Medicine and Health Sciences Commons^™

Naturalistic Clinical Decision Making By Emergency Department Staff And The Assignment Of Categorical Suicide Risk Ratings Within An Urban Veteran Population, Gerd R. Naydock

PCOM Psychology Dissertations

The ability to comprehensively and effectively identify those individuals who are at greatest risk to engage in self-directed violence (SDV) forms the cornerstone for all professional suicide prevention activities. To that end, mental health professionals have come to rely on the use of risk stratification to identify at-risk individuals as a way to inform and guide risk management and treatment, without having the benefit of empirical evidence to support such practices. The current program evaluation examined archival data comprised of suicide risk assessments conducted by mental health professionals on suicidal veterans (N = 1,560) in the emergency department of a …

The Effects Of Speech Impairment On Quality Of Life Over Time In Patients With Amyotrophic Lateral Sclerosis, Jacqueline Kelley Blessinger

PCOM Psychology Dissertations

Limited research exists on how speech impairments affect quality of life (QOL) factors over time in patients with amyotrophic lateral sclerosis (ALS). A review of the literature, including the history, disease course, and prevalence of ALS, is presented. Physical and psychosocial functioning, especially the decline of bulbar functioning’s potential impact on QOL factors and communication style, are outlined. This study is a follow-up study on a study by Duff, who found a significant difference in QOL relative to level of bulbar functioning in a cross-sectional design. The current study used a longitudinal design to look at bulbar functioning, specifically levels …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

Tramadol, Pharmacology, Side Effects, And Serotonin Syndrome: A Review, Burton D. Beakley, Adam M. Kaye, Alan David Kaye

School of Pharmacy Faculty Articles

Background: Serotonin syndrome is a mild to potentially life-threatening syndrome associated with excessive serotonergic activity within the central nervous system. Serotonin syndrome is associated with medication use, drug interactions, and overdose. While serotonin syndrome is often associated with the use of selective serotonin inhibitors (SSRI), an increasing number of reports are being presented involving the use of tramadol. Methods: This review article contains an overview of serotonin syndrome while specifically looking at tramadol's pharmacology and risk factors for serotonin syndrome. With tramadol's increasing popularity, the goal of this article is to make physicians more alert and aware of this potential …

A Survey On Practices Of Koraga Tribes During Diarrhoea In Children, Shrisha, Binu E. Margaret Mrs, Sheela Shetty Mrs

Manipal Journal of Nursing and Health Sciences

Introduction: Every society follows different practices to treat various childhood illnesses. Tribal populations are isolated from the general population by their own lifestyle and practices. The objective of the study was to assess the treatment practices of the Koraga tribes during diarrhoea in children. Materials and Methods: A descriptive survey using face-to-face interview technique was undertaken among 200 caretakers of Koraga tribe using a semi-structured questionnaire. Data analysis was done using SPSS v16.0. Results: 110 (55%) respondents were using arrowroot mixture; curd and salt were used by 34 (17%) to treat diarrhoea. Other practices include use of wheat sooji porridge …

Breast And Prostate Cancer Survivor Responses To Group Exercise And Supportive Group Psychotherapy, Eric Martin, Caroline Bulsara, Claudio Battaglini, Beth Hands, Fiona L. Naumann

Health Sciences Papers and Journal Articles

This study qualitatively examined an 8 week group exercise and counseling intervention for breast and prostate cancer survivors. Groups exercised 3 days per week, 50 minutes per session, performing moderate intensity aerobic and resistance training. Groups also underwent 90 minute supportive group psychotherapy sessions once per week. Survivors discussed their experiences in focus groups post intervention. Transcripts were analyzed using interpretative phenomenological analysis. Survivors described how exercise facilitated counseling by creating mutual aid and trust, and counseling helped participants with self-identity, sexuality, and returning to normalcy. When possible, counselors and fitness professionals should create partnerships to optimally support cancer survivors.

