Medicine and Health Sciences Commons^™

Ebola Virus Disease And Critical Illness, Aleksandra Leligdowicz, William A. Fischer, Timothy M. Uyeki, Thomas E. Fletcher, Neill K.J. Adhikari, Gina Portella, Francois Lamontagne, Christophe Clement, Shevin T. Jacob, Lewis Rubinson, Abel Vanderschuren, Jan Hajek, Srinivas Murthy, Mauricio Ferri, Ian Crozier, Elhadj Ibrahima, Marie-Claire Lamah, John S. Schieffelin, David Brett-Major, Daniel G. Bausch, Nikki Shindo, Adrienne K. Chan, Tim O'Dempsey, Sharmistha Mishra, Michael Jacobs, Stuart Dickson, G. Marshall Lyon, Robert A. Fowler

Journal Articles: Epidemiology

As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury. Hypoxia and ventilation failure occurs most often with severe illness and …

Costs And Consequences: Hepatitis C Seroprevalence In The Military And Its Impact On Potential Screening Strategies, David Brett-Major, Kevin D. Frick, Jennifer A. Malia, Shilpa Hakre, Jason F. Okulicz, Charmagne G. Beckett, Linda L. Jagodinski, Michael A. Forgione, Philip L. Gould, Stephen A. Harrison, Clinton K. Murray, Francisco J. Rentas, Adam W. Armstrong, Aatif M. Hayat, Laura A. Pacha, Peter Dawson, Angelia A. Eick-Cost, Hala H Maktabi, Nelson L. Michael, Steven B. Cersovsky, Sheila A. Peel, Paul T. Scott

Journal Articles: Epidemiology

UNLABELLED: Knowledge of the contemporary epidemiology of hepatitis C viral (HCV) infection among military personnel can inform potential Department of Defense screening policy. HCV infection status at the time of accession and following deployment was determined by evaluating reposed serum from 10,000 service members recently deployed to combat operations in Iraq and Afghanistan in the period 2007-2010. A cost model was developed from the perspective of the Department of Defense for a military applicant screening program. Return on investment was based on comparison between screening program costs and potential treatment costs avoided. The prevalence of HCV antibody-positive and chronic HCV …

Yo-Yo Intermittent Recovery Test Performance In Subelite Gaelic Football Players From Under Thirteen To Senior Age Groups, Mark Roe, Shane Malone

Articles

Gaelic football is indigenous to Ireland and has similar locomotion profiles to soccer and Australian Football. Given the increasing attention on long-term player development, investigations into age-related variation in Yo-YoIR1 performance may provide useful information in talent identification, programme design, and player monitoring. Therefore, the aim of this study was to evaluate Yo-YoIR1 performance across Gaelic football age groups. Male participants (n = 355) were recruited from division one, Gaelic football teams. Participants were allocated to one of seven groups according to respective age groups from under 13 (U13), under 14, under 15 (U15), under 16 (U16), minor, under 21 …

Prospects For Subunit Vaccines: Technology Advances Resulting In Efficacious Antigens Requires Matching Advances In Early Clinical Trial Investment, Siobhan Mcclean

Articles

With the continued march of antimicrobial resistance, a renewed impetus for better vaccines has been heralded. Identification of potent subunit vaccines has been greatly facilitated by recent developments in reverse vaccinology and proteomics strategies. There are a range of antimicrobial resistant bacterial pathogens that could be targeted by potent vaccine antigens identified within the coming years. However, cost is a significant hurdle in progressing lead antigen candidates to clinical trials. In order for novel vaccine technologies to realize their clinical potential, there is a requirement to improve investment and incentives to expedite the development of vaccines that are apparently efficacious …

Retrospective Review Of Task-Shifting Community-Based Programs Supporting Arv Treatment And Retention In Uganda, Sam Kalibala, Jerry Okal, Brady Zieman, Nrupa Jani, Lung Vu, Josephine Birungi, Stephen Okoboi, Jonathan Wangisi, Christine Nabiryo, Joanne Lyavala Okullu, Michael Etukoit, Lydia Buzaalirwa, Augustine Lubanga, Paul Kiyingi, Jonathan Ikapule, Syson Nakyeyune, Stephen Nakibinge, Penninah Lutung, Samuel Waliggo, Joseph Nsamba, Yashien Wamanga, Joseph Kamya, Robina Sentongo, Robert Yiga

