Medicine and Health Sciences Commons^™

Intravenous Acetaminophen Reduces Opioid Use For Postoperative Pain In Obese Patients Undergoing Laparoscopic Cholecystectomy, Kimberly S. Burks

Doctoral Projects

Opioid-induced respiratory depression is categorized as a sentinel event, which is an unanticipated occurrence that may result in severe injury or death. Although the incidence of opioid-induced respiratory depression is 0.2 to 2%, this issue persists as a substantial basis of morbidity and mortality. The obese population has multiple physiologic elements that increase their risk for opioid-induced respiratory depression. This retrospective study examined if intravenous (IV) acetaminophen reduces opioid consumption in the postoperative period in obese patients who underwent a laparoscopic cholecystectomy. Adequately controlled postoperative pain provides for greater patient satisfaction, decreased hospital length of stay (LOS), and reduced costs …

Twenty-Week Abortion Bans: Ineffective, Unconstitutional And Unwise, Paul Benjamin Linton

Brigham Young University Journal of Public Law

No abstract provided.

Overweight Predicts Poorer Exercise Capacity In Congenital Heart Disease Patients, Karen Kuehl, Alicia Tucker, Munziba Khan, Paula Goldberg, E. Anne Greene, Megan Smith

Pediatrics Faculty Publications

Background

Overweight (OW) and obesity (OB) are endemic in the United States and affect adolescents and adults with congenital heart disease (ACHD). Defining the burden of excess weight on the cardiovascular system in ACHD is the goal of this study. Limitation of exercise capacity due to overweight or obesity might be reversible with weight loss and improve quality of life for ACHD adults.

Methods

Exercise tests performed using a Bruce protocol and measurement of maximum oxygen consumption were retrospectively reviewed on 418 CHD patients. OW and OB were defined as the 85–95 or > 95 percentile respectively for age and gender …

Clinical Support Personnel In The U.S. Hospitals: Job Trends From 2010-2014, Patricia Pittman, Suhui Li, Xinxin Han

Health Workforce Research Center Publications

The use of various forms of Clinical Support Personnel (CSP), who perform healthcare tasks under the supervision of registered nurses and other licensed healthcare providers has been used as a primary strategy for managing professional shortages (Huston, 1996; Zimmerman, 2000), while at the same time reducing costs (Orne, Garland, O’Hara, Perfetto, & Stielau, 1998; Keenan, 2003). The purpose of this analysis is to better understand how hospitals are using CSP, and to explore changes that may have occurred since the 2010 passage of the Affordable Care Act. We use the term CSP to refer to a portion of the allied …

Leisure-Time Physical Activity, Falls, And Fall Injuries In Middle-Aged Adults., Alberto J. Caban-Martinez, Theodore K. Courtney, Wen-Ruey Chang, David A. Lombardi, Melissa J. Perry, Jeffrey N. Katz, David C. Christiani, Santosh K. Verma

Environmental and Occupational Health Faculty Publications

Introduction

Although exercise and strength training have been shown to be protective against falls in older adults (aged 65 years and older), evidence for the role of leisure-time physical activity (LTPA) in the prevention of falls and resulting injuries in middle-aged adults (aged 45–64 years) is lacking. In the present study, we investigate the association between self-reported engagement in LTPA and the frequency of falls and fall-related injuries among middle-aged and older adults, while controlling for key sociodemographic and health characteristics.

Methods

Nationally representative data from the 2010 U.S. Behavioral Risk Factor Surveillance Survey were analyzed in April 2014 to …

The Relationship Between Pass Completion Percentage And Perceived Player Workload In Ncaa Division I Women's Soccer, Alexa L. Passingham

Undergraduate Honors Theses

In an attempt to demonstrate the interconnecting nature of the pillars of sport (Hacker, 2000) this thesis explores the relationship between physical, psychological and technical variables. Five National Collegiate Athletic Association (NCAA) Division I Women’s Soccer players were analyzed in four conference matches. The athlete's rate of perceived exertion (RPE) values were correlated to pass completion percentages (PC%) to investigate the potential effect that psychological satisfaction or dissatisfaction of technical performance has on perceived exertion ratings. PlayerLoad^TM (PL) values, gathered through the utilization of a Catapult Minimax S4 GPS device (miniMax-10 Hz, Catapult Innovations, Melbourne, Australia), were used as …

Quality And Cost Of Diabetes Mellitus Care In Community Health Centers In The United States., Patrick Richard, Peter Shin, Tishra Beeson, Laura S. Burke, Susan F. Wood, Sara Rosenbaum

Health Policy and Management Faculty Publications

OBJECTIVE: To examine variations in the quality and cost of care provided to patients with diabetes mellitus by Community Health Centers (CHCs) compared to other primary care settings.

