Medicine and Health Sciences Commons^™

The Acute Effects Of Different Foam Rolling Timing Durations On Hamstring Flexibility, Chloe Marie Kipnis

UNLV Theses, Dissertations, Professional Papers, and Capstones

The use of a foam roller is growing in popularity as a part of a warm-up in order to prepare for activity. The current research, however, lacks an accepted timing duration for how long an athlete should foam roll prior to activity in order to increase range of motion (ROM). In order to guide clinical practice, it is necessary to establish a standard for how long an athlete should foam roll a muscle group with the goal to increase ROM. Therefore, the purpose of this study was to compare hamstring flexibility changes following a single foam rolling bout, performed for …

Measurement Of Neutron Activation From A High Energy Varian Linear Accelerator, Timothy Thatcher

UNLV Theses, Dissertations, Professional Papers, and Capstones

Linear accelerators producing photons above 10 MeV may induce photonuclear reactions in high Z components of the accelerator. These liberated neutrons can then activate the structural components of the accelerator and other materials in the beam path through neutron capture reactions. The induced activity within the accelerator may contribute to additional dose to both patients and personnel. This project seeks to determine the total activity and activity per activated isotope following irradiation from a Varian medical linear accelerator at energies above 10 MeV. A Varian 21iX accelerator was used to irradiate a 30 cm x 30 cm x 20 cm …

Student Motivation, Stressors, And Intent To Leave A Nursing Phd Or Dnp Program: A National Study Using Path Analysis, Delene Renee Volkert

UNLV Theses, Dissertations, Professional Papers, and Capstones

The growing need for nurse scientists and nurse faculty researchers has led to the call to double the number of doctorally prepared nurses by 2020 (Institute of Medicine [IOM], 2010). Nursing has responded with more doctoral degree programs resulting in an increase from 122 DNP graduates in 2007 to 8,184 nurses who hold DNP degrees by 2013. PhD programs have also seen 5,306 graduates between the years 2004 through 2013 (American Association of Colleges of Nursing [AACN], 2014a). One troubling aspect that affects nursing and other doctoral programs is high attrition rates. A recent ten year longitudinal study from the …

Association Between Alcohol Screening And Brief Intervention During Routine Check-Ups And Alcohol Consumption Among Adults Living In California, Gene Kilian Wells

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Alcohol consumption accounts for 1 in 10 deaths among U.S. adults, and has cost upwards of $200 billion in a single year due to lost productivity. Alcohol Screening and Brief Intervention (ASBI) was developed as a treatment approach for use in primary care to identify and reduce hazardous and harmful substance use behaviors among the general population. Although ASBI has proven to be successful, implementation rates remain low. Few studies have been conducted in Nevada to encourage or improve ASBI implementation in primary care. In order to better support Nevada policy decisions, this study investigates the proportion of ASBI …

The Effects Of Carbohydrate Mouth Rinse Concentration On Cycling Time Trial Performance, Jonathan Youell

Boise State University Theses and Dissertations

Mouth rinsing with a carbohydrate (CHO) solution during exercise has been shown to improve endurance exercise performance. However, it is unclear if performance is improved to a greater extent with a higher concentration mouth rinse. PURPOSE: The purpose of this study was to determine if there was a dose-response effect to CHO mouth rinse concentration on endurance performance during a 1h cycling time trial. METHODS: Fourteen male participants, aged 18-45 years old, who cycled a minimum of 30 miles per week, participated in this study. Participants completed five, 1h time trials on a cycle ergometer, each separated by at least …

A Case Of Pituitary Abscess Presenting Without A Source Of Infection Or Prior Pituitary Pathology, Derick Adams, Philip A. Kern

Internal Medicine Faculty Publications

Pituitary abscess is a relatively uncommon cause of pituitary hormone deficiencies and/or a suprasellar mass. Risk factors for pituitary abscess include prior surgery, irradiation and/or pathology of the suprasellar region as well as underlying infections. We present the case of a 22-year-old female presenting with a spontaneous pituitary abscess in the absence of risk factors described previously. Her initial presentation included headache, bitemporal hemianopia, polyuria, polydipsia and amenorrhoea. Magnetic resonance imaging (MRI) of her pituitary showed a suprasellar mass. As the patient did not have any risk factors for pituitary abscess or symptoms of infection, the diagnosis was not suspected …

