Medicine and Health Sciences Commons^™

A Randomised Controlled Trial Comparing Weight Adjusted Dose Versus Fixed Dose Prophylactic Phenylephrine Infusion On Maintaining Systolic Blood Pressure During Caesarean Section Under Spinal Anaesthesia, Lucy Mwaura, Vitalis Mung’Ayi, Jimmie Kabugi, Samina Mir

Anaesthesiology, East Africa

Background: Spinal anaesthesia is the standard of care for elective caesarean delivery. It has advantages over general anaesthesia. However the sympathetic blockade induced by spinal anaesthesia results in an 80 percent incidence of hypotension without prophylactic management. Current evidence supports co-loading with intravenous fluids in conjunction with the use of vasopressors as the most effective way to prevent and treat the hypotension. Phenylephrine is the accepted vasopressor of choice in the parturient. A prophylactic phenylephrine infusion combined with a fluid co-load is proven to be an effective and safe method of maintaining maternal hemodynamic stability. While most published studies have …

Annexin A5 Is The Most Abundant Membrane-Associated Protein In Stereocilia But Is Dispensable For Hair-Bundle Development And Function, Jocelyn F. Krey, Meghan Drummond, Sarah Foster, Edward Porsov, Sarath Vijayakumar, Dongseok Choi, Karen Friderici, Sherri M. Jones, Alfred L. Nuttall, Peter G. Barr-Gillespie

Department of Special Education and Communication Disorders: Faculty Publications

The phospholipid- and Ca²⁺-binding protein annexin A5 (ANXA5) is the most abundant membrane-associated protein of ~P23 mouse vestibular hair bundles, the inner ear’s sensory organelle. Using quantitative mass spectrometry, we estimated that ANXA5 accounts for ~15,000 copies per stereocilium, or ~2% of the total protein there. Although seven other annexin genes are expressed in mouse utricles, mass spectrometry showed that none were present at levels near ANXA5 in bundles and none were upregulated in stereocilia of Anxa5^−/− mice. Annexins have been proposed to mediate Ca²⁺-dependent repair of membrane lesions, which could be part of the …

Predicting Burnout Among Psychiatric Technicians, Sarah E. Hernandez

Electronic Theses, Projects, and Dissertations

This thesis attempted to examine stressors associated with the psychiatric technician profession and levels of burnout amongst them. This was accomplished through the use of a survey which included demographic data, the Maslach Burnout Inventory Human Services Survey (MBI‑HSS), an adaptation of the Nursing Stress Scale (NSS) and a self‑care assessment tool. A total of three research questions were examined statistically including levels of burnout on subcategories (personal accomplishment, emotional exhaustion and depersonalization), most common stressors identified by psychiatric technicians and percentage of participants who utilized therapy to cope with work related stress. The survey was made available via survey …

Strategic Planning For Setting Up Base Stations In Emergency Medical Systems, Supriyo Ghosh, Pradeep Varakantham

Research Collection School Of Computing and Information Systems

Emergency Medical Systems (EMSs) are an important component of public health-care services. Improving infrastructure for EMS and specifically the construction of base stations at the ”right” locations to reduce response times is the main focus of this paper. This is a computationally challenging task because of the: (a) exponentially large action space arising from having to consider combinations of potential base locations, which themselves can be significant; and (b) direct impact on the performance of the ambulance allocation problem, where we decide allocation of ambulances to bases. We present an incremental greedy approach to discover the placement of bases that …

Patient Engagement In The Medical Facility Waiting Room Using Gamified Healthcare Information Delivery, Raheel Hassan, Nathan W. Twyman, Fiona Fui-Hoon Nah, Keng Siau

Research Collection School Of Computing and Information Systems

This study explores the proposition that medical facility waiting rooms are an opportune setting to engage with and educate patients while they are waiting for care. In collaboration with emergency department (ED) personnel, we developed ER Hero, a tablet-based application for waiting rooms that introduces patients to ED professionals and operations through mini-games and story-like interaction. We evaluated this prototype with human participants to determine how well it performed when compared to paper-based information disclosure presenting the same information. Participants using the application exhibited increased ED knowledge, decreased nervousness, and increased interest. The gamified application outperformed a paper-based approach on …

Mir-1207-3p Is A Novel Prognostic Biomarker Of Prostate Cancer, Dibash K. Das, Joseph R. Osborne, Hui-Yi Lin, Jong Y. Park, Olorunseun O. Ogunwobi

