Medicine and Health Sciences Commons^™

Developing And Implementing A Quality Assurance Strategy For Electroconvulsive Therapy, Jessa Hollingsworth

Theses and Dissertations

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care, however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed …

Environmental Relationships And Predator-Prey Interactions Within The Snapper-Grouper Complex In The Southeastern U.S. Atlantic – Implications For Fisheries Management, Dawn M. Glasgow

Theses and Dissertations

Stock assessments indicate many valuable fish species are declining, or are considered overfished and/or are undergoing overfishing. Fisheries scientists and managers in the southeastern U.S. typically have utilized a single-species approach, and relied on catch per unit effort data derived from fishery-independent surveys to determine indices of abundance for economically important reef fish. However, catchability for these surveys vary for many reasons including environmental and predator-prey relationships. This research was developed to elucidate environmental influences on reef fish assemblages and distribution of reef-associated marine predators, and examine predator-prey dynamics that may influence relative abundance of large predators based on chevron …

The Role Of Inflammation In Atherosclerosis, Fatma Saaoud

Theses and Dissertations

Atherosclerosis is both a chronic inflammatory disease and lipid deposition disorder characterized by accumulation of lipids, fibrous tissue, and inflammatory cells in the arterial wall. Thus, investigating the role of inflammation and the immune system in the progression of atherosclerosis may help in the development of novel therapeutics for atherosclerotic disease. Current atherosclerosis therapy is aimed at lipid targets and focused primarily on reducing plasma cholesterol levels. Clinical and experimental data support the critical role of inflammation in atherosclerosis and suggest that reducing inflammation even without affecting lipid levels may reduce the event rate of cardiovascular disease. Yet, no pure …

Involvement Of Men In Responsible Parenthood In Croatia, India, And Mexico: Major Factors, Correlates, And National Policy, Salima Kasymova

Theses and Dissertations

For this research I explored the association between men's gender attitudes and their endorsement of paternity leave policies as a way to begin to understand the determinants of men’s support of paternity leave policies. In addition, in order to understand factors that influencing paternal involvement, I examined the association between men’s gender attitudes and their actual involvement in caregiving among a sub-sample of fathers. I also explored whether men's leave-taking when their child was born mediated the association between their gender attitudes and involvement in child care. Considering the importance of national policy documents for promotion men’s participation in childcare, …

Applications Of Multimedia Resources Developed As Part Of The Virtual Cell Animation Collection In Undergraduate Introductory Biology, Eric Edward Goff

Theses and Dissertations

Calls for reform in undergraduate STEM education have arisen from an increased need for well-trained biology graduates in the future scientific workforce. To address this need, many institutions have focused on a pedagogical restructuring of instructional practices to promote deeper conceptual understanding of core biological concepts. This study investigates the implementation of multimedia resources as a possible reliable supplement to undergraduate introductory biology and aims to provide empirical evidence on the instructional best practices of their use. As a central part of this study, we focus on one specific multimedia package, the Virtual Cell Animation Collection, due to its developmental …

Analysis Of Food Exposures In Foodborne Disease Outbreaks, Alecia T. Alianell

Theses and Dissertations

Foodborne illness remains a serious public health problem in the United States in general as well as South Carolina in particular. Obtaining good food ingestion histories as well as possible risky environmental exposures is one of the earliest, most important tasks to complete in any foodborne outbreak investigations. Because time is of the essence in investigations, we have evaluated a rarely used biostatistical method, Random Forests, to data obtained from DHEC. Random Forests has the potential to facilitate more rapid identification of foods or environmental exposures that may be associated with outbreaks. We also examined previous cases of salmonellosis using …

Adoptees’ Experiences With Direct-To-Consumer Genetic Testing: Emotions, Satisfaction, And Motivating Factors, Anna Childers

Theses and Dissertations

Public awareness of the role of genetics in disease continues to expand along with the use of direct-to-consumer genetic testing (DTC-GT). One subset of customers taking advantage of the growing DTC-GT market is adoptees. Prior research has shown that adoptees appear to be more motivated than non-adoptees to learn about their genetic disease risk but have similar responses to health-related information acquired through DTC-GT. In this exploratory qualitative study, fourteen adoptees were asked about their motivations for pursuing DTC-GT; satisfaction with results; emotions throughout the process; and interest in meeting with a genetic counselor. Motivations for pursuing DTCGT fell into …

