Medicine and Health Sciences Commons^™

Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman

Electronic Theses and Dissertations

As the nation’s healthcare system moves through the 21^st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.

This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to …

Massive Pulmonary Embolism Presenting As Seizures, Shahrukh Hashmani, Fateh Ali Tipoo Sultan, Murtaza Kazmi, Amammarah Yasmeen

Department of Pathology and Laboratory Medicine

Pulmonary embolism can present in various ways, though seizure activity has been rarely reported. We report a 38 years old male who had met a road traffic accident, underwent surgery, presented a month later with seizures, chest pain, shortness of breath and low blood pressure. Massive pulmonary embolism was diagnosed on CTPA, with classical features on ECG and echocardiogram and the patient was successfully managed with thrombolysis. Massive pulmonary embolism (MPE) should be kept in mind in patients who present with seizures, chest pain and haemodynamic instability.

Alternate Efflux Pump Mechanism May Contribute To Drug Resistance In Extensively Drug-Resistant Isolates Of Mycobacterium Tuberculosis, Akbar Kanji, Rumina Hasan, Ambreen Zaver, Asho Ali, Kehkashan Imtiaz, Mussarat Ashraf, Taane G. Clark, Ruth Mc Nerney, Samreen Shafiq, Zahra Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Effect Of Time Duration Of Digestion/Decontamination Technique On Yield Of Mycobacteria And Contamination Rates From Sterile Body Fluids (Pleural And Ascitic Fluid) And Pus Specimens, Samreen Shafiq, Faryal Saleem, Kauser Jabeen, Joveria Farooqi, Warda Alam, Sadia Hanif, Shazia Ali, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:
Duration of digestion/decontamination has a considerable impact on yield of mycobacteria especially from sterile body fluids and pus specimens. Additionally, duration of digestion/decontamination affects the contamination rates. This study evaluates the effect of digestion/decontamination protocol for 15 and 20min versus inoculation of media directly from the sample on contamination rates as well as the yield of mycobacteria from pus and sterile fluids other than cerebrospinal fluids.
Methods:
Pleural fluid (n=60), pus (n=48) and ascitic fluid (n=12) specimens were cultured for mycobacteria and evaluated for contamination and mycobacterial yield using three different processing methodologies: without digestion/decontamination with 5% NaOH-NALC (D/D), …

Pulmonary Infections After Tuberculosis, Kauser Jabeen

Department of Pathology and Laboratory Medicine

Aims and Objective: Despite effective treatment of pulmonary tuberculosis (TB) patients, destruction of lung parenchyma may lead to complications including repeated infections. These infections are often misdiagnosed or wrongly identified as TB recurrence, and hence are not treated effectively. The frequency and severity of these infections vary with the extent of damage, and are much more prominent in patients with post-TB bronchiectasis and fibrocavitary diseases. This presentation will focus on the epidemiology, treatment, and management of post-TB infections and challenges, and the impact of these infections on public health in high-TB-burden countries.
Methods: Published literature and review articles were evaluated …

Tuberculosis In Vulnerable Populations In Eastern Mediterranean Region-Implications For Control, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objectives: Socially and economically disadvantaged or "vulnerable" people are at high risk of tuberculosis (TB) and also contribute to active chains of TB transmission. Included in such vulnerable populations are children, women, prisoners, people living with human immunodeficiency virus, the homeless, and displaced people. The ongoing active transmission of TB among such populations is made more difficult to assess and control by difficult access, health inequities, poverty, and other chronic and debilitating health conditions at individual, domestic, and community levels.
Methods: The 22 Eastern Mediterranean Region member states encompass diverse sociopolitical and socioeconomic situations with far-reaching effects on vulnerable populations …

Homoeopathic Medicine Validation: Do It, But Do It Right!, Lex Rutten

Indian Journal of Research in Homoeopathy

No abstract provided.

Zika Virus-Associated Seizures, Ali Akbar Asadi-Pooya

Department of Neurology Faculty Papers

No abstract provided.

