Medicine and Health Sciences Commons^™

Brief Cognitive Screening Tools For Primary Care Practice, K Rhoads, Nancy B. Isenberg, L Korte

Articles, Abstracts, and Reports

Early detection and diagnosis of Alzheimer’s disease and other cognitive impairment presents as a critical issue facing primary and specialty care providers in Washington State. In order to address the gaps and challenges faced by providers, the Dementia Action Collaborative offers the current paper to provide information and guidance around early detection and diagnosis of memory loss and dementia, including Alzheimer’s disease. At the conclusion of this paper, providers should be able to identify indications and opportunities for detection, appropriate tools, and care pathways for individuals and families affected by cognitive impairment and dementia.

Incomplete Resolution Of Deep Vein Thromboses During Rivaroxaban Therapy., Jonathan M Yaghoubian, Jacob Adashek, Bahareh Yaghoubian-Yazi, Menachem Nagar, Nojan Toomari, Richard J Pietras, Uri M Ben-Zur

Articles, Abstracts, and Reports

We present the case of a patient with a deep vein thrombosis (DVT) who failed rivaroxaban therapy. Our patient initially presented with left lower extremity edema, erythema, and pain. He was subsequently started on rivaroxaban therapy for a combined treatment period of 12 months, during and after which he persisted to have evidence of a DVT. The patient's prescribed drug regimen was changed from rivaroxaban to warfarin, which demonstrated a rapid resolution of the DVTs as determined by ultrasound assessment of our patient's lower extremity veins. Rivaroxaban, a factor Xa inhibitor, is a well-known oral anticoagulant that is used for …

Early Mutation Bursts In Colorectal Tumors., Junsong Zhao, Matthew P Salomon, Darryl Shibata, Christina Curtis, Kimberly Siegmund, Paul Marjoram

Articles, Abstracts, and Reports

Tumor growth is an evolutionary process involving accumulation of mutations, copy number alterations, and cancer stem cell (CSC) division and differentiation. As direct observation of this process is impossible, inference regarding when mutations occur and how stem cells divide is difficult. However, this ancestral information is encoded within the tumor itself, in the form of intratumoral heterogeneity of the tumor cell genomes. Here we present a framework that allows simulation of these processes and estimation of mutation rates at the various stages of tumor development and CSC division patterns for single-gland sequencing data from colorectal tumors. We parameterize the mutation …

Differential Phenotypes Of Memory Cd4 And Cd8 T Cells In The Spleen And Peripheral Tissues Following Immunostimulatory Therapy., Gail D Sckisel, Annie Mirsoian, Christine M Minnar, Marka R Crittenden, Brendan Curti, Jane Q Chen, Bruce R Blazar, Alexander D Borowsky, Arta M Monjazeb, William J Murphy

Articles, Abstracts, and Reports

BACKGROUND: Studies assessing immune parameters typically utilize human PBMCs or murine splenocytes to generate data that is interpreted as representative of immune status. Using splenocytes, we have shown memory CD4-T cells that expand following systemic immunostimulatory therapies undergo rapid IFNg-mediated activation induced cell death (AICD) resulting in a net loss of total CD4-T cells which correlates with elevated PD-1 expression. This is in contrast to CD8-T cells which expand with minimal PD-1 upregulation and apoptosis. In this study we expand upon our previous work by evaluating CD4 and CD8-T cell phenotype and distribution in peripheral organs which are more representative …

Persuasive Interventions For Controversial Cancer Screening Recommendations: Testing A Novel Approach To Help Patients Make Evidence-Based Decisions., Barry Saver, Kathleen M Mazor, Roger Luckmann, Sarah L Cutrona, Marcela Hayes, Tatyana Gorodetsky, Nancy Esparza, Gonzalo Bacigalupe

Articles, Abstracts, and Reports

PURPOSE: We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009).