Health Literacy As A Moderator In The Relationship Between Diabetes Knowledge And Diabetes Outcomes, Jameshyia Ballard Thompson

Dissertations

The purpose of this research was to determine if health literacy was a moderator in the relationship between diabetes knowledge and diabetes outcomes, and explore the relationship between diabetes knowledge and health literacy. The target population included adults living in Mississippi with a diagnosis of diabetes at any point in life. A pilot study was performed to determine if the Functional Communicative Critical Health Literacy scales (FCCHL) and the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) were appropriate for use in a population of adults in Mississippi with a diagnosis of diabetes. Participants for the pilot study were …

Als Mutant Sod1 Interacts With G3bp1 And Affects Stress Granule Dynamics, Jozsef Gal, Lisha Kuang, Kelly R. Barnett, Brian Z. Zhu, Susannah C. Shissler, Konstantin V. Korotkov, Lawrence J. Hayward, Edward J. Kasarskis, Haining Zhu

Molecular and Cellular Biochemistry Faculty Publications

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Mutations in Cu/Zn superoxide dismutase (SOD1) are responsible for approximately 20 % of the familial ALS cases. ALS-causing SOD1 mutants display a gain-of-toxicity phenotype, but the nature of this toxicity is still not fully understood. The Ras GTPase-activating protein-binding protein G3BP1 plays a critical role in stress granule dynamics. Alterations in the dynamics of stress granules have been reported in several other forms of ALS unrelated to SOD1. To our surprise, the mutant G93A SOD1 transgenic mice exhibited pathological cytoplasmic inclusions that co-localized with G3BP1-positive granules in spinal cord motor neurons. …

3-Hydroxy Fatty Acid Induce Trophoblast And Hepatocyte Lipoapoptosis, Taylor Bruett, Taylor Heng, Sathish Kumar Natarajan

UCARE: Research Products

Acute Fatty Liver of Pregnancy (AFLP) is a very rare and fatal condition for both the mother and the unborn offspring accompanied by severe maternal liver dysfunction. AFLP usually develops during the third trimester of pregnancy with symptoms of liver disease. AFLP is associated with a mutation in the enzyme, long-chain 3-hydroxy acyl CoA dehydrogenase (LCHAD) which is involved in the mitochondrial beta-oxidation of fatty acids. Defective beta-oxidation of fatty acids results in the individual unable to metabolize fatty acids which then causes fatty infiltration in their organs, such as the liver. This interferes with normal function of the liver …

Implementation Of A Smart Goal Intervention For Diabetic Patients: A Practice Change In Primary Care, Mackenzie Swanson

Doctoral Projects

Self-management techniques have been shown to be useful practice tools for providers managing patients with chronic disease. One valuable aspect of self-management is goal setting, whereby the patient is directed to create highly attainable personal goals to modify a selected behavior. Through the attainment of these goals, the patient begins to experience confidence and improved self-efficacy in managing chronic diseases such as diabetes. This paper provides background on the use of SMART goals for diabetic patients, how this practice change supports Meaningful Use objectives and helps meet the requirements for future reimbursement opportunities. A thorough organizational assessment of a Midwest …

Population Health Management Risk Assessment Tool Validation: Directing Resource Utilization, Sonya L. Christensen

Doctoral Projects

The Affordable Care Act (ACA) of 2010 is transforming health care across the nation into a value-based system that emphasizes quality and continuity with reimbursement tied to patient outcomes. The shift in emphasis is best realized through the strategy of Population Health Management, a change from traditional episodic treatment of illness to management of the health needs of populations throughout the continuum of health. The goal of care is to ensure that patients, especially the chronically ill, receive effective attention to their health needs in order to improve outcomes, decrease costs, and provide a positive patient experience. An important component …

