment to disability process as it relates to the client's career transition. Participants will learn how career interventions can facilitate the client's adjustment to their disability.

Relationship Between Fear, Fall & Balance In Cummunity Dwelling Older Adults, Ayesha Afridi, Sadia Maqbool, Arshad Nawaz Malik

Pakistan Journal of Neurological Sciences (PJNS)

Background:
In older population the risk of fall is always at high risk and there are many contributing factor which increase the prevalence of fall. The impaired balance leads to limited daily activities and confidence level.

Purpose of the study:
The main purpose of this study was to determine the relationship between fall, fear and balance in older population.

Method & methodology:
The descriptive cross sectional study design was used and a sample of 271 older adult were recruited through purpose sampling technique. The detail demographic was noted, history of fall and other related co-morbidities were mention in performa. The …

A Rare Case Of Simple Hereditary Recessive Optic Atrophy, Fazal M. Arain, Prem Chand, Tanveer A. Choudary

Pakistan Journal of Neurological Sciences (PJNS)

Simple Autosomal Recessive Optic Atrophy (AROA) is a rare hereditary disorder that belongs to a group of disorders called Hereditary Optic Atrophy. Patients diagnosed with simple AROA have complete blindness since birth or from first few months of life. This blindness does not improve with age. However, no other organ or system is affected in this disorder. There is no known cause or gene mutation associated with it. Here we report a case of a two year old child diagnosed with simple AROA. Family history of the patient revealed that an older deceased relative also suffered from similar symptoms. Identification …

Challenges In Certification And Credentialing Of Pakistani Physicians In Middle East, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Jam: Sharing The Voices Of Regional Practicing Midwives, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

First Private Sector Midwifery Education Initiative In Bangladesh: Experience From The Brac University, Ismat Bhuiya, Asiful Haidar Chowdhury, Km Zahiduzzaman

Journal of Asian Midwives (JAM)

In an attempt to further improve maternal and newborn health in Bangladesh, the BRAC University has started a three-year diploma in midwifery education programme, with the goal of ensuring availability of at least one midwife in all the 4,500 unions of the country by 2030, starting from the hard-to-reach under-served areas. The programme used a ‘hub and spoke’ model, where the BRAC University is the hub and six NGOs working in the rural under-served areas are the spokes, termed as academic sites. In addition, a new academic site was established in 2014 by the BRAC University in urban, Dhaka through …

Twinning In Nepal: The Royal College Of Midwives Uk And The Midwifery Society Of Nepal Working In Partnership, Jillian Ireland, Edwin Van Teijlingen, Joy Kemp

Journal of Asian Midwives (JAM)

The midwifery association of the United Kingdom, the Royal College of Midwives (RCM), has twinned with the Midwifery Society of Nepal (MIDSON) to help strengthen the latter association, through its Global Midwifery Twinning Project (GMTP). The GMTP aims to strengthen midwifery and develop leadership, advocacy, and campaigning skills both at the level of the association and at the individual midwife level. Reciprocity is an important aspect of twinning as the RCM also hopes to strengthen midwifery in the UK through greater engagement of its members and a raised profile of global maternal and new-born health. This paper describes the importance …

A Survey Of Women’S Views Of Epidural Analgesia In The Middle East, Grace Edwards, Tarek Ansari

Journal of Asian Midwives (JAM)

Background: There is little information on the factors that influence epidural uptake in the Middle East. Anecdotal evidence suggests that the uptake is low, overall, but rising due to socio-economic change and increased awareness of analgesia options in labour. The low prevalence of epidural in labour is influenced by many factors; however, there is a general lack of information about epidurals, both risks and benefits.
Methods: This study was a questionnaire -based study eliciting women’s knowledge of epidural analgesia immediately post-delivery. It was based on a survey using a questionnaire with, largely, closed questions, with one final section inviting open-ended …

Midwifery In Gilgit Baltistan By Aga Khan Health Service, Pakistan, Nawroz Zeenat, Rafat Jan

Journal of Asian Midwives (JAM)

Midwives are practicing in diverse capacities in public and private health settings of Pakistan, including Non-Governmental Organizations (NGOs) such as the Aga Khan Health Service, Pakistan (AKHS, P), which is a leading non-profit, non-governmental and non-denominational community-based organization that provides quality maternal and child health services all over Pakistan. Maternal and child health centers led by registered Midwives and Lady Health visitors (LHV), were specifically established in Gilgit Baltistan in 1974 by this NGO as a strategy to combat the alarming rates of maternal and child mortalities.

