Medicine and Health Sciences Commons^™

Marginal Structural Cox Model For Survival Data With Treatment-Confounder Feedback, Yanan Zhang

Theses and Dissertations

In an observational longitudinal study, there can be time-varying exposure/treatment and time-varying confounders. When the confounders affect the exposure and prior exposure also has an impact on levels of confounders, there is treatment confounder feedback. To admit estimation of unbiased causal effects, these conditions need to be hold, exchangeability, positivity, consistency. The traditional method of conditioning on potential confounders does not meet these 3 conditions. Therefore, parameter estimates from traditional Cox model are biased casual effect estimates when the treatment confounder feedback exists. The marginal structural Cox model can be used to address this issue. By calculating and including inverse …

The Impact Of Autoimmune Disease On Breast Cancer Survival, Samantha Truman

Theses and Dissertations

Background Breast cancer is the second leading cause of cancer death for women in developed countries, while autoimmune disease effects approximately 10 million people in the United States, of which approximately 80% are female. Both diseases are associated with hormonal risk factors and are related to the divergent effects of the cellular and humoral immunity that is associated with the T-helper 1 and T-helper 2 immune response. To investigate the potential implications that autoimmune disease may have on breast cancer-specific mortality, we have conducted a population-based retrospective cohort study of women who were diagnosed with breast cancer between January 1, …

Trends In Gestational Weight Gain In South Carolina, 2004 - 2015, Marilyn Elizabeth Wende

Theses and Dissertations

Objective: Excessive and inadequate gestational weight gain (GWG) are associated with a myriad of adverse pregnancy outcomes. The objective of this study was to examine secular trends in GWG in South Carolina (SC) from 2004 to 2015. We hypothesized that there was a trend of higher GWG z scores (GWGZ) over this 11-year time period after adjusting for changes in population characteristics. We also hypothesize that a trend of higher mean GWGZ at higher percentiles is more apparent for African Americans, rural women, and women who are overweight or obese before pregnancy.

Data and Methods: Data came from SC …

Hemodynamic Regulation Of Cardiac Valve Development, Vinal Menon

Theses and Dissertations

It is well established that valvulogenesis is a result of a complex interplay between genetic and environmental factors. Hemodynamics is one such environmental stimulus that is well documented to influence the development of heart valves. Using advanced imaging modalities, such as optical coherence tomography, investigators have better understood the effects of altering hemodynamic loads in the embryonic (avian) heart. However, the field of valvulogenesis is currently stagnant with a paucity of studies aiming to understand the molecular mechanisms influenced/affected by hemodynamic stimuli. Deciphering these pathways is critical from a valve development perspective, but also becomes vital as potential therapeutic targets, …

Development Of An Estrogen-Related Dietary Pattern And Lifestyle Score To Examine Breast Cancer Risk In Postmenopausal Women, Mark Andrew Guinter

Theses and Dissertations

Introduction: Studies examining the association between individual dietary components and breast cancer have been inconclusive. The use of dietary patterns is a holistic approach which may yield stronger associations. We sought to develop a dietary pattern based on an estrogen metabolite (EM) profile hypothesized to increase breast cancer risk (high unconjugated estradiol and low ratio of 2- to 16-hydroxylated EMs (2/16 ratio)). This estrogen-related dietary pattern (ERDP) was examined for associations with postmenopausal breast cancer in two study populations and was incorporated into an estrogen-related lifestyle score (ERLS) with other modifiable risk factors for breast cancer.

Methods: EM …

The Women's Wellness After Cancer Program: A Multisite, Single-Blinded, Randomised Controlled Trial Protocol, D Anderson, C Seib, D Tjondronegoro, J Turner, L Monterosso, A Mcguire, J Porter-Steele, W Song, P Yates, N King, L Young, K White, K Lee, S Hall, M Krishnasamy, K Wells, S Balaam, A Mccarthy

Nursing Papers and Journal Articles

Background: Despite advances in cancer diagnosis and treatment have significantly improved survival rates, patients post-treatment-related health needs are often not adequately addressed by current health services. The aim of the Women’s Wellness after Cancer Program (WWACP), which is a digitised multimodal lifestyle intervention, is to enhance health-related quality of life in women previously treated for blood, breast and gynaecological cancers.

