Medicine and Health Sciences Commons^™

The Effect Of Complex Falls Prevention Interventions On Falls In Residential Aged Care Settings: A Systematic Review Protocol, Jacqueline Francis-Coad, Christopher Etherton-Beer, Debbie Nobre, Chiara Naseri, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident.

Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings?

Can A Web-Based Community Of Practice Be Established And Operated To Lead Falls Prevention Activity In Residential Care?, Jacqueline Francis-Coad, Christopher Etherton-Beer, Caroline Bulsara, Debbie Nobre, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted …

Science As Speech, Natalie Ram

All Faculty Scholarship

In April 2015, researchers in China reported the successful genetic editing of human embryos using a new technology that promised to make gene editing easier and more effective than ever before. In the United States, the announcement drew immediate calls to regulate or prohibit
outright any use of this technology to alter human embryos, even for purely research purposes. The fervent response to the Chinese announcement was, in one respect, unexceptional. Proposals to regulate or prohibit scientific research following a new breakthrough occur with substantial frequency. Innovations in cloning technology and embryonic stem cell research have prompted similar outcries, and …

Hearing Loss: A Silent Health Disparity, Katherine Valek

Senior Honors Theses and Projects

This paper presents an analysis of various aspects of hearing loss and its connection to healthcare settings, particularly nursing. Normal hearing is defined, followed by the definition of hearing loss and deafness. Cultural Deafness is then explained, followed by ways to prevent hearing loss. Additionally, healthcare experiences of individuals with hearing loss will be presented. The project will conclude with recommendations for healthcare professionals in regard to caring for their patients with hearing loss. The main population focus of the paper are Deaf and Hard of Hearing (HOH) individuals. Specifically, their unique experiences in healthcare encounters will be evaluated. Interactions …

Effect Of Slant Boards In Combination With Handwriting Practice, Kristen N. Brevoort

Occupational Therapy Program Student Theses, Dissertations and Capstones

Handwriting difficulties affect 10% to 30% of children in elementary school often hindering their successful participation in a number of occupations, including academic participation. Occupational therapists provide treatments for handwriting difficulties; however, many of these interventions have limited to no evidence to support their effectiveness. One of these interventions is the use of a slant board, a treatment strategy often combined with handwriting practice. Clinicians commonly combine the use of slant boards and handwriting practice to facilitate the development of handwriting skills in young children. However, the effectiveness of this combination of interventions in improving the quality of handwriting remains …

Effects Of Moderate Pressure Massage On Self-Regulation And Play In Preterm Babies, Helene Chaya Hendel

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this study was to examine whether mother-administered moderate pressure massage intervention could improve self-regulation, which would result in improvements in play outcomes. It was posited that a child who is self-regulated may be more successful in his/her play and that moderate pressure massage could be an effective tool to improve self-regulation in preterm infants with decreased self-regulation. Participants in the study were five preterm children ranging from 12 to 18 months corrected age and their mothers. The study utilized an A-B nonconcurrent multiple baselines across subjects design in which each participant acted as his/her own control as …

Role Of Jagged1 In The Enrichment Of Cancer Stem Cells In Her2+ Breast Cancer, Deep Shah

Dissertations

Purpose: Breast cancer is the second leading cause of cancer-related deaths among women worldwide. Human Epidermal Growth Factor Receptor 2 (HER2) positive subtype of breast cancer is driven by a subpopulation of cells possessing stem cell properties of self-renewal and differentiation, known as Cancer Stem Cells (CSCs). CSCs are implicated in tumor growth as well as radiotherapy and chemotherapy associated resistance. Notch receptors promote breast CSCs survival and self-renewal, and overexpression of Notch ligand Jagged1 predicts poor prognosis. We showed previously that Notch could be an important target in trastuzumab/lapatinib resistant HER2+ breast cancer.