METHODS: We created recorded vignettes of physician-patient discussions about prostate cancer screening and mammography, accompanied by illustrative slides, based on principles derived from preceding qualitative work and behavioral science literature. We conducted a randomized crossover study with repeated measures with 27 men aged 50 to 74 years and 35 women aged 40 to 49 years. All participants saw …

Astrocytes Promote Progression Of Breast Cancer Metastases To The Brain Via A Kiss1-Mediated Autophagy., Natalya Kaverina, Anton V Borovjagin, Zaira Kadagidze, Anatoly Baryshnikov, Maria Baryshnikova, Dmitry Malin, Dhimankrishhna Ghosh, Nameeta Shah, Danny R Welch, Patrik Gabikian, Apollon Karseladze, Charles Cobbs, Ilya V Ulasov

Articles, Abstracts, and Reports

Formation of metastases, also known as cancer dissemination, is an important stage of breast cancer (BrCa) development. KISS1 expression is associated with inhibition of metastases development. Recently we have demonstrated that BrCa metastases to the brain exhibit low levels of KISS1 expression at both mRNA and protein levels. By using multicolor immunofluorescence and coculture techniques here we show that normal adult astrocytes in the brain are capable of promoting metastatic transformation of circulating breast cancer cells localized to the brain through secretion of chemokine CXCL12. The latter was found in this study to downregulate KISS1 expression at the post-transcriptional level …

Persistence Of Low Disease Activity After Tumour Necrosis Factor Inhibitor (Tnfi) Discontinuation In Patients With Psoriatic Arthritis., D H Huynh, T A Boyd, C J Etzel, V Cox, J Kremer, P Mease, A Kavanaugh

Articles, Abstracts, and Reports

OBJECTIVE: To determine the duration of clinical benefit among patients with psoriatic arthritis (PsA) discontinuing tumour necrosis factor inhibitor (TNFi) therapy while in low disease activity (LDA), and to identify patient characteristics associated with prolonged clinical benefit.

METHODS: We performed an observational cohort study assessing patients with PsA from the Consortium of Rheumatology Researchers of North America (CORRONA) registry who had discontinued TNFi after achieving LDA, defined as clinical disease activity index (CDAI) score ≤10 and physician's global assessment (PGA) of skin psoriasis ≤20/100. Kaplan-Meier method was used to estimate the duration of clinical benefit.

RESULTS: Of the 5945 patients …

Health Care For All In Ireland? The Consequences Of Politics For Health Policy, Vivienne Byers

Articles

The Irish health-care system is a complicated mix of public and private providers, with inequitable and unclear routes for health-service users to access and navigate the system. In 2011, the Irish Government committed to significant health reform to develop a universal single-tier health system. In line with other European nations this was to be underpinned by the principle of social solidarity, with equitable access based on need rather than ability to pay. The road to this reform and its recent collapse highlights the practical implications of political and policy choices in health care, and has implications for financing and delivery, …

A Workload-Centered Perspective On Reduced Crew Operations In Commercial Aviation, Daniela Schmid

H-Workload 2017: Models and Applications (Works in Progress)

Mental workload of a pilot, in short workload, depends on various characteristics of different accumulated tasks on the flight deck. Exogenous task demands and endogenous supply of attentional or information processing resources determine workload [1]. Performance is expect to drop if the demand exceeds the available resources of the pilot. Expertise and experience modulate the endogenous sup- ply of resources like perceiving, updating memory, planing, making a decision, and executing and processing a response. Subsequently, workload manifests in performance variables, subjective experience, and physiological parameters [2]. This is how we can summarize workload very brie y to introduce a model …

A Pilot Study Into Bio-Behavioural Measurements On Air Traffic Controllers In Remote Tower Operations, Tanja Bos, Rolf Zon, Eszter Furedi, Dezso Dudas, Daniel Rohacs

H-Workload 2017: Models and Applications (Works in Progress)

What is the impact of shifting to remote tower operations on the Air Traffic Controller? In the joint HungaroControl-Netherlands Aerospace Centre NLR pilot project an assessment of bio-behaviour on three air traffic controllers was made in a remote tower and conventional tower. The research is motivated by HungaroControl’s plans in shifting to remote tower operations at Budapest airport in the upcoming years. This pilot project is considered a feasibility study to investigate if an eye tracker and a heart rate sensor can be used to derive workload, the controllers’ division of attention over information elements, and scanning strategies in two …

A Systems Approach To Predicting And Measuring Workload In Rail Traffic Management Systems, Joanna Evans

H-Workload 2017: Models and Applications (Works in Progress)

The introduction of systems such as Traffic Management (TM) will result in a number of changes in how the railway is managed for operations and maintenance staff such as, an increase in collaborative working styles and shared responsibilities. In order to react to these changing operational demands and user needs, TM workstation designs need to have greater flexibility and be configurable to support the information requirements for each specific role as well as support each role during different scenarios. Although this flexibility in system design has the potential to enhance performance, it increases the complexity of measuring operator workload. The …