Does Motor Competence Affect Self-Perceptions Differently For Adolescent Males And Females?, Elizabeth Rose, Dawne Larkin, Helen Parker, Beth Hands

Health Sciences Papers and Journal Articles

Little is understood about the impact of level of motor competence on self-perceptions in adolescence, in particular how this may differentially affect girls and boys. A sample of 1,568 14-year-old participants (766 girls and 802 boys) were grouped into four motor competence levels (very low to high) based on the McCarron Assessment of Neuromuscular Development (MAND). Self-perceptions were assessed using the Self-Perception Profile for Adolescents. Boys had higher self-perceptions of global self-worth, athletic competence, and physical appearance, whereas girls had higher scores for close friendships and behavioral conduct. Main effects in the predicted direction were found for motor competence for …

"We Are All One Together": Peer Educators' Views About Falls Prevention Education For Community-Dwelling Older Adults - A Qualitative Study, Linda Khong, Fiona Farringdon, Keith D. Hill, Anne-Marie Hill

Health Sciences Papers and Journal Articles

Background: Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering …

The Role Of Alternative Splicing In The Control Of Immune Homeostasis And Cellular Differentiation, Mehmet Yabas, Hannah Elliott, Gerard F. Hoyne

Health Sciences Papers and Journal Articles

Alternative splicing of pre-mRNA helps to enhance the genetic diversity within mammalian cells by increasing the number of protein isoforms that can be generated from one gene product. This provides a great deal of flexibility to the host cell to alter protein function, but when dysregulation in splicing occurs this can have important impact on health and disease. Alternative splicing is widely used in the mammalian immune system to control the development and function of antigen specific lymphocytes. In this review we will examine the splicing of pre-mRNAs yielding key proteins in the immune system that regulate apoptosis, lymphocyte differentiation, …

The Ct20 Peptide As An Agent For Cancer Treatment, Rania Bassiouni

Electronic Theses and Dissertations

Due to cancer recurrence and the development of drug resistance, metastatic breast cancer is a leading cause of death in women. In the search for a new therapeutic to treat metastatic disease, we discovered CT20p, an amphipathic peptide based on the C-terminus of Bax. Due to inherent properties of its sequence and similarity to antimicrobial peptides, CT20p is a promising cytotoxic agent whose activity is distinct from the parent protein (e.g. does not cause apoptosis). CT20p is not membrane permeable but can be introduced to cells using polymeric nanoparticles, a method that promotes efficient delivery of the peptide into the …

Nation-State Personality Theory: A Qualitative Comparative Historical Analysis Of Russian Behavior, During Social/Political Transition, Mark George Bound

Department of Conflict Resolution Studies Theses and Dissertations

The study theorizes that a nation-state can manifest a condition similar to that of personality commonly associated with humans. Through the identification of consistent behaviors, a personality like condition is recognizable, and the underlining motivations dictate national policy independent of any current social/political influence. The research examines Russia during two historical periods examining the conflict events and social/political transitions of the period, to identify common behavioral characteristics, which indicate the existence of any independent personality like trait.

The study focuses on two historical periods: the Monarch Period of Peter I (The Great), and the Post-Soviet Union period of Vladimir Putin, …

Pre And Post Implementation Evaluation Of An Emergency Department Severe Sepsis Alert And Practice Protocol, Darleen Williams

Electronic Theses and Dissertations

Severe sepsis kills an estimated 1,400 people worldwide every day. This often fatal infectious process accounts for an estimated 215,000 deaths in the United States (US) annually. The main goal of this project was to evaluate the impact of the Emergency Department Severe Sepsis Alert and Practice Protocol (EDSSAPP) post implementation, on time to first antibiotic administration, length of stay, and mortality in patients admitted via the ORMC ED with severe sepsis. This study evaluated the time to first antibiotic administration, total ED and hospital length of stay (LOS) and mortality of severe sepsis patients either with a severe sepsis …

Sodium Bicarbonate Supplementation And Its Effect On Fatigue In A Maximal Bout Of Exercise, Tony John Ramos

Graduate Theses/Dissertations

The purpose of this study was to determine or assess if sodium bicarbonate (NaHCO3) supplementation is a plausible method of delaying fatigue in a maximal effort bout of exercise. Fourteen, college aged, cardiovascular trained males participated in the study (Age- 21.38 +- 1.50y, Height- 180.46 +- 10.12cm, Weight- 79.15 +- 9.28kg). Sodium bicarbonate was compared with sodium chloride and a baseline. Following the initial meeting and tolerance test, participants completed 3 exercise trials which consisted of Day 1: Initial meeting & tolerance testing and Days 2, 3, and 4: Exercise Test Sessions 1-3. Data being collected was run time, RPE, …

Co-Targeting Of Cyclooxygenase-2 And Foxm1 Is A Viable Strategy In Inducing Anticancer Effects In Colorectal Cancer Cells, Maqbool Ahmed, Azhar Hussain, Abdul K. Siraj, Shahab Uddin, Nasser Al-Sanea, Fouad Al-Dayel, Mohammed Al-Assiri, Shaham Beg, Khawla S. Al-Kuraya

