Medicine and Health Sciences Commons^™

Impact Of Baseline Magnetic Resonance Imaging On Neurologic, Functional, And Safety Outcomes In Patients With Acute Traumatic Spinal Cord Injury, Shekar N. Kurpad, Allan R. Martin, Lindsay A. Tetreault, Dena J. Fischer, Andrea C. Skelly, David J. Mikulis, Adam E. Flanders, Bizhan Aarabi, Thomas E. Mroz, Eve Tsai, Michael G. Fehlings

Department of Radiology Faculty Papers

Study Design: Systematic review. Objective: To perform a systematic review to evaluate the utility of magnetic resonance imaging (MRI) in patients with acute spinal cord injury (SCI). Methods: An electronic search of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar was conducted for literature published through May 12, 2015, to answer key questions associated with the use of MRI in patients with acute SCI. Results: The literature search yielded 796 potentially relevant citations, 8 of which were included in this review. One study used MRI in a protocol to decide on early surgical decompression. The MRI-protocol group showed improved …

Acute Effects Of Plyometric And Resistance Training On Running Economy In Trained Runners, Richard T. Marcello, Beau K. Greer, Anna E. Greer

All PTHMS Faculty Publications

Results regarding the acute effects of plyometric and resistance training (PRT) on running economy (RE) are conflicting. Eight male collegiate distance runners (21 +/- 1 years, 62.5 +/- 7.8 ml/kg/min V[Combining Dot Above]O2 peak) completed V[Combining Dot Above]O2 peak and 1 repetition maximum (1RM) testing. Seven days later, subjects completed a 12 minute RE test at 60% and 80% V[Combining Dot Above]O2 peak, followed by a PRT protocol or a rested condition of equal duration (CON). The PRT protocol consisted of 3 sets of 5 repetitions at 85% 1RM for barbell squats, Romanian deadlifts, and barbell lunges; the same volume …

Clustered And Distinct: A Taxonomy Of Local Multihospital Systems, Patrick D. Shay, Stephen S. Farnsworth Mick

Health Care Administration Faculty Research

Despite their prevalence and power in markets throughout the United States, local multihospital systems (LMSs)—also referred to as hospital-based “clusters”—remain an understudied organizational form, with studies instead primarily focusing either upon individual hospitals or viewing hospital systems collectively without distinguishing the local “sub-systems” that comprise larger regional or national hospital chains. To better understand these organizational forms, we develop a taxonomy specifically devoted to LMSs, applying taxonomic analysis methods to a sample of LMSs in six U.S. states while accounting for LMSs’ geographic arrangements and non-hospital-based service locations. Our analysis identifies five distinct LMS categories, with forms clearly distinguished according …

Efficacy And Safety Of Methylprednisolone Sodium Succinate In Acute Spinal Cord Injury: A Systematic Review, Michael G. Fehlings, Jefferson R. Wilson, James S. Harrop, Brian Kwon, Lindsay A. Tetreault, Paul M. Arnold, Jeffrey M. Singh, Gregory W.J. Hawryluk, Joseph R. Dettori

Department of Neurosurgery Faculty Papers

Study Design: Systematic review and meta-analysis. Objective: The objective of this study was to conduct a systematic review to assess the comparative effectiveness and safety of high-dose methylprednisolone sodium succinate (MPSS) versus no pharmacological treatment in patients with traumatic spinal cord injury (SCI). Methods: A systematic search was performed in PubMed and the Cochrane Collaboration Library for literature published between January 1956 and June 17, 2015. Included studies were critically appraised, and Grades of Recommendation Assessment, Development and Evaluation methods were used to determine the overall quality of evidence for primary outcomes. Previous systematic reviews on this topic were collated …

A Clinical Practice Guideline For The Management Of Acute Spinal Cord Injury: Introduction, Rationale, And Scope, Michael G. Fehlings, Lindsay A. Tetreault, Jefferson R. Wilson, Brian K. Kwon, Anthony S. Burns, Allan R. Martin, Gregory Hawryluk, James S. Harrop

Department of Neurosurgery Faculty Papers

Acute spinal cord injury (SCI) is a traumatic event that results in disturbances to normal sensory, motor, or autonomic function and ultimately affects a patient’s physical, psychological, and social well-being. The management of patients with SCI has drastically evolved over the past century as a result of increasing knowledge on injury mechanisms, disease pathophysiology, and the role of surgery. There still, however, remain controversial areas surrounding available management strategies for the treatment of SCI, including the use of corticosteroids such as methylprednisolone sodium succinate, the optimal timing of surgical intervention, the type and timing of anticoagulation prophylaxis, the role of …