Blood-Brain Barrier Transport Machineries And Targeted Therapy Of Brain Diseases, Jaleh Barar, Mohammad Rafi, Mohamad Mostafa Pourseif, Yadollah Omidi

Department of Neurology Faculty Papers

Introduction: Desired clinical outcome of pharmacotherapy of brain diseases largely depends upon the safe drug delivery into the brain parenchyma. However, due to the robust blockade function of the blood-brain barrier (BBB), drug transport into the brain is selectively controlled by the BBB formed by brain capillary endothelial cells and supported by astrocytes and pericytes. Methods: In the current study, we have reviewed the most recent literature on the subject to provide an insight upon the role and impacts of BBB on brain drug delivery and targeting. Results: All drugs, either small molecules or macromolecules, designated to treat brain diseases …

A Multicenter, Observational, Homoeopathic Clinical Verification Study Of Cynodon Dactylon Revealing Symptom Prevalence In A Cohort Of 340 Patients, Rajkumar Manchanda, Parthasarathi Chakraborty, Pramodji Singh, P Pradhan, V Prasad, Ojit Singh, M Rai, Munmun Koley

Indian Journal of Research in Homoeopathy

Context: Clinical verification is an ongoing research program of the Council that verified many rare homoeopathic drugs. Aim: This study was carried out to clinically verify the "symptomatology" of Cynodon dactylon and to ascertain the prevalence of symptoms in the "improved" and "not improved" groups. Materials and Methods: The study was a multicenter, open, observational study. A total of 462 patients were enrolled after matching with the available symptom, compendium of the drug, and eligibility criteria in seven units/institutes of the Council. The medicine was prescribed in 6C, 30C, 200C and 1M potencies as per the need of each patient, …

Symptom Prevalence In A Cohort Of 147 Patients Improved With The Homoeopathic Medicine Ocimum Canum: A Multicenter, Open, Observational, Clinical Verification Study, Rajkumar Manchanda, Parthasarathi Chakraborty, K Das, M Rai, Ojit Singh, P Pradhan, Darshan Singh, Munmun Koley

Indian Journal of Research in Homoeopathy

Context: Clinical verification is an ongoing research program of the Council that verified many rare homoeopathic drugs. Aims: To clinically verify the "symptomatology" of Ocimum canum by ascertaining the prevalence of symptoms. Materials and Methods: The study was a multicenter, open, observational trial. A total of 214 patients were enrolled after matching with the available symptom compendium and eligibility criteria in seven units/institutes of the Council. The medicine was prescribed in 6C, 30C, 200C and 1M potencies as per the need of each patient, following homoeopathic principles and protocol developed by the Council. The collected data were presented in terms …

Dr. Vp Singh (1947-2016), Anil Khurana, Divya Taneja

Indian Journal of Research in Homoeopathy

No abstract provided.

Research Highlights (October-December 2016), Deepti Chalia

Indian Journal of Research in Homoeopathy

No abstract provided.

Prevalence Of Triple-Negative Breast Cancer In India: Systematic Review And Meta-Analysis, Gurprataap S. Sandhu, Sebhat Erqou, Heidi Patterson, Aju Mathew

Markey Cancer Center Faculty Publications

Purpose There is considerable variation in prevalence rates of triple-negative breast cancer (TNBC) reported by various studies from India. We performed a systematic review and literature-based meta-analysis of these studies.

Methods We searched databases of Medline, Scopus, EMBASE, and Web of Science for studies that reported on the prevalence of TNBC in India that were published between January 1, 1999, and December 31, 2015. We extracted relevant information from each study by using a standardized form. We pooled study-specific estimates by using random-effects meta-analysis to provide summary estimates. We explored sources of heterogeneity by using subgroup analyses and metaregression.

