Medicine and Health Sciences Commons^™

Development Of A Novel In Vivo Corneal Fibrosis Model In The Dog, K. M. Gronkiewicz, Elizabeth A. Giuliano, K. Kuroki, F. Bunyak, Ajay Sharma, L. B. C. Teixeira, C. W. Hamm, R. R. Mohan

Pharmacy Faculty Articles and Research

The aim of this study was to develop a novel in vivo corneal model of fibrosis in dogs utilizing alkali burn and determine the ability of suberanilohydroxamic acid (SAHA) to inhibit corneal fibrosis using this large animal model. To accomplish this, we used seven research Beagle dogs. An axial corneal alkali burn in dogs was created using 1 N NaOH topically. Six dogs were randomly and equally assigned into 2 groups: A) vehicle (DMSO, 2 μL/mL); B) anti-fibrotic treatment (50 μM SAHA). The degree of corneal opacity, ocular health, and anti-fibrotic effects of SAHA were determined utilizing the Fantes grading …

Examination Of The Pharmacodynamics And Pharmacokinetics Of A Diclofenac Poly(Lactic-Co-Glycolic) Acid Nanoparticle Formulation In The Rat, Sam Harirforoosh, Kelsi O. West, Derek E. Murrell, James W. Denham, Peter C. Panus, Greg A. Hanley

Pharmacy Faculty Articles and Research

OBJECTIVE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are assembled into two categories; cyclooxygenase (COX-1) sparing inhibitors of COX-2 and non-selective NSAIDs. Diclofenac (DICLO) is a non-selective NSAID that has been linked to serious side effects including gastric ulcers and renal injury. In this study, we examine the effect of poly(lactic-co-glycolic) acid nanoformulation on DICLO-associated adverse events and pharmacokinetics using a nanoparticle (NP) formulation previously developed in our laboratory.

MATERIALS AND METHODS: Rats were administered a single dose of methylcellulose (VEH), blank NP, DICLO (10 mg/kg), or a DICLO-NP suspension equivalent to the DICLO dose. Urinary and blood parameters were measured …

Molecular Mechanisms Of Suberoylanilide Hydroxamic Acid In The Inhibition Of Tgf-Β1-Mediated Canine Corneal Fibrosis, Kristina M. Gronkiewicz, Elizabeth A. Giuliano, Ajay Sharma, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Objective—To investigate molecular mechanisms mediating anti-fibrotic effect of SAHA in the canine cornea using an in vitro model. We hypothesized that SAHA attenuates corneal fibrosis by modulating Smad-dependent and, to a lesser extent, Smad-independent signaling pathways activated by TGF-β1, as well as matrix metalloproteinase (MMP) activity.

Methods—Cultured canine corneal fibroblasts (CCF) were incubated in the presence/absence of TGF-β1 (5ng/ml) and SAHA (2.5μM) for 24hrs. Western blot analysis was used to quantify non-phosphorylated and phosphorylated isoforms of Smad2/3, p38 MAP kinase (MAPK), ERK1/2 and JNK1. Real-time PCR and zymography were utilized to quantify MMP1, MMP2, MMP8 and MMP9 mRNA expression and …

Recurrence Of Ganglion Cysts Following Re-Excision, Lindsay S. Mcalpine, Msiii, Juana Medina, Md, Nayoung Kim, Bs, Michael Rivlin, Md

CwiC Posters

Previous studies have examined the recurrence of ganglion cysts after surgical excision at a rate of 4 to 40%. However, recurrence after revision surgical excision is unknown. The purpose of this study was to define the incidence of recurrent ganglion cysts in patients who underwent a 2nd excisional procedure.

The Influence Of Safety, Efficacy, And Medical Condition Severity On Natural V. Synthetic Drug Preference, Brian P. Meier, Courtney M. Lappas

Psychology Faculty Publications

Research indicates that there is a preference for natural v. synthetic products, but the influence of this preference on drug choice in the medical domain is largely unknown. We present 5 studies in which participants were asked to consider a hypothetical situation in which they had a medical issue requiring pharmacological therapy. Participants ( N = 1223) were asked to select a natural, plant-derived, or synthetic drug. In studies 1a and 1b, approximately 79% of participants selected the natural v. synthetic drug, even though the safety and efficacy of the drugs were identical. Furthermore, participants rated the natural drug as …

Family Aided Community Treatment For The Treatment Of Early Psychosis: A Proof Of Concept Study, Ryan P. Melton, Cass Dykeman

Regional Research Institute for Human Services

Major psychotic disorders are one of the leading causes of disability worldwide. If these conditions are identified early and treatment promptly implemented, the prognosis is improved. This study examined the impact of a yearlong family aided community treatment (FACT) intervention upon psychiatric symptoms. Psychiatric symptom scores improved with the FACT intervention. Improved training on early recognition for mental health clinicians, implementation of a specific treatment model in community settings and policy around treatment funding allocation are implications of this study.