Timing Of Decompression In Patients With Acute Spinal Cord Injury: A Systematic Review, Jefferson R. Wilson, Lindsay A. Tetreault, Brian Kwon, Paul M. Arnold, Thomas E. Mroz, Christopher I. Shaffrey, James S. Harrop, Jens R. Chapman, Steven Casha, Andrea C. Skelly, Haley K. Holmer, Erika D. Brodt, Michael G. Fehlings

Department of Neurosurgery Faculty Papers

Study Design: Systematic review. Objective: To conduct a systematic review and synthesis of the literature to assess the comparative effectiveness, safety, and cost-effectiveness of early (≤24 hours) versus late decompression (>24 hours) in adults with acute spinal cord injury (SCI). Methods: A systematic search was conducted of Medline, EMBASE, the Cochrane Collaboration Library, and Google Scholar to identify studies published through November 6, 2014. Studies published in any language, in humans, and with an abstract were considered for inclusion. Included studies were critically appraised and the overall strength of evidence was determined using methods proposed by the Grading of …

Intracranial Eeg Fluctuates Over Months After Implanting Electrodes In Human Brain., Hoameng Ung, Steven N. Baldassano, Hank Bink, Abba M. Krieger, Shawniqua Williams, Flavia Vitale, Chengyuan Wu, Dean Freestone, Ewan Nurse, Kent Leyde, Kathryn A. Davis, Mark Cook, Brian Litt

Department of Neurosurgery Faculty Papers

OBJECTIVE: Implanting subdural and penetrating electrodes in the brain causes acute trauma and inflammation that affect intracranial electroencephalographic (iEEG) recordings. This behavior and its potential impact on clinical decision-making and algorithms for implanted devices have not been assessed in detail. In this study we aim to characterize the temporal and spatial variability of continuous, prolonged human iEEG recordings.

APPROACH: Intracranial electroencephalography from 15 patients with drug-refractory epilepsy, each implanted with 16 subdural electrodes and continuously monitored for an average of 18 months, was included in this study. Time and spectral domain features were computed each day for each channel for …

Bilateral Retinal Problem In A Patient With Alport Syndrome., Sundeep K. Kasi, Murtaza K Adam, David S Ehmann

Wills Eye Hospital Papers

No abstract provided.

Pediatric Nurses' Perspectives On Medication Teaching In A Children's Hospital, Cori A. Gibson, Ashley Stelter, Kristin Haglund, Stacee M. Lerret

College of Nursing Faculty Research and Publications

Purpose

To explore inpatient pediatric nurses' current experiences and perspectives on medication teaching.

Design and Methods

A descriptive qualitative study was conducted at a Midwest pediatric hospital. Using convenience sampling, 26 nurses participated in six focus groups. Data were analyzed in an iterative group coding process.

Results

Three themes emerged. 1) Medication teaching is an opportunity. 2) Medication teaching is challenging. Nurses experienced structural and process challenges to deliver medication teaching. Structural challenges included the physical hospital environment, electronic health record, and institutional discharge workflow while process challenges included knowledge, relationships and interactions with caregivers, and available resources. 3) Medication …

The Impact Of Simulation Sequencing On Perceived Clinical Decision Making, Aimee A. Woda, Jamie Hansen, Mary Paquette, Robert V. Topp

College of Nursing Faculty Research and Publications

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences.

A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, …

Physical Activity, Functional Ability, And Obesity In Older Adults: A Gender Difference, Kimberlee A. Gretebeck, Leann M. Sabatini, David R. Black, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Disability, institutionalization, and loss of independence may be directly caused or exacerbated by physical inactivity and obesity. The purpose of the current cross-sectional survey was to explore the impact of gender and obesity on functional ability tasks, physical activity, and psychosocial factors in older adults. Participants comprised 964 University retirees (55% female, mean age = 75.3 years, SD = 6.7 years) with a mean body mass index (BMI) of 26.1 kg/m² (SD = 4.7 kg/m²). Results revealed significant gender and BMI interaction effects. Women were less active than men and obese women were most functionally impaired, …

A Minimal Contact Diet And Physical Activity Intervention For White-Collar Workers, Kimberlee A. Gretebeck, Tatiana Bailey, Randall J. Gretebeck