Brain Connectivity After Concussion, Armin Iraji

Wayne State University Dissertations

Mild traumatic brain injury (mTBI) accounts for over one million emergency visits in the United States each year. While most mTBI patients have normal findings in clinical neuroimaging, alterations in brain structure and functional connectivity have frequently been reported. In this study, we investigated the large-scale brain structural and functional connectivity using diffusion MRI and resting-state fMRI data. Data from 40 mTBI patients was acquired at the acute stage (within 24 hrs after injury). 35 patients returned for data acquisition at a follow-up (4-6 weeks after injury). Data was also collected from a cohort of 58 healthy subjects, 36 of …

Ada News Convention Daily - 2017 Day 3, American Dental Association, Publishing Division

ADA News

The ADA News Daily (also called the ADA News Convention Daily) is a special edition of the ADA News published each day during American Dental Association Annual Sessions.

The Distribution Of Talker Variability Impacts Infants’ Word Learning, Carolyn Quam, Sara Knight, Louann Gerken

Speech and Hearing Sciences Faculty Publications and Presentations

Infants struggle to apply earlier-demonstrated sound-discrimination abilities to later word learning, attending to non-constrastive acoustic dimensions (e.g., Hay et al., 2015), and not always to contrastive dimensions (e.g., Stager & Werker, 1997). One hint about the nature of infants’ difficulties comes from the observation that input from multiple talkers can improve word learning (Rost & McMurray, 2009). This may be because, when a single talker says both of the to-be-learned words, consistent talker’s-voice characteristics make the acoustics of the two words more overlapping (Apfelbaum & McMurray, 2011). Here, we test that notion. We taught 14-month-old infants two similar-sounding words in …

Assessing Parent Invovlment In Applied Behavior Analysis Treatment For Children With Autism, Krista Marie Clancy

Wayne State University Dissertations

The purpose of this study was to compare two groups of parents whose children participated in ABA on their levels of stress, self-efficacy, treatment acceptability, and parents’ level of involvement in their children’s treatment, and to assess variables that may explain variance in parent involvement. Parents in the treatment group participated in a voluntary parent training (n=18) and the comparison group were parents who elected not to participate in the voluntary training (n=22). This was a quasi-experimental design study where parents and their therapists completed a survey regarding parents’ involvement in their children’s treatment programs. Additional parent measures collected as …

Updating The People Living With Hiv Stigma Index, Project Soar

HIV and AIDS

In October 2015, supported by USAID/PEPFAR, Project SOAR established a small working group (SWG) with representatives from a variety of nongovernmental organizations, and several experts within and external to SOAR. The SWG outlined a process for evaluating and updating the Stigma Index, launched in 2008, that would be transparent and incorporate as many perspectives as possible in the process. The Stigma Index is both a data collection tool and an empowering intervention for the interviewers collecting data and the interviewees who are sharing their experiences of stigma. Since the Stigma Index was launched, there have been shifts in the HIV …

A Journey Of Educational Transformation And Organizational Improvement Through Development Of An Institutional Patient Blood Management Program, Robert Raggi, Karen Klein, Marci Swearingen, Mark Domantay

Articles, Abstracts, and Reports

Providence Holy Cross Medical Center (PHCMC) has embarked on this journey to improve outcomes by reducing the number of unnecessary transfusions through the development of a PBM program. Transfusion-related health risks and increasing economic pressures have driven hospitals to recognize development of blood management programs as an important strategy to improve patient outcomes and reduce costs.

Targeted Educational Interventions To Increase Knowledge And Influence Attitudes About Nutritional Concepts In School-Aged Children, Chelsea Weaks, Ashley Montoya, Angela Nelson, Shivanee Sathia, Rachael Evans, Jessica Siechman, Caroline Crilley

OUR Journal: ODU Undergraduate Research Journal

Good nutritional habits have been linked to increased overall health and wellness, therefore working with children has the greatest impact on their overall lifestyle and lifelong habits. Nutritional interventions decrease the risk of future health complications that can result in premature death. This study aims to evaluate the knowledge base of school-aged children sampled from an existing after-school nutrition education program and measure the efficacy of an additional two-step intervention. Our two-step intervention includes a content knowledge educational intervention on day one and a play-based learning intervention on day two to allow for knowledge acquisition and subsequent application of knowledge …