Experimental Design: Here, we sought to …

It Is Always The Monkey On My Back: The Diagnosis Of Cirrhosis, Mary Tiberg

Dissertations

Mary Tiberg

Loyola University Chicago

IT IS ALWAYS THE MONKEY ON MY BACK: THE DIAGNOSIS OF CIRRHOSIS

A significant current challenge in health care today is meeting the needs of a population that has chronic disease, especially for those that have a health condition with a life threatening long -term outcome (Falkenstern, et al., 2005). In these health illness transitions, when there are no secure expectations, there are the additional burdens of enduring emotional unease, facing the closing stages of physical stamina, and confronting an indeterminate future. The objective of this study was to explore and describe the experience of …

Examining The Effects Of Adolescent Binge Alcohol Exposure On The Negative Feedback Of The Hpa Axis And Adult Responses To Psychological Stress, Audrey Rose Torcaso

Dissertations

Binge drinking during adolescence is a common occurrence which is associated with increased risk of developing alcohol dependence and other mental health disorders. Hypothalamo-pituitary-adrenal (HPA) axis dysfunction is one characteristic commonly observed in many affective disorders, including anxiety and depression. Our laboratory has previously demonstrated that adolescent binge-pattern alcohol exposure results in long-term dysfunction of the HPA axis in a Wistar rat model, characterized by deficient glucocorticoid feedback inhibition. The current study aimed to characterize the behavioral phenotype of these rats in response to psychological stress during adulthood, and furthermore sought to understand the molecular mechanisms by which adolescent binge …

Does Dietary Melatonin Play A Role In Bone Mineralization?, Martha Renee Wasserbauer

Theses - ALL

Introduction: Melatonin is generated as a product of normal circadian rhythm and is also is thought to play an important role in maintaining bone mineral density (BMD) by reducing chronic inflammation. Postmenopausal women are at an elevated risk of BMD loss due to declining estrogen and a natural decrease in melatonin synthesis with increasing age. Endogenous melatonin production is largely influenced by exposure to external light cues, but recent research has indicated that serum melatonin may be increased by the consumption of melatonin-rich foods. The purpose of this study was to quantify dietary-derived melatonin and examine its effects on inflammation, …

Actionable Patient Safety Solution (Apss) #3c: Improve Prevention Of Severe Hypoglycemia, Jerika Lam, Steven Barker, Michael Ramsay, Ariana Longley, Joe Kiani

Pharmacy Faculty Articles and Research

This report presents a plan of action for introducing a "program to reduce errors in the recognition and treatment of [severe hypoglycemia]".

The Patient Survey Programme: Transforming The Patient Experience In Irish Healthcare, Vivienne Byers, D. Fahey, C. Mullins, C. Roe

Articles

For more than a decade, health policy in Ireland has pushed the centrality of the patient in the delivery and management of healthcare services, including the development of a National Strategy for Service User Involvement in the Health Service 2008–2013 (Health Service Executive, 2008). More recently, the need to provide a ‘patientcentred’ (Department of Health, 2012, 2013, 2014) or ‘person-centred’ (Department of Health, 2016) service has been a guiding principle of health policy documents. The National Service Plan 2017 (Health Service Executive, 2016) also outlines the importance of increasing the rates of service user engagement and feedback across the health …

Universal Design Across The Curriculum: Training For Students And Teachers, Trish Mackeogh, James Hubbard, Kieran O'Callaghan

Research and Innovation - Articles

Providing an inclusive educational setting for children with disabilities is essential if they are to truly benefit from mainstream education. Universal design (UD) provides a framework to develop our classrooms, materials and methods to accommodate diverse learners and students with special educational needs without the need to retrofit or remove the student from the classroom. This paper outlines the theory and the approach of two training courses on Universal Design developed for teachers and students.

Alzheimer’S Disease And Other Dementias Workgroup: Alzheimer’S Disease And Other Dementias Report And Recommendations, V Weir (Ed), K Rhoads (Chair), Nancy B. Isenberg, See All Group Members In Comments

Articles, Abstracts, and Reports

Rates of Alzheimer’s disease and other dementias are expected to increase greatly over the next decades. Many practices lack guidelines on how to increase quality of diagnosing, treating, and supporting people with dementia and their family members and other caregivers. This workgroup met from January to November 2017, aligned with and built off the Alzheimer’s State Plan, and organized recommendations with the following focus areas:

• Early detection and appropriate diagnosis
• Ongoing care and support or management including for family members and caregivers
• Advance care planning and palliative care
• Assessment and planning for need for increased support and/or higher levels …