Publications and Research

MicroRNAs (miRNAs) have been found to be dysregulated in prostate cancer (PCa). In this study, we investigated if miR-1207-3p is capable of distinguishing between indolent and aggressive PCa and if it contributes to explaining the disproportionate aggressiveness of PCa in men of African ancestry (moAA). A total of 404 patients with primary adenocarcinoma of the prostate were recruited between 1988 and 2003 at the Moffitt Cancer Center, Tampa, FL, USA. Patient clinicopathological features and demographic characteristics such as race were identified. RNA samples from 404 postprostatectomy prostate tumor tissue samples were analyzed by real-time quantitative reverse transcription polymerase chain reaction …

Patients' Satisfaction And Spectacle Independence After Cataract Surgery With Multifocal Intraocular Lens Implantation In A Tertiary Care Hospital, Rashid Baig, Tanveer Anjum Chaudhry, Saajan Kukreja,, Sidra Shakil, Khabir Ahmad

Department of Surgery Docs

Abstract

This single group cohort study, undertaken at Aga Khan University Hospital, Karachi, from Jan 2012 to September 2013, assessed patients' satisfaction, spectacle independence and visual disturbance after implantation of multifocal IOLs. A total of 39 patients who underwent bilateral cataract surgery with multifocal IOL implantation were included for telephonic interviews. The mean age of participants was 55.5 ± 8.1 years. The mean follow up time was 9.60 ± 3.19 months. The overall satisfaction rate after surgery was found to be 84.6% and there was no statistically significant association of satisfaction with gender, age or education. In all 84.6%, 94.9% …

Biodegradable Magnesium Alloys For Orthopaedic Applications: A Review On Corrosion, Biocompatibility And Surface Modifications., Sankalp Agarwal, James Curtin, Brendan Duffy, Swarna Jaiswal

Articles

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its …

Prep Advocacy Project: Increasing The Adoption Of Pre-­Exposure Prophylaxis (Prep) In San Luis Obispo County, Leona Rajaee

Journalism

The following study investigates the need for Pre­exposure Prophylaxis (PrEP) in San Luis Obispo (SLO) County in order to develop an effective health outreach and advocacy program that could increase the adoption of PrEP treatment and in turn decrease new HIV transmissions in the community studied. The sponsor of this study is the Access Support Network (ASN), a non­profit organization that provides supportive services for individuals living with HIV/AIDS. ASN launched this study after observing the effectiveness of PrEP in metropolitan cities. At the same time, ASN also noticed a rise in new HIV transmissions, particularly among injecting drug users …

Evaluation Of The Effectiveness Of A Prescription Drug Abuse Prevention Curriculum For College Students, Danielle M. Colangelo, Alexis K. Sepulveda

Kinesiology and Public Health

The recreational use of prescription drugs has been increasingly common in university communities (Office of National Drug Control Policy, 2015). Students may abuse prescription drugs to get high, study longer or sleep. A survey conducted by Kinesiology students used snowball sampling to assess the number of Cal Poly students recreationally using prescription drugs and their knowledge of prescription drug abuse (Colangelo & Sepulveda, 2015). The assessment showed 30.7% of students had abused prescription drugs in the last six months. There was an increase in abuse between college freshmen (19.2%), college sophomores (41.4%) and juniors (44.3%) (Colangelo & Sepulveda, 2015). This …

Managing Opioid-Tolerant Patients In The Perioperative Surgical Home., John T. Wenzel, Eric S. Schwenk, Jaime L. Baratta, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

Management of acute postoperative pain is important to decrease perioperative morbidity and improve patient satisfaction. Opioids are associated with potential adverse events that may lead to significant risk. Uncontrolled pain is a risk factor in the transformation of acute pain to chronic pain. Balancing these issues can be especially challenging in opioid-tolerant patients undergoing surgery, for whom rapidly escalating opioid doses in an effort to control pain can be associated with increased complications. In the perioperative surgical home model, anesthesiologists are positioned to coordinate a comprehensive perioperative analgesic plan that begins with the preoperative assessment and continues through discharge.

Modern Contraceptive Use Among Migrant And Non-Migrant Women In Kenya, Rhoune Ochako, Ian Askew, Jerry Okal, John Oucho, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Manifest socio-economic differences are a trigger for internal migration in many sub-Saharan settings including Kenya. An interplay of the social, political and economic factors often lead to internal migration. Internal migration potentially has significant consequences on an individual’s economic growth and on access to health services, however, there has been little research on these dynamics. In Kenya, where regional differentials in population growth and poverty reduction continue to be priorities in the post MDG development agenda, understanding the relationships between contraceptive use and internal migration is highly relevant.