Woman, Mother And Baby: A Relishing Experience, Shahnaz Shahid, Ayesha Anwar

Journal of Asian Midwives (JAM)

No abstract provided.

Stability Of Glutamate-Aspartate Cardioplegia Additive Solution In Polyolefin Iv Bags, Steven D. Rush, Stephanie E. Kim, Susan E. Hughes, Justine M. Gilbert, Peter P. Ciancaglini, Fang Zhao

Doctoral External Publications

Objective: Glutamate-aspartate cardioplegia additive solution (GACAS) is used to enhance myocardial preservation and left ventricular function during some cardiac surgeries. This study was designed to evaluate the stability of compounded GACAS stored in sterile polyolefin intravenous (IV) bags. The goal is to extend the default USP beyond-use date (BUD) and reduce unnecessary inventory waste.

Methods: GACAS was compounded and packaged in sterile polyolefin 250 mL IV bags. The concentration was 232 mM for each amino acid. The samples were stored under refrigeration (2°C-8°C) and analyzed at 0, 1, and 2 months. At each time point, the samples were evaluated by …

Salvage Brachytherapy In Combination With Interstitial Hyperthermia For Locally Recurrent Prostate Carcinoma Following External Beam Radiation Therapy: A Prospective Phase Ii Study., Andrzej M Kukiełka, Vratislav Strnad, Paul R. Stauffer, Tomasz Dąbrowski, Marcin Hetnał, Damian Nahajowski, Tomasz Walasek, Piotr Brandys, Robert Matys

Department of Radiation Oncology Faculty Papers

Optimal treatment for patients with only local prostate cancer recurrence after external beam radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical prostatectomy, cryosurgery, and brachytherapy. Several single institution series proved that high-dose-rate brachytherapy (HDRBT) and pulsed-dose-rate brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore, hyperthermia has shown the potential to enhance the efficacy of re-irradiation. Consequently, a prospective trial is urgently needed to attain clear …

Evolutionary Convergence Of The Caffeine Biosynthetic Pathway In Chocolate Followed Duplication Of A Constrained Ancestral Enzyme, Andrew J. O'Donnell

Masters Theses

Caffeine biosynthesis is widely distributed in flowering plants and requires three consecutive methylation steps of xanthine alkaloids. Genes that have previously been reported to participate in the multi-step pathway in Coffea sp. (coffee) and Camellia sinensis (tea) encode members of the SABATH family of methyltransferases. Two genes highly expressed in fruits of Theobroma cacao (cacao) are orthologous to the caffeine genes in tea and appear to have diversified following gene duplication. Biochemical characterization of the enzymes (XMTs) encoded by these genes strongly suggest an unprecedented major pathway to theobromine, a precursor to caffeine. These findings imply that caffeine biosynthesis evolved …

Long-Term Risk Of Type 2 Diabetes Mellitus In Relation To Bmi And Weight Change Among Women With A History Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Edwina Yeung, Deirdre K. Tobias, Frank B. Hu, Allan A. Vaag, Jorge Chavarro, James L. Mills, Louise Groth Grunnet, Katherine Bowers, Sylvia H. Ley, Michele Kiely, Sjurdur F. Olsen, Cuilin Zhang

Publications and Research

Aims/hypothesis—Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM.

Methods—We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women’s Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% …

The Effects Of Schedule Density Of Reinforcement For Alternative Behavior On Resurgence, Kathryn M. Kestner

Dissertations

Resurgence is the reemergence of a previously extinguished response when an alternative response no longer produces reinforcement. Although returning to previously successful methods for obtaining reinforcement is likely advantageous, resurgence also occurs in the form of treatment relapse. An individual may return to problematic behavior (e.g., aggression, self-injury, drug use) when an alternative behavior (e.g., communication response, coping skill, social behavior, etc.) is no longer successful at producing a reinforcer. Behavior analysts rely on treatments based on differential reinforcement of alternative behavior, and resurgence has been demonstrated following changes to reinforcement schedules due to errors in treatment integrity or intentional …

Comparison Of Robotics, Functional Electrical Stimulation, And Motor Learning Methods For Treatment Of Persistent Upper Extremity Dysfunction After Stroke: A Randomized Controlled Trial, Jessica Mccabe, Michelle Monkiewicz, John P. Holcomb, Svetlana Pundik, Janis J. Daly

Mathematics and Statistics Faculty Publications

Objective

To compare response to upper-limb treatment using robotics plus motor learning (ML) versus functional electrical stimulation (FES) plus ML versus ML alone, according to a measure of complex functional everyday tasks for chronic, severely impaired stroke survivors.