Evaluating The Impact Of Remedial Authority: Adjudicative Tribunals In The Health Sector, Steven J. Hoffman, Lorne Sossin

Osgoode Legal Studies Research Paper Series

Adjudicative tribunals play an important role in the health sector yet their actual influence, as part of the health system, remains undetermined. Most of the studies that have evaluated their work have focused on measures of accountability and independence, rather than the indicators of societal impact. As efforts to reform health systems continue internationally, it is crucial that we understand the benefits and costs of adjudicative tribunals for providers and consumers of heath. In this regard, empirically evaluating the impact of adjudicative tribunals will help inform policymaking through the collection of objective data. A strong and accountable health care system …

Biological And Chemical Investigation Of Panamanian Plants For Potential Utility Against Metabolic Syndrome, Yelkaira Vasquez

Electronic Theses and Dissertations

Metabolic syndrome (MetS) affects approximately 25% of the adult population of the world and represents a public health concern with high socioeconomic impact worldwide. Latin American populations exhibit a high prevalence of MetS, similar or even higher than developed countries. This complex and progressive disorder can develop over many years as a cluster of conditions characterized by a constellation of metabolic abnormalities. Specific guidelines have not yet been established for the treatment of MetS per se. The increased prevalence of MetS has been associated with a greater risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). In …

Challenges Of Internet And Social Media Use In Adolescents, Mandakini Sadhir, Stephanie J. Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

There has been tremendous growth in use of technology in recent decades. The majority of teens now have access to a desktop/laptop computer as well as a gaming console and smartphone. With growing internet and social media use teens now face challenges including cyberbullying, sexting and problematic internet use that result in various health implications. Health care providers are in unique position to educate adolescents and families about current challenges and provide age appropriate guidance to promote healthy internet behaviors.

I'M Still Standing, But I'M Not Standing Still, Janice E. Hawkins

Ellmer School of Nursing Faculty Publications

(First paragraph) When I made the decision to return to school for a PhD, I anticipated hard work, challenges, and a demanding schedule. Two years into my part-time program, I proudly informed readers of Reflections on Nursing Leadership that I was still standing and happy with my decision (Hawkins, 2014). Two years later, I'm not quite done.

Effects Of Race, Socioeconomic Factors On Emergency Management Of Threatened And Early Pregnancy Loss, Connie Yu Heng Cheng

Yale Medicine Thesis Digital Library

Our study aims to determine the effects of race, insurance, and hospital characteristics on the management of threatened abortion and early pregnancy loss. In this retrospective cohort study using the National Hospital Ambulatory Medical Care Survey, patient record files from 2002-2010 with diagnoses of threatened abortion, hemorrhage in pregnancy, or incomplete, inevitable, or unspecified spontaneous abortion were examined using logistic regression. Primary outcomes were rates of admission and active management, defined as surgical termination or use of abortifacients misoprostol or Cytotec. Covariates included race/ethnicity, age, insurance, and hospital location, ownership, and metropolitan status.

Of 5,882,623 ED visits for threatened abortion …

Transitioning Of Hiv-Infected Children From Pediatric To Adult Care: A Jamaican Case Study, Flavia De Souza

Yale Medicine Thesis Digital Library

Successful public access to antiretroviral therapy in resource-limited settings (RLS) has resulted in survival of HIV perinatally infected children into adulthood. There are few studies on transition of care in RLS, where 90% of HIV-infected children reside. We aimed to characterize the current landscape of the transfer process of HIV-infected adolescents in one such RLS, Jamaica. We conducted in-depth interviews of 18 HIV-infected adolescents in pediatric care and 21 health care providers. We analyzed the data using the grounded theory approach. Five themes emerged: 1. Pediatric clinics were like families who provided care-taking and developmental support in addition to HIV …

Emergency Medical Services Utilization And Interventions By Paramedics During A Blizzard, Shalom Sokolow

Yale Medicine Thesis Digital Library

EMERGENCY MEDICAL SERVICES UTLIZATION AND INTERVENTIONS BY PARAMEDICS DURING A BLIZZARD.