Methods: Using data from the 2008–09 Kenya Demographic and Health Survey …

Subjective Well-Being And Cardiometabolic Health: An 8-11 Year Study Of Midlife Adults, Julia K. Boehm, Ying Chen, David R. Williams, Carol D. Ryff, Laura D. Kubzansky

Psychology Faculty Articles and Research

Objective: Individuals who are satisfied and experience frequent positive emotions tend to have reduced risk for coronary heart disease (CHD). However, conflicting evidence exists and little research has investigated whether well-being is associated with early-warning indicators of biological risk that precede CHD. We investigated whether life satisfaction and positive emotions longitudinally predicted reduced risk of incident cardiometabolic conditions and healthier cardiometabolic risk scores, which may provide insight into underlying mechanisms and novel prevention targets.

Methods: Initially healthy men and women (N=754–854) reported their baseline life satisfaction and positive emotions. During follow-up, presence of manifest cardiometabolic conditions was assessed …

Unusual Case Of Non-Resolving Necrotizing Pneumonia: A Last Resort Measure For Cure., Naseem Salahuddin, Naila Baig Ansari, Saulat H. Fatimi

Department of Surgery Docs

Abstract

To our knowledge, this is an unusual case of a community-acquired pneumonia (CAP) with sepsis secondary to Streptococcus pneumoniae that required lung resection for a non-resolving consolidation. A 74 year old previously healthy woman, presented with acute fever, chills and pleuritic chest pain in Emergency Department (ED). A diagnosis of CAP was established with a Pneumonia Severity Index CURB-65 score of 5/5. In the ER, she was promptly and appropriately managed with antibiotics and aggressive supportive therapy. She remained on ten days of intravenous antibiotics. However, 48 hours post antibiotic course, she returned to ER with fever and signs …

Effects Of Laryngeal Restriction On Pharyngeal Peristalsis And Biomechanics: Clinical Implications, Rita Shaker, Patrick Sanvanson, Gokulakrishnan Balasubramanian, Mark Kern, Ashley Wuerl, Allison S. Hyngstrom

Physical Therapy Faculty Research and Publications

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine …

Reliability And Validity Of Ratings Of Perceived Exertion In Persons With Multiple Sclerosis, Brice T. Cleland, Benjamin A. Ingraham, Molly C. Pitluck, Alexander V. Ng

Exercise Science Faculty Research and Publications

Objective: To test the reliability and validity of using the Borg rating of perceived exertion (RPE) scale (ratings 6e20) in persons with multiple sclerosis (PwMS).

Design: Nonrandomized repeated measures.

Setting: Research laboratory.

Participants: Volunteer sample (N=27) comprised of 16 PwMS (10 women) and 11 age-matched persons without multiple sclerosis (MS) (6 women). Clinical measures included symptomatic fatigue, depression, and MS functional capacity.

Interventions: A submaximal cycling test was performed to estimate maximal capacity. Participants then pedaled for 2 minutes at 50% and 60% of predicted maximal oxygen consumption per unit time (V̇O₂), and physiological measures and RPE were …

A Systems Framework For Development Projects And Partnerships In Eye Health Training, Diane Wallace

Doctoral

Purpose: Development projects in eye health have evolved over the past fifteen years in response to VISION 2020: The Right to Sight. Estimates that 285 million people, mainly in the developing world, are needlessly vision impaired largely due to the lack of trained eye health professionals have moved development initiatives away from vertical, service delivery approaches towards the establishment of more sustainable, locally owned professional training programmes in an effort to ensure long term production of adequately trained human resource capacity to address this challenge. The Mozambique Eyecare Project was one such initiative, established as a solution to the challenge …

Removable Partial Dentures Vs Overdentures In Children With Ectodermal Dysplasia: Two Case Reports, Georgios Maroulakos, Ioli I. Artopoulou, Matina V. Angelopoulou, Dimitris Emmanouil

School of Dentistry Faculty Research and Publications

Ectodermal dysplasia (ED) represents a disorder group characterised by abnormal development of the ectodermal derivatives. Removable partial dentures (RPD), complete dentures (CD) or overdentures (OD) are most often the treatment of choice for young affected patients. Prosthetic intervention is of utmost importance in the management of ED patients, as it resolves problems associated with functional, aesthetic, and psychological issues, and improves a patient’s quality of life. However, few studies present the principles and guidelines that can assist in the decision-making process of the most appropriate removable prosthesis. The purpose of this study was to suggest a simple treatment decision-making algorithm …