Mast Cells And Lipid Cross-Talk In Skin Inflammation, Piper Alexandra Wedman

Theses and Dissertations

Atopic dermatitis (AD) is an inflammatory skin disease whose pathogenic mechanisms remain unclear. Using a validated human AD-like mouse model, we observed that skin remodeling started at a pre-symptomatic stage of AD that included cellular infiltration of the hypodermis, accompanied with activated/degranulated mast cells (MC). Local MC activation was quantified using a novel method of computer-assisted image analysis we developed and reported. Using a variation of this method, we defined morphometric parameters allowing for quantitation rather than scoring of cellular infiltration. Cell recruitment correlated with MC activation, chemokine production and increased levels of sphingolipid sphingosine-1-phosphate (S1P), produced by sphingosine kinase-1 …

Tuberculosis Screening In New Healthcare Employees: A Comparison Of Quantiferon®-Tb Gold In-Tube Test And Tuberculin Skin Test, Mary C. Giovannetti

Theses and Dissertations

Background: Streamlining onboarding processes for new hires to maximize efficiency and reduce costs while meeting regulatory requirements is a constant challenge for healthcare systems’ Employee Health staff. Health screening is a required step and includes obtaining a detailed health history, tuberculosis screening, drug screens, immunizations, fit for duty examinations, obtaining medical records, clarification of disability accommodations, pre-work screens, and other tests which are time consuming and result in delays in hire dates. Faced with a high volume of potential new employee hires a major southeast healthcare system was concerned about delays in new hire start dates. The two-step tuberculin skin …

Scribes Impact On Patient And Provider Experience In The Outpatient Setting, Kimberly A. Taylor

Theses and Dissertations

The purpose of this project was to evaluate the effectiveness of using scribes in the outpatient setting on patient and provider experience. A mixed methods approach with a convenience sample of voluntary patient participants scheduled for an outpatient appointment was utilized. Two primary care physicians volunteered to receive scribes. Four hospital corpsmen were selected and trained to serve in the scribe role.

This quality improvement project evaluated two aspects of experience during the implementation of the scribes. These included: 1) patient experience as indicated via a pre and post implementation questionnaire; and 2) provider experience as indicated via a pre …

Unavoidable Pressure Ulcers: An Ethnonursing Study, Catherine M. Clarey-Sanford

Dissertations

Catherine M. Clarey-Sanford

Loyola University Chicago

UNAVOIDABLE PRESSURE ULCER: AN ETHNONURSING STUDY

In an effort to improve patient safety and the quality of care in the acute care setting, there has been an increased focus on the prevention of adverse events believed to be avoidable. Hospital-acquired pressure ulcers (HAPU) have been listed as one of those adverse events, and hospitals are no longer reimbursed for related costs. However, there are patient conditions and clinical situations in which a pressure ulcer can be deemed unavoidable. In acute care, unavoidable means that the patient developed a pressure ulcer even though the provider …

Investigating Novel Methods Of Interaction With Pharmaceutically Relevant Enzymes, Cory T. Reidl

Dissertations

Metalloproteins requiring one or more metal ions for normal function make up 30% of all known proteins, and many critical biological pathways contain at least one metallo-enzyme. Di-nuclear metallo-proteins constitute a large class of these proteins yet we currently lack effective methods of inhibiting these enzymes for the development of new medical therapies, particularly for the discovery of new antibiotics. Our work has focused on developing novel functionalities that selectively interact with di-nuclear catalytic centers, and we are targeting three separate di-zinc-metallo-enzymes that are unique to bacteria and play key roles in their growth and development. These enzymes are DapE, …

Simulation Using A Standardized Patient To Measure Perception And Congruency Of Spiritual Care For A Veteran From Three Perspectives To Inform Nursing Education And Practice, Mary E. Desmond

Dissertations

Spiritual care refers to a purposeful process of helping another find meaning and purpose

in life through a mutual connection. Providing spiritual care is a professional nursing mandate, yet nurses report barriers in education and practice. Veterans want spiritual care to promote quality of life, and to cope with military experiences and chronic conditions. Patients report receiving less than desired spiritual care and nurses report infrequent provision of spiritual care. It is also unclear how congruent patients and nurses are in their perceptions of spiritual care. A spiritual care simulation and performance checklist was developed using a review of the …

