Medicine and Health Sciences Commons^™

Cerebrovascular Accident Survival: Strategies Of Flight Nursing And Aeromedical Transport, Alexis Caudle

Senior Honors Theses

Cerebrovascular accidents (CVA), known as strokes, are a leading cause of death worldwide. The delivery and timing of treatment for CVAs is a critical factor in restoring health to the patient. One of the variables in recovery is the method of transport used in bringing the patient to a health care facility. Aeromedical transport remains a valuable resource to achieve full recovery in stroke patients. An ongoing debate of risk versus benefit of helicopter emergency services will be included as well as examination of variables including location, time, physiology of the flight, and the patient’s condition to be scrutinized. In …

Competency Development In Community-Based Occupational Therapy, Sunny R. Winstead

All Theses And Dissertations

The aims of this study were: a) to discover which strategies community-based occupational therapists (OTs) find most effective for developing the competencies that have been identified as unique to community-based occupational therapy (OT) practice, b) to examine respondents’ perceptions of the effectiveness of their academic training and of current professional development resources, and c) to explore respondents’ suggestions for improving academic training and continuing education for OTs in community-based practice. Data collection was completed using an electronic survey that targeted members of the American Occupational Therapy Association who have experience in community-based OT. The survey was completed by 81 OTs …

Sexual Behavior Among Orphaned Adolescents In Western Kenya: A Comparison Of Institutional-And Family-Based Care Settings, Lonnie Embleton, Joram Nyandat, David Ayuku, Edwin Sang, Allan Kamanda, Samuel Ayaya, Winstone Nyandiko, Peter Gisore, Rachel Vreeman, Lukoye Atwoli

Internal Medicine, East Africa

Purpose: This study sought to assess whether risky sexual behaviors and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya.

Methods: We analyzed baseline data from a cohort of orphaned adolescents aged 10–18 years living in 300 randomly selected households and 19 charitable children's institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex. Multivariate logistic regression compared these between participants in institutional care and family-based care while adjusting for age, sex, orphan status, importance of religion, caregiver support and supervision, school attendance, …

Gender-Related Differences In Child Speakers’ Use Of Nonmainstream English Forms, Anneliese K. Moore

Honors Capstones

No abstract provided.

Development Of Word Recognition Materials For Native Cebuano Speakers, Sarah Mickele Gordon

Theses and Dissertations

Within recent decades speech audiometry materials have been developed in various languages in order to more accurately identify and evaluate hearing impairment in native speakers. This advantage, however, is not available to native Cebuano speakers. The purpose of this study was to develop, digitally record, evaluate, and psychometrically equate a set of Cebuano bisyllabic word lists for use in measuring word recognition ability. This process began with recording 260 commonly used bisyllabic Cebuano words by a native speaker noted for his quality and pleasantness of speech in his native tongue. These recordings were then evaluated by 20 normally hearing native …

Solitary-Pretend Play In Children With Language Impairment And Their Typically-Developing Peers, Mallory Paige Scofield

Theses and Dissertations

Children with language impairment (LI) are more likely to be socially withdrawn than their typically-developing peers. This withdrawal can lead to negative outcomes later in life. This study focuses on a subtype of withdrawal labeled as solitary-pretend play, which involves parallel play and solitary-dramatizing. The effectiveness of the Teacher Behavior Rating Scale (TBRS) to measure the construct of solitary-pretend play was considered in a group of 256 children. First, confirmatory factor analysis was used on the entire sample to assess the TBRS questions. The TBRS ratings of 128 children with LI and 128 typically developing peers were then compared, with …

Cost Outcomes For Major Depressive Disorder And Bipolar Disorder Across Professional License Types And Modalities, Julia H. Jones

Theses and Dissertations

The purpose of this study was to compare outcomes for patients with Bipolar Disorder or Major Depressive Disorder based on severity of diagnosis. This study also compared psychotherapy providers and therapy modalities on total cost, number of sessions, and dropout. Our data set (N=136,439) came from Cigna, a national health care company. Results showed significant differences by severity of diagnosis. The comparison of providers showed that psychologists had higher costs and session numbers, while the other providers were not significantly different. However, all providers successfully provided low cost treatment on both MDD and BD. There is no support for the …

Nursing Perspective Of Preparedness To Deliver End-Of-Life Care: A Descriptive Study, Caitlin B. Mccann

Nursing Masters

Abstract

Background: Death of patients in the intensive care unit (ICU) is often sudden and unexpected. When ICU care transitions from curative to palliative, nursing staff frequently feel ill prepared to effectively care for dying patients and their families [1, 2]. The purpose of this study was to identify ICU nursing staff’s perception of the effectiveness of current end-of-life care (EOLC) education methods and their preparedness to deliver EOLC to dying patients and their families.