Methods: A single-blinded, multi-centre randomized controlled trial recruited a total of 330 women within 24 months of completion of chemotherapy (primary or adjuvant) and/or radiotherapy. Women were randomly assigned to either usual care or intervention using computer-generated permuted-block randomisation. The …

The Influence Of The Art Of Clinical Supervision Program On Nurses' Knowledge And Attitude About Working With Students, K Russell, S Alliex, H Gluyas

Nursing Papers and Journal Articles

The Art of Clinical Supervision program was developed, implemented and evaluated, to determine nursing staff knowledge and attitudes towards nursing students and the clinical supervision thereof. A key point of the program was the inclusion of strategies to promote one’s attitude towards working with students. A mixed methods approach of surveys, online reflections and interviews, was used to determine the programs effect. The findings highlighted a positive impact on participants’ self-knowledge and attitudes towards students and student clinical supervision.

Surgical Plume And Its Implications: A Review Of The Risk And Barriers To A Safe Work Place, E. Tan, K. Russell

Nursing Papers and Journal Articles

Every year thousands of health care professionals worldwide are exposed to surgical smoke. There is evidence that this smoke consists of toxic gases, pathogens and particulate matter that is a hazard for patients and the perioperative team. Past research indicates that perioperative staff inconsistently comply with smoke evacuation recommendations. The aim of this study was to identify, review and discuss the issues related to surgical plume and its implications for patients and perioperative staff. The findings of this review relate to: surgical smoke content, its risks to the health of the perioperative staff, preventative measures, infection control measures, compliance with …

The Validity And Reliability Characteristics Of The M-Back Questionnaire To Assess The Barriers, Attitudes, Confidence, And Knowledge Of Mental Health Staff Regarding Metabolic Health Of Mental Health Service Users, Andrew Watkins, Simon Rosenbaum, Philip B. Ward, Joanna Patching, Elizabeth Denny-Wilson, Jane Stein-Parbury

Nursing Papers and Journal Articles

Background: Addressing the burden of poor physical health and the subsequent gap in life expectancy experienced by people with mental illness is a major priority in mental health services. To equip mental health staff with the competence to deliver evidence-based interventions, targeted staff training regarding metabolic health is required. In order to evaluate the effectiveness of staff training regarding metabolic health, we aimed to develop a succinct measure to determine the barriers, attitudes, confidence, and knowledge of health practitioners through the development and test–retest reliability of the Metabolic-Barriers, Attitudes, Confidence, and Knowledge Questionnaire (M-BACK).

Methods: The M-BACK questionnaire was developed …

Patient Evaluation Of Emotional Comfort Experienced (Peece): Developing And Testing A Measurement Instrument, Anne Williams, Leanne Lester, Caroline Bulsara, Anna Petterson, Kellie Bennett, E Allen, David Joske

Nursing Papers and Journal Articles

Objectives: The Patient Evaluation of Emotional Comfort Experienced (PEECE) is a 12-item questionnaire which measures the mental well-being state of emotional comfort in patients. The instrument was developed using previous qualitative work and published literature.

Design: Instrument development.

Setting: Acute Care Public Hospital, Western Australia.

Participants: Sample of 374 patients.

Interventions: A multidisciplinary expert panel assessed the face and content validity of the instrument and following a pilot study, the psychometric properties of the instrument were explored.

Main outcome measures: Exploratory and confirmatory factor analysis assessed the underlying dimensions of the PEECE instrument; Cronbach’s α was used to determine the …

The Essence Of Helping: Significant Others And Nurses In Action Draw Men Into Nursing, D Juliff, Kylie P. Russell, Caroline Bulsara

Nursing Papers and Journal Articles

Background: Nurses are ageing placing nursing workforce sustainability under threat. An untapped potential resource of men in nursing exists within Australia. Objective: The aim of the first phase of this longitudinal study was to investigate why men choose nursing. Design: Qualitative methodological approach used interpretative phenomenological analysis (IPA).

Research question: “What are the experiences of male graduate nurses regarding their career choice?”

Method: The IPA method focused on personal subjective experience where the participants’ own sense-making is important. Discussions were audio-recorded, transcribed verbatim and analysed using a format relevant to IPA. Participants: Purposeful snowball sampling recruited nine nurses.