Interpretation Of Positive Troponin Results Among Patients With And Without Myocardial Infarction., Kristen M Tecson, William Arnold, Tyler Barrett, Robert Birkhahn, Lori B Daniels, Christopher Defilippi, Gary Headden, W Frank Peacock, Michael Reed, Adam J Singer, Jeffrey M Schussler, Stephen Smith, Martin P Than, Peter A Mccullough

Articles, Abstracts, and Reports

Measuring cardiac troponins is integral to diagnosing acute myocardial infarction (AMI); however, troponins may be elevated without AMI, and the use of multiple different assays confounds comparisons. We considered characteristics and serial troponin values in emergency department chest pain patients with and without AMI to interpret troponin excursions. We compared serial troponin in 124 AMI and non-AMI patients from the observational Performance of Triage Cardiac Markers in the Clinical Setting (PEARL) study who presented with chest pain and had at least one troponin value exceeding the 99th percentile of normal. Because 8 assays were used during data collection, we employed …

Associations Between Prescribed Chinese Herbal Medicine And Risk Of Hepatocellular Carcinoma In Patients With Chronic Hepatitis B: A Nationwide Population-Based Cohort Study, Tzung-Yi Tsai, Hanoch Livneh, Tsung-Hsing Hung, I-Hsin Lin, Ming-Chi Lu, Chia-Chou Yeh

Counselor Education Faculty Publications and Presentations

Objective: Patients with chronic hepatitis B (CHB) are reported to exhibit higher risk of subsequent hepatocellular carcinoma (HCC). However, it remains unclear if Chinese herbal medicine (CHM), an important category of traditional Chinese medicine (TCM), may lower HCC risk in this population. So this study aimed to investigate the effects of CHM on HCC risk among patients with CHB.

Methods: This cohort study used the Taiwanese National Health Insurance Research Database to identify 21,020 newly diagnosed patients with CHB from 1998 to 2007. Among them, 8640 received CHM products after CHB onset (CHM users), and the remaining 12,380 patients were …

Mutational Landscapes Of Smoking-Related Cancers In Caucasians And African Americans: Precision Oncology Perspectives At Wake Forest Baptist Comprehensive Cancer Center., Ville Kytola, Umit Topaloglu, Lance D Miller, Rhonda L Bitting, Michael M Goodman, Ralph B D Agostino, Rodwige J Desnoyers, Carol Albright, George Yacoub, Shadi A Qasem, Barry Deyoung, Vesteinn Thorsson, Ilya Shmulevich, Meng Yang, Anastasia Shcherban, Matthew Pagni, Liang Liu, Matti Nykter, Kexin Chen, Gregory A Hawkins, Stefan C Grant, W Jeffrey Petty, Angela Tatiana Alistar, Edward A Levine, Edgar D Staren, Carl D Langefeld, Vincent Miller, Gaurav Singal, Robin M Petro, Mac Robinson, William Blackstock, Bayard L Powell, Lynne I Wagner, Kristie L Foley, Edward Abraham, Boris Pasche, Wei Zhang

Articles, Abstracts, and Reports

Background: Cancers related to tobacco use and African-American ancestry are under-characterized by genomics. This gap in precision oncology research represents a major challenge in the health disparities in the United States. Methods: The Precision Oncology trial at the Wake Forest Baptist Comprehensive Cancer Center enrolled 431 cancer patients from March 2015 to May 2016. The composition of these patients consists of a high representation of tobacco-related cancers (e.g., lung, colorectal, and bladder) and African-American ancestry (13.5%). Tumors were sequenced to identify mutations to gain insight into genetic alterations associated with smoking and/or African-American ancestry. Results: Tobacco-related cancers exhibit a high …

Setting The Stage: Success In Performance Excellence, Providence St. Joseph Health

Articles, Abstracts, and Reports

No abstract provided.