College of Nursing Faculty Research and Publications

Minimal contact lifestyle interventions with multiple components coupled with health screening have the potential to improve worker health. The purpose of this study was to test a minimal contact multiple component lifestyle diet and exercise intervention. The multiple components that were included in this project included a worksite health screening, brief counseling session, emailed newsletter, and a pedometer. In response to the intervention, participants reported an increase in green salad, fruit, and vegetable consumption as well as an increase in self-efficacy for consuming three servings of fruits and vegetables a day. Study participants also demonstrated a significant increase in physical …

Debrief In Emergency Departments To Improve Compassion Fatigue And Promote Resiliency, Kristin Haglund, Madeline Schmidt

College of Nursing Faculty Research and Publications

The purpose of this case study was to describe compassion fatigue using one nurse's experience as an example and to present the process of Personal Reflective Debrief as an intervention to prevent compassion fatigue in emergency department (ED) nurses. Debriefing after adverse outcomes using a structured model has been used in health care as a nonthreatening and relatively low-cost way to discuss unanticipated outcomes, identify opportunities for improvement, and heal as a group. There are many methods of debrief tailored to specific timing around events, specific populations of health care workers, and amount of time for debriefing. Debrief with personal …

Efficacy And Safety Of Abatacept, A T-Cell Modulator, In A Randomised, Double-Blind, Placebo-Controlled, Phase Iii Study In Psoriatic Arthritis, Philip Mease, Alice Gottlieb, D Van Der Heijde, O Fitzgerald, A Johnsen, M Nys, S Banerjee, D Gladman

NYMC Faculty Publications

OBJECTIVES: To assess the efficacy and safety of abatacept, a selective T-cell costimulation modulator, in a phase III study in psoriatic arthritis (PsA). METHODS: This study randomised patients (1:1) with active PsA (~60% with prior exposure to a tumour necrosis factor inhibitor) to blinded weekly subcutaneous abatacept 125 mg (n=213) or placebo (n=211) for 24 weeks, followed by open-label subcutaneous abatacept. Patients without >/=20% improvement in joint counts at week 16 were switched to open-label abatacept. The primary end point was the proportion of patients with >/=20% improvement in the American College of Rheumatology (ACR20) criteria at week 24. RESULTS: …

The Role Of Efferent Reduction Of Cochlear Compression In The Detection Of Tones In Noise, Shaum Bhagat, Anusha Yellamsetty

Faculty Publications

Stimulation of medial olivocochlear (MOC) efferent neurons reduces basilar membrane (BM) sensitivity and increases the slope of BM input-output (I/O) functions in animal models. Decreased compression of I/O functions associated with activation of MOC efferent neurons may assist in extending the neural response to the tone above that of noise, leading to an improvement in masked thresholds. To evaluate this hypothesis, the distortion-product otoacoustic emission (DPOAE) I/O function, a proxy measure of BM compression, was examined in conditions with presentation of contralateral noise. DPOAE I/O functions were measured at f2 frequencies of 1000 and 2000 Hz in 16 normal-hearing adults. …

Sex Specific Analysis Of The Vulnerable Elders Survey As A Predictor Of Falls., Rebecca Brown Md, Marna R. Greenberg Do, Mph, Facep, Bryan G. Kane Md, Robert D. Barraco Md, Mph, Jeanne L. Jacoby Md

Department of Emergency Medicine

No abstract provided.

No Sex-Specific Differences In Preference Of Management Options To Prevent Elderly Falls, Marna R. Greenberg Do, Mph, Facep, Jeanne L. Jacoby Md, Robert D. Barraco Md, Mph, Bernadette Glenn-Porter Bs, Kyle Durics Bs, Ryan Day Md, Victoria Goodheart Do, Danielle Mills Md, Alexander Youngdahl Do, Bryan G. Kane Md

Department of Emergency Medicine

No abstract provided.

