Medicine and Health Sciences Commons^™

Improving Influenza And Tdap Vaccination During Pregnancy: A Cluster-Randomized Trial Of A Multi-Component Antenatal Vaccine Promotion Package In Late Influenza Season, A. T. Chamberlain, K. Seib, K. A. Ault, E. S. Rosenberg, Paula M. Frew, M. Cortés, E. A. S. Whitney, R. L. Berkelman, W. A. Orenstein, S. B. Omer

Environmental & Global Health Faculty Research

Background Evidence-based interventions to improve influenza vaccine coverage among pregnant women are needed, particularly among those who remain unvaccinated late into the influenza season. Improving rates of antenatal tetanus, diphtheria and acellular pertussis (Tdap) vaccination is also needed.

The Effects Of Marital Attachment And Family-Of-Origin Stressors On Body Mass Index, Merle Natasha Bates

Theses and Dissertations

The purpose of this study was to examine the moderating effect of couple's attachment behavior on family-of-origin (FOO) issues and body mass index (BMI). Previous research has indicated that family and couple relational factors may influence BMI. The vulnerability and stress model provided a theoretical framework for understanding how attachment behaviors may give greater adaptability to managing vulnerabilities from family stress. 1214 couples between the ages of 18 and 70, who identified themselves as in a serious relationship were surveyed using the RELATE questionnaire; both partners responded. Results indicated that there was a significant association between FOO stress and adult …

Leadership Style And Patient Safety: Implications For Nurse Managers, Katreena Collette Merrill

Faculty Publications

OBJECTIVE: The purpose of this study was to explore the relationship between nurse manager (NM) leadership style and safety climate.

BACKGROUND: Nursing leaders are needed who will change the environment and increase patient safety. Hospital NMs are positioned to impact day-to-day operations. Therefore, it is essential to inform nurse executives regarding the impact of leadership style on patient safety.

METHODS: A descriptive correlational study was conducted in 41 nursing departments across 9 hospitals. The hospital unit safety climate survey and multifactorial leadership questionnaire were completed by 466 staff nurses. Bivariate and regression analyses were conducted to determine how well leadership …

Understanding Nucleus Pulposus Cell Phenotype: A Prerequisite For Stem Cell Based Therapies To Treat Intervertebral Disc Degeneration., Hyowon Choi, Zariel I. Johnson, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Intervertebral disc (IVD) degeneration and associated low back pain (LBP) remains a major burden to our society without significant improvements in treatment strategies or patient's quality of life. While the recent cell-transplantation studies for treatment of degenerative disc disease have shown promising results, to better gauge the success and functional outcomes of these therapies, it is crucial to understand if transplanted cells give rise to healthy nucleus pulposus (NP) tissue. NP cell phenotype is unique and is defined by expression of a characteristic set of markers that reflect specialized physiology and function. This review summarizes phenotypic markers that mirror the …

Characterization Of In-Hospital Cardiac Arrest In Adult Patients At A Tertiary Hospital In Kenya, Benjamin Wachira

Internal Medicine, East Africa

Background:In-hospital cardiac arrest (IHCA) is defined as a cardiac arrest that occurs in a hospital and for which resuscitation is attempted. Despite the increased morbidity and mortality, IHCA incidence and outcomes remain largely unknown especially in sub-Saharan Africa. This study describes the baseline characteristics, prearrest physiological parameters and the rate of survival to hospital discharge of adult patients with an IHCA at a tertiary hospital in Kenya.

Methods:This was a retrospective chart review. Data on patient characteristics, pre-arrest physiological parameters and discharge condition were collected on all patients 18 years of age or older with an IHCA at …

Accelerating The Dual Elimination Of Mother-To-Child Transmission Of Syphilis And Hiv: Why Now?, James Kiarie, Chandra K. Mishra, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Even though the elimination of congenital syphilis has been on the maternal and child health (MCH) agenda for over a decade, elimination has not yet been achieved; what, then, are the factors currently facilitating the elimination of mother-to-child transmission (MTCT) of syphilis?

Which Role Do Midwives And Gynecologists Have In Smoking Cessation In Pregnant Women?–A Study In Flanders, Belgium, Katrien De Wilde, Inge Tency, Sarah Steckel, Marleen Temmerman, Hedwig Boudrez, Lea Maes

Obstetrics and Gynaecology, East Africa

Objectives: The objectives of our study were (1) to explore knowledge, beliefs and practice among mid-wives and gynecologists concerning a smoking cessation policy for pregnant women and their partners and (2) to examine if midwives and gynecologists do have a role in smoking cessation in pregnant women.

