Medicine and Health Sciences Commons^™

Influence Of Environmental Exposure On Human Epigenetic Regulation, C. J. Marsit

Dartmouth Scholarship

Environmental toxicants can alter epigenetic regulatory features such as DNA methylation and microRNA expression. As the sensitivity of epigenomic regulatory features may be greatest during the in utero period, when critical windows are narrow, and when epigenomic profiles are being set, this review will highlight research focused on that period. I will focus on work in human populations, where the impact of environmental toxicants in utero, including cigarette smoke and toxic trace metals such as arsenic, mercury and manganese, on genome-wide, gene-specific DNA methylation has been assessed. In particular, arsenic is highlighted, as this metalloid has been the focus …

The Impact Of Performance-Based Assessment On University Esl Learners' Motivation, Kadidja Koné

All Graduate Theses, Dissertations, and Other Capstone Projects

This thesis examines the impact of performance-based assessment on university ESL learners' motivation. To reach this aim, data were collected from 21 international ESL students taking an intensive oracy course for non-native speakers. Online motivation questionnaires were used in order to find out how these learners responded emotionally and motivationally to performance-based assessment, specifically an oral presentation project both before and after the project. The results revealed that the students responded positively to this type of project. However, their motivational and emotional states varied across time depending on their experience with the oral presentation, their performance, and the cohesion of …

Learning From Women About Hiv Risk, Hiv Testing Behaviors, And Prevention Practices In Mpumalanga, South Africa: A Descriptive Study To Inform Microbicides Introduction, Martha Brady, Saiqa Mullick, Barbara Friedland, Marlena Gehret Plagianos, Linda Du Plessis, Thabiso Mango

HIV and AIDS

The provision of any new prevention product in clinical trial settings is often vastly different from implementation in “real life” public sector settings. In addition, use of antiretrovirals (ARV), such as tenofovir gel, for pre-exposure prophylaxis requires regular HIV testing to ensure users are uninfected before initiating and continuing product use. Therefore, before any ARV-based prevention product can be introduced to women, information is needed on HIV testing practices, how best to integrate products into existing primary health care systems, and women’s risk perception and health-seeking behaviors. The Population Council, in partnership with Solutions IPPT, conducted a study to learn …

Impact And Prevention Of Psychiatric Polypharmacy In The Elderly, Rose Cordelia E Onyekwe

Walden Dissertations and Doctoral Studies

Adequate medication management is a focus of effective care that is often overlooked in caring for adults with comorbid psychiatric and physical conditions, especially in patients who are treated by multiple care providers and have a variety of health issues at the same time. The purpose of this project was to develop evidence-based policies and practice guidelines to reduce polypharmacy in elderly patients in a rural outpatient psychiatric clinic. Bandura's self-efficacy theory was used to inform the project for its value in assessing motivation, capacity for self-regulation, and perceptions of individual ability. An interdisciplinary team of stakeholders explored best practices …

Go Wish- Pediatrics : Pilot Study Of A Conversation Tool In Pediatric Palliative Care, Meghan Ryan Potthoff

Electronic Theses and Dissertations

Problem: Difficult conversations and decisions are an unfortunate reality for parents caring for children facing life threatening conditions. Confusing, inadequate, and inconsistent communication by health care providers makes advance care planning difficult in pediatrics.
Design: A mixed methods design was utilized to evaluate the effectiveness of an advance care planning conversation tool, Go Wish- Pediatrics, on the emotional resources and distress experienced by parents caring for children in palliative care.
Methods: For this pilot study, a mailed invitation to participate was sent to 134 parents of children currently enrolled in palliative care which yielded a total of ten participants. …

Weight Management Counseling And Obesity Severity In Children With Special Health Care Needs, Adeola Sonaike

Walden Dissertations and Doctoral Studies

Epidemiologic surveillance indicates an increased susceptibility to obesity among children with special health care needs (SHCN) in comparison to children without. The present study investigated this disparity in weight severity between both groups, with a focus on the provision of obesity management counseling by physicians. This study consisted of a retrospective medical record review that acknowledged the effect of patient-provider interactions on health behaviors and risk perceptions. An independent sample t test compared the incidence of clinician-initiated obesity management counseling received by children with SHCN to that which was received by children without SHCN. This t test revealed a statistically …