Effects Of Bomb Blast Injury On The Ears: The Aga Khan University Hospital Experience, Talha Ahmed Qureshi,, Mohammad Sohail Awan, Nabeel Hamayun Hassan, Agha Hussain Aftab, Syed Adnan Ali

Section of Otolaryngology, Head & Neck Surgery

Abstract Objective: To evaluate the frequency and effects of blast-related otologic injuries. Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised charts of patients who were victims of bomb explosions between January 2011 and July 2013. Frequency and percentages were reported using cross tabulation with size of bomb, distance of person from blast and the presence of victim in open or closed space. Association of associated variables were also analysed. Results: Of the 100 patients, 81(81%) were men and 19(19%) were women. Besides, 68(68%) patients were aged <30 years. Also, 78(78%) subjects were exposed to < 80kg of explosives and 68(68%) were at a distance of>10m. Furthermore, 61(61%) patients were exposed to …

Clinical Evaluation Of Xylazine, Lidocaine And Ketamine Intravenous Infusion To Reduce Isoflurane Requirement In Thai Native Cross-Bred Ponies, Juthamas Leklub, Aree Laikul, Kanittha Phetudomsinsuk

The Thai Journal of Veterinary Medicine

Balanced anesthesia in equine could reduce anesthetic-related fatalities. Sedative, anesthetic and analgesic agents currently available in Thailand such as xylazine, ketamine, isoflurane and lidocaine are extensively used in equine practice, but their combination has not been reported. The present study aimed to determine the minimum alveolar concentration (MAC) of isoflurane and clinical parameters in Thai native cross-bred ponies under general anesthesia. Six Thai native cross-bred ponies were examined by a random crossover method. They were categorized into 4 groups according to the maintenance of anesthesia which were isoflurane group (I), isoflurane and lidocaine group (IL), isoflurane, xylazine and ketamine group …

Effects Of Dexmedetomidine On Plasma Glucose, Cortisol And Adrenocorticotropic Hormone Concentrations Of Canine Undergoing Ovariohysterectomy, Lin Li, Jing Dong, Xiujing Fen, Bei Li, Yongping Chen, Jicheng Sha, Honggang Fan

The Thai Journal of Veterinary Medicine

To study the effect of dexmedetomidine on plasma glucose, cortisol and adrenocorticotropic hormone concentrations in canine undergoing ovariohysterectomy, 24 beagles were divided into 3 groups randomly. Group A was intramuscularly injected with 2 ml of saline 10 min after surgery. Group B was intramuscularly injected with 20 μg/kg of dexmedetomidine 10 min before surgery. Group C was intramuscularly injected with 20 μg/kg of dexmedetomidine 10 min after surgery. Two milliliters of blood was collected at 3 h, on the second day and on the third day after surgery. Plasma glucose, cortisol and adrenocorticotropic hormone concentrations were measured. The study showed …

Group A Rotavirus And Mycobacterium Avium Subspecies Paratuberculosis Associated With Diarrhea In Dromedary Camels In Eastern Province, Saudi Arabia, Ibrahim M. El-Sabagh, Ahmed M. Al-Ali, Abdelmohsen A. Al-Naeem

The Thai Journal of Veterinary Medicine

Diarrhea in newborn calves as well as in adult dromedary camels is considered the most serious constrains of camel production. It is recorded in the Eastern Province of Saudi Arabia to be very high, therefore, it is necessary to investigate the role of certain pathogenic agents. In the present study, group A rotavirus was detected in 5/50 (10%) and 6/50 (12%) diarrheic samples collected from one- to three-month-old camel calves using immune chromatographic and ELISA techniques, respectively. The characteristic wheel-like morphology of rotavirus particles was identified in the positive samples by electron microscopy. Also, Mycobacterium avium subspecies paratuberculosis was detected …

Seroprevalence Of Mycoplasma Ovipneumoniae In Goats In Hunan Province, China, Ping-Yuan Xu, Yun-Chao Peng, Xu-Xiang Ouyang, Sheng-Guo Tan

The Thai Journal of Veterinary Medicine

Little information is available about the seroprevalence of Mycoplasma ovipneumoniae infection in goats in China. In the present study, the seroprevalence of M. ovipneumoniae infection in goats was investigated in Hunan province, China between September 2015 and September 2016. A total of 750 serum samples collected from 10 herds in various administrative regions in Hunan province, China were evaluated using indirect hemagglutination assay (IHA). Antibodies to M. ovipneumoniae were tested in 234 of 750 serum samples (31.2%) (IHA titer≥1:16). The M. ovipneumoniae seroprevalence ranged from 22% to 50% among different regions in Hunan province, and the difference was statistically significant …

Granulomatous Myocarditis In A Toco Toucan (Ramphastos Toco Albogularis), Yen-Li Huang, Shinn-Shyong Tsai, Omir Adrian Castaneda, Supochana Charoensin, Duangsuda Thongchan, Hung-Yi Wu