Method: We performed a qualitative study using semi-structured interviews with nine midwives and eight gynecologists. Data were analyzed using deductive content analysis, based on the 5 A’s frame-work (Ask–Advise–Assess–Assist–Arrange).

Results: The national smoking cessation policy seemed to be insufficiently known. “Ask” and “Advise" were part of a standard prenatal consultation, the next three …

Infection Of Thai Influenza A Viruses Subtype H5n1 Using Tracheal Culture, Napawan Bunpapong, Supanat Boonyapisitsopa, Kamol Suwannakarn, Rachod Tantilertchareon, Roongroje Thanawongnuwech, Alongkorn Amonsin

The Thai Journal of Veterinary Medicine

Avian influenza (AI) is caused by influenza A virus subtype H5N1. The virus causes severe disease and death in several avian and mammalian species. This study investigated the ability of swine and chicken tracheal cultures to support highly pathogenic avian influenza subtype H5N1 (HPAI-H5N1) viral replication. Three Thai HPAI-H5N1 viruses isolated from chicken (A/chicken/Thailand/CU-K2/04), duck (A/duck/Thailand/CU-328/07), and tiger (A/tiger/Thailand /CU-T7/04) were used to infect the swine and chicken tracheal cultures. Our results indicated that the chicken tracheal culture could support virus replication in contrast to the swine tracheal culture, suggesting that pig has low susceptibility to Thai HPAI-H5N1 infection. Immunohistochemical …

Symptoms Of Depression Among Patients Attending A Diabetes Care Clinic In Rural Western Kenya, Kristen Shirey, Simon M. Manyara, Lukoye Atwoli, Ryan Tomlin, Benson Gakinya, Stephanie Cheng, Jemima Kamano, Jeremiah Laktabai, Sonak Pastakia

Internal Medicine, East Africa

Objective: The prevalence of diabetes in sub-Saharan Africa is rising, but its relationship to depression is not well-characterized. This report describes depressive symptom prevalence and associations with adherence and outcomes among patients with diabetes in a rural, resource-constrained setting.

Methods: In the Webuye, Kenya diabetes clinic, we conducted a chart review, analyzing data including medication adherence, hemoglobin A1c (HbA1c), clinic attendance, and PHQ-2 depression screening results.

Results: Among 253 patients, 20.9% screened positive for depression. Prevalence in females was higher than in males; 27% vs 15% (p = 0.023). Glycemic control trends were better in those screening negative; at 24 …

Depression Among Asian-American Adults In The Community: Systematic Review And Meta-Analysis., Hee Jun Kim, Eunmi Park, Carla L Storr, Katherine Tran, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

OBJECTIVES: In this systematic review, we provide an overview of the literature on depression among Asian-Americans and explore the possible variations in depression prevalence estimates by methodological and demographic factors.

METHODS: Six databases were used to identify studies reporting a prevalence estimate for depression in Asian-American adults in non-clinical settings. Meta-analysis was used to calculate pooled estimates of rates of depression by assessment type. Statistical heterogeneity was assessed for subgroup analyses by gender, age, ethnicity, and other participant characteristics.

RESULTS: A total of 58 studies met the review criteria (n = 21.731 Asian-American adults). Heterogeneity across the studies was considerably …

Age And Sex Differences In Steadiness Of Elbow Flexor Muscles With Imposed Cognitive Demand, Hugo M. Pereira, Vincent C. Spears, Bonnie Schlinder-Delap, Tejin Yoon, Kristy A. Nielson, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Purpose: These studies determined (1) age and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and, (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2).

Methods: 36 young adults (18–25 years; 18 women) and 30 older adults (60–82 years; 17 women) performed isometric contractions at 5%, 30% and 40% of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session …

Prophylactic Methylprednisolone To Reduce Inflammation And Improve Outcomes From One Lung Ventilation In Children: A Randomized Clinical Trial., Mary C. Theroux, Alicia Olivant Fisher, Maria E. Rodriguez, Robert P. Brislin, Kirk W. Reichard, Suken A. Shah, Matt Mccoy, Melinda Brown, Kirk W. Dabney, William G. Mackenzie, Douglas A. Katz, Thomas H. Shaffer

Department of Anesthesiology Faculty Papers

BACKGROUND: One lung ventilation (OLV) results in inflammatory and mechanical injury, leading to intraoperative and postoperative complications in children. No interventions have been studied in children to minimize such injury.