HIV and AIDS

The purpose of this study was to examine examples of task-shifting programs in Uganda with the aim of generating data that could inform the development of task-shifting policies, guidelines, and practices. The overall purpose of the study was to contribute to the growing knowledge base about task-shifting by describing the service delivery approaches of three purposively selected major AIDS service organizations (ASOs) in Uganda that have adopted task-shifting. The study showed that in the three ASOs, almost all key tasks in antiretroviral therapy (ART), including determining eligibility, initiating ART, and dispensing antiretrovirals, can be feasibly shifted to lower-level cadres or …

Dental Practice Success Vol. 2 No. 4, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

Transitions Of Care, Kelly A. Rabah

Obstetrics and Gynecology Faculty Publications

Objectives:

• Define and Describe the various points of transition of care

• Define and Describe the potential risks for TOC

• Articulate the value of interdisciplinary team planning

• Demonstrate an effective patient hand-off via role play.

Creating An Exceptional Patient Experience, Kelly A. Rabah, Nada Elmagbari

Obstetrics and Gynecology Faculty Publications

The patient's experience affects:

• Reimbursement
• Market Share
• Readmission
• Compliance
• Liability and M&M

Common Living Situations With Older Patients: Balancing Support With Independence, Kelly A. Rabah

Obstetrics and Gynecology Faculty Publications

Objectives:

1. Understand and discuss common challenges with aging patients that impact safety, independence and quality of life.

2. Describe how to assess for safety in living environment as well as what resources are available to support patient/family.

3. Know how to identify caregiver challenges, stress, and risk.

4. Understand the importance of addressing and documenting concerns and challenges, while being supportive and offering resources to promote QOL and Independence.

Analyses Of Endothelial Cells And Endothelial Progenitor Cells Released Microvesicles By Using Microbead And Q-Dot Based Nanoparticle Tracking Analysis, Jinju Wang, Yun Zhong, Xiaotang Ma, Xiang Xiao, Chuanfang Cheng, Yusen Chen, Ifeanyi Iwuchukwu, Kenneth J. Gaines, Bin Zhao, Shiming Liu, Jeffrey B. Travers, Ji C. Bihl, Yanfang Chen

Pharmacology and Toxicology Faculty Publications

Accurate analysis of specific microvesicles (MVs) from biofluids is critical and challenging. Here we described novel methods to purify and detect MVs shed from endothelial cells (ECs) and endothelial progenitor cells (EPCs) by combining microbeads with fluorescence quantum dots (Q-dots) coupled nanoparticle tracking analysis (NTA). In the in vitroscreening systems, we demonstrated that 1) anti-CD105 (EC marker) and anti-CD34 (EPC marker) conjugated-microbeads had the highest sensitivity and specificity for isolating respective MVs, which were confirmed with negative controls, CD41 and CD235a; 2) anti-CD144 (EC marker) and anti-KDR (EPC marker) conjugated-Q-dots exhibited the best sensitivity and specificity for their respective …

Treatment Options For Skin And Soft Tissue Infections Caused By Methicillin-Resistant Staphylococcus Aureus, Renee Weinberg

The Science Journal of the Lander College of Arts and Sciences

Staphylococcus aureus is a pathogen responsible for common skin infections, such as impetigo, cellulitis, folliculitis, and abscess and it is the most common cause for skin and soft tissue infections (SSTI). Humans are carriers of this microorganism and are responsible for facilitating its spread around the world. Over time it has developed resistance to multiple antibiotics, such as penicillin and methicillin, which has made S. aureus a persistent problem in the healthcare world today. Its methicillin resistance has given it the more commonly known name methicillin-resistant S. aureus (MRSA). MRSA was initially discovered solely in the healthcare environment and thus …

Retrospective Assessment Of Treatment With T-Dm1 After Pertuzumab In Her2-Positive Metastatic Breast Cancer, Hannah Elizabeth Dzimitrowicz