Breast Is Best: A Case Study Of Bottom-Up Implementation, Britni Ayers

Graduate Theses and Dissertations

The institutional narrative surrounding breastfeeding is that breast is best. Research on infant feeding practices in the United States are abundant, especially among WIC recipients. Although WIC is championed as being a breastfeeding promotional venue, WIC recipients demonstrate lower breastfeeding rates than non-WIC recipients of similar economic standing suggesting the need for further research into the policies and breastfeeding promotional tools being implemented within WIC. Concurrently, research demonstrates that breastfeeding duration rates among WIC recipients can be prolonged with women’s interaction with a Breastfeeding Peer Counselors (BFPC). However, there has been little exploration into the experiences of BFPC or the …

The Perceived Invalidation Of Emotion Scale (Pies): Development And Psychometric Properties, Melissa Jean Zielinski

Graduate Theses and Dissertations

Despite the decades that have passed since invalidation was first theorized to causally influence the development of psychopathology (Linehan, 1993), no measures have been designed and statistically validated to index current emotion invalidation. Research on invalidation has thus grown slowly and often used measures that were designed to assess other constructs (e.g., criticism, abuse) or that retrospectively assess childhood invalidation. This series of five studies describes the development and psychometric evaluation of the Perceived Invalidation of Emotion Scale (PIES), a novel measure of emotion invalidation. Items for the PIES were developed using themes from a qualitative investigation of adults’ experiences …

The Juvenile Addiction Risk Rating For Use In Vocational Rehabilitation, Paul Tyler Hickerson

Graduate Theses and Dissertations

The prevalence of substance use among adolescents warrants considerable concern since it often has detrimental effects on an individual’s physical and mental health, and correlates with worsened Social, physical, and employment outcomes. Research shows that adolescents with disabilities are especially susceptible to the development of substance use disorders. To address this concern and to ensure accurate rehabilitation service planning, effective screening for substance use risk is necessary. Unfortunately, the most common screening instruments for adolescent substance use rely on information obtained solely from self-report. This type of data, although useful, is also susceptible to inaccuracies due to such factors as …

True Knot Of Umbilical Cord: Case Report And Review Of Literat, Momna Khan, Sana Zahiruddin, Maria Iftikhar

Department of Obstetrics & Gynaecology

True knot of umbilical cord (TKUC) is a rare abnormality. When it becomes tight, it may lead to the obstruction of the foetal circulation and intrauterine death (IUD). We present two cases of TKUC managed at The Aga Khan University Hospital with two extreme outcomes. A 22 years old primigravida was diagnosed with unexplained intrauterine foetal demise at 28th week gestation. She delivered vaginally after induction and tight TKUC was identified as a cause of IUD. The second patient delivered an alive healthy male baby vaginally who was found to have a lose TKUC.

Factors Associated With Self-Care Behavior In Persons With Heart Failure., Mohammed Munther Al-Hammouri

Electronic Theses and Dissertations

Introduction: Heart failure is a serious illness that mostly affects the elderly. It is characterized by progressive deterioration of the heart muscle and affects the quality of life of those living with it. The progression of the illness has been shown to be slower with appropriate self-care. Several studies examined predictors of self-care extensively. The results were inconsistent and usually explained a small fraction of the variance in self-care in persons with heart failure, and they usually overlooked some potential predictors that could be related to self-care in person with heart failure. Purpose: The purpose of this study was to …

Influences On Self-Care In Women With Heart Failure: A Pilot Study, Joy Corcione

Dissertations and Theses (Open Access)

Background: Heart Failure self-care becomes exceedingly difficult to perform as the disease progresses; therefore social support becomes important in facilitating heart failure self-care. Woman with heart failure represent a significant and growing vulnerable population. Women tend to have lower self-confidence in providing self-care, experience greater negative emotions, decreased social support, experience more adverse psychosocial factors affecting self-care and experience greater psychosocial adversity than do men. Self-care is vital in managing heart failure and social support greatly facilitates self-care behaviors.