Centre for Regenerative Medicine & Stem Cell Research

Background: Cross-talk between deregulated signaling pathways in cancer cells causes uncontrolled growth and proliferation. These cancers cells become more aggressive and quickly develop resistance to therapy. Therefore targeting of these deregulated pathways simultaneously can result in efficient cell death of cancer cells. In this study we investigated co-expression of Cox-2 and FoxM1 in a cohort of colorectal carcinoma (CRC) samples and also examined whether inhibition of Cox-2 and FoxM1 simultaneously can lead to inhibition of cell viability and induction of apoptosis in colorectal cancer cell lines and in vivo xenograf
Methods: Protein expression of Cox-2 and FoxM1 was determined …

Handwriting With Adult With Developmental Delays, Joseph Hoctor

A with Honors Projects

This paper provides an assessment of the author's experience working with an adult male with Downs Syndrome to improve his cursive handwriting skills.

Hearing Loss From Traumatic Brain Injury, Nathan Young

A with Honors Projects

Traumatic brain injury to the parts of the brain responsible for processing auditory information can result in hearing loss that is difficult to assess and treat. Symptoms can include difficulty in filtering background noises or filtering out specific sounds, confusion, and disorientation or nausea. Treatment of this type of hearing loss varies, but primarily consists of psychological treatment focused around rehabilitation and coping.

Dr. Mary Edwards Walker: Years Ahead Of Her Time., Dre M. Irizarry, Bs, Nicole Salomone, As, Karen A. Chojnacki, Md, Charles J. Yeo, Md, Scott W. Cowan, Md, Linda J. Bogar, Md

Department of Surgery Gibbon Society Historical Profiles

Women phsycians in the United States were virtually nonexistent in the early to mid-1800s. Traditional medical schools still did not accept women, and few secretarian or eclectic medical schools were beginning to open their doors to female students. In 1849 at Geneva College, Elizabeth Blackwell became the first woman to achieve a medical degree in the United States.1 At the time of the Civil War, the few women who had managed to obtain medical degrees mainly served as nurses in the war, because society was not yet ready to accept the female physician.2 Dr. Mary Edwards Walker would help change …

Expression Of Interferon Gamma By A Recombinant Rabies Virus Strongly Attenuates The Pathogenicity Of The Virus Via Induction Of Type I Interferon., Darryll A Barkhouse, Samantha A Garcia, Emily K Bongiorno, Aurore Lebrun, Milosz Faber, D Craig Hooper, Phd

Department of Cancer Biology Faculty Papers

UNLABELLED: Previous animal model experiments have shown a correlation between interferon gamma (IFN-γ) expression and both survival from infection with attenuated rabies virus (RABV) and reduction of neurological sequelae. Therefore, we hypothesized that rapid production of murine IFN-γ by the rabies virus itself would induce a more robust antiviral response than would occur naturally in mice. To test this hypothesis, we used reverse engineering to clone the mouse IFN-γ gene into a pathogenic rabies virus backbone, SPBN, to produce the recombinant rabies virus designated SPBNγ. Morbidity and mortality were monitored in mice infected intranasally with SPBNγ or SPBN(-) control virus …

Diagnostic Value Of Endoscopic Ultrasound-Guided Fine Needle Aspiration Of Intra-Abdominal Lymph Nodes In Patients With Concurrent Biopsy Of Intra-Abdominal Tumors, Allison F. Goldberg, Md, Charalambos C. Solomides, Md, Marluce Bibbo, Md, Rossitza Draganova-Tacheva, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

BACKGROUND

• Diagnostic endoscopic biopsy of intra-abdominal lesions may be performed prior to surgical resections.

• Endoscopic ultrasound-guided fine needle aspiration of intra-abdominal lymph nodes may also be performed to:

• Yield more information

• Allow for more accurate staging

• We evaluate the additional staging information concurrent fine needle aspiration of intra-abdominal lymph nodes provided

DESIGN

• We included all patients at our institution from January 1, 2000 to March 30, 2015 who, during the same endoscopic procedure, had:

• Endoscopic ultrasound guided fine needle aspiration of an intra-abdominal lymph node AND

• Endoscopic ultrasound guided fine needle aspiration …

Improved Accuracy Of Surgical Pathology Accessioning, Coding, And Billing Practices After Self-Evaluation, Allison F. Goldberg, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

INTRODUCTION

Accurate accessioning, coding, and billing of specimens are vital, but often disregarded, aspects of a surgical pathologist’s job. This study had two aims related to those aspects. First, to evaluate the quality of our systems based practices in order to identify areas for improvement. Second, to assess if changes made based on our self-evaluation improved accuracy.