Yale Medicine Thesis Digital Library

T-DM1/ ado-trastuzumab emtansine, the most recent addition to the HER2-targeted therapies approved to treat HER2-positive metastatic breast cancer (MBC), is an antibody-drug conjugate with a favorable side effect profile. T-DM1 is currently approved for patients with HER2-positive MBC who previously received trastuzumab and a taxane. Since the trial resulting in T-DM1 approval was conducted, the standard first-line therapy for metastatic HER2-positive breast cancer has changed from trastuzumab and a taxane to a three-drug combination of trastuzumab and a taxane plus pertuzumab. Due to the timing of these approvals, there is no clinical trial or observational data on the activity of …

Assessment Of Specific T-Cell Receptor Engagement Without Necessity For Identification Of The Relevant Antigen, Harib Hassan Ezaldein

Yale Medicine Thesis Digital Library

Individual cancers, even of the same cell type, express unique arrays of distinctive tumor antigens, requiring accurate laboratory measurement of induced immunity against them problematic. Fluorescently tagged reagents (dextramers) that selectively engage clonal T-cell receptors (TCR) can cytofluorographically quantify both frequency and avidity antigen-specific T-cells, but cannot be synthesized without prior identification of the relevant antigen. Since clinically evident tumors may contain as many as 300 unique point mutations capable of generating a large number of uniquely antigenic proteins, and since procurement of such information for each cancer is currently unrealistic, it is presently only possible to assess responses to …

Clinical Conditions And Cardiac Function: Correlations With Left Atrial Fibrosis By Mri In Subjects With And Without Atrial Fibrillation, Karl Grunseich

Yale Medicine Thesis Digital Library

The purpose of this study was to evaluate the clinical conditions and cardiac functions associated with left atrial (LA) fibrosis by late gadolinium enhancement (LGE). LA LGE has been found to be associated with various measures of cardiac functions, procedural outcomes, and adverse events in patients who already have atrial fibrillation (AF). Assessment of LA fibrosis by LGE in patients without AF has largely been unexamined and comparison of these patients to those with AF could prove useful. This study was a retrospective chart and imaging review of 137 consecutive subjects imaged with a 3D LGE sequence at one institution …

Ethical Challenges In Student Global Health Research Projects, Katherine Rebecca Standish

Yale Medicine Thesis Digital Library

U.S. students are participating in global health electives and research in low- and middle-income countries (LMIC) in increasing numbers, yet the significant ethical challenges they face have not been well documented. We conducted a mixed methods study of graduate, health professional and undergraduate students at a research-focused university about their experiences conducting global health research activities, focusing on ethical challenges and support for addressing those challenges. An online, structured questionnaire was completed by 123 participants, and in-depth, semi-structured interviews were conducted with 17 participants and analyzed using the constant comparison method. Among questionnaire respondents, 31% reported a significant or moderate …

Insulin Dependence Heralds Adverse Events After Hip And Knee Arthroplasty, Matthew Webb

Yale Medicine Thesis Digital Library

ABSTRACT

Background – Total hip arthroplasty (THA) is one of the most frequently performed orthopaedic procedures. As the prevalence of diabetes mellitus (DM) continues to increase the burden of its sequelae and associated surgical complications have also increased. For these reasons, it is important to understand the associations between DM and the rates of perioperative adverse events in patients with DM who will undergo THA.

Methods – The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database records perioperative adverse events as well as patient factors including demographics and comorbidities. Patients who underwent THA between 2005 and …

Sperm Quality And Dna Integrity Of Coke Oven Workers Exposed To Polycyclic Aromatic Hydrocarbons, Hueiwang A. Jeng, Chih Hong Pan, Mu R. Chao, Chien C. Chiu, Guodong Zhou, Chon-Kit Chuo, Wen-Yi Lin