Mediation And Moderation Analysis Of Nutrition, Inflammatory Biomarkers, And Cognition In Older Adults, Elizabeth Handing

USF Tampa Graduate Theses and Dissertations

Nutrition can be viewed as a modifiable factor related to maintaining and preserving health in older adults. Previous studies have found that nutritional factors can influence cognitive abilities, however few studies have examined macronutrients and micronutrients as they relate to cognitive functioning. Research has yet to examine the mechanisms related to nutrition, cognition and aging in an older adult population from a holistic and interactive perspective.

This dissertation examined three research questions to better understand the relationship between age, nutrition, cognition, and inflammatory biomarkers. First, is nutrition related to cognition beyond demographic factors? Do individual nutrients serve as mediators? Second, …

Using Auditory Feedback To Improve Dance Movements Of Children With Disabilities, Takema J. James

USF Tampa Graduate Theses and Dissertations

Research incorporating behavior analysis to improve sports performance has shown that various feedback types (e.g., video feedback, public posting) can increase skills. Recently, auditory feedback has been shown to be effective. The purpose of this study was to evaluate the utility of auditory feedback to improve dance movements of children with disabilities using an ABAB design embedded in a multiple baseline across participants design. The target behaviors were fundamental dance skills, individualized to each student, and scored using a task analysis to calculate the percentage of correct steps. The results showed that auditory feedback was valuable in increasing the specific …

Using Video Feedback To Increase Job Interview Skills For Young Adults With Developmental Disabilities, Jessica Lynn Moore

USF Tampa Graduate Theses and Dissertations

Individuals diagnosed with developmental disabilities often lack the skills needed to gain meaningful employment in the community. One crucial skill is interviewing as this is the first and often the only pre-job interaction an individual has with his or her employer. In a short interaction, the person must convey information about specific work history, employability, and a general impression of character. This study evaluated the effectiveness of video feedback in improving job interview behaviors for three young adults with developmental disabilities. The interview related-behaviors were appropriate greeting, responses to interview questions, and appropriate closing statement. The performance across the participants …

Fmic Annual Report 2015 | English, French Medical Institute For Mothers And Children

French Medical Institute for Mothers and Children (FMIC) Archives

No abstract provided.

Cutaneous Ulcers As Initial Presentation Of Localized Granulomatosis With Polyangiitis: A Case Report And Review Of The Literature, Noreen Nasir, Syed Ahsan Ali, Hafiz Mohammed Mehmood Riaz

Section of Internal Medicine

Background. Granulomatosis with polyangiitis (GPA) is an ANCA associated small vessel vasculitis characterized by necrotizing granulomatous inflammation involving the upper and the lower respiratory tract and the kidneys. The disease has a broad clinical spectrum that ranges from limited/localized involvement of a single organ system to a generalized systemic vasculitis that affects several organs with evidence of end organ damage. Atypical forms of the disease have been recognized with or without respiratory tract involvement with a long protracted course before manifesting as generalized disease.

Case Presentation. We describe a 57-year-old woman who presented with recurrent fever and cutaneous ulcers on …

Genu Recurvatum In Dance Training: Assessing And Addressing The Structural Deformity In Dancers, Anne Mercedes Mushrush

Undergraduate Honors Thesis Collection

Genu recurvatum is a medical condition in which the knee curves baac kwar d past the normal range of extension predominantly in the sagittal plane. Hyperextension can be attributed to extra laxity in the body, therefore the surrounding ligaments of the knee allow for the femur and tibia to be placed past a sagittal alignment of 180°, which is the possible knee extension of normal knee alignment. Genu recurvatum, medically viewed as a deformity, is desirable and considered a positive attribute in the dance world, especially classical ballet. Hyperextension also makes the line of the leg appear longer and straighter …

Relationship Between Attribute Variables And First-Year Physician Assistant Students' Ratings Of Professional Attire, Jaclyn Demeter

Undergraduate Honors Thesis Collection

Objective. The purpose of this survey study was to investigate the noncausal relationships between various attribute variables of first year PA students (age, gender, ethnicity, education level, family income, and professional phase GPA) and their professionalism ratings of photos of three different outfits depicting each of five categories of attire (scrubs, casual, business casual, business, and white coat) worn in clinical settings.