Elevated Hydrostatic Pressure Selectively Enhances Matricellular Gene Expression In Human Trabecular Meshwork Cells, Jonathan Lautz

Dissertations

Primary open-angle glaucoma (POAG) is a progressive optic neuropathy

characterized by loss of peripheral vision secondarily associated with elevated intraocular pressure (IOP). Transforming growth factor (TGF)-β2 is markedly elevated in the aqueous humor (AH) of patients with POAG. It has been previously shown that TGF-β2 increases IOP, in part, by inducing expression and release of endothelin-1 (ET-1) and connective tissue growth factor (CTGF) within the trabecular meshwork (TM). ET-1 and CTGF may ultimately lead to increases in IOP by enhancing TM cell contractility and extracellular matrix (ECM) deposition. Here we confirm that TGF-β2 enhances mRNA content of ET-1, CTGF, and …

What Is The Relationship Between Vitamin D Status, Pregnancy Symptoms And Quality Of Life?, Jennifer Woo

Dissertations

Purpose and Background/Significance: The main purpose of the study is to determine: (1) to determine if there is a relationship between vitamin D status, pregnancy symptoms, health promoting behaviors, and quality of life and (2) to determine if differences exist in pregnancy symptoms, health promoting behaviors and quality of life between African American and Hispanic women. There is evidence to show that vitamin D deficiency has been associated with numerous symptoms such as musculoskeletal pain, poor sleep, and depression. However, whether low levels of vitamin D is associated with these and other symptoms during pregnancy is unknown. What is known …

A Potential Tool For Clinicians; Evaluating A Computer-Led Dietary Assessment Method In Overweight And Obese Women During Weight Loss, Adrianne Widaman, Nancy Keim, Dustin Burnett, Beverly Miller, Megan Witbracht, Keith Widaman, Kevin Laugero

Faculty Publications

Many Americans are attempting to lose weight with the help of healthcare professionals. Clinicians can improve weight loss results by using technology. Accurate dietary assessment is crucial to effective weight loss. The aim of this study was to validate a computer-led dietary assessment method in overweight/obese women. Known dietary intake was compared to Automated Self-Administered 24-h recall (ASA24) reported intake in women (n = 45), 19–50 years, with body mass index of 27–39.9 kg/m2. Participants received nutrition education and reduced body weight by 4%–10%. Participants completed one unannounced dietary recall and their responses were compared to actual intake. Accuracy of …

Die Genveränderung Von Embryonen Bürdet Kindern Eine Unzumutbare Last Auf, Hille Haker

Theology: Faculty Publications and Other Works

Die Forschung an menschlichen Embryonen unterliegt in den meisten Staaten einer besonderen Kontrolle, die auch in den bestehenden internationalen Rechtsinstrumenten festgelegt ist. Angesichts der nun möglichen Keimbahnveränderungen durch das sogenannte «Gene Editing» oder «Genome Editing» ist eine öffentliche Diskussion aber nicht nur dringend notwendig, sondern überfällig. Die Wissenschaftsethik muss dabei eine grössere Rolle spielen, als dies derzeit der Fall ist. Meine Überlegungen in diesem Artikel betreffen ausschliesslich die reproduktive Anwendung, die ich einer ethischen Analyse unterziehe. Darüber hinaus steht jedoch eine Diskussion auch zu den anderen Anwendungsfeldern aus, so etwa zur Embryonenforschung insgesamt und zur embryonalen Stammzellforschung, zum Einsatz des …

Obese Children With Metabolic Syndrome Have 3 Times Higher Risk To Have Nonalcoholic Fatty Liver Disease Compared With Those Without Metabolic Syndrome, Dimitrios Papandreou, Mirey Karavetian, Zacharoula Karabouta, Eleni Andreou

All Works

Copyright © 2017 Dimitrios Papandreou et al. Background: The aim of this study was to investigate the relationship between metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in obese children. One hundred and twenty-five subjects aged 11-12 years old participated in the study. Methods: Anthropometric and biochemical indices were measured, including lipid and liver profile, blood glucose, serum insulin, and liver ultrasound. Results: Forty-four children (58.6%) were found to have MS. Insulin resistance was present in 78 (62.4%) children. Patients with MS were more likely to have NAFLD (P <; 0.001). Children with NAFLD had significantly higher body mass index, waist circumference, triglycerides, fasting insulin, and lower high-density lipoprotein compared to patients with normal livers (P < 0.001). Insulin resistance was significantly higher in children with NAFLD (P <; 0.001). Obese children presenting with MS were 3.01 (2.87-3.57, P < 0.002) times more likely to develop NAFLD compared to those without metabolic syndrome after adjustment of cofounders. Conclusions: Obese children with MS have a higher risk of developing NAFLD. Weight management and early prevention should be the first line of treatment to prevent any possible health issues later on.