Tumor Metabolism In The Microenvironment Of Nodal Metastasis In Head And Neck Squamous Cell Carcinoma, Mehri Mollaee, Md, Patrick T. Tassone, Md, David Cognetti, Md, Adam J. Luginbuhl, Md, Joanie Johnson, Ubaldo E. Martinez-Outshoorn, Md, Tingting Zhan, Joseph M. Curry, Md, Madalina Tuluc, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

ABSTRACT

Introduction: Monocarboxylate transporter 4 (MCT4) is a cell membrane transporter of lactate. MCT4 is a tumor-specific marker of oxidative stress, glycolysis and hypoxia in tumor stromal cells. We investigated HPV positive and negative tumors with regional metastases to cervical lymph nodes (LN) to study how the metastatic tumor cells interact with their microenvironment. By selecting cancers with extracapsular extension (ECE), we intended to evaluate the interaction between metastases and the surrounding extranodal tissue.

Methods:

Clinical data were collected from 24 advanced stage oropharyngeal squamous cell carcinoma (OPSCC) patients with neck LN metastasis. All patients presented with at least N1 …

Assessment Of Utility Of Daily Patient Results Averages As Adjunct Quality Control In A Weekday-Only Satellite Chemistry Laboratory, Dimath Alyemni, Md, Laura J. Mccloskey, Md, Barbara Goldsmith, Phd, Facb, Aryana Treweek, Robert T. Stapp, Do, Douglas F. Stickle, Phd

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

ABSTRACT

Background:

Our department operates a weekday-only (8AM-5PM) satellite laboratory in an infusion center with a menu of 18 chemistry tests on a Roche c501 analyzer. We examined whether daily patient results averages (PRA) in this setting might be useful as a patient-based quality control (PBQC) adjunct to standard daily liquid quality control (LQC) measurements. First, we evaluated the reproducibility (coefficient of variation, CV) of daily PRAs for each analyte, and compared these to CVs of LQC. Second, for select analytes found to have relatively low PRA CVs, we evaluated the extent to which use of daily PRA measurements could …

Is Hemoglobin Variant Analysis Helpful In The Diagnostic Work-Up Of Patients Revealing Microcytic Erythrocytosis On Complete Blood Count?, Upasana Joneja, Md, Alina Dulau-Florea, Gene Gulati, Ph.D, Jerald Z. Gong, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Introduction:

Microcytic erythrocytosis is an abnormal CBC (complete blood count) finding that is under-recognized, poorly understood, and consequently under-utilized in patient care. It is characterized by decreased MCV and increased RBC count. Its etiology is likely multifactorial and includes thalassemias and hemoglobinopathies. The focus of our study was to determine the relative prevalence of hemoglobin-associated disorders in patients revealing microcytic erythrocytosis on CBC and to demonstrate whether or not hemoglobin variant analysis should be included in the diagnostic work-up of such cases.

Analysis Of Patient Results Distributions To Reevaluate A Reference Range Change For Calcium, After A Change In Assay Reagents On The Roche Cobas C500 Analyzer, Upasana Joneja, Md, Laura J. Mccloskey, Md, Douglas F. Stickle, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Introduction:

A change in reagents for calcium (Ca) on the Roche Cobas c500 used in our laboratory analyzer took place in 2013. The previous reference range (8.5-10.5 mg/dL) was replaced with that from the manufacturer's study (8.6-10.0 mg/dL), based on correlation of results between the new and old assays. As a matter of quality assurance, we undertook a post-assay-change reevaluation of the reference range change, using a method based on that of Bhattacharya [1]. In short, the method relies on the assumption that the reference range is a normal distribution, which assumption enables this distribution to be isolated mathematically from …

Quantification Of Csf Chemokines And Cytokines Allows For Rapid Laboratory Detection Of Cns Infections And Further Discrimination Between Viral And Non-Viral Pathogens, Danielle Fortuna, Md, Am Cardenas, Eh Graf, Amity L. Roberts, Phd, D(Abmm), Larry A. Harshyne, Phd, D. Craig Hooper, Phd, Mark T. Curtis, Md, Phd