Community & Environmental Health Faculty Publications

Objectives: The objective of this study was to assess sperm quality and deoxyribonucleic acid (DNA) integrity of coke oven workers exposed to polycyclic aromatic hydrocarbons (PAHs) as compared to control subjects. Material and Methods: The coke oven workers (N = 52) and administrative staff (N = 35) of a steel plant served as the exposed and control groups, respectively. Exposure to PAHs was assessed by measuring 1-hydroxypyren. Analysis of sperm quality (concentration, motility, vitality, and morphology) was performed simultaneously with sperm DNA integrity analysis, including DNA fragmentation, denaturation, bulky DNA adducts, and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-dGuo). A questionnaire was conducted to collect …

Association Between Social Integration And Health Among Internal Migrants In Zhongshan, China, Yanwei Lin, Qi Zhang, Wen Chen, Jingrong Shi, Siqi Han, Xiaolei Song, Yong Xu, Li Ling

Community & Environmental Health Faculty Publications

Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. …

Pesticide Exposure In The Caribbean: A Case From Nutmeg Processing, Muge Akpinar-Elci, My Ngoc Thuy Nguyen, Satesh Bidaisee, Omur Cinai Elci

Community & Environmental Health Faculty Publications

Many developed countries around the world have implemented regulations to phase out or greatly restrict the use of pesticides. Pesticides are still utilized with minimal restrictions, however, in fumigating agricultural commodities in developing countries such as Grenada. This special report presents the case of a nutmeg factory worker in Grenada who worked with various pesticides including methyl bromide, magnesium phosphide (magtoxin), and aluminum phosphide (phostoxin) without the proper awareness and utilization of health and safety measures. The nutmeg factory worker later developed metastatic bladder cancer, which may have been triggered by a combination of individual risk factors along with long-term …

Oil & Gas Drilling In National Parks, Elizabeth Ann Glass Geltman

Publications and Research

While a great deal of public attention addresses the Halliburton loophole of the Energy Policy Act of 2005 and Bureau of Land Management efforts to regulate hydraulic fracturing on public lands, less attention has been paid to the National Park Service “9B Regulations,” which provide a national regulatory framework governing the exercise of nonfederal oil and gas rights in national parks. This article begins with a review of law pertaining to oil and gas drilling in national parks. The article examines the tension in striking a balance between environmental protection, conservation of national lands and achieving energy independence, including National …

Improving Handovers Between Emergency Department And In Patient Cardiac Units, Amy Engstrom

All Nursing Boot Camp Posters

No abstract provided.

Sexual Attraction In The Therapy Room: An Exploration Of Licensed Marriage And Family Therapists’ Experiences And Training, Rafiah Prince

Department of Family Therapy Dissertations and Applied Clinical Projects

The client-therapist relationship is an essential part of therapy and is central in helping clients achieve therapeutic goals as the joining process facilitates the change process. However, in an effort to create a space for change, there is a possibility that professional boundaries may become blurred wherein a client may express a sexual attraction toward their therapist. To explore this phenomenon, the researcher employed convergent parallel mixed method design to explore the experiences of Licensed Marriage and Family Therapists (LMFTs) who have experienced sexual attraction from their clients. The study was conducted online through a secure forum. Implications for clients, …

Process Evaluation On Crisis Services In Northern Idaho, Claudia G. Miewald

Doctor of Nursing Practice Projects

Background: Idaho ranks last of all states for per capita spending on mental health treatment (Kaiser Family Foundation, 2014). In Idaho, individuals in crisis who suffer from mental illness or Substance Use Disorder (SUD) have few options for care. They often utilize the most expensive treatment through the emergency department, inpatient services, or by going to jail. Idaho has the 7^th highest suicide rate in the nation (Suicide Prevention Action Network of Idaho, 2015), while Region 1 of Idaho has the second highest suicide rate in the state from 2010-2014 (Suicide Prevention Action Network of Idaho, 2015).