The Effect Of A Drinking Water Education Program On The Threat Perception Of Nitrate Contaminated Water By Pregnant Women, Beatrice Asomani, Yedda Descalo, Meliss Dillard, Brandy Hudgins, Caitlin Niblick, Kristina Wall

OUR Journal: ODU Undergraduate Research Journal

The purpose of this study is to determine the effects of a drinking water education program in a rural community on the perceived threat of nitrate-contaminated water by pregnant women. The proposed study aims to reach out to at least 120 pregnant women in their first trimester. Data will be collected using a Protection Motivation Theory (PMT) scale pretest and posttest that will gauge pregnant women’s perceived threat of nitrate-contaminated drinking water before and after the education program. The data will be analyzed using descriptive and inferential statistics. A paired sample t-test will be used to determine the effects of …

Human Dignity As A Normative Standard Or As A Value In Global Health Care Decisionmaking, George P. Smith Ii

Scholarly Articles

Dignity is seen commonly as an ethical obligation owed to human persons. The dimensions of this obligation in today's post secular society, are -- however -- subject to wide discussion and debate; for, the term, human dignity, and its preservation, defies universal agreement. Yet, its preservation -- together with the prevention of indignity -- should be a guiding principle or at least a vector of force in a wide range of issues in health care management ranging from embryo research and assisted reproduction to biomedical enhancement, and the care of the disabled and the dying. In clinical medicine, safeguarding the …

Total Knee Arthroplasty Rehabilitation Case Report, Abby R. Brenner

Physical Therapy Scholarly Projects

Background & Purpose Total knee arthroplasties (TKAs) are the most commonly performed elective surgery in the United States. Osteoarthritis (OA) is the most common diagnosis treated with a TKA, which aims to restore an individual's functional ability by improving joint biomechanics and decreasing pain. The purpose of this case report is to describe the progression of physical therapy rehabilitation for a patient status post total knee arthroplasty.

Case Description The patient was a 64 year old male who underwent a TKA surgery to resolve the complications from severe osteoarthritis (OA) of his left knee. He presented to physical therapy with …

Aβ Vaccination In Combination With Behavioral Enrichment In Aged Beagles: Effects On Cognition, Aβ, And Microhemorrhages, Paulina R. Davis, Ginevra Giannini, Karin Rudolph, Nathaniel Calloway, Christopher M. Royer, Tina L. Beckett, M. Paul Murphy, Frederick Bresch, Dieter Pagani, Thomas Platt, Xiaohong Wang, Amy Skinner Donovan, Tiffany L. Sudduth, Wenjie Lou, Erin L. Abner, Richard J. Kryscio, Donna M. Wilcock, Edward G. Barrett, Elizabeth Head

Sanders-Brown Center on Aging Faculty Publications

Beta-amyloid (Aβ) immunotherapy is a promising intervention to slow Alzheimer’s disease (AD). Aging dogs naturally accumulate Aβ and show cognitive decline. An active vaccine against fibrillar Aβ 1–42 (VAC) in aged beagles resulted in maintenance but not improvement of cognition along with reduced brain Aβ. Behavioral enrichment (ENR) led to cognitive benefits but no reduction in Aβ. We hypothesized cognitive outcomes could be improved by combining VAC with ENR in aged dogs. Aged dogs (11–12 years) were placed into 4 groups: (1) control/control (C/C); (2) control/VAC (C/V); (3) ENR/control (E/C); (4) ENR and VAC (E/V) and treated for 20 months. …

The Association Between Clinical Recognition Of Depression And Unplanned Hospital Readmission Among Older Adults, Karen M. Jones

Theses and Dissertations

Purpose

The likelihood of a depression diagnosis may differ based on whether the patient was seen in an inpatient or outpatient setting. Depression has been associated with an increased risk of a 30-day readmission. The purpose of this study was to determine the level of agreement (concordance) between depression diagnosis as identified by inpatient and outpatient records and examine the relationship between depression diagnostic concordance and 30-day readmission.