Peripheral Huntingtin Silencing Does Not Ameliorate Central Signs Of Disease In The B6.Httq111/+ Mouse Model Of Huntington's Disease., Sydney R Coffey, Robert M Bragg, Shawn Minnig, Seth A Ament, Jeffrey P Cantle, Anne Glickenhaus, Daniel Shelnut, José M Carrillo, Dominic D Shuttleworth, Julie-Anne Rodier, Kimihiro Noguchi, C Frank Bennett, Nathan D Price, Holly B Kordasiewicz, Jeffrey B Carroll

Articles, Abstracts, and Reports

Huntington's disease (HD) is an autosomal dominant neurodegenerative disease whose predominant neuropathological signature is the selective loss of medium spiny neurons in the striatum. Despite this selective neuropathology, the mutant protein (huntingtin) is found in virtually every cell so far studied, and, consequently, phenotypes are observed in a wide range of organ systems both inside and outside the central nervous system. We, and others, have suggested that peripheral dysfunction could contribute to the rate of progression of striatal phenotypes of HD. To test this hypothesis, we lowered levels of huntingtin by treating mice with antisense oligonucleotides (ASOs) targeting the murine …

A Randomized Study Comparing Digital Imaging To Traditional Glass Slide Microscopy For Breast Biopsy And Cancer Diagnosis., Joann G Elmore, Gary M Longton, Margaret S Pepe, Patricia A Carney, Heidi D Nelson, Kimberly H Allison, Berta M Geller, Tracy Onega, Anna N A Tosteson, Ezgi Mercan, Linda G Shapiro, Tad T Brunyé, Thomas R Morgan, Donald L Weaver

Articles, Abstracts, and Reports

BACKGROUND: Digital whole slide imaging may be useful for obtaining second opinions and is used in many countries. However, the U.S. Food and Drug Administration requires verification studies.

METHODS: Pathologists were randomized to interpret one of four sets of breast biopsy cases during two phases, separated by ≥9 months, using glass slides or digital format (sixty cases per set, one slide per case,

RESULTS: Sixty-five percent of responding pathologists were eligible, and 252 consented to randomization; 208 completed Phase I (115 glass, 93 digital); and 172 completed Phase II (86 glass, 86 digital). Accuracy was slightly higher using glass compared …

Does Gated Beam Delivery Impact Delivery Accuracy On An Elekta Linac?, Mohammed Jermoumi, Roger Xie, Daliang Cao, David J Housley, David M Shepard

Articles, Abstracts, and Reports

In this study, we evaluated the performance of an Elekta linac in the delivery of gated radiotherapy. Delivery accuracy was examined with an emphasis on the impact of using short gating windows (low monitor unit beam-on segments) or long beam hold times. The performance was assessed using a 20cm by 20cm open field with the radiation delivered using a range of beam-on and beam-off time periods. Gated delivery measurements were also performed for two SBRT plans delivered using volumetric modulated arc therapy (VMAT). Tests included both free-breathing based gating (covering a variety of gating windows) and simulated breath-hold based gating. …

A Previously Unreported Arterial Variant Of The Suboccipital Region Based On Cadaveric Dissection., Christian Fisahn, Brittni Burgess, Joe Iwanaga, Fernando Alonso, Jens R Chapman, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

No abstract provided.

New Cancer Immunotherapy Agents In Development: A Report From An Associated Program Of The 31, Prasad S Adusumilli, Edward Cha, Mark Cornfeld, Thomas Davis, Adi Diab, Thomas W Dubensky, Elizabeth Evans, Jane L Grogan, Bryan A Irving, Rom Leidner, Shane A Olwill, Patrick Soon-Shiong, Frederic Triebel, David Tuck, Adrian Bot, Roger D Dansey, Charles G Drake, Gordon J Freeman, Ramy Ibrahim, Salil Patel, Daniel S Chen

Articles, Abstracts, and Reports

This report is a summary of 'New Cancer Immunotherapy Agents in Development' program, which took place in association with the 31st Annual Meeting of the Society for Immunotherapy of Cancer (SITC), on November 9, 2016 in National Harbor, Maryland. Presenters gave brief overviews of emerging clinical and pre-clinical immune-based agents and combinations, before participating in an extended panel discussion with multidisciplinary leaders, including members of the FDA, leading academic institutions and industrial drug developers, to consider topics relevant to the future of cancer immunotherapy.

The Significance Of Injustice For Bioethics, Leslie P. Francis

Utah Law Faculty Scholarship

In my judgment, applied ethics is ineluctably non-ideal and partial compliance theory. It’s ethics in the context of unjust institutions and conduct. Theorizing or teaching about concepts such as autonomy in abstraction from this recognition is misleading. Instead, questions such as how to realize autonomy should be framed in the context of incomplete justice. There’s much to be learned from the past nearly 50 years of discussions of justice to help with this enterprise, but they are too little known or discussed in much contemporary bioethics.