Methods. An observational ecological design was utilized to measure students' perceptions of professional attire. First-year physician assistant students from Butler University in Indianapolis, Indiana were asked to rank outfits from 1= unprofessional to 7= professional using a semantic …

Motives For Acquiring And Saving In Hoarding Disorder, Ocd, And Community Controls, Randy O. Frost, Gail Steketee, David F. Tolin, Nicole Sinopoli, Dylan Ruby

Psychology: Faculty Publications

Hoarding disorder (HD) was classified as a separate disorder in DSM-5 (. APA, 2013). However, only recently research on hoarding has begun in earnest, and as of yet, very little research exists on the motivation to acquire and save the excessive volume of possessions seen in patients with this disorder. This investigation examined the frequency of four motives for acquiring and saving possessions that are often reported anecdotally by people with HD (information, emotional reasons, avoid waste, and aesthetic reasons). Comparisons in a sample of 443 participants indicated that those with HD reported higher frequencies of each of these four …

Predictors Of Relationship Dissolution In Lesbian, Gay, And Heterosexual Adoptive Parents, Abbie E. Goldberg, Randi L. Garcia

Psychology: Faculty Publications

Little work has examined relationship dissolution or divorce in adoptive parents or same-sex parent couples. The current study examined predictors of relationship dissolution across the first 5 years of parenthood among a sample of heterosexual, lesbian, and gay male adoptive couples. Of the 190 couples in the study, 15 (7.9%) dissolved their relationships during the first 5 years of adoptive parenthood. Specifically, 7 of 57 lesbian couples (12.3%), 1 of 49 gay male couples (2.0%), and 7 of 84 heterosexual couples (8.3%) dissolved their unions. Results of our logistic regression analysis revealed that the odds of relationship dissolution were significantly …

Mediators Of Behavior Change Resulting From A Sexual Risk Reduction Intervention For Sti Patients, Cape Town, South Africa, Eileen V. Pitpitan, Seth C. Kalichman, Randi L. Garcia, Demetria Cain, Lisa A. Eaton, Leickness C. Simbayi

Psychology: Faculty Publications

Theory-based sexual risk reduction interventions are often demonstrated effective, but few studies have examined the mechanisms that mediate their behavior changes. In addition, critical contextual factors, such as alcohol use, are often not accounted for by social cognitive theories and may add to the explanatory value of intervention effects. The purpose of this study is to examine the underlying mechanisms driving condom use following a brief sexual risk reduction intervention grounded in the information, motivation, behavioral skills (IMB) model of behavior change. We examined IMB theoretical constructs and alcohol-related contextual factors as potential mediators in separate models. Patients (n = …

The Hispanic Pharmacist: Value Beyond A Common Language, Gabriela C. Cipriano, Carlota O. Andrews

Pharmacy Faculty/Staff Publications

Objective: To highlight the added value of bilingual Hispanic pharmacists in the care of Hispanic patients by sharing their patients’ language and culture.

Summary: Inability to speak and/or write in the patients’ native language severely impairs our best efforts to deliver good health care. This is a widely recognized cause of non-compliance or less than favorable possible health outcomes in Hispanic patients. What has received less attention, however, is that the ability to speak Spanish alone may not remove completely the barrier for non-compliance among Hispanics. Bilingual Spanish–English pharmacists do not have the language barrier, but if they do not …

Self-Directed Learning Through Journal Use In An Elective Pharmacy Course, Melinda E. Lull, Casey U. Slevinski, Andrea N. Traina

Pharmacy Faculty/Staff Publications

Introduction: The objective of this study was to implement and assess the use of electronic self-directed learning journals in a one-semester pharmacy elective course as a development tool to promote self-learning amongst students.

Description of Course: In a toxicology doctor of pharmacy elective course, students completed self-directed assignments based on in-class material in an electronic journal. Students participated in group discussions based on the assignment. Journals were graded for completeness and pursuit of individual interests was encouraged.