Methods: A newly developed online survey was utilized on Qualtrics survey generator and distributed through social media to allow for snowball sampling. Descriptive statistics were …

Implementation & Evaluation Of An Interprofessional Teamstepps Simulation Program, Valerie Grapensteter

Nursing Doctoral

Joint Commission 2015 sentinel event data identified communication as the third leading cause of all medical errors in the United States. The complex delivery of health care requires teamwork; however, members of the health care team are rarely trained together and often come from different educational and cultural backgrounds. To improve communication, an interprofessional high fidelity simulation-based program that uses the Agency for Healthcare Research and Quality TeamSTEPPS® 2.0 Framework and associated communication tools was implemented and evaluated in a medium sized acute care community hospital. This quantitative descriptive correlational study addresses two research questions: (1) how does the implementation …

A Case Series On Nutrition In Hip Fracture Patients: A Mismatch Between Needs And Dietary Intake, Njalalle Baraza, Eamon Ramhamadany, Thomas Laios

General Surgery, East Africa

Hip fractures are common in the United Kingdom with an overall estimated annual incidence of 100 fractures per 10,000 of the population for males and 81 per 10,000 for females [1], and with an ageing population this figure is set to rise [2]. From recent estimates, this costs the British tax payer over £750,000,000 a year, with over half this amount spent in social care of the patients recovering from the fracture [3]. Elderly hip fracture patients often have co-morbidities and mortality in the first year can be as high as 33% [4].

The Bulletin: Sidney Kimmel Medical College At Thomas Jefferson University, Volume 66, Issue 1, Spring 2017

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

This issue includes:

• Making a difference for Children's Health: Jefferson's Initiatives Aim to Help Kids Thrive
• Who Was the First? Previously unknown African-American graduates of Jefferson's medical college
• Dean's Column
• The Beacon: Lights, Drones, Action
• Vanquishing Banquo's Ghost: A Message from Elizabeth Dale
• Alumni Weekend: Alumni Return to Campus to Reconnect
• Awards: 2016 Alumni Achievement Award Winners
• On Campus
• JEFFMD: A Q&A with Deborah Ziring, MD
• Blue is the New Pink: Colon Cancer Awareness
• Class Notes
• In Memoriam
• By the Numbers

Posttraumatic Stress Disorder In The World Mental Health Surveys, K C. Koenen, A Ratanatharathorn, L Ng, K A. Mclaughlin, E J. Bromet, D J. Stein, E G. Karam, A Meron Ruscio, C Benjet, K Scott, Lukoye Atwoli

Internal Medicine, East Africa

Background: Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.

Methods: Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country …

Bomb Blast In A Tertiary Care Hospital, The Challenges Faced During Management Of Victims In A Resource Limited Country, Rizwan Sultan, Hasnain Zafar, Umar B, Khabir Ahmed

Department of Surgery Docs

Abstract Introduction: A bomb blast in a hospital results in a many fold increase in the casualties. The affected health care in the region is the next challenge faced by the administration of the city. We discuss the challenges faced after a bomb blast in the civil hospital of Quetta, Pakistan on 8 August 2016. Methods: A retrospective review of the medical records of patients who were transferred by air to the Aga Khan University Hospital Karachi over a period of 86 h after the blast in Quetta. Results: Seventy-five patients were received in three separate waves; those received in …

The Many Guises Of Primary Hyperparathyroidism… An Unchanged Scenario, Tasnim Ahsan, Uzma Erum, K. M. Inam Pal, Rukhshanda Jabeen, Saima Ghaus Qureeshi, Urooj Lal Rehman, Zeenat Banu

Department of Surgery Docs

Abstract

OBJECTIVE:

To study the causes, characteristics and outcome of treatment of patients with primary hyperparathyroidism.

METHODS:

This retrospective cohort analysis was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with primary hyperparathyroidism between 2004 and 2014. .SPSS 17 was used for data analysis.

RESULTS:

Of the 25 patients,1(4%)was male and 24(96%) were female. The overall mean age was 41.72±15.9 years, with a mean duration of symptoms of 4.1±3.3 years. The mean pre-operative parathyroid hormone level was 879.48±793.51 pg/ml. Skeletal manifestations were reported in 17(68%) patients, whereas 4(16%) patients had renal stone disease. Besides, 2(8.0%) …

The Application Of Crispr Technology To High Content Screening In Primary Neurons, Ben L. Callif, Brian Maunze, Nick L. Krueger, Matthew T. Simpson, Murray G. Blackmore

Biomedical Sciences Faculty Research and Publications

Axon growth is coordinated by multiple interacting proteins that remain incompletely characterized. High content screening (HCS), in which manipulation of candidate genes is combined with rapid image analysis of phenotypic effects, has emerged as a powerful technique to identify key regulators of axon outgrowth. Here we explore the utility of a genome editing approach referred to as CRISPR (Clustered Regularly Interspersed Palindromic Repeats) for knockout screening in primary neurons. In the CRISPR approach a DNA-cleaving Cas enzyme is guided to genomic target sequences by user-created guide RNA (sgRNA), where it initiates a double-stranded break that ultimately results in frameshift mutation …