Purpose: The purpose of this pilot study was to gain a deeper understanding about the sources of perceived social support and …

Effect Of Vorapaxar Alone And In Combination With Aspirin On Bleeding Time And Platelet Aggregation In Healthy Adult Subjects., Walter K. Kraft, J H Gilmartin, D L Chappell, F Gheyas, B M Walker, S Nagalla, U P Naik, J C Horrow, R E Wrishko, S Zhang, M S Anderson

Department of Pharmacology and Experimental Therapeutics Faculty Papers

The effect of the protease-activated receptor-1 (PAR-1) antagonist vorapaxar on human bleeding time is not known. This was a randomized, two-period, open-label trial in healthy men (n = 31) and women (n = 5). In period 1, subjects received 81 mg aspirin q.d. or a vorapaxar regimen achieving steady-state plasma concentrations equivalent to chronic 2.5 mg q.d. doses, for 7 days. In period 2, each group added 7 days of the therapy alternate to that of period 1 without washout. Bleeding time and platelet aggregation using arachidonic acid, ADP, and TRAP agonists were assessed. Bleeding time geometric mean ratio (90% …

Nutrinews, Volume 19, August 2016, Department Of Nutrition And Dietetics, University Of North Florida

NutriNews

This issue features The Truth about Anorexia Athletica, What's the Buzz on Caffeine?, Comparison of Japanese Food labels, How to Add Vegan Variety to your life

Geographical Location And Stage Of Breast Cancer Diagnosis: A Systematic Review Of The Literature, Faustine Williams, Aimee S. James, Stephen Jeanetta

ETSU Faculty Works

Objective: To examine systematically the literature on the effect of geographical location variation on breast cancer stage at diagnosis, race/ethnicity, and socioeconomic status.

Methods. Eight electronic databases were searched using combination of key words. Of the 312 articles retrieved from the search, 36 studies from 12 countries were considered eligible for inclusion.

Results. This review identified 17 (47%) of 36 studies in which breast cancer patients residing in geographically remote/rural areas had more late-stage diagnosis than urban women. Ten (28%) studies reported higher proportions of women diagnosed with breast cancer resided in urban than rural counties. Nine …

Mechanistic And Functional Characterization Of B And T Lymphocyte Attenuator (Btla) In Cd8 Tumor Infiltrating Lymphocytes, Krit Ritthipichai

Dissertations and Theses (Open Access)

This dissertation project focused on understanding the functional role of BTLA on CD8⁺ Tumor Infiltrating Lymphocytes (TIL) from metastatic melanoma patients. Clinical trials of adoptive T-cell therapy (ACT) using autologous ex vivo expanded TIL have demonstrated the great potential of this immunotherapy with an overall clinical response rate 40-50% for stage IV metastatic melanoma patients. We have investigated a number of biomarkers in both the infused TIL and the tumor microenvironment for their association with clinical response. Surprisingly, a subset of CD8⁺ TIL expressing the co-inhibitory molecule BTLA (B-and-T lymphocyte attenuator) was highly associated with clinical response, while …

Identifying Treatment Planning System Errors In Iroc-Houston Head And Neck Phantom Irradiations, James Kerns

Dissertations and Theses (Open Access)

Treatment Planning System (TPS) errors can affect large numbers of cancer patients receiving radiation therapy. Using an independent recalculation system, the Imaging and Radiation Oncology Core-Houston (IROC-H) can identify institutions that have not sufficiently modelled their linear accelerators in their TPS model. Linear accelerator point measurement data from IROC-H’s site visits was aggregated and analyzed from over 30 linear accelerator models. Dosimetrically similar models were combined to create “classes”. The class data was used to construct customized beam models in an independent treatment dose verification system (TVS). Approximately 200 head and neck phantom plans from 2012 to 2015 were recalculated …

Bias And Variability In Image-Based Volumetric Yttrium-90 Dosimetry, Wendy Siman

Dissertations and Theses (Open Access)

90Y-microsphere therapy has been widely accepted as a treatment option for both primary and metastatic liver tumors where the patients are ineligible for surgical resection and external beam radiation therapy. The prognosis of untreated patient having liver cancer is very poor with life expectancy less than a year at advance stage. Hence the ability to predict treatment efficacy right after the treatment from post-therapy imaging will help personalize treatment strategies and achieve better outcome. Such prediction can be modeled from correlation of dose and tumor response metrics.