Findings: The …

A Qualitative Study Of The Post-Treatment Experiences And Support Needs Of Survivors Of Lymphoma, Leanne Monterosso, Karen Taylor, Violet Platt, Elizabeth Lobb, Meinir Krishnasamy, Toni Musiello, Caroline Bulsara, David Joske

Nursing Papers and Journal Articles

Purpose: To explore the post-treatment experiences and preferences for follow-up support of lymphoma survivors.

Methods: Two focus groups were conducted with 17 participants to explore informational, psychological, emotional, social, practical and physical needs, 6-30 months post-treatment for lymphoma. Perceptions regarding a potential model of survivorship care were also elicited.

Results: Thematic content analysis revealed five key themes: Information; Loss and uncertainty; Family, support and post-treatment experience; Transition, connectivity and normalcy, and Person-centred posttreatment care. Participants described a sense of loss as they transitioned away from regular interaction with the hospital at the end of treatment, but also talked about the …

Selective Fusion Of Structural And Functional Data For Improved Glaucoma Detection, Paul Y. Kim, Khan M. Iftekharuddin, Pinakin G. Davey, Gabor Holló, Martha Tóth, Anita Garas, Edward A. Essock

Electrical & Computer Engineering Faculty Publications

This work proposes novel selective feature fusion of structural and functional data for improved glaucoma detection. The structural data such as retinal nerve fiber layer (RNFL) thickness measurement acquired by scanning laser polarimetry (SLP) is fused with the functional visual field (VF) measurement recorded from the standard automated perimetry (SAP) test. The proposed selective feature fusion exploits correspondence between structural and functional data obtained over multiple sectors. The correlation coefficients for corresponding structural-function sector pairs are used as weights in subsequent feature selection. The sectors are ranked according to the correlation coefficients and the first four highly ranked sectors are …

Heart Disease And African Americans, Patricia Guy-Walls, Jody Long

Research, Publications & Creative Work

Good health depends on multiple factors, including financial status. Higher socioeconomic status correlates with a lower risk of cancer, diabetes, and heart disease. Lukachko, Hatzenbuehler, and Keyes (2014) stated that the advantages of income status make a difference with health, specifically heart disease. Another significant factor affecting heart disease is health care disparity. Kahng (2010) found that the accumulative impact of health care disparities experienced over a lifetime contributes to chronic stress and heart-related problems.

Despite advancement in care, more African Americans, compared with other racial groups, die from cardiovascular disease (Centers for Disease Control and Prevention [CDC], 2016). Several …

The Effects Of Superordinate Identity Recategorization And Social Value Orientation On Ethical Decision-Making In A Business Dilemma, Thomas Steven Colville

Master's Theses

The purpose of the present study was to investigate potential solutions to the prevalence of unethical behavior in groups, specifically through the use of superordinate recategorization. Superordinate recategorization allows group members to feel an affinity with others not typically included in their in-group. This should promote ethical decision-making by enabling the inherent in-group favoring tendencies found in groups to be extended to a more inclusive category. In the context of the present study, the ethicality of participants' behavior in the Panalba scenario was determined by their choices on a 1 to 6 scale from least to most ethical. Additionally, participants’ …

Using Tcr Transgenic, Gp100 Reactive T Cells And Checkpoint Inhibition To Target Lymphangioleimyomatosis, Christian Ankney

Master's Theses

Lymphangioleiomyomatosis (LAM) is a low-grade neoplastic disease affecting primarily women. It is characterized by cystic lung disease as well as renal and retroperitoneal tumors called angiomyolipomas and lymphangiomas. Tumor cells have smooth muscle features as well as neuroendocrine cell surface markers, and the disease can be diagnosed by HMB45 staining of tumor cells. We questioned whether expression of melanocytic antigens, specifically gp100, creates an opportunity to treat LAM by adoptive T cell transfer. LAM lung lesions demonstrate poor immune surveillance, therefore adoptive T cell transfer could offer benefits in this disease.

A link was made between melanoma and depigmenting vitiligo …

Creating A Bret Assay To Monitor The Interaction Between Β-Arrestin-1 And Stam-1, James Buhrmaster

Master's Theses

CXCR4 is a chemokine receptor that is overexpressed in multiple disease states, including cancer. Understanding the mechanisms by which cells regulate CXCR4 expression is of high importance, as they can reveal downstream effectors that can potentially be targeted pharmacologically to more effectively treat diseases with fewer side effects.