After The Paris Agreement: How India Can Use Climate Financing To Implement A Sustainable Clean Cookstove Program, Hannah Kornfeld

Master's Theses

The burning of biomass for cooking purposes without proper ventilation and filters poses a massive health and climate risk. Health implications from exposure to household air pollution from this type of fuel impacts women and children in many developing countries, who spend many hours a day cooking and gathering fuel. Climate implications from burning solid biomass results in increased carbon dioxide and black carbon emissions, which contribute to global climate change. This thesis aims to explore the issues associated with biomass cookstoves in terms of both health and climate, and seeks to understand how a new national clean cookstove program …

Assessment Of Micronutrient Status In Pregnant Malawian Women Before And After Treatment For Moderate Malnutrition, Cambria M. Glosz

Master's Theses

Background: Multiple micronutrient deficiencies are prevalent in pregnant women in developing countries and can result in adverse effects to both the mother and infant. Multiple micronutrient supplements or supplementary foods may be a way to combat micronutrient deficiencies.

Objective: To assess change in micronutrient and protein levels in moderately malnourished pregnant Malawian women after receiving one of three nutritional interventions.

Methods: Serum retinol, 25-hydroxyvitamin D, ferritin, vitamin B₁₂, folate, zinc, albumin and C-reactive protein concentrations were measured in pregnant women with MUAC >20.6 cm and

Results: Baseline micronutrient concentrations indicated high rates of deficiency …

Association Of Plasma Cytokines With Radiological Recovery In Pulmonary Tuberculosis Patients, Najeeha Talat Iqbal, Rabia Hussain, Firdaus Shahid, Ghaffar Dawood

Department of Paediatrics and Child Health

Background: The characterization of tuberculosis (TB) patients as slow or fast responders post anti-TB treatment has always been a matter of tremendous interest as slow responders are most likely to relapse and/or develop complications. Pulmonary tissue healing as assessed with radiology is the only available tool for tissue recovery but is not predictive at intake. The objective of the current study was to assess biomarkers associated with fast and slow recovery in TB patients at recruitment.Methods: Pulmonary TB patients (N=15) were assessed for radiological recovery serially in parallel with clinical signs and symptoms, hematological parameters, and plasma cytokines at 0months, …

Priming Cardiovascular Stem Cells For Transplantation Using Short-Term Hypoxia, Ivan Hernandez

Electronic Theses, Projects, and Dissertations

Conventional medical treatments fail to address the underlying problems associated with the damage inflicted by a coronary event. Thus, the long-term prognosis of patients admitted for heart failure is disheartening, with reported survival rates of 25 percent. Recent advances in stem cell research highlight the potential benefits of autologous stem cell transplantation for stimulating repair in heart tissue. However, a majority of those suffering from cardiovascular diseases are older adults whose autologous cells no longer possess optimum functional capacity. Additional work is needed to identify the optimal cell types or conditions that will promote cardiovascular regeneration across all age groups. …

Thermal Dosimetry For Bladder Hyperthermia Treatment. An Overview., Gerben Schooneveldt, Akke Bakker, Edmond Balidemaj, Rajiv Chopra, Johannes Crezee, Elisabeth D. Geijsen, Josefin Hartmann, Maarten C.C.M. Hulshof, H. Petra Kok, Margarethus M. Paulides, Alejandro Sousa-Escandon, Paul R. Stauffer, Paolo F. Maccarini

Department of Radiation Oncology Faculty Papers

The urinary bladder is a fluid-filled organ. This makes, on the one hand, the internal surface of the bladder wall relatively easy to heat and ensures in most cases a relatively homogeneous temperature distribution; on the other hand the variable volume, organ motion, and moving fluid cause artefacts for most non-invasive thermometry methods, and require additional efforts in planning accurate thermal treatment of bladder cancer. We give an overview of the thermometry methods currently used and investigated for hyperthermia treatments of bladder cancer, and discuss their advantages and disadvantages within the context of the specific disease (muscle-invasive or non-muscle-invasive bladder …

Professional Practices Promoting Health Of Healthcare Workers: Comparison Of Public And Private Hospitals In Pakistan, Nourin Jivany, Javed Yakoob, Shazia Bana, Asima Faisa, Humeira Jawed

Section of Gastroenterology

Background and Objectives: Health and safety of healthcare workers (HCWs) is a determinant of the quality of healthcare delivered to the population at large. This study aimed at comparing various dimension of HCWs’ health and safety between public and private hospitals (PHs) in the Pakistan context.