Evaluation: Students responded positively to journal assignments and their educational value. Faculty members also recognised a high level of learning by students based …

Intravascular Atp And The Regulation Of Blood Flow And Oxygen Delivery In Humans, Anne R. Crecelius, Brett S. Kirby, Frank A. Dinenno

Health and Sport Science Faculty Publications

Regulation of vascular tone is a complex response that integrates multiple signals which allow for blood flow and oxygen supply to appropriately match oxygen demand. Here, we discuss the potential role of intravascular ATP as a primary factor in these responses and propose that deficient ATP release may contribute to impairments in vascular control exhibited in aged and diseased populations.

Engagement In Activities And Cognitive Functioning Among Older Adults In The Health And Retirement Study, Pamela Emily May

Wayne State University Dissertations

The goal of this dissertation is to examine the effect of cognitive and social activities on cognitive performance and health conditions in a national sample of older adults from the Health and Retirement Study (HRS). This dissertation first aimed to identify longitudinal relations between activity frequency and cognitive functioning. Two hypotheses were tested, baseline activity frequency predicts change in cognitive functioning over time, and baseline cognitive performance predicts change in activity frequency over time. The dissertation’s second aim was to identify links between activity frequency and cognitive trajectories. The third aim was to identify longitudinal relations between activity frequency and …

Predictive Analytics For Disease Condition Of Patients In Emergency Department, Azade Tabaie

Wayne State University Theses

Emergency Departments (EDs) in hospitals are experiencing severe crowding and prolonged patient waiting times. The reported crowding in hospitals shows patients in hospital hallways, long waiting times and full occupancy of ED beds. ED crowding has several potential unfavorable effects including patients and staff frustration, lower patient satisfaction and poor health outcomes. The primary motivations behind this study are shortening the patients’ waiting time and improving patient satisfaction and level of care.

The very initial interaction between clinicians and a patient is recorded on nurse triage notes which contain details of the reason for patient’s visit including specific symptoms and …

The Relationship Between Axonal Injury, Biomarker Expression And Mechanical Response In A Rodent Head Impact Acceleration Model, Yan Li

Wayne State University Dissertations

In the United States 1.4 million people sustain traumatic brain injury (TBI) each year, resulting in 235,000 hospitalizations and 50,000 fatalities annually. Traumatic axonal injury (TAI) is a serious outcome of TBI that accounts for 40-50% of hospitalizations due to head injury and one third of the mortality due to TBI, and it is difficult to diagnose and evaluate. The purpose of this dissertation is to determine mechanical injury predictors for TAI and identify potential biomarkers to evaluate TAI.

In this dissertation, a modified Marmarou impact acceleration injury model was developed to allow the monitoring of velocity of the impactor …

Rehabilitation Of A Patient With A Jones Fracture, Calvin Crawford

Physical Therapy Scholarly Projects

Background and Purpose: Ankle and foot injuries are common for all age groups, no matter the activity level. Ankle and foot injures can include strains, sprains, and/or fractures in any combination which can be debilitating for ambulation and functional activities. The most common foot fracture is an avulsion of the fifth metatarsal base, also called a Jones fracture, often associated with forced inversion of the foot. Almost all patients will return to their prior ambulatory state with proper care and rehabilitation within 12-16 weeks. The purpose of this scholarly project is to show the rehabilitation of a Jones fracture in …

Transition: A Concept Of Significance To Nursing And Health Care Professionals, Nabeel Al-Yateem, Charles Docherty

Centre for Innovation in Medical Education

The concept of transition has growing significance within the healthcare settings. Healthcare professionals’ encounters with patients and family during periods of health-illness transitions in addition to other transitions (e.g., developmental) can be significant. Therefore healthcare professionals should be aware of the meaning and the process of transition, to ensure efficient and competent provision of care. This paper will explore the concept of transition in the context of healthcare, and will suggest strategies to enable professionals to manage transition effectively.

Sexual Onset And Contraceptive Use Among Adolescents From Poor Neighbourhoods In Managua, Nicaragua, Peter Decat, Sara De Meyer, Lina Jaruseviciene, Miguel Orozco, Marcia Ibarra, Zoyla Segura, Bernardo Vega, Kristien Michielsen, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Background and objectives: The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned.

Methods: From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use.