CXCR4 is internalized in response to stimulation by its ligand CXCL12, and localizes to early endosomes as part of a homologous desensitization mechanism. From the endosome, CXCR4 can enter one of two pathways whereby it is either recycled back to the plasma membrane, where it can undergo another signaling event, or it …

The Unconventional Secretion Of Alpha-Synuclein By Autophagic Mechanisms And The Novel Characterization Of Pathological Alpha-Synuclein Associated Extracellular Vesicles, Kevin Burbidge

Master's Theses

Synucleinopathies are a group of neurodegenerative diseases associated with the intracellular accumulation of aggregated α-synuclein, a neurotoxic process resulting in cell death. Research indicates that pathology results from α-synuclein misfolding and self-propagation, as well as, cell-to-cell transmission. Furthermore, pathological α-synuclein transmission may occur through unconventional secretion.

In this thesis, we investigated how autophagy influences unconventional secretion of our novel α-synuclein dual-split protein model that we first verified by reproducing documented results from treatment of known autophagic regulators. Afterwards, we investigated how knocking out autophagic proteins ATG7 and Beclin-1 influenced α-synuclein secretion.

Additionally, we developed a methodology for analyzing extracellular vesicles …

Comparative Studies On Biochemical And Pharmacological Profiles Of Bovine, Ovine And Porcine Heparins, Ahmed Kouta

Master's Theses

Heparin, a highly sulfated glycosaminoglycan (GAG), is used extensively as an anticoagulant. It consists of repeating disaccharide units, containing iduronic acid (or glucuronic acid) and glucosamine, exhibiting variable degrees of sulfation. Heparin, and its analogues, are used during surgery and dialysis, and are often used to coat indwelling catheters and other devices where the vascular system is exposed. Administered parenterally, often continuously due to its short half-life, over 0.5 billion doses are required per year. Heparin is currently obtained from mucosal tissue of meat animals, mainly porcine intestine, and to a lesser extent bovine and ovine sources. The early stages …

Feasibility Of Antiretroviral Treatment Monitoring In The Era Of Decentralized Hiv Care: A Systematic Review, Minh D. Pham, Lorena Romero, Bruce Parnell, David A. Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings.

Methods: A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference …

High Resolution Melting: A Useful Field-Deployable Method To Measure Dhfr And Dhps Drug Resistance In Both Highly And Lowly Endemic Plasmodium Populations, Yaye Dié Ndiaye, Cyrille K. Diédhiou, Amy K. Bei, Baba Dieye, Aminata Mbaye, Nasserdine Papa Mze, Rachel F. Daniels, Ibrahima M. Ndiaye, Awa B. Déme, Amy Gaye, Mouhamad Sy, Tolla Ndiaye, Aida S. Badiane, Mouhamadou Ndiaye, Zul Premji, Dyann F. Wirth, Souleymane Mboup, Donald Krogstad, Sarah K. Volkman, Ambroise D. Ahouidi, Daouda Ndiaye

Pathology, East Africa

Background: Emergence and spread of drug resistance to every anti-malarial used to date, creates an urgent need for development of sensitive, specifc and feld-deployable molecular tools for detection and surveillance of validated drug resistance markers. Such tools would allow early detection of mutations in resistance loci. The aim of this study was to compare common population signatures and drug resistance marker frequencies between two populations with diferent levels of malaria endemicity and history of anti-malarial drug use: Tanzania and Sénégal. This was accomplished by implementing a high resolution melting assay to study molecular markers of drug resistance as compared to …

Reference Intervals For Thyroid Stimulating Hormone And Free Thyroxine Derived From Neonates Undergoing Routine Screening For Congenital Hypothyroidism At A University Teaching Hospital In Nairobi, Kenya: A Cross Sectional Study, Geoffrey Omuse, Ali Kassim, Francis Kiigu, Ra'ana Hussain, Mary Limbe

Pathology, East Africa

Background: In order to accurately interpret neonatal thyroid function tests (TFTs), it is necessary to have population specific reference intervals (RIs) as there is significant variation across different populations possibly due to genetic, environmental or analytical issues. Despite the importance of RIs, globally there are very few publications on RIs for neonatal TFTs primarily due to ethical and technical issues surrounding recruitment of neonates for a prospective study. To the best of our knowledge, this is the first report from Africa on neonatal RIs for TFTs.