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Background:

Prompt diagnosis of central nervous system (CNS) disease is critical to guide intervention and appropriate therapy. Development of novel laboratory approaches to rapidly classify acute-onset CNS disease is in great demand. Serious microbial pathogens, especially viruses, are quickly expanding beyond their historic geographic range and may not even be considered in the clinician’s differential diagnosis. Unlike bacterial cultures, current viral testing targets a limited number of viruses. Additionally, despite diversity in etiology, signs and symptoms of both infectious and non-infectious CNS disorders can be remarkably similar, which can confuse the clinical picture and delay treatment. Bacterial, viral, fungal and …

Human Parechovirus And Enterovirus Initiate Divergent Innate Immune Responses In The Cns: Pathogenic And Diagnostic Implications, Danielle Fortuna, Md, Ana Maria Cardenas, Phd, Erin H. Graf, Phd, Larry A. Harshyne, Kevin Quann, Bs, D. Craig Hooper, Phd, Mark T. Curtis, Md, Phd

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

The picornaviruses human parechovirus (HPeV) and enterovirus (EV) cause a wide range of diseases, including CNS infections, which can be severe and potentially fatal. EV causes most cases of pediatric meningoencephalitis worldwide, and HPeV type 3 (HPeV3) is the most common cause of viral meningitis in young infants. Each year in the United States, there are over 75,000 cases of aseptic meningitis. Despite reassuring short-term outcomes, negative neurodevelopmental sequalae are increasingly associated with HPeV and EV.

The pathogenesis and severity of HPeV and EV infections are undoubtedly linked to the innate and adaptive immune responses elicited by these viruses. Until …

A Distinct Pattern Of Beclin-1 Staining Helps Distinguish Sessile Serrated Adenomas, Danielle Fortuna, Md, Juan P. Palazzo, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Autophagy, a lysosomal degradation system, has both cell survival and cell death-promoting capabilities, and its versatility is exploited in many pathologic entities. In neoplastic processes, autophagy has been demonstrated to contribute to both tumor suppression and tumorigenesis in a relatively tumor-specific fashion. Beclin-1 is a protein involved in the formation of the autophagosome, the core unit of autophagy, and serves as one of the general markers for this process. Previous studies have shown Beclin-1 overexpression in both pre-neoplastic and invasive colon carcinoma but weak to absent expression in normal colonic mucosa.

Serrated polyps (SPs) of the colon represent morphologically and …

Cerebrospinal Fluid Cytokine And Chemokine Patterns In Central Nervous System Infections, Hemorrhage And Neoplasms, Danielle Fortuna, Md, Larry A. Harshyne, Phd, D. Craig Hooper, Phd, Amity L. Roberts, Phd, D(Abmm), Danielle Hutchings

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Cytokines and chemokines are soluble proteins that act as regulators of cellular functions throughout the body. Cytokines and chemokines released in the setting of various CNS disorders appear in the CSF compartment where determination of their levels can provide insight into pathogenic processes such as neuroinflammation. We utilized the Millipore HCYTOMAG 60K assay/kit/system to perform multiplex profiling of 42 different cytokines/chemokines in the CSF of patients with a variety of distinct CNS disease processes, including infection, hemorrhage and neoplasia. CNS infections included viral (Chronic Parechovirus type 3 (HPeV3), Enterovirus (EV) 68, Adenovirus, JC virus, West Nile virus), bacterial (Mycobacterium tuberculosis, …

Genomic Analysis Of Advanced Breast Cancer Using Two Types Of Next Generation Sequencing, Laura Biederman, Upasana Joneja, Md, Laura K. Austin, Md, M. Cristofanilli

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

The aim of this study is to characterize the genomic alterations of advance stage breast cancer using next generation sequencing (NGS) to identify pathways that may be commonly altered in advance stage breast cancer.

Hiv Genotyping Cost Analysis With Follow-Up As An Indicator, Laura Biederman, Md, Amity L. Roberts, Phd, D(Abmm)

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

HIV-1 genotype (GHIV), HIV-1 Integrase (HIV1I) and HIV-1 Trophile (HIV1T) assays are sendout tests that incur a significant financial burden on the laboratory when ordered on inpatients who do not receive follow-up clinic visits. For these assays to be utilized in guiding antiretroviral therapy, the patient must receive follow-up. It will reduce the sendout budget by restricting these tests to the outpatient clinic setting.