Design

Single-blind, randomized trial.

Setting

Medical center.

Participants

Enrolled subjects (N=39) were >1 year post single stroke (attrition rate=10%; 35 completed the study).

Interventions

All groups received treatment 5d/wk for 5h/d (60 sessions), with unique treatment as follows: ML alone (n=11) (5h/d partial- and whole-task practice of complex functional tasks), robotics plus ML (n=12) (3.5h/d of ML and 1.5h/d of shoulder/elbow robotics), …

Clinical Management Of Insomnia, Karl Doghramji, Paul P. Doghramji

Department of Psychiatry and Human Behavior Faculty Papers

Throughout the book, we are guided by our main goal of providing practitioners with clinically relevant, evidence-based, and state-of-the-art information in the evaluation and management of insomnia. We have made a concerted attempt to ensure that our reviews are consistent with professional guidelines to the extent that current knowledge permits.

Designing An Effective User Interface For A Mobile Application, Cynthia N. Kim

Graphic Communication

The purpose of this study was to determine the best user interface design practices for an iOS mobile application created for Pre-R, a local start-up company that offers physician house calls and telemedicine services throughout San Luis Obispo. The study included initial background research on best user interface design practices, mapping out and implementing the entire process of designing for mobile applications, conducting usability tests on potential users, and making changes according to the test results. Usability tests allowed for a greater understanding of the effectiveness of Pre-R’s mobile interface design prototype. Results from the usability tests have indicated a …

A Randomized Controlled Trial Comparing Haemodynamic Stability In Elderly Patients Undergoing Spinal Anaesthesia At L5, S1 Versus Spinal Anaesthesia At L3, 4 At A Tertiary African Hospital., Vitalis Mung’Ayi, Karen Mbaya, Sharif Thikra, Dorothy Kamya

Anaesthesiology, East Africa

Background: Spinal anaesthesia is a routinely used anaesthetic technique in elderly patients (> 60 years) undergoing operations involving the lower limbs, lower abdomen, pelvis and the perineum. Spinal anaesthesia has several advantages over general anaesthesia including stable haemodynamic variables, less blood loss, less post-operative pain, faster recovery time and less post-operative confusion. Despite these advantages, the sympathetic blockade induced by spinal anaesthesia can result in hypotension, bradycardia, dysrhythmias and cardiac arrests. Conventionally, spinal anaesthesia is performed at the level of L3,4 interspace; with a reported incidence of hypotension in the elderly ranging between 65% and 69%. A possible strategy for …

Sequencing Strategies And Characterization Of 721 Vervet Monkey Genomes For Future Genetic Analyses Of Medically Relevant Traits, Yu S. Huang, Vasily Ramensky, Susan K. Service, Anna J. Jasinska, Yoon Jung, Oi-Wa Choi, Rita M. Cantor, Thomas D. Dyer, John Blangero

School of Medicine Publications

Background

We report here the first genome-wide high-resolution polymorphism resource for non-human primate (NHP) association and linkage studies, constructed for the Caribbean-origin vervet monkey, or African green monkey (Chlorocebus aethiops sabaeus), one of the most widely used NHPs in biomedical research. We generated this resource by whole genome sequencing (WGS) of monkeys from the Vervet Research Colony (VRC), an NIH-supported research resource for which extensive phenotypic data are available.

Results

We identified genome-wide single nucleotide polymorphisms (SNPs) by WGS of 721 members of an extended pedigree from the VRC. From high-depth WGS data we identified more than 4 …

Anesthesia Preoperative Clinic Referral For Elevated Hba1c Reduces Complication Rate In Diabetic Patients Undergoing Total Joint Arthroplasty, Peter J. Kallio, Jenea Nolan, Amy C. Olsen, Susan Breakwell, Richard Topp, Paul S. Pagel

College of Nursing Faculty Research and Publications

Background: Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery.

Objectives: We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA).

Patients and Methods: Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled). Those evaluated between in subsequent two-year intervals were referred to primary care for HbA1c ≥ 10% and ≥ 8%, respectively, to improve DM control before surgery. Complications …