OBJECTIVE: We hypothesized that a single 2-mg·kg(-1) dose of methylprednisolone given 45-60 min prior to lung collapse would minimize injury from OLV and improve physiological stability.

METHODS: Twenty-eight children scheduled to undergo OLV were randomly assigned to receive 2 mg·kg(-1) methylprednisolone (MP) or normal saline (placebo group) prior to OLV. Anesthetic management was standardized, and data were collected for physiological stability (bronchospasm, respiratory resistance, and compliance). Plasma was assayed for …

Vitamin D As An Adjunctive Therapy In Asthma. Part 2: A Review Of Human Studies, Conor Kerley, Basil Elnazir, John Faul, Liam Cormican

Articles

Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25- dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to …

Vitamin D As An Adjunctive Therapy In Asthma. Part 1: A Review Of Potential Mechanisms, Conor Kerley, Basil Elnazir, John Faul, Liam Cormican

Articles

Vitamin D deficiency (VDD) is highly prevalent worldwide. The classical role for vitamin D is to regulate calcium absorption form the gastrointestinal tract and influence bone health. Recently vitamin D receptors and vitamin D metabolic enzymes have been discovered in numerous sites systemically supporting diverse extra-skeletal roles of vitamin D, for example in asthmatic disease. Further, VDD and asthma share several common risk factors including high latitude, winter season, industrialization, poor diet, obesity, and dark skin pigmentation. Vitamin D has been demonstrated to possess potent immunomodulatory effects, including effects on T cells and B cells as well as increasing production …

Evaluation Of Vaccination Policies Among Utah Pediatric Clinic Employees, Karlen Beth Luthy, Tia Peterson, Janelle L B Macintosh, Lacey M. Eden, Renea L. Beckstrand, Nathan H. Wiley

Faculty Publications

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

Association Of Markers Of Inflammation With Sleep And Physical Activity Among People Living With Hiv Or Aids, Michael D. Wirth, Jason R. Jaggers, Wesley D. Dudgeon, James R. Hebert, Shawn D. Youngstedt, Steven N. Blair, Gregory A. Hand

Faculty and Staff Scholarship

This study examined associations of sleep and minutes spent in moderate-vigorous physical activity (MVPA) with C-reactive protein (CRP) and interleukin (IL)-6 among persons living with HIV (PLWH). Cross-sectional analyses (n=45) focused on associations of inflammatory outcomes (i.e., CRP and IL-6) with actigraph-derived sleep duration, latency, and efficiency; bedtime; wake time; and wake-after-sleep-onset; as well as MVPA. Least square means for CRP and IL-6 by levels of sleep and MVPA were computed from general linear models. Individuals below the median of sleep duration, above the median for bedtime, and below the median of MVPA minutes had higher CRP or IL-6 levels. …

Utilization Of Specialized Camp Services Among Parents Of A Child With A Disability, Heather Ann Wroten

Electronic Theses, Projects, and Dissertations

The purpose of this study was to explore the utilization of specialized camp services among parents of a child with a disability. This study sought to investigate specialized camp services as respite for families. The data was gathered utilizing a mixed method survey approach. The surveys were distributed to primary caregivers of a child with a disability who have attended Camp Paivika within the past three years. The sample size of this study was 69 respondents. The results show that the family unit benefits by way of de-isolation. The camper increases social skills, confidence, and independence. The caregivers experience emotional …

The Relationship Between Self-Determination And Client Outcomes Among The Homeless, Samuel M. Hanna

Electronic Theses, Projects, and Dissertations

This paper has attempted to determine if there is a significant relationship between self-determination and client outcomes among the homeless. The study has been based upon the conceptual framework set forth in Self-Determination Theory. The purpose of the study was to explore the relationship between self-determination and client outcomes among the homeless. Using a data collection instrument, based on empirically validated instrumentation, clients from several homeless service providers in the City of San Bernardino were assessed for the level of self-determination and autonomy support they experience within these agencies. Outcome measures included such things as whether the client was going …

Beliefs About Hospice Care Among Helping Professionals, Teresa Y. Phinazee

Electronic Theses, Projects, and Dissertations

ABSTRACT

Centered on interviews with 13 hospice care professionals from two large hospice organizations in Southern California, this thesis project examines the challenges that arise in hospice work. Hospice’s delivery of end-of-life care is becoming even more significant as the population lives longer. According to the National Institute on Aging (2014), the face of aging in the United States is changing dramatically. This examination discloses some of the challenges that hospice workers face in a continuously changing health care system, while trying to provide extraordinary service to the terminally ill.