Impact Of Atmospheric Pressure Nonequilibrium Plasma Discharge On Polymer Surface Metrology, Laurence Scally, James Lalor, Patrick J. Cullen, Vladimir Milosavljevic

Articles

Due to the attraction of plasma technologies as a clean and efficient means of surface modification, significant research has gone into the physical and chemical aspects of polymer functionalization. In this study, it was shown that the use of an atmospheric plasma jet can efficiently modify the surface of polyethylene terephthalate samples and change their hydrophobic properties to more hydrophilic characteristics. The dependence on the changes with respect to time, distance, and atomic oxygen (O I) intensity were considered as factors. It was found that with closer proximity to the plasma source (without causing thermal degradation) and with increasing levels …

Evaluation Of Chemical Immersion Treatments To Reduce Microbial Populations In Fresh Beef, Ahmed Kassem, Joseph Meade, James Gibbons, Kevina Mcgill, Ciara Walsh, James Lyng, Paul Whyte

Articles

The aim of the current study was to assess the ability of a number of chemicals (acetic Acid (AA), citric acid (CA) lactic acid (LA), sodium decanoate (SD) and trisodium phosphate (TSP)) to reduce microbial populations (total viable count, Campylobacter jejuni, Escherichia coli, Salmonella typhimurium and Listeria monocytogenes) on raw beef using an immersion system. The following concentrations of each chemical were used: 3 & 5% for AA, CA, LA, SD and 10 & 12% for TSP. Possible synergistic effects of using combinations of two chemicals sequentially (LA +CA and LA +AA) were also investigated. L*, a* and b* values …

Relationship Of Religiosity And Spirituality To Hazardous Drinking, Drug Use, And Depression Among Sexual Minority Women, Laurie Drabble, Cindy Veldhuis, Barth Riley, Sharon Rostosky, Tonda Hughes

Faculty Publications

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. …

Situation Awareness, Sociotechnical Systems, And Automation In Emergency Medical Services: Theory And Measurement, David Schuster, Dan Nathan-Roberts

Faculty Publications

No abstract provided.

Characteristics Of Hiv-Infected Children At Enrollment Into Care And At Antiretroviral Therapy Initiation In Central Africa, A Adedimeji, A Edmonds, Donald R. Hoover, Qiuhu Shi, J Sinayobye, M Nduwimana, P Lelo, D Nash, K Anastos, M Yotebieng

NYMC Faculty Publications

BACKGROUND: Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described. MATERIALS AND METHODS: Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0-15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and …

Cancer Risk In Waterpipe Smokers: A Meta-Analysis, Ravinder Mamtani, Sohaila Cheema, J Sheikh, A Al Mulla, Albert Lowenfels, P Maisonneuve

NYMC Faculty Publications

OBJECTIVES: To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder. METHODS: We performed a systematic literature search to identify relevant studies, scored their quality, used fixed and random-effect models to estimate summary relative risks (SRR), evaluated heterogeneity and publication bias. RESULTS: We retrieved information from 28 published reports. Considering only highquality studies, waterpipe smoking was associated with increased risk of head and neck cancer (SRR 2.97; 95 % CI 2.26-3.90), esophageal cancer (1.84; 1.42-2.38) and lung cancer (2.22; 1.24-3.97), with no evidence of heterogeneity or publication …

Clinical Consultations And Investigations Before And After Discontinuation Of Endocrine Therapy In Women With Primary Breast Cancer, Derrick Lopez, Anna Kemp-Casey, Christobel Saunders, Elizabeth Roughead, Frances Boyle, Max Bulsara, David Preen

Health Sciences Papers and Journal Articles

Objective: Although clinical trials recommend that women with hormone-dependent primary breast cancer remain on endocrine therapy for at least 5 years, up to 60% discontinue treatment early. We determined whether these women had consulted with clinicians or had investigations for cancer recurrence or metastasis around the time they discontinued endocrine therapy, and whether clinical contact continued after discontinuation.