RESEARCH DESIGN AND METHODS: We used data from the 2005-2008 Medical Expenditure Panel Survey (N = 2,108). We used two dependent variables: quality of care and ambulatory care expenditures. Our primary independent variable was whether the respondent received care in a Community Health Centers (CHCs) or not. We estimated logistic regression models to determine the probability of quality of care, and used generalized linear models with log link and gamma distribution to …

The Role Of Platelets In The Successful Closure Of The Ductus Arteriosus In Premature Infants After Indomethacin Treatment, Joan Heilskov

Nursing Dissertations - Archive

Premature birth (birth before 37 weeks gestation) remain a global problem with negative consequences profundly affecting the infants, their families, and society. Persistent patent ductus arteriosus (PDA) is a significant complication seen in preterm infants. Premature infants with persistent PDAs are at increased risk for morbidity and mortality. Indomethacin is reported to successfully close the PDA in only 20-40 percent of infants whose birth weights are less than 1,000g. Common side effects of Indomethacin include renal dysfunction, gastric perforations, and decreased cerebral blood flow and perfusion. Several studies have shown thrombocytopenia is associated with persistent PDA in premature infants who …

Predictors Of Persistence In Online Graduate Nursing Students, Denise Cauble

Nursing Dissertations - Archive

Persistence is an important measure of success for individual students and institutions of higher learning. The purpose of this study was to explore personal and academic factors that influence persistence in online graduate nursing students. A predictive correlational study design was used. Data were extracted from existing student records in two online graduate programs within a large, urban college of nursing. A sample size of 197 graduate nursing students was selected, 94 who persisted to graduation from their program within 36 months and 103 who did not. Age, gender, race/ethnicity, undergraduate GPA, undergraduate education (BSN or RN-BSN level) were examined …

Enhancement Of Knowledge And Skills Of Community Midwives In Sindh, Pakistan, Sadia Abbas Ali, Arusa Lakhani, Rafat Jan, Shahnaz Shahid, Marina Baig, Farzana Adnan

Journal of Asian Midwives (JAM)

With a maternal mortality rate of 276 deaths per 100,000 live births, Pakistan is one of the countries with a large share in the percentage of world’s maternal mortality. As an intervention for the Millennium Development Goals (MDG) 4 and 5, the World Health Organization (WHO) strongly suggests that skilled care before, during, and after childbirth can save the lives of women and newborn babies. One of the interventions to ensure care to mothers and babies by skilled care providers is the capacity building training of Community Midwives (CMWs) aiming to improve their midwifery competency.

One such training intervention was …

Another Year Over …., Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

The Effect Of Bereavement Counseling On Women With Psychological Problems Associated With Late Pregnancy Loss, Christy Simpson, Pramila Lee, Jessie Lionel

Journal of Asian Midwives (JAM)

Pregnancy is most often a joyful experience and a woman’s plans and dreams are shattered when the death of an unborn or newborn infant occurs. Studies have reported that these women experience psychological problems such as grief, depression, and anxiety which can be minimized by counselling. Hence, this study was undertaken to assess the effect of bereavement counseling on women with psychological problems associated with pregnancy, focusing on Roy’s adaptation theory. An experimental design, with pre-test and post-test, was used with randomly allocated experimental and control groups. Women were randomly allocated to the experimental and control groups with 45 women …

Muscle Cramping During A 161-Km Ultramarathon: Comparison Of Characteristics Of Those With And Without Cramping, Martin D. Hoffman, Kristin J. Stuempfle

Health Sciences Faculty Publications

Background: This work sought to identify characteristics differing between those with and without muscle cramping during a 161-km ultramarathon.

Methods: In this observational study, race participants underwent body weight measurements before, during, and after the race; completed a post-race questionnaire about muscle cramping and “near” cramping (controllable, not reaching full-blown cramping), drinking strategies, and use of sodium supplementation during four race segments; and underwent a post-race blood draw for determination of serum sodium and blood creatine kinase (CK) concentrations.

Results: The post-race questionnaire was completed by 280 (74.5 %) of the 376 starters. A post-race blood sample was provided by …

Outcomes With As-Needed Ranibizumab After Initial Monthly Therapy: Long-Term Outcomes Of The Phase Iii Ride And Rise Trials., David S. Boyer, Quan Dong Nguyen, David M. Brown, Karen Basu, Jason S. Ehrlich

Journal Articles: Ophthalmology

PURPOSE: To determine whether the efficacy and safety achieved with monthly ranibizumab as treatment for diabetic macular edema (DME) can be maintained with less-than-monthly treatment.

DESIGN: Open-label extension (OLE) phase of randomized, sham-controlled phase III trials: RIDE (NCT00473382) and RISE (NCT00473330).