It has been shown that local dose deposition method can generate dose map …

Inspiring Health Worker Motivation With Supportive Supervision: A Survey Of Lady Health Supervisor Motivating Factors In Rural Pakistan, Fauziah Rabbani, Leah Shipton, Wafa Aftab, Kashif Sangrasi, Shagufta Perveen, Aysha Zahidie

Community Health Sciences

BACKGROUND:

Community health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision.

METHODS:

Twenty-nine …

Available Interventions For Prevention Of Cotton Dust-Associated Lung Diseases Among Textile Workers, Asaad Ahmed Nafees, Zafar Fatmi

Community Health Sciences

The authors reviewed literature on interventions for cotton dust-associated lung diseases among textile workers. Internet sources (PubMed, Cochrane Library, Google and Google Scholar) were accessed and interventions were categorized into: Engineering or administrative controls, or personal protective equipment (PPE). Ten relevant articles were shortlisted, five related to engineering controls (pre-processing, bactericidal treatment of cotton, improved workplace design, machinery and dust control measures). Administrative controls may involve setting standards, environmental surveillance, periodic medical examinations, and workers training. Although specific guidelines are available regarding the use of PPEs, but there was little literature on their effectiveness. It was concluded that there is …

Motivation And Retention Of Physicians In Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan, Sayed Masoom Shah, Shehla Zaidi, Jamil Ahmed, Shafiq Ur Rehman

Community Health Sciences

BACKGROUND:

Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan's health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan.

METHODS:

An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental …

Seizure Outcome After Switching Antiepileptic Drugs: A Matched, Prospective Study., Jon Marc Finamore, Michael R. Sperling, Tingting Zhan, Maromi Nei, Christopher T. Skidmore, Scott Mintzer

Department of Neurology Faculty Papers

OBJECTIVE: Outcomes after changing antiepileptic drugs (AEDs) have largely been studied in single cohort series. We recently reported the first study to examine this question in a controlled manner. Here we expand on these results by using a matched, prospective methodology applied to both uncontrolled and well-controlled patients taking any AED.

METHODS: We reviewed all outpatient notes over a 9-month period and identified patients with focal epilepsy who were on monotherapy. We classified those who switched AEDs as case patients, with those remaining on the same drug serving as controls. We matched cases with controls for seizure status (seizure-free in …

Ictal Pain: Occurrence, Clinical Features, And Underlying Etiologies., Ali Akbar Asadi-Pooya, Marjan Asadollahi, Michael R. Sperling

Department of Neurology Faculty Papers

PURPOSE: We analyzed a series of patients with ictal pain to estimate its occurrence and characterize the underlying etiologies.

METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "pain" in the text body. All the extracted reports were reviewed, and patients with at least one documented episode of ictal pain in the epilepsy monitoring unit (EMU) were included in the study.

RESULTS: During the study period, 5133 patients were investigated in our EMU. Forty-six patients (0.9%) had at least one documented episode of ictal …

Diabetes Is Associated With Cerebrovascular But Not Alzheimer's Disease Neuropathology, Erin L. Abner, Peter T. Nelson, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Randall L. Woltjer, Nigel J. Cairns, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L. Tyas, David A. Bennett, Julie A. Schneider, Zoe Arvanitakis

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.

METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.

RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.

DISCUSSION: This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to …

Pattern Of Relapse In Paediatric Acute Lymphoblastic Leukaemia In A Tertiary Care Unit, Emaduddin Siddiqui, Sayyeda Ghazala Kazi, Muhammad Irfan Habib, Khalid Mehmood Ahmed Khan, Nukhba Zia

Department of Emergency Medicine

OBJECTIVE:

To determine the frequency, site and time to relapse from diagnosis, and to see the relationship of relapse with important prognostic factors.

METHODS:

The prospective descriptive observational study was conducted at the National Institute of Child Health, Karachi, June 2005 to May 2007, and comprised newly-diagnosed cases of acute lymphoblastic leukaemia. Bone marrow aspiration was done on reappearance of blast cells in peripheral smear and cerebrospinal fluid. Detailed report was done each time when intra-thecal chemotherapy was given or there were signs and symptoms suggestive of central nervous system relapse. SPSS 12 was used for data analysis.

RESULTS:

Of …