Methods: This …

Supporting Physical Activity In The Childcare Environment (Space): Rationale And Study Protocol For A Cluster Randomized Controlled Trial, Patricia Tucker, Shauna Burke, Anca Gaston, Jennifer Irwin, Andrew Johnson, Brian Timmons, Leigh Vanderloo, Molly Driediger

Health Studies Publications

ackground: Young children are prone to low levels of physical activity in childcare. Researchers have identified that preschoolers tend to be more active outdoors than indoors, with higher activity levels occurring during the first 10 minutes of outdoor playtime. Additionally, interventions incorporating either staff training or the inclusion of play equipment have been effective at increasing children’s activity in this setting. As such, the overarching objective of the Supporting Physical Activity in the Childcare Environment (SPACE) intervention is to improve the physical activity levels of preschoolers during childcare hours, utilizing a combination of the above components. The purpose of this …

Evaluation Of Borrelia Burgdorferi Sensu Lato Seroprevalencein The Province Of Bolu, Turkey, Özlem Bucak, Mücahi̇de Esra Koçoğlu, Teki̇n Taş, Firat Zafer Mengeloğlu

Turkish Journal of Medical Sciences

Background/aim: The aim of the present study was to determine the seroprevalence of Borrelia burgdorferi sensu lato in the city center and the province of Bolu, Turkey. Materials and methods: A stratified sampling method was used to determine the study population. A total of 196 blood samples were collected. A questionnaire was completed by each participant in the study. ELISA was performed and positive serologic results were confirmed using western blotting. Data were analyzed statistically using the chi-square test. Results: Seropositivity rates of B. burgdorferi IgM and IgG were determined as 14.8% (29/196) and 13.7% (27/196) respectively by ELISA. A …

The Effects Of Bupivacaine Combined With Different Adjuvants On Block Onset And Duration And On Ion Channel Expressions (Scn9a, Trpm) In Sciatic Nerve Block In Rats, Nurgül Dolu, Levent Şahi̇n, Davut Si̇nan Kaplan, Tuncer Demi̇r, Hasan Şi̇mşek, Mehri̇can Şahi̇n, Beyhan Cengi̇z

Turkish Journal of Medical Sciences

Background/aim: The objective of this experimental study was to examine the effects of epinephrine, dexmedetomidine, and clonidine added as adjuvants to bupivacaine on block onset and effect times, as well as the effects on the Na+ and Ca+2 channel gene expressions, which may indicate cell damage in the sciatic nerve cell membrane. Materials and methods: Rats were divided into five groups: Group S (sham), saline solution; Group B, bupivacaine; Group BD, bupivacaine + dexmedetomidine; Group BC, bupivacaine + clonidine; and Group BE, bupivacaine + epinephrine. For each group, 0.2 mL of local anesthetic was injected into the sciatic nerve bifurcation …

A Study Of Occupational Health : Disclosing Homosexuality In The Workplace, Yim Yam, Whywhy Chan

Bachelor of Social Sciences – Senior Theses

In this study, the associations among disclosing homosexuality, discrimination and occupational health was examined, as well as the associations among disclosing homosexuality, workplace sexual identity management strategies and occupational health. It is aimed to investigating whether discrimination serves as a moderator between disclosing homosexuality and occupational health, plus whether workplace sexual identity management strategies serves as a mediator between disclosing homosexuality and occupational health. In total, 225 gays and lesbians full-time workers in Hong Kong were participated in this study through completing an online questionnaire. Results showed that discrimination serves as a moderator between disclosure and job satisfaction, and workplace …

Color Your Plate: A Pilot Nutrition Education Intervention To Increase Fruit And Vegetable Intake Among Older Adults Participating In The Congregate Meal Site Program In Kentucky Senior Centers, Emily Dickens

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study was to determine if the amount and variety of fruit and vegetable intake increased among community-dwelling older adults participating in Kentucky’s congregate meal site program following a series of educational nutrition lessons. A convenience sample (n=35) of community-dwelling older adults at two intervention (n=19) and two control (n=16) senior centers in central Kentucky participated in this quasi-experimental pre-post pilot study. Following the intervention there was a trend towards increased self-reported intake in the variety of fruit and vegetables among the intervention group (range:0.03±3.31 to 1.32±2.75 servings per week); a significant increase in the number of …

Ua10/1 Suzanne Vitale Clinical Education Complex (2015-2016 Annual Report), Mary Lloyd Moore, Executive Director, Wku Suzanne Vitale Clinical Education Complex

CEC Publications

No abstract provided.

Virginia Dental Journal (Vol. 93, No. 2, 2016)

Virginia Dental Journal

No abstract provided.