Results …

Using Mouse Models To Define How The P53 R72p Polymorphism Impacts The Adverse Effects Of Doxorubicin And Ionizing Radiation, Emily Dominguez

Dissertations and Theses (Open Access)

The single nucleotide polymorphism (SNP) at codon 72 of the tumor suppressor gene p53 codes for either an arginine (R) or proline (P) (p53 R72P). This SNP may impact how cells respond to genotoxic insult. Studies in cell culture and in tissues from mouse models of the SNP indicate that, in response to gentoxic treatment, the two variants may differentially induce apoptosis and expression of p53 target genes. In epidemiological studies, the P variant is associated with decreased cancer survival and increased risk of side-effects from genotoxic cancer treatment. Genotoxic therapy is still the mainstay of cancer treatment, and doxorubicin …

Environmental Signaling Through The Target Of Rapamycin Complex 1 (Torc1) And The Regulation Of Epigenetic Mechanisms, Jason J. Workman

Theses and Dissertations (ETD)

The gene expression profile of a eukaryotic cell is responsive to a variety of extracellular stimuli, including nutrient availability, which allows cells to toggle between anabolism and catabolism based on the favorability of their environment. Much of this information is relayed through signaling complexes, such as the target of rapamycin complex 1 (TORC1), to downstream chromatin modifying enzymes. These enzymes impact the gene regulatory process through altered histone post-translation modifications, changes in chromatin structure, and docking of chromatin regulatory complexes. Yet, despite preliminary studies suggesting that TORC1 affects epigenetic mechanisms, including histone H3 lysine 56 acetylation (H3K56ac), almost nothing is …

Role Of Occludin In The Regulation Of Epithelial Tight Junctions, Bhargavi Manda

Theses and Dissertations (ETD)

Tight junctions (TJ) constitute the primary component of epithelial barrier function, a disruption of which is involved in the pathogenesis of many gastrointestinal, pulmonary and renal diseases. Occludin is the major transmembrane protein of TJ, a deletion of which leads to a complex phenotype including chronic inflammation in several epithelial tissues of occludin deficient mice and poor TJ integrity in epithelial cell lines. Its down regulation was seen in Crohn’s disease, tumors of the colon, brain, endometrium and breast cancer. Occludin is also known to be a target that enables Hepatitis C Virus infection and bacterial pathogenesis. But the specific …

Regulation Of Cancer Metastasis By Protein Kinase D1: A Global Regulatory Cascade, Aditya Ganju

Theses and Dissertations (ETD)

Protein Kinase D1 (PKD1) is a serine threonine kinase which is downregulated in Prostate, Breast and Colon Cancer. It functions as a tumor suppressor in different cancer cells. Downregulation of PKD1 is known to be associated with aggressiveness of the cancer. PKD1 is known to regulate many key oncogenic signaling pathways such as E-cadherin, β-catenin and Androgen Receptor signaling pathways. Aberrant expression of these oncogenic pathways leads to transformation of cells from normal to malignant phenotype, thereby leading to increased proliferation, growth and metastasis to distant organs of these cancer cells. Literature evidence also points to the fact that E-cadherin …

The Nucleolar Protein Nucleophosmin Undergoes Liquid-Liquid Phase Separation With Arginine-Rich Nucleolar Proteins Through Weak, Multivalent Electrostatic Interactions, Jaclyn Alicia Cika

Theses and Dissertations (ETD)

Nucleoli are nuclear membrane-less organelles that are the sites for ribosome biogenesis and serve as sensors of cellular stress. Weak, multivalent protein-protein interactions and interactions between disordered, low complexity domains (LCDs) and rRNA have been shown to promote liquid-liquid phase separation (LLPS) in vitro, suggesting a basis for the liquid-like behavior of nucleoli. Nucleophosmin (NPM1), a multifunctional and highly abundant nucleolar protein, exhibits structural features associated with LLPS suggesting a role in nucleolar organization. Specifically, NPM1 forms a pentamer through its N-terminal oligomerization domain and can bind to rRNA through its C-terminal nucleic acid binding domain. Multiple acidic tracts throughout …

Dissecting The Physiological Roles Of Ulk1/2 In The Mouse Brain, Bo Wang

Theses and Dissertations (ETD)