Methods: We used hospital based data largely derived from neonates attending the wellness clinic …

Urolithiasis Analysis In A Multiethnic Population At A Tertiary Hospital In Nairobi, Kenya, Francis Kiigu, Alfred Hayombe, Daniel Maina

Pathology, East Africa

Background: Urolithiasis is a global problem whose incidence is reported to be on the rise across the world. Previously, urolithiasis was reported as being rare among the indigenous African population but recent data suggest otherwise. This study reviewed the demographic and clinical characteristics of patients with urolithiasis seen at the Aga Khan University hospital Nairobi (AKUHN) as well as the chemical composition of the stones and the modalities of therapy used.

Methods: This was a retrospective study which utilized patients’ clinical and laboratory records from 2013 to 2014. Sixty-seven symptomatic patients with confrmed urolithiasis formed the study. This study aimed …

Knowledge Of Polymath Walks, Talks, Makes Waves, Turns Into Deeds, Hamlet Isaxanli, Waqas Ahmed

Khazar Journal of Humanities and Social Sciences

In this interview, Hamlet Isaxanli shares his opinion on polymathy. What makes a polymath? Isaxanli stresses the importance of two factors: a person’s nature may lead him/her to an insatiable thirst for knowledge and the desire to explore different fields simultaneously. On the other hand, the education system encourages polymathy from the perspective of the richness and diversity of the high school curriculum. Isaxanli also goes into the relationship between math and poetry as well as the art-science-humanities connections. He then calls attention to Omar Khayyam, Nasr al-Din Tusi and some polymaths of the 20th century. Finally yet importantly, Isaxanli …

Effects Of Bidi Smoking On All-Cause Mortality And Cardiorespiratory Outcomes In Men From South Asia: An Observational Community-Based Substudy Of The Prospective Urban Rural Epidemiology Study (Pure), Mylinh Duong, Sumathy Rangarajan, Xiaohe Zhang, Kieran Killian, Prem Mony, Sumathi Swaminathan, Ankalmadagu Venkatsubbareddy Bharathi, Sanjeev Nair, Krishnapillai Vijayakumar, Indu Mohan, Romaina Iqbal, Khawar Kazmi

Community Health Sciences

Background: Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region.
Methods: This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh. Men aged 35–70 years completed spirometry testing and standardised questionnaires at baseline and were followed up yearly. We used multilevel regression to compare cross-sectional baseline cardiorespiratory symptoms, spirometry measurements, and follow-up events (all-cause mortality, cardiovascular events, respiratory events) …

Unintended Pregnancies Among Married Women In Sindh Pakistan: Role Of Lady Health Workers, Sumera Aziz Ali, Unaib Rabbani

Community Health Sciences

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.
Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women …

The Effect Of Breastfeeding On The Cognitive And Language Development Of Children Under 3 Years Of Age: Results Of Balochistan-Early Childhood Development Project, Meesha Iqbal Iqbal, Ghazala Rafique, Sumera Aziz Ali

Community Health Sciences

Background: Breastfeeding is known to be an important factor in the overall growth and development of children. Breastfeeding is thought to lead to enhance cognitive and language development of a child. However, this association has not yet been scientifically and statistically established. This study aimed to explore this association in children under 3 years of age.
Methods: This was a secondary data-analysis of the baseline data of “Balochistan – Early Childhood Development Project”. The final sample comprised of 604 children less than 3 years of age. The children were selected by three-stage stratified random sampling from three districts of Balochistan …

Can Right To Health Help Policy Makers To Address Maternal Mortality?: A Short Communication, Sumera Aziz Ali, Nadir Suhail, Savera Aziz Ali

Community Health Sciences

No abstract provided.

Long Term Survival Rate Of Tavr With And Without Dialysis., Taryn Samet Md, Sydney Pickering, Timothy S. Misselbeck, Raymond L. Singer Md, Mmm, James K. Wu Md

Department of Surgery

No abstract provided.

The Meaning Of Giving Birth: Voices Of Hmong Women Living In Vietnam, Cheryl A. Corbett, Lynn Clark Callister, Jamie Peterson Gettys, Jacob R. Hickman

Faculty Publications

Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives of birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical wold as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, …