Hospice regards dying as a conventional progression, and neither hastens …

The Effects Of A Novel Exercise Training Suit On Cardiorespiratory Fitness, Body Composition And Leg Strength, Trevor M. Curry, Steven C. Davis, Aydin Nazmi, Don Clegg

Master's Theses

ABSTRACT

The Effects of a Novel Exercise Training Suit on Cardiorespiratory Fitness, Body Composition and Leg Strength

Trevor Michael Curry

The physiological responses to physical activity or exercise using external load carriage systems (LCS) in the form of weighted personal protective equipment, backpacks, or vests have biomechanical and human performance implications. It remains unclear whether a new unique LCS in the form of a weighted (5.45 kg) full-bodied exercise suit can induce greater improvements in performance and body composition. Twenty-one healthy males (20±3 years; 24.9±3.6 body mass index (BMI); 25.1±6.4% total percentage body fat ( % fat); 120.1±17.3 kg lean …

Hepatic Encephalopathy In Chronic Liver Disease: Predisposing Factors In A Developing Country, Fakhar Qazi, Shameem Behram Khan, Anam Umar

Section of Gastroenterology

Objective: To fi nd out the risk factors for developing Hepatic Encephalopathy in patients suffering from Chronic liver disease.

Background: Hepatic encephalopathy (HE) is a neuropsychiatric disorder that is caused by liver damage. In its pathology, alterations in normal brain function are associated with an increase in blood ammonia, benzodiazepine like substances, products of neurotoxic fatty acids, and other gut derived toxins, which gain access to the brain as a result of liver dysfunction.

Study Design: Hospital based descriptive, cross sectional study.

Settings: Medical Unit 1, Ward- 5, Jinnah Post Graduate Medical Centre, Karachi.

Duration: July 2013 to December 2013. …

Examining The Toxicity, Exposure, And Regulatory Approach To Potential Human Health Risks Of The Algal Toxin Domoic Acid, Thomas H. Angus

Graduate Doctoral Dissertations

Domoic acid is a neurotoxin produced by the marine diatom genus Pseudo-nitzschia and causes cell death primarily in the area of the brain responsible for long-term memory. The resulting severe illness has been termed amnesic shellfish poisoning. Domoic acid accumulates in shellfish and planktivorous fish that consume Pseudo-nitzschia, resulting in exposure to humans through consumption of planktivorous seafood. A regulatory standard in seafood was developed shortly after its discovery in 1987 to protect against acute effects. This regulatory standard has not been revised despite significant recent data in the scientific literature.

This dissertation is divided into four sections: (1) …

Mala Lā’Au Lapa’Au: Preserving The Hawaiian ‘Āina And Mo’Omehue, Sandra Fogg

Senior Honors Projects

The study of medicinal plants in the western world tends to focus on the isolation and elucidation of natural products that have bioactive characteristics and potential for pharmaceutical formulation. However, the utilization of medicinal plants in cultures that still practice ancient medicine, such as Hawai’i and other Pacific Island nations, involves the use of whole plant parts in conjunction with spiritual rituals to heal illnesses and ailments. In order to gather a different perspective of the use of plants in medicine, a diverse investigation of “Lā’au Lapa’au,” or the Hawaiian art of healing through the use of plants and spiritual …

Establishing Normative Data For Contact Patterns Of Fricative Production By Native German Speakers: An Electropalatography Study, Lisa Diane Isaacson

Theses and Dissertations

Electropalatography (EPG) provides real-time visual biofeedback for linguapalatal contact during speech and swallowing. Historically, EPG has proved to be an effective tool for assessment and treatment of a variety of speech disorders across a wide age range. The present thesis is part of a larger study examining the effectiveness of using EPG in assisting second language (L2) learners to acquire the German fricatives , [x], and //. Real and nonsense word productions were collected from six native German speakers. Electrode activation levels were generally highest for and lowest for [x]. Even when considering the impact of vowel context, [x] consistently …