Exploring The Knowledge And Perceptions Of Elementary And Middle School Staff With Regard To The Utilization Of A Dental Hygienist In A School Setting, Hannah Elizabeth Fender

Undergraduate Honors Theses

Abstract:

Background: Dental hygienists can be utilized to provide care to adolescents and young adults in a school-based setting. These dental health care professionals work to improve upon public oral health through educational practices, preventative methods, and referrals. The purpose of this study was to explore the knowledge and perceptions of elementary and middle school staff with regard to the utilization of a dental hygienist in a school setting. Methods: The international review board at approved the following study. A total of eight faculty and staff members from Unicoi County Elementary School and Unicoi County Middle School completed a 14-question …

Physical Activity Minimum Threshold Predicting Improved Function In Adults With Lower‐Extremity Symptoms, Dorothy D. Dunlop, Jing Song, Jungwha Lee, Abigail L. Gilbert, Pamela A. Semanik, Linda S. Ehrlich-Jones, Christine A. Pellegrini, Daniel Pinto, Barbara Ainsworth, Rowland W. Chang

Physical Therapy Faculty Research and Publications

Objective

To identify an evidence‐based minimum physical activity threshold to predict improved or sustained high function for adults with lower‐extremity joint symptoms.

Methods

Prospective multisite data from 1,629 adults, age ≥49 years with symptomatic lower‐extremity joint pain/aching/stiffness, participating in the Osteoarthritis Initiative accelerometer monitoring substudy were clinically assessed 2 years apart. Improved/high function in 2‐year gait speed and patient‐reported outcomes (PROs) were based on improving or remaining in the best (i.e., maintaining high) function quintile compared to baseline status. Optimal thresholds predicting improved/high function were investigated using classification trees for the legacy federal guideline metric requiring 150 minutes/week of moderate‐vigorous …

Lead Exposure Assessment Among Pregnant Women, Newborns, And Children: Case Study From Karachi, Pakistan., Zafar Fatmi, Ambreen Sahito, Akihiko Ikegami, Atsuko Mizuno, Xiaoyi Cui, Nathan Mise, Mai Takagi, Yayoi Kobayashi, Fujio Kayama

Community Health Sciences

Lead (Pb) in petrol has been banned in developed countries. Despite the control of Pb in petrol since 2001, high levels were reported in the blood of pregnant women and children in Pakistan. However, the identification of sources of Pb has been elusive due to its pervasiveness. In this study, we assessed the lead intake of pregnant women and one- to three-year-old children from food, water, house dust, respirable dust, and soil. In addition, we completed the fingerprinting of the Pb isotopic ratios (LIR) of petrol and secondary sources (food, house-dust, respirable dust, soil, surma (eye cosmetics)) of exposure within …

Comparison Of Multiple Obesity Indices For Cardiovascular Disease Risk Classification In South Asian Adults: The Carrs Study., Shivani A. Patel, Mohan Deepa, Roopa Shivashankar, Mohammed K. Ali, Deksha Kapoor, Ruby Gupta, Dorothy Lall, Nikhil Tandon, Viswanathan Mohan, Muhammad Masood Kadir, Zafar Fatmi, Dorairaj Prabhakaran, K. M. Venkat Narayan

Community Health Sciences

BACKGROUND:

We comparatively assessed the performance of six simple obesity indices to identify adults with cardiovascular disease (CVD) risk factors in a diverse and contemporary South Asian population.

METHODS:

8,892 participants aged 20-60 years in 2010-2011 were analyzed. Six obesity indices were examined: body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), log of the sum of triceps and subscapular skin fold thickness (LTS), and percent body fat derived from bioelectric impedance analysis (BIA). We estimated models with obesity indices specified as deciles and as continuous linear variables to predict prevalent hypertension, diabetes, and high cholesterol …

Repeat 24-Hour Recalls And Locally Developed Food Composition Databases: A Feasible Method To Estimate Dietary Adequacy In A Multi-Site Preconception Maternal Nutrition Rct., Rebecca L. Lander, K. Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Ana Garces, Lester Figueroa, Gabriela Tejeda, Adrien Lokangaka, Tshilenge S. Diba, Manjunath S. Somannavar, Ranjitha Honnayya, Sumera Aziz Ali, Umber S. Khan, Elizabeth M. Mcclure, Vanessa R. Thorsten, Kristen B. Stolka, For The Women First Preconception Nutrition Trial Group

Community Health Sciences

Background:

Our aim was to utilize a feasible quantitative methodology to estimate the dietary adequacy of >900 first-trimester pregnant women in poor rural areas of the Democratic Republic of the Congo, Guatemala, India and Pakistan. This paper outlines the dietary methods used.