Shalom Sokolow (Sponsored by Sandy Bogucki). Department of Emergency Medicine, Yale University, School of Medicine, New Haven, CT.

On February 8th, 2013, southern Connecticut was struck by a powerful blizzard. Emergency Medical Services (EMS) crews experienced significantly increased call volume along with increased response and transport times. This study examined which types of EMS calls increased or decreased during the storm and whether paramedics performed more or fewer advanced life support (ALS) interventions.

EMS calls were differentiated by call type and analyzed to determine which types increased or decreased …

Student Perspectives On Interprofessional Education: Implications For Curriculum Development, Jacob Alan Weatherly

Yale Medicine Thesis Digital Library

Background

The Yale Schools of Medicine and Nursing and the Yale Physician Associate (PA) Program are collaborating to implement an interprofessional curriculum. Although healthcare organizations have called for interprofessional education (IPE), such initiatives have been difficult to implement. Per the Kern framework of curriculum development, design and implementation is likely to be more successful if a needs assessment is done as the first step.

Objective

To better understand healthcare professional students’ perspectives about IPE as part of a needs assessment for developing an IPE curriculum.

Methods

Because little is known about stakeholder perceptions of IPE, we used a qualitative, content …

Understanding The Roles And Uses Of Art Making In Art Therapy, Mary Ellen Hluska

Expressive Therapies Dissertations

This study looked at the role of art making in art therapy, specifically how art therapists value, understand, use, and make decisions regarding art in personal practice and in professional practice. The art-making aspect of art therapy is understudied considering it is art that differentiates art therapists from other helping professions that use art in practice. Additionally, the study sought to illuminate how art making informs both the artist and art therapist identities of professional clinicians. A mixed-methods design was employed to gather data based on inductive and deductive study methods. Constructivist philosophy provided a process for generating ideas and …

Touch Painting: An Art Therapy Intervention On Anxiety In Older Adults, Carrie May Ezell

Expressive Therapies Dissertations

This study investigated the use of two art therapy painting interventions with anxious older adults in long-term care or assisted living facilities in the Southeast. The control group used ‘traditional painting’ as defined by using a paintbrush and the intervention group used ‘touch painting’ as defined by using a foam core board with tissue paper. All participants in the study (n=44) were identified as having symptoms of anxiety as determined by their facility staff. Participants completed the Geriatric Anxiety Inventory (GAI) as a pre-test and post-test assessment. Both groups attended four art therapy sessions with the following themes: (1) Free …

Family-Based Music Therapy: Family Therapists' Perspectives, Beth Nemesh

Expressive Therapies Dissertations

ABSTRACT The purpose of this mixed methods study was to explore the use of musical interventions borrowed from music therapy in a family therapy context. Furthermore, the study aimed to move beyond current application of family-music therapy that focuses on a child, a member with special needs, or families with additional diagnoses to non-clinical families seeking therapy, focusing on the family as an entity. This research was based on the premise that engaging in musical activities is a natural, common endeavor that does not require special musical skills. This does not replace the immense body of knowledge needed for conventional …

The Art Museum As A Therapeutic Space, Sarah Hamil

Expressive Therapies Dissertations

This study explores the essential qualities of the multiple perspectives informing the practice of art therapy in the museum context. Museum-based art therapy is defined as art therapy provided in partnership with museums as part of strategic efforts to engage in community practice. The study focuses on obtaining in-depth information through audio-recorded interviews with seven expert practitioners with direct knowledge and experience in the therapeutic use of art in museums that welcome community engagement. The interview contents were interpreted by identifying salient passages and important points emphasized in participant responses as an exploration into new perspectives regarding the use of …

Art Therapy And Cancer Care: A Qualitative Analysis Of Visual Oncology Narratives, Jill Mcnutt

Expressive Therapies Dissertations

This document reviews the artworks created in the form of visual narratives of cancer survivors. The work sought to explore the subjective experience of cancer and explore potential functions of art therapy in oncology care. Previous research found stages of the cancer trajectory and psychosocial benefits of art therapy. Fifteen adult cancer survivors created visual narratives and participated in this qualitative inquiry. The research was action-based and used arts based and qualitative methodologies. Eight themes emerged and reflected stages of the cancer experience and corresponding functions of art therapy participation. The themes included: diagnosis and the onset of the cancer …