Methods: A sample of 1146 HCWs from 2 public and 2 PHls in a metropolitan city were invited to response to a structured questionnaire, assessing various aspects of health and safety promotion practices in their hospital. Categorical data were compared using chi-square test or Fisher exact test or likelihood ratio tests.

Findings: According to …

Sociodemographic And Geospatial Correlates Of Stillbirths And Neonatal Mortality In Indonesia (1993–2007), Alka Dev

Dissertations, Theses, and Capstone Projects

Little research has focused on the determinants of stillbirth and neonatal mortality in Indonesia despite the fact that the country has one of the highest rates of stillbirths in the world and one of the highest rates of neonatal mortality in Asia. Several areas have not been explored due to data limitations, such as shared risk factors and measurement challenges, which can inform health policy and interventions and guide future research. This dissertation addresses this gap by comparing measurement challenges for stillbirth and neonatal mortality and identifying risk factors for both using Indonesian reproductive health survey data. Differences in estimates …

Brainstorming Solutions For The Unintended Consequences Of Antibiotics And The Development Of Resistant Bacteria, Rajini D. Ramsukh

Dissertations, Theses, and Capstone Projects

This thesis entails the study of bacteria that cause infections requiring antibiotic treatments and the development of antibiotic resistance as an unintended consequence. Antibiotics were originally formulated to remedy medical problems, but the consequence of inappropriate usage has created a serious setback: the development of drug-resistant bacteria. The objective of this thesis is to illuminate the misuse, over-prescription, and mis-monitoring of the dispensing of antibiotics that results in the development of antibiotic-resistant bacteria. However, the core of the thesis is to evaluate the solutions implemented thus far to remedy the already existing problem of resistant bacteria and to propose suggestions …

Screening The Low Molecular Weight Fraction Of Human Serum Using Atr-Ir Spectroscopy, Franck Bonnier, Matthew J. Baker, Hugh Byrne

Articles

Vibrational spectroscopic techniques can detect small variations in molecular content, linked with disease, showing promise for screening and early diagnosis. Biological fluids, particularly blood serum, are potentially valuable for diagnosis purposes. The so-called Low Molecular Weight Fraction (LMWF) contains the associated peptidome and metabolome and has been identified as potentially the most relevant molecular population for disease-associated biomarker research. Although vibrational spectroscopy can deliver a specific chemical fingerprint of the samples, the High Molecular Weight Fraction (HMWF), composed of the most abundant serum proteins, strongly dominates the response and ultimately makes the detection of minor spectral variations a challenging task. …

Differences Among Life Care Planners And Physiatrists Regarding The Likelihood And Frequency Of Secondary Complications For Persons With Spinal Cord Injury, Noel A. Ysasi, Irmo Marini, Matt Sprong, Irasema Silva

School of Rehabilitation Services & Counseling Faculty Publications

Life care planners (LCPs) who provide expert witness testimony must provide their professional opinions within a certain degree of life care planning probability or essentially a 51% chance or greater likelihood of the good or service occurring. In cases involving spinal cord injury (SCI), such opinions become complicated when attempting to include the costs of future secondary complications (SCs) that may or may not have a consistent body of empirical support and/or several physician specialists supporting the probability of occurrence. The present study surveyed 243 life care planners (LCPs), life care planning physiatrists (physiatrist LCPs), and non-life care planning physiatrists …

A Novel Point-Of-Care Testing Strategy For Sexually Transmitted Infections Among Pregnant Women In High-Burden Settings: Results Of A Feasibility Study In Papua New Guinea, Steven G. Badman, Lisa M. Vallely, Pamela Toliman, Grace Kariwiga, Bomesina Lote, William Pomat, Caroline Holmer, Rebecca Guy, Stanley Luchters, Chris Morgan

Population Health, East Africa

Background: Sexually transmitted and genital infections in pregnancy are associated with an increased risk of adverse maternal and neonatal health outcomes. High prevalences of sexually transmitted infections have been identified among antenatal attenders in Papua New Guinea. Papua New Guinea has amongst the highest neonatal mortality rates worldwide, with preterm birth and low birth weight major contributors to neonatal mortality. The overall aim of our study was to determine if a novel point-of-care testing and treatment strategy for the sexually transmitted and genital infections Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) in pregnancy is …

Does Myocardial Necrosis Occur In Rhabdomyolysis?, Gabriel M Aisenberg, Herbert L Fred

Faculty, Staff and Student Publications

No abstract provided.