Methods:

Local nutritionists were trained at the sites by the lead study nutritionist and received ongoing mentoring throughout the study. Training topics focused on the standardized conduct of repeat multiple-pass 24-hr dietary recalls, including interview techniques, estimation of portion sizes, and construction of a unique site-specific food composition database (FCDB). Each FCDB was based on 13 …

Use Of Dimensional Analysis In An Associate Degree Nursing Program, Bridget Maley, Patricia Ford Garofalo

Publications and Research

The aim of this retrospective study was to show the use of dimensional analysis increased associate degree nursing students’ mathematical computation competency and may reduce nursing medication errors in practice. A recent report compiled by Mackary and Daniel from John Hopkins, stated that medical error is the third leading cause of death in the United States [1]. The most commonly cited estimate of annual deaths from medical error in the United States is a 1999 Institute of Medicine (IOM) report which is possibly limited and now outdated [2]. Medication errors contribute to patients’ deaths, whereas nurses administer either incorrect medication, …

Definiendo La Concepción De La Salud Mental Y Espiritual: La Influencia De La Biomedicina Y La Religión Occidental En La Comunidad Mapuche De La Araucanía, Maya Salvio

Independent Study Project (ISP) Collection

Research Question: In what ways has occidental religions and the biomedical health system influenced the conception of mental health in the Mapuche community in the Araucania?

Objectives: The general objective of this study is to identify the ways in which mental and spiritual health are conceptualized by the Mapuche community and identify the influences of occidental religion and biomedicine in Carahue and Saavedra. The specific objectives are to identify the conceptions of mental and spiritual health among the three predominant ideologies, characterize their perceptions of anxiety and depression (two occidental mental illnesses), identify the relationships between the three ideologies, and …

El Suma Qamaña: La Convivencia En Relación A La Salud Según La Gente Aymara De Arica, Codpa, Y Putre / El Suma Qamaña: Coexistence In Relation To Health According To The Aymara People Of Arica, Codpa, And Putre, Alison Ogawa

Independent Study Project (ISP) Collection

Suma qamaña, comúnmente conocido como buen vivir o convivir bien, es un concepto andino relacionado con la manera en que la gente entiende la vida y conceptualiza la salud. Es un modelo de armonía en que se busca un equilibrio con todas las cosas, incluida la comunidad, la naturaleza, la espiritualidad, la familia, el cuerpo, y la mente. Esta investigación busca responder a la pregunta ¿Cómo se entiende y vive la salud en el marco del concepto del buen vivir de la gente aymara de Arica, Codpa, y Putre? También, intenta explicar el concepto del buen vivir o suma qamaña, …

Shifting Mental Health From The Back Burner: An Investigation Of The Mental Health Treatment Gap, Eva Hanorah Stanton

Independent Study Project (ISP) Collection

The purpose of this research project is to investigate solutions to the so-called ‘mental health treatment gap’. The need for scholarship in this area is underscored by the recent tragedy in the Gauteng province, which has brought the neglect of the mental health sector into the public eye. Through semi-structured interviews with six key stakeholders in the fields of mental health and health policy this project seeks to better understand the causes of the mental health treatment gap and the impact National Health Insurance (NHI) rollout may have on access to quality mental healthcare. Sub-themes explored include: the integration of …

Discourses Of Psychiatry And Culture: The Interface Between Western And Traditional Medicine In The Treatment Of Mental Illness, Madeline Molot

Independent Study Project (ISP) Collection

Mental illness is a burden of disease that, in many countries, is neglected; South Africa is no exception. There are many reasons for this, including but not limited to a lack of specialized mental health personnel in primary care settings, a budget that favors South Africa’s communicable disease epidemic, and a continued stigma around mental illness. Whenever discussing the healthcare system in South Africa, however, it is important to note another parallel system of care, one with little to no budget or regulation: that of traditional healing. It is estimated that over 70% of South Africans have at some point …

Music As The Guide On The Pathway To Empowerment And Wellbeing. A Narrative On An Arts-Based Holistic Health Solution., Sabine Adler

Independent Study Project (ISP) Collection

This study explored music as the guide on the pathway to empowerment and wellbeing at a nonprofit organization called Durban Music School. Using narrative inquiry, I have collected stories from different people involved with Durban Music school as well my own observations and reflections. Through finding empowerment through music myself, I was able to add in my personal experiences to compliment the experience of others. Using informal interviews and conversations, direct observations, journaling, and playing guitar as a method of inner reflection, I looked to explore through stories how underprivileged individuals have found empowerment through their musical journey. Out of …

Resilience Of Romanian Institutions During The Global Gag Rule: 20012007, Sara Hayet

Independent Study Project