The Thai Journal of Veterinary Medicine

An uncommon lesion was diagnosed in a 1-year-old female toco toucan (Ramphastos toco albogularis) based on microscopic examinations. Necropsy, histopathology and molecular diagnosis were carried out. At necropsy, possible granulomatous myocarditis was diagnosed in the bird and was confirmed as shown by histopathology. Polymerase chain reaction (PCR) revealed an unspecific trematode species as the causative agent. Research on parasitic granulomatous myocarditis in toco toucan has been rarely reported. Therefore, it should be considered during differential diagnosis of avian granuloma cases.

Adverse Events In Veterans Affairs Inpatient Psychiatric Units: Staff Perspectives On Contributing And Protective Factors., Gala True, Rosemary Frasso, Sara W. Cullen, Richard C. Hermann, Steven C. Marcus

College of Population Health Faculty Papers

OBJECTIVES: This study sought to identify risk factors and protective factors in hospital-based mental health settings in the Veterans Health Administration (VHA), with the goal of informing interventions to improve care of persons with serious mental illness.

METHODS: Twenty key informants from a stratified sample of 7 VHA inpatient psychiatric units were interviewed to gain their insights on causes of patient safety events and the factors that constrain or facilitate patient safety efforts.

RESULTS: Respondents identified threats to patient safety at the system-, provider-, and patient-levels. Protective factors that, when in place, made patient safety events less likely to occur …

Trends In The Environmental Health Job Market For New Graduates, Jason W. Marion, Timothy J. Murphy Phd, Anne Marie Zimeri Phd

EKU Faculty and Staff Scholarship

The question of whether the job market can support future graduates of environmental health programs remains an important and difficult question for environmental health programs, current and prospective students, parents, and other stakeholders. Our previous report using 2014 data from the U.S. Bureau of Labor Statistics demonstrated anticipated growth and higher than average pay in the profession through at least 2022 for baccalaureate degree holders (Marion & Sinde, 2015). Growth in the profession does not necessarily translate into job availability if the market is saturated with job candidates. While university programs produce graduates, local health departments (LHDs) have suffered tremendous …

Trends In Hpv Vaccine Initiation And Completion Among Girls In Texas: Behavioral Risk Factor Surveillance System Data, 2008–2010, Tatjana Gazibara, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objective: The objective of this study was to evaluate the trend of HPV vaccine initiation and completion among girls in Texas from 2008 to 2010.

Methods: Data were obtained from the Behavioral Risk Factors Surveillance System (BRFSS) over 3 years (2008–2010). The information regarding HPV vaccination was gathered from the parents of 9- to 17-year-old daughters (choosing only 1 per household) in randomly selected households in the sample area.

Results: The highest prevalence of vaccine initiation and completion were detected in 2010 (20.9% and 9.7%, respectively). Over the study period, HPV vaccine initiation statistically significantly increased (2008, 14.9%; 2009, 20.7%; …

Survey Of Prescription Medication Disposal Practices In Older Patients, Kimberly A. Madson

University Grant Program Reports

The purpose of the proposed study was to survey participants on current medication disposal practices, and to gather preliminary data on the types of medications found in the home environment.

Treatment Of Second‐Degree Burns With Lactic Acid Skin Substitute In Outpatient Setting: Pain And Patient Comfort., Deborah Boorse Rn, Cnp, Sigrid A. Blome-Eberwein Md

Department of Surgery

No abstract provided.

Evaluation Of A Scientifically Developed Anesthesiology Handoff Protocol, Kristen Lise Welsh Webster

Doctoral Dissertations and Master's Theses

Communication failures have been cited as the leading cause of avoidable adverse events in healthcare. Specifically, within handoffs, these communication failures can cause error in the transfer of patient information. A multitude of factors can affect the transmission of patient information between providers including transactive memory, power distance, and conversational noise; however, literature suggests that the use of handoff protocols assist in improving communication and efficiency during handoffs. Studies regarding handoffs have typically centered on the content or delivery of the information during the handoff. To date, none have targeted the underlying mechanisms of the communication and their effects on …

Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons, Amanda Fallin-Bennett, Nadra E. Lisha, Pamela M. Ling

Nursing Faculty Publications

Introduction—Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5–2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined.

Methods—A cross-sectional survey of young adults (aged 18–26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and …