Results: Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption …

Intravenous Tranexamic Acid As An Adjunct Haemostat To Ornipressin During Open Myomectomy. A Randomized Double Blind Placebo Controlled Trial, Sammy Ngichabe, Timona Obura, William Stones

Obstetrics and Gynaecology, East Africa

Background: Myomectomy is a surgical technique used for removal of uterine fibroids and historically hysterectomy has represented the mainstay of treatment. The options of conservative surgical approaches mainly aim at retention of fertility but have to be balanced against potential risks such as haemorrhage; blood loss at myomectomy still remains troublesome with use of various pharmacologic agents yielding inconclusive results. This trial aimed to explore the benefit of combining ornipressin and tranexamic acid during open myomectomy.

Study design: A randomized double blind placebo controlled trial.

Methods: Women who satisfied eligibility criteria were enrolled into the study and randomized into one …

Anti-Cancer Activity Of Withaferin A In B-Cell Lymphoma., M K Mckenna, B W Gachuki, S S Alhakeem, K N Oben, V M Rangnekar, R C Gupta, Subbarao Bondada

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Withaferin A (WA), a withanolide from the plant, Ashwagandha (Withania somnifera) used in Ayurvedic medicine, has been found to be valuable in the treatment of several medical ailments. WA has been found to have anticancer activity against various solid tumors, but its effects on hematological malignancies have not been studied in detail. WA strongly inhibited the survival of several human and murine B cell lymphoma cell lines. Additionally, in vivo studies with syngeneic-graft lymphoma cells suggest that WA inhibits the growth of tumor but does not affect other proliferative tissues. We demonstrate that WA inhibits the efficiency of NF-κB nuclear …

Difficult And Frustrating? Caring For Those With Chronic And Complex Conditions, Rachel Rossiter, Sharon Brownie

School of Nursing & Midwifery, East Africa

Caring for people with chronic and complex health needs has become an ever-larger part of everyday nursing. The World Health Organization has identified common and preventable risk factors that are the primary cause of chronic illness worldwide—hypertension, tobacco use, hyperglycaemia, physical inactivity, and overweight or obesity. Nurses now need an expanded range of skills and expertise that will enable them to work effectively with people whose chronic and frequently complex health issues may be seen as difficult and challenging.

This article invites you to think about your experiences of caring for people with chronic and complex conditions. Before you read …

Fret Detection Of Lymphocyte Function-Associated Antigen-1 Conformational Extension, Alexandre Chigaev, Yelena Smagley, Mark K. Haynes, Oleg Ursu, Cristian G. Bologa, Liliana Halip, Tudor Oprea, Anna Waller, Mark B. Carter, Yinan Zhang, Wei Wang, Tione Buranda, Larry A. Sklar

Pharmaceutical Sciences Faculty Publications

Lymphocyte function-associated antigen 1 (LFA-1, CD11a/CD18, αLβ2-integrin) and its ligands are essential for adhesion between T-cells and antigen-presenting cells, formation of the immunological synapse, and other immune cell interactions. LFA-1 function is regulated through conformational changes that include the modulation of ligand binding affinity and molecular extension. However, the relationship between molecular conformation and function is unclear. Here fluorescence resonance energy transfer (FRET) with new LFA-1-specific fluorescent probes showed that triggering of the pathway used for T-cell activation induced rapid unquenching of the FRET signal consistent with extension of the molecule. Analysis of the FRET quenching at rest revealed an …

A Review Of Factors Associated With The Utilization Of Healthcare Services And Strategies For Improving Postpartum Care In Africa, Danielle Yugbare Belemsaga, Anne Goujon, Joel A. Kiendrebeogo, Els Duysburgh, Seni Kouanda, Olivier Degomme, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Reducing maternal mortality continues to be a major challenge for African countries. We conducted a literature review to identify the factors associated with the utilization of maternal and child healthcare services during the postpartum period and the strategies for strengthening postpartum healthcare in Africa. We carried out an electronic search in several databases of texts published between 1995 and 2012 related to maternal and child health. Seventy-five publications fitted the eligibility criteria. Our analysis shows that to a large extent the socio-economic context was dominant among the factors associated with the quality and utilization of postpartum services. The best interventions …