An Evaluation Of A Developmental Individualized Relationship (Dir®) And Creative Arts Therapies Program For Children With Autism, Faith Thayer

Expressive Therapies Dissertations

This study evaluated a Developmental Individual Differences Relationship-based (DIR®) creative arts therapy (CAT) program for children with ASD. The study was intended to assess whether the program met its stated goals to stimulate individualized social-emotional growth for children with ASD. The study was motivated by a central research question: Do DIR®-based creative arts therapies promote the social-emotional growth of children with ASD? A summative, longitudinal program evaluation research design was used to examine the program’s fidelity and outcomes. The evaluation included assessments for pre- and post-test quantitative standardized measures for data collection and analysis. The study also collected data from …

Genotoxic Effects Of Magnesium Deficiency In The Cardiovascular System And Their Relationships To Cardiovascular Diseases And Atherogenesis, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

The authors present evidence for a novel, new hypothesis whereby magnesium deficiency (MgD) acts as a genotoxic agent which probably causes numerous, hertofore, unrecognized consequences, even over a short-term, on the physiological, molecular and biochemical machinery of cardiovascular tissues and cells. The end result of these genotoxic effects of MgD probably plays important roles in the etiology and generation of diverse cardiovascular diseases, atherosclerosis, inflammation, and strokes via alterations in the epigenome of cardiovascular tissues and cells. The importance of adequate water-borne and dietary levels of Mg is emphasized.

The Expression Of Platelet-Activating Factor Is Induced By Low Extracellular Mg2+ In Aortic, Cerebral And Neonatal Coronary Vascular Smooth Muscle; Cross Talk With Ceramide Production, Nf–Kb And Proto-Oncogenes: Possible Links To Atherogenesis And Sudden Cardiac Death In Children And Infants, And Aging: Hypothesis, Review And Viewpoint, Burton M. Altura, Wenyan Li, Aimin Zhang, Tao Zheng, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

An attempt is made, herein, to reconcile, and integrate, various phenomena associated with magnesium deficiency (MgD) in cardiovascular health, disease, and aging as well as reasons for the high incidence of sudden cardiac death in infants and young adults. With new experiments, we demonstrate, for the first time, that very low concentrations of platelet-activating factor (PAF), when added to primary cultured cerebral, neonatal coronary, and aortic vascular smooth muscle (VSM) cells (from three different mammals) promote rapid rises in free intracellular Ca2+ ions and a significant, concomitant reduction in free intracellular Mg2+ ions; these actions of PAF being curtailed with …

Magnesium Deficiency Results In Oxidation And Fragmentation Of Dna, Down Regulation Of Telomerase Activity, And Ceramide Release In Cardiovascular Tissues And Cells: Potential Relationship To Atherogenesis, Cardiovascular Diseases And Aging, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

The School of Health Sciences Publications and Research

The authors discuss the potential relationship between magnesium, cardiovascular diseases, and aging.

Potential Roles Of Magnesium Deficiency In Inflammation And Atherogenesis: Importance And Cross-Talk Of Platelet-Activating Factor And Ceramide, Burton M. Altura, Asefa Gebrewold, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

Epidemiologic studies in North America and Europe have shown that people consuming Western-type diets are low in magnesium (Mg) content (i.e., < 30 - 65% of the RDA for Mg); most such diets in the USA show that 60 - 80% of Americans are consuming only 185 - 235 mg/day of Mg. Low Mg content in areas of soft-water, and Mg-poor soil, is associated with high incidences of ischemic heart disease (IHD), coronary artery disease, hypertension, and sudden cardiac death (SCD). It is clear that the leading underlying cause of death worldwide is atherosclerosis. Importantly, both animal and human studies have shown an inverse relationship between dietary intake of Mg and atherosclerosis. The myocardial level of Mg has consistently been observed to be lower in subjects dying from IHD and SCD in soft-water areas than those in hard-water areas. Over the past 20 years, our laboratories, using several types of primary cultured vascular smooth muscle (VSM) cells, and myocardial cells, demonstrated that declining levels of extracellular Mg ([Mg2+]0) activated several enzymatic pathways to produce increases in cellular sphingolipids, particularly ceramides which are known to exert numerous types of cardiovascular manifestations including inflammatory effects; the latter play important roles in atherogenesis and cardiovascular diseases. Approximately 20 years ago, we reported that low [Mg2+]0 caused formation of platelet-activating factor (PAF) as well as other types of PAF-like molecules and suggested that these molecules might be causative agents in low Mg2+- induced IHD and SCD. Herein, we review results and data from our labs which strongly support roles for ceramides, PAF and PAF-like lipids in low [Mg2+]0-induced IHD and SCD.