Supply Effects Of Implementing Donor Interval Strategies To Prevent Iron Deficiency In Blood Donors, Kevin Joseph Belanger

MUSC Theses and Dissertations

Iron depletion in blood donors has been a topic of concern for the AABB over the past couple of years. In March 2017 the AABB published bulletin #17-02 recommending blood collection facilities implement additional actions to limit or prevent iron deficiency in blood donors. Three of the recommended strategies were to limit the donation interval for all individuals to two times in a 12-month period, limit 16-18 year olds to one donation in a 12-month period, and to limit pre-menopausal woman to one donation in a twelve month period. With a declining donor pool, the focus of this study is …

Barriers To Colorectal Cancer Screening Within A Rural Community In Ohio, Kristina Knoll

DNP Projects

Purpose: The purpose of this study was to perform a needs assessment within the primary care practice of ProMedica Family Medicine in Fostoria, OH. The needs assessment will specifically identify intentions and behaviors, attitudes and beliefs, subjective norms about behavioral control, and healthcare provider or healthcare system barriers related to colorectal cancer screening.

Methods: This was a cross-sectional study using a survey among a convenience sample of patients who were 50 - 75 years of age and were not currently up-to-date with their colorectal cancer screening. In total, 222 patients were screened, 133 patients were determined to not be up-to-date, …

Examining The Activities, Effectiveness, And Contribution Of Local Health Departments Using A National Longitudinal Survey Of Public Health Systems, Lava R. Timsina

Theses and Dissertations--Epidemiology and Biostatistics

Health services research and public health services and systems research in the past have contributed to a strong foundation of evidence-based progress in organizing, financing, and delivering medical care and public health strategies across the United States. The purpose of this dissertation was to examine disparities in public health systems and in the delivery of population health services in communities served by these systems using nationally representative data from the National Longitudinal Survey of Local Public Health Systems (1998, 2006, 2012, and 2014).

Data from the 1998 cohort of 497 local health jurisdictions serving at least 100,000 residents, and from …

Methods For Determining Time To Return To Play After Recreational Injury In Field And Court Sport Athletes, Sarah N. Morris

Theses and Dissertations--Epidemiology and Biostatistics

An observational study was used to illustrate the application of time to event analysis methods to return to play; a secondary data analysis of athlete injury data from the High School RIO^TM Injury Surveillance System (ISS) database was conducted. National Athletic Trainers’ Association (NATA)-certified athletic trainers from approximately 100 high schools in the US enroll their school in the system and complete the online “Exposure Report Form” for reportable injuries each week. New lateral ankle sprains and single-ligament knee injuries experienced by high school athletes during regularly scheduled participation in school-sanctioned sports for seven academic years (2005-2006 through 2011-2012) …

Mixture Modeling With Applications In Alzheimer's Disease, Frank Appiah

Theses and Dissertations--Epidemiology and Biostatistics

This dissertation involves an application of mixture of regression models to 114 individuals who are cognitively intact (from the Alzheimer's Disease and Neuroimaging Initiative-ADNI, data). The correct number of components in the model were estimated with the Singular BIC (SBIC), marking the first time it has been applied to such a problem. The smallest true model in conjunction with the approximation of SBIC was fixed at 1. The resulting posterior probabilities from the model were used to estimate the probability of a person transitioning and risk plots were obtained that could in principle be used by clinicians to identify patients …

Uchunguzi (Journal Watch/ Montre De Journal) June 2017, Benjamin Wachira

Emergency Medicine, East Africa

The purpose of an effective emergency care system is to provide universal emergency care to all regardless of socioeconomic status, to stabilise patients who have a life-threatening illness or injury, and to reduce consequences of preventable mortality, morbidity and disability. Unfortunately, the limited availability of resources remains a significant barrier to the development and implementation of emergency care systems in low- and middle-income countries (LMICs). In this recent study from Cameroon, of 3201 participants from 619 households surveyed, 1113 (34.8%) had experienced one or more emergency conditions in the previous year. Despite this high incidence of emergency conditions, only 7% …