Mammalian UNC-51–like kinases 1 and 2 (ULK1 and ULK2), Caenorhabditis elegans UNC-51 and Drosophila melanogaster Atg1 are redundant serine/threonine kinases that regulate flux through the autophagy pathway in response to various types of cellular stress. C. elegans UNC-51 and D. melanogaster Atg1 also promote axonal growth and defasciculation, and disruption of these genes results in defects in axon guidance in invertebrates. Germline Ulk1/2-deficient mice die perinatally. Therefore, we used a conditional-knockout approach to investigate the roles of ULK1/2 in the brain. Mice lacking Ulk1 and Ulk2 in their central nervous systems (CNS) showed defects in axonal pathfinding and defasciculation affecting …

Endosomal Trafficking As A Determinant Of Antifungal Tolerance In The Pathogenic Fungus Candida Albicans, Arturo Luis Luna

Theses and Dissertations (ETD)

Several important antifungal drugs inhibit the synthesis of ergosterol, a lipid that modulates the thickness, fluidity and permeability of fungal cell membranes. These include the azole antifungals, which block ergosterol biosynthesis by inhibiting lanosterol demethylase (Erg11p). The resulting depletion of cellular ergosterol and the accumulation of ‘toxic’ sterol intermediates are both thought to cause plasma membrane dysfunction and ultimately growth arrest. However, the effects of ergosterol depletion upon the function of intracellular membranes and organelles are not well described. The purpose of this study was to characterize the effects of azole treatment upon the integrity of the Candida albicans vacuole, …

Examining The Associations Between Depressive Symptoms, Body Mass Index, And Physical Activity Self-Efficacy In African American Mother-Child Dyads, Y'Esha Vonyae Williams

Theses and Dissertations (ETD)

In recent decades the prevalence of childhood and adult depression and obesity has increased worldwide. Multiple factors influence the onset of both depression and obesity. Individual manifestations of depressive symptomatology and health-related problems associated with obesity vary; however, genetics and environmental and psychological factors have been implicated as correlates. Consequently, both disorders can ultimately interfere with individuals’ activities of daily living and decrease their quality of life. African American women are known to have a higher prevalence of obesity and more severe depressive symptoms in comparison to Caucasian women. Likewise, African American children are more obese and experience many factors …

Georgia’S Rapid Expansion Of Mosquito Surveillance In Response To Zika Virus, R. Christopher Rustin, Deonte Martin, Rosmarie Kelly

Environmental Health Sciences: Faculty Presentations (2010-2017)

Objective: To describe the Georgia Department of Public Health’s (DPH) mosquito surveillance capacity before and after Zika virus was declared a public health emergency, review and compare mosquito surveillance results from 2015 to 2016, and evaluate the risk of autochthonous vector transmission of Zika virus based on 2016 surveillance data of Aedes aegypti and Aedes albopictus mosquitoes.

Introduction: Zika virus was declared an international public health emergency by the World Health Organization on February 1, 2016. With Georgia hosting the world’s busiest international airport and a sub-tropical climate that can support the primary Zika virus vector, Aedes aegypti, and secondary …

Field Study Of Seroconversion Of Three Different Commercial Vaccines Of Chicken Infectious Anemia Virus In Thailand, Niwat Chansiripornchai

The Thai Journal of Veterinary Medicine

The aim of this study was to evaluate the effects of different chicken infectious anemia virus (CIAV) vaccine strains in breeders and progeny under field conditions. For this experiment, one commercial poultry company was selected, and independent management for each house was applied to avoid vaccine cross contamination. No natural infection was found before vaccination. BioChek ELISA kits were used, and a minimum of 20 birds per flock were sampled in each sampling time. Three commercial CIAV vaccine strains that are available in Thailand were selected for the study: 26P4 was vaccinated subcutaneously, Cux-1 was vaccinated orally, and Del Ros …

Ophthalmology Snapshot, Nalinee Tuntivanich

The Thai Journal of Veterinary Medicine

No abstract provided.