Methods: We performed case-control and cohort studies of women from the 45 and Up Study who were diagnosed with invasive primary breast cancer between January 2003 and December 2008, and who had ≥12 months of anastrozole, exemestane, letrozole or tamoxifen subsequently dispensed. …

Health Economics Of Targeted Intraoperative Radiotherapy (Targit-Iort) For Early Breast Cancer: A Cost-Effectiveness Analysis In The United Kingdom, Anil Vaidya, Param Vaidya, Brigitte Both, Chris Brew-Graves, Max Bulsara, Jayant S. Vaidya

Health Sciences Papers and Journal Articles

Objective: The clinical effectiveness of targeted intraoperative radiotherapy (TARGIT-IORT) has been confirmed in the randomised TARGIT-A (targeted intraoperative radiotherapy-alone) trial to be similar to a several weeks’ course of whole-breast external-beam radiation therapy (EBRT) in patients with early breast cancer. This study aims to determine the cost effectiveness of TARGIT-IORT to inform policy decisions about its wider implementation. Setting TARGIT-A randomised clinical trial (ISRCTN34086741) which compared TARGIT with traditional EBRT and found similar breast cancer control, particularly when TARGIT was given simultaneously with lumpectomy.

Methods: Cost-utility analysis using decision analytic modelling by a Markov model. A cost-effectiveness Markov model was …

The Most Important "Factor" In Producing Clubhead Speed In Golf, C Joyce

Health Sciences Papers and Journal Articles

Substantial experiential research into x-factor, and to a lesser extent crunch-factor has been undertaken with the aim of increasing clubhead speed. However, a direct comparison of the golf swing kinematics associated with each ‘factor’ has not, and possible differences when using a driver compared to an iron. Fifteen low handicap male golfers who displayed a modern swing had their golf swing kinematic data measured when hitting their own driver and five-iron, using a 10-camera motion analysis system operating at 250 Hz. Clubhead speed was collected using a validated launch monitor. No between-club differences in x-factor and crunch-factor existed. Correlation analyses …

Neuromuscular Training Improves Lower Extremity Biomechanics Associated With Knee Injury During Landing In 11-13 Year Old Female Netball Athletes, A Hopper, E Haff, C Joyce, R Lloyd, G Haff

Health Sciences Papers and Journal Articles

The purpose of this study was to examine the effects of a neuromuscular training (NMT) program on lower-extremity biomechanics in youth female netball athletes. The hypothesis was that significant improvements would be found in landing biomechanics of the lower-extremities, commonly associated with anterior cruciate ligament (ACL) injury, following NMT. Twenty-three athletes (age = 12.2 ± 0.9 years; height = 1.63 ± 0.08m; mass = 51.8 ± 8.5 kg) completed two testing sessions separated by 7-weeks and were randomly assigned to either a experimental or control group. Thirteen athletes underwent 6-weeks of NMT, while the remaining 10 served as controls and …

Tumour-Infiltrating Regulatory T Cell Density Before Neoadjuvant Chemoradiotherapy For Rectal Cancer Does Not Predict Treatment Response, Melanie J. Mccoy, Chris Hemmings, Chidozie C. Anyaegbu, Stephanie J. Austin, Tracey F. Lee-Pullen, Timothy J. Miller, Max K. Bulsara, Nikolajs Zeps, Anna K. Nowak, Richard A. Lake, Cameron F. Platell

Health Sciences Papers and Journal Articles

Neoadjuvant (preoperative) chemoradiotherapy (CRT) decreases the risk of rectal cancer recurrence and reduces tumour volume prior to surgery. However, response to CRT varies considerably between individuals and factors associated with response are poorly understood. Foxp3+ regulatory T cells (Tregs) inhibit anti-tumour immunity and may limit any response to chemotherapy and radiotherapy. We have previously reported that a low density of Tregs in the tumour stroma following neoadjuvant CRT for rectal cancer is associated with improved tumour regression. Here we have examined the association between Treg density in pre-treatment diagnostic biopsy specimens and treatment response, in this same patient cohort. We …

Life Care Planning In A Country With For-Profit Medicine, Rigel Macarena Pinon, Irmo Marini

School of Rehabilitation Services & Counseling Faculty Publications

No abstract provided.