PARTICIPANTS: Five hundred of 582 adults who completed the 36-month randomized core studies elected to enter the OLE.

METHODS: All patients participating in the OLE were eligible to receive 0.5 mg ranibizumab according to predefined re-treatment criteria: Treatment was administered when DME was identified by the investigator on optical coherence tomography or when best-corrected visual acuity (BCVA) worsened by …

Misconceptional Views About Epilepsy Exist Across Social Class System Of Society, Shoaib Rao, Bakhtyar Ali Shah, Nimra Altaf, Fazal M. Arain

Pakistan Journal of Neurological Sciences (PJNS)

Epilepsy affects over 1% of population worldwide. Studies have shown that although our understanding about epilepsy has come a long way, misconceptions about its etiology and treatment exist in rural slums. However, no study has been conducted to see whether such misconceptions exist in middle and upper socio-economic class. This study aims to explore the existence of misconceptions and social stigma in the middle and upper socio-economic class. Materials and Methods: We conducted a survey-based study about epilepsy on 227 participants, belonging to middle and upper socio-economic class. Results: The symptoms of generalized tonic-clonic seizures were correctly described by participants. …

Albuminocytological Dissociation In Different Electrophysiological Gbs Variants, Ali Zohair Nomani, Mansoor Iqbal, Haris Majeed, Mazhar Badshah, Sumaira Nabi, Zakir Jan, Uzma Jamil

Pakistan Journal of Neurological Sciences (PJNS)

The objective of our study was to determine the distribution of different electrophysiological variants of GBS and its relationship with albuminocytological dissociation (ACD). The rationale of the study was to determine whether presence or absence of albuminocytological dissociation has any association with NCS findings and whether can be relied upon as an indirect predictor of axonal variant which warrants poor patient out comes versus demyelinating. Materials and Methods: A consecutive series of 76 patients who presented at PIMS over a 12 month period with GBS were included. Nerve Conduction studies (NCS) and Electromyographic (EMG) findings with CSF characterization for albuminocytological …

The Effects Of Ketorolac And Its Enantiomers On Breast Cancer Proliferation And Metastasis, Amanda Sheree Peretti

Biomedical Sciences ETDs

Breast cancer is the second leading cause of cancer related deaths in women. Advanced breast cancer can metastasize to the lungs, liver, bones and brain becoming fatal conditions for many patients. There is a dire need for metastasis preventing medications, however the process required for a medication to become FDA approved for clinical use is long and arduous. Studies have found promising benefits for breast cancer patients given ToradolTM, or racemic ketorolac, as an NSAID during resection surgery. However, long-term use of racemic ketorolac is not recommended. Currently FDA-approved for use in the racemic form, ketorolac has the potential to …

Describing The Prevalence And Awareness Of Sport-Related Concussion In University Intramural And Club Sport Participants, Makenzie L. Brown

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Concussion injuries are growing in number among athletes across the nation. The majority of concussion research to date focuses on collegiate and high school athletes. University athletes make up a small percentage of the student body population compared to the large number of students that participate in club and intramural sports. These students participate in the same sports, assume the same risks, and may experience the same adverse effects of concussion, often without appropriate medical oversight.

Purpose: The purpose of this study was to determine if concussion is a problem among intramural and club sport participants, if these participants …

Dr. John H. Gibbon, Jr. And Jefferson's Heart-Lung Machine: Commemoration Of The World's First Successful Bypass Surgery, F. Michael Angelo

Posters: Jefferson History

On May 6, 1953 at Jefferson Medical College Hospital, Dr. John Heysham Gibbon, Jr., his staff, and with the help of his latest-designed heart-lung machine, “Model II,” closed a very serious septal defect between the upper chambers of the heart of eighteen-year-old Cecelia Bavolek. This was the first successful intercardiac surgery of its kind performed on a human patient. Ms. Bavolek was connected to the device for three-quarters of an hour and for 26 crucial minutes, the patient totally depended upon the machine’s artificial cardiac and respiratory functions. “Jack” Gibbon did not follow this epoch-making event by holding an international …

African American Graduates Of Jefferson Medical College: The First Hundred Years, F. Michael Angelo

Posters: Jefferson History

Beginnings…

The story of early African American physicians begins in 18th century Philadelphia with James Derham who is recognized as the first black allopathic (regular, non-sectarian) medical doctor. The first medical school in the U.S. to admit an African American was Rush Medical College in Chicago that awarded, in 1847, David J. Peck his degree. Dr. Peck came to the “Quaker City” to set up his practice the same year that the A.M.A. was formed, also here in Philadelphia. In 1877, Jefferson doctors protested the seating of the delegates from Howard University, the nation’s most important black medical school, in …

Latin Heritage Month. Carlos Juan Finlay: Outrageous, Courageous And Correct, Dorothy E. Berenbrok

Posters: Jefferson History

In 1855, a modest Cuban physician named Carlos Juan Finlay graduated from Jefferson Medical College. He was among JMC’s first dozen Hispanic graduates, initially signing the registrar’s log as “Charles”. He left Philadelphia at the age of 22 to begin private practice. Preceptor and close friend S. Weir Mitchell, among others, urged Finlay to work among the burgeoning Spanishspeaking population in New York City, but he returned to Cuba and set up practice in Matanzas, a town near Havana. He took a binocular microscope with him, similar to one used byMitchell, which would serve him well for many years.