Methods

Using universal administrative claims data from South Carolina, we examined inpatient and outpatient records. The analysis was restricted to Medicaid recipients aged 55 years and older with a primary admitting diagnosis …

Misuse Of Novel Synthetic Opioids: A Deadly New Trend, Matthew P. Prekupec, Peter A. Mansky, Michael H. Baumann

College of Osteopathic Medicine (TUN) Publications and Research

Novel synthetic opioids (NSOs) include various analogs of fentanyl and newly emerging non-fentanyl compounds. Together with illicitly manufactured fentanyl (IMF), these drugs have caused a recent spike in overdose deaths, whereas deaths from prescription opioids have stabilized. NSOs are used as stand-alone products, as adulterants in heroin, or as constituents of counterfeit prescription medications. During 2015 alone, there were 9580 deaths from synthetic opioids other than methadone. Most of these fatalities were associated with IMF rather than diverted pharmaceutical fentanyl. In opioid overdose cases, where the presence of fentanyl analogs was examined, analogs were implicated in 17% of fatalities. Recent …

Validation Of The Japanese Version Of The Fremantle Back Awareness Questionnaire In Patients With Low Back Pain, T Nishigami, A Mibu, K Tanaka, Y Yamashita, M Shimizu, B Wand, M Catley, T Stanton, G Moseley

Physiotherapy Papers and Journal Articles

Background: There is a growing interest in the role of disturbed body perception in people with persistent pain problems such as chronic low back pain (CLBP). A questionnaire, the Fremantle Back Awareness Questionnaire (FreBAQ), was recently developed as a simple and quick way of assessing disturbed perceptual awareness of the back in people with CLBP and appears to have acceptable psychometric properties. The aim of the present study was to develop a Japanese version of the FreBAQ (FreBAQ-J) and evaluate its psychometric properties in a sample of Japanese people with low back pain (LBP).

Methods: Translation of the FreBAQ into …

Disrupted Body-Image And Pregnancy-Related Lumbopelvic Pain. A Preliminary Investigation, B Wand, R Elliott, A Sawyer, R Spence, D Beales, P O'Sullivan, A Smith, W Gibson

Physiotherapy Papers and Journal Articles

Background: Recent investigations have suggested that disrupted body-image may contribute to the lumbopelvic pain experience. The changes in body shape and size associated with pregnancy suggest that pregnancy-related lumbopelvic pain might be a problem in which alterations in body-image are particularly relevant.

Objectives: To investigate if self-reported body-image is related to lumbopelvic pain status in women during pregnancy and explore the factors that might contribute to changes in body-image in women experiencing pregnancy-related lumbopelvic pain.

Design: Cross-sectional cohort study.

Method: Forty-two women in the third trimester of pregnancy were recruited regardless of clinical status. Pain intensity and disability were measured …

Physiotherapy In Upper Abdominal Surgery - What Is Current Practice In Australia?, S Patman, A Bartley, A Ferraz, C Bunting

Physiotherapy Papers and Journal Articles

Background: Upper abdominal surgery (UAS) has the potential to cause post-operative pulmonary complications (PPCs). In the absence of high-quality research regarding post-operative physiotherapy management, consensus-based best practice guidelines formulated by Hanekom et al. (2012) are available to clinicians providing recommendations for post-UAS treatment. Such best practice guidelines have recommended that physiotherapists should be using early mobilisation and respiratory intervention to minimise risk of PPCs. However, recent evidence supports the implementation of mobilisation as a standalone treatment in PPC prevention, though the diversity in literature poses questions regarding ideal current practice. This project aimed to document and report the assessment measures …

Resistance Training For Rehabilitation After Burn Injury: A Systematic Literature Review And Meta-Analysis, P Gittings, T Grisbrook, Dale Edgar, F Wood, B Wand, N O'Connell

Physiotherapy Papers and Journal Articles

Background/aim: Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury.

Methods: Medline & EMBASE, PubMed, CINAHL and CENTRAL were searched from inception to October 2016. Studies were identified that implemented resistance training in rehabilitation. Data were combined and included in meta-analyses for muscle strength and lean mass. Otherwise, narrative analysis was completed. The quality of evidence for each outcome was summarised and …

Developing Minimum Clinical Standards For Physiotherapy In South African Icus: A Qualitative Study, H Van Aswegen, S Patman, N Plani, S Hanekom

Physiotherapy Papers and Journal Articles

Rationale, aims, and objectives: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients.

Method: Experienced physiotherapists offering a service to South African ICUs were purposively sampled. Three focus …

After-Hours Respiratory Physiotherapy For Intubated And Mechanically Ventilated Patients With Community-Acquired Pneumonia: An Australian Perspective, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Introduction: Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals.

Materials and methods: A cross-sectional, mixed methods online survey was conducted. Participants were senior intensive care unit physiotherapists from 88 public and private hospitals. Main outcome measures included presence and nature of an after-hours physiotherapy service and factors perceived to influence …