False Positives On Neuropsychological Measures Of Effort Among Bilingual Neurologically Intact Mexican Americans, Arnoldo Amador Jr.

Theses and Dissertations

The present study examines the performance of bilingual Mexican Americans on neuropsychological measures of effort in language and visual-perceptual formats. Optimal/suboptimal effort cutoff scores derived from monolingual English Speakers were used to test participants divided by language of administration and bilingual groupings based upon Spanish-English difference scores on the Woodcock Munoz Language Survey-Revised Picture Vocabulary subtest. Participants produced more false positives (misidentification of suboptimal effort) on the Reliable Digit Span, a language formatted measure, and similar rates of false positives on visual-perceptual effort measures: Test of Memory Malingering and the Dot Counting Test as compared to established rates using monolingual …

Mid-Level Dental Care Provider: Awareness And Attitudes Of Ohio’S Dental Hygienists, Cynthia S. Leverich

Electronic Theses and Dissertations

The purpose of this study was to determine the awareness and attitudes of dental hygienists in Ohio regarding the Advanced Dental Hygiene Practitioner (ADHP) as an occupation proposed by the American Dental Hygienists’ Association and to determine whether the ADHP could be a viable career option for Ohio dental hygienists.

I developed a survey to assess dental hygienists’ awareness, attitudes, and their views regarding the new mid-level dental provider. The study was limited to licensed dental hygienists in Ohio. The study included a simple random sample of 400 of the 4100 dental hygienists in Ohio obtained by a systematic approach, …

Self-Perceived Coordinated School Health Coordinator Leadership Styles And Practices, Heather R. Ledbetter

Electronic Theses and Dissertations

School-aged children’s health needs have changed over the last several decades to the present day population of many overweight and obese children with health complications (Centers for Disease Control & Prevention, 2015). Tennessee has implemented the Centers for Disease Control and Prevention’s (CDC) model for Coordinated School Health (CSH) in all public schools. Leading each school district’s program is a CSH Coordinator. The role of CSH Coordinators is to provide leadership to district and school administrators while effectively and efficiently implementing the CSH program (Wechsler, 2012).

The purpose of this quantitative study was to explore the self-perceived leadership styles and …

Prevalence And Correlates Of Sexual And Gender-Based Violence Against Chinese Adolescent Women Who Are Involved In Commercial Sex: A Cross-Sectional Study, Xu-Dong Zhang, Sierra Myers, Hong-Juan Yang, Yun Li, Ji-Hong Li, Wei Luo, Stanley Luchters

Population Health, East Africa

Objectives: Despite the vast quantity of research among Chinese female sex workers (FSWs) to address concerns regarding HIV/sexually transmitted infection (STI) risk, there is a paucity of research on issues of sexual and gender-based violence (SGBV) and the missed opportunity for sexual and reproductive health (SRH) promotion among young FSWs. Our research aimed to assess the prevalence and correlates of SGBV among Chinese adolescent FSWs, and to explore SRH service utilisation.

Design and methods: A cross-sectional study using a one-stage cluster sampling method was employed. A semistructured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression …

Intravenous Ketamine For Subacute Treatment Of Refractory Chronic Migraine: A Case Series., Clinton Lauritsen, Santiago Mazuera, Richard B. Lipton, Sait Ashina

Department of Neurology Faculty Papers

BACKGROUND: Refractory migraine is a challenging condition with great impact on health related quality of life. Intravenous (IV) ketamine has been previously used to treat various refractory pain conditions. We present a series of patients with refractory migraine treated with intravenous ketamine in the hospital setting.

METHODS: Based on retrospective chart review, we identified six patients with refractory migraine admitted from 2010 through 2014 for treatment with intravenous ketamine. Ketamine was administered using a standard protocol starting with a dose of 0.1 mg/kg/hr and increased by 0.1 mg/kg/hr every 3 to 4 h as tolerated until the target pain score …