The Effect Of Dose On The Antimalarial Efficacy Of Artemether-Lumefantrine: A Systematic Review And Pooled Analysis Of Individual Patient Data, N. M. Anstey, R. N. Price, T. M.E. Davis, H. A. Karunajeewa, I. Mueller, U. D'Alessandro, A. Massougbodji, F. Nikiema, J. B. Ouédraogo, H. Tinto, I. Zongo, A. Same-Ekobo, M. Koné, H. Menan, W. Yavo, A. O. Touré, P. E. Kofoed, B. H. Alemayehu, D. Jima, E. Baudin, E. Espié, C. Nabasumba, L. Pinoges, B. Schramm, M. Cot, P. Deloron, J. F. Faucher, J. P. Guthmann

All Peer-Reviewed Publications

Background: Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. Methods: We searched PubMed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to December, 2012. We merged individual patient data from these trials by use of standardised methods. The primary endpoint was the PCR-adjusted risk of Plasmodium falciparum recrudescence by day 28. Secondary endpoints consisted of the PCR-adjusted risk of P …

Environmental And Food Allergens Reactivity And Its Association With Total Ige, Age And Gender In Karachi, Pakistan, Noreen Abbas, Ahmed Raheem, Farooq Ghani

Department of Pathology and Laboratory Medicine

Aim: The aim of this study is to assess the frequency of food and environmental allergens reactivity and its association in with age, gender and total IgE levels
Material and Methods: The study population consisted of 88 individuals including children and adults (male: 47 and female: 41). The study was conducted in the clinical laboratory, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital from May 2009 till May 2010. Sera of patients positive for total IgE were tested for allergen specific IgE levels by Immulite 2000, 3gAllergyTM. We divided allergens into two panels, namely food and environmental.
Results: …

Validation Study Of The Mini-Mental State Examination In Urdu Language For Pakistani Population, Safia Awan, Naila Shahbaz,, Syed Wasim Akhtar, Arsalan Ahmad, Sadaf Iqba, Sellal Ahmed, Haider Naqvi, Mohammad Wasay

Section of Neurology

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. Objective: This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani’s and study the effects of gender and education on the MMSE performance in our population. Methods: Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. Results: There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu …

Non-Communicable Diseases And Preventive Health Behaviors: A Comparison Of Hispanics Nationally And Those Living Along The Us-Mexico Border, Belinda M. Reininger, Jing Wang, Susan P. Fisher-Hoch, Alycia Boutte, Kristina Vatcheva, Joseph B. Mccormick

School of Mathematical & Statistical Sciences Faculty Publications

Background: Non-communicable diseases (NCDs) are rising among US Hispanics, but few studies have examined the preventive health behaviors for these NCDs among Hispanics. This study compared the preventive health behaviors of smoke-free living, physical activity, fruit and vegetable consumption, and avoidance of heavy alcohol use in Hispanics in the United States and Hispanics living along the US-Mexico border.

Methods: Two weighted data sets with information on Hispanic populations were analyzed: 1) the national Behavioral Risk Factor Surveillance Survey (n = 29,942) from 2009; and 2) the Cameron County Hispanic Cohort (n = 1,439) recruited from the US-Mexico border between 2008–2011. …

Effect Of A Simulation Course On Medication Administration Safety Of Malaysian Nursing Student, Noraidah L. Guntalib

Loma Linda University Electronic Theses, Dissertations & Projects

Improving safety during medication administration has been a goal of today’s healthcare environment. The complexity of both medication use and the medication management process, especially in the in-patient setting, creates a significant risk for hospitalized clients. Medication administration errors have harmed millions of people and cost millions of dollars worldwide, including Malaysia. Patient safety is dependent on nurses (including student nurses), who must consistently demonstrate behaviour fundamental to the safe administration of medication. Therefore, nursing education must provide teaching and foster learning in students to prepare them to be a safe nurse. Literature has shown that deficiencies of knowledge and …

Molecular Mechanisms That Govern Human Cardiac Stem Cell Age Disparity, Tania Fuentes

Loma Linda University Electronic Theses, Dissertations & Projects

Transplantation of adult endogenous cardiovascular progenitor cells for heart repair results in some clinical benefit, however these stem cells lack the regenerative capacity unique to neonatal cardiovascular stem cells. The goal of this work was to identify mechanisms that contribute to the decline of cardiac stem cell regenerative ability with age and investigate novel therapeutic strategies to improve cardiac stem cell function. When comparing neonatal and adult cardiovascular stem cell clones, both cell types were capable of cardiomyogenic differentiation. However, the expression levels of forty-one microRNAs were significantly altered with age. Expression differences were correlated with reduced proliferation and a …