During …

United States Medicine, Women And Jefferson Medical College, F. Michael Angelo

Posters: Jefferson History

Timeline of women at Jefferson Medical College.

Efficacy And Safety Of Vorapaxar In Non-St-Segment Elevation Acute Coronary Syndrome Patients Undergoing Noncardiac Surgery, Sean Van Diepen, Pierluigi Tricoci, Mohua Podder, Cynthia M. Westerhout, Philip E. Aylward, Claes Held, Frans Van De Werf, John Strony, Lars Wallentin, David J. Moliterno, Harvey D. White, Kenneth W. Mahaffey, Robert A. Harrington, Paul W. Armstrong

Gill Heart & Vascular Institute Faculty Publications

Background—Perioperative antiplatelet agents potentially increase bleeding after non–ST‐segment elevation (NSTE) acute coronary syndromes (ACS). The protease‐activated receptor 1 antagonist vorapaxar reduced cardiovascular events and was associated with increased bleeding versus placebo in NSTE ACS, but its efficacy and safety in noncardiac surgery (NCS) remain unknown. We aimed to evaluate ischemic, bleeding, and long‐term outcomes of vorapaxar in NCS after NSTE ACS.

Methods and Results—In the TRACER trial, 2202 (17.0%) patients underwent major or minor NCS after NSTE ACS over 1.5 years (median); continuing study treatment perioperatively was recommended. The primary ischemic end point for this analysis was cardiovascular …

Conflict Between Paternalism And Autonomy., Amber Hussain Sayani

School of Nursing & Midwifery

In the past, paternalism played an important role in making decisions at the end of life. However, in the modern era its significance has become unpopular as it require physicians to decide what is good or bad for the patient without considering patients wish and interest. This commentary article is based on a case study of a woman whose life was lost due to complications of pregnancy. The paper critically reviews this case study, and attempts to provide a reasonable and systematic framework to make sound decisions in similar cases.

Effect Of Raised Body Fat On Vitamin D, Leptin And Bone Mass, Syeda Sadia Fatima, Saad Farooq, Maaida Asif Tauni, Omar Irfan, Faiza Alam

Department of Biological & Biomedical Sciences

Objective: To estimate leptin, vitamin D and bone mineral density levels in individuals with high fat mass, and to assess any correlation.Methods: The cross-sectional study was conducted at the Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, and Aga Khan University, Karachi, from August 2012 to July 2014, and comprised healthy male volunteers between the ages of 18-60 years. Body fat percentage was determined using bioelectrical impedance analysis and the participants were classified as: Group A (15-21.9); Group B (22-27.9); and Group C ( > 28). Bone mineral density was calculated by ultrasound bone densitometer (T-score between +1 and …

Theory Of Mind Indexes The Broader Autism Phenotype In Siblings Of Children With Autism At School Age, Tawny Tsang, Kristen Gillepsie-Lynch, Ted Huntman

Publications and Research

Subclinical variants of the social-communicative challenges and rigidity that define autism spectrum disorder (ASD) are known as the broader autism phenotype (BAP). The BAP has been conceptualized categorically (as specific to a subset of relatives of individuals with ASD) and dimensionally (as continuously distributed within the general population). The current study examined the compatibility of these two approaches by assessing associations among autism symptoms and social-communicative skills in young school-age children with ASD, children who have a sibling with ASD, and children without a sibling with ASD. Autism symptomswere associated with reducedTheory ofMind (ToM), adaptive skills, cognitive empathy, and language …

Full Issue, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Alumni Earning Doctorates, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Scholarships Awarded To Mcnair Scholars, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Resurrecting Health Care Rate Regulation, Erin C. Fuse Brown

Faculty Publications By Year

Our excess health care spending in the United States is driven largely by our high health care prices. Our prices are so high because they are undisciplined by market forces, in a health care system rife with market failures, which include information asymmetries, noncompetitive levels of provider market concentration, moral hazard created by health insurance, multiple principal-agent relationships with misaligned incentives, and externalities from unwarranted price variation and discrimination. These health care market failures invite a regulatory solution. An array of legal and policy solutions are typically advanced to control our health care prices and spending, including: (1) market solutions …