Sudden Cardiac Death In Infants, Children And Young Adults: Possible Roles Of Dietary Magnesium Intake And Generation Of Platelet-Activating Factor In Coronary Arteries, Burton M. Altura, Wenyan Li, Aimin Zhang, Tao Zheng, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

Magnesium (Mg) is a co-factor for more than 500 enzymes, and is the second most abundant intracellular cation after potassium. It is vital in numerous physiological, cellular and biochemical functions and systems necessary for life. Approximately 35 years ago, our laboratory suggested that a progressive, dietary deficiency and/or metabolic induced loss of Mg from the body, beginning early in life, particularly during development of the coronary arteries, could lead to coronary arterial vasospasm, ischemic heart disease, and sudden-cardiac death (SCD). Herein, we review evidence for a brand-new, novel hypothesis which combines knowledge suggesting a combined role for hypomagnesemia and platelet-activating …

Communicating Social Support: Understanding Complexities Of Breastfeeding Communication Among African American Mothers, Nicole Rachael Peritore

Theses and Dissertations--Communication

Breast milk is the best choice for meeting the nutritional needs for an infant whenever possible. Despite the knowledge that this nutritional choice is the best choice for an infant, data demonstrates that there is a sharp decline in the rates of breastfeeding mothers. Among African Americans, breastfeeding rates are significantly lower than the national averages. Despite many of the applications of social support in communication research, there is a gap in knowledge on the social support systems in the context of breastfeeding, especially for African Americans. With the social ecological model as a framework, social support theory provides understanding …

Non-Medical Use Of Cognitive Enhancing Prescription Medications Among Occupational Therapy And Speech Language Pathology Health Care Students: A Pilot Study, Randy P. Mccombie, Hannah Slanina

Internet Journal of Allied Health Sciences and Practice

Purpose: This research was designed to serve as a pilot study to generate baseline data on non-medical use of prescription drugs (NMUPD) for cognitive/academic enhancement purposes among students representing two healthcare professions, Occupational Therapy (OT) and Speech Language Pathology (SLP) and to assess students’ opinions regarding whether use of these medications constitutes academic “cheating.” Introduction: NMUPD, such as Adderall ® or Ritalin ®, to reduce fatigue, improve memory, and increase concentration to ultimately improve grades has increased among college students in recent years, with estimated use put as high as 35% on some campuses. These drugs appear to be readily …

A Systematic Review On The Use Of Psychosocial Interventions In Conjunction With Medications For The Treatment Of Opioid Addiction, K Dugosh, A. Abraham, B. Seymour, K. Mcloyd, M. Chalk, David Festinger

PCOM Scholarly Works

Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions …

Pharmacological Activity Of Costus Spicatus In Experimental Bothrops Atrox Envenomation, Leide Caroline Dos Santos Picanço, José Adolfo Homobono Machado Bittencourt, Shayanne Vanessa Correia Henriques, Juliane Silva Da Silva, Juliana Maria Da Silva Oliveira, José Renato Ribeiro, Antony-Babu Sanjay, José Carlos Tavares Carvalho, Didier Stien, Jocivânia Oliveira Da Silva

Department of Food Science and Technology: Faculty Publications

Context: Medicinal plants encompass a rich source of active compounds that can neutralize snake venoms or toxins. Costus spicatus (Jacq.) Sw. (Costaceae) is used by the Amazonian population to treat inflammation, pain and other pathological manifestations.

Objective: To evaluate the influence of C. spicatus aqueous extract on edema, peritonitis, nociception, coagulation, haemorrhage and indirect haemolytic activity induced by Bothrops atrox venom (BAV).

Materials and methods: Dried and pulverized leaves were extracted with distilled water. Envenoming was induced by administration of B. atrox snake venom in Swiss Webster mice. The experimental groups consisted of BAV (at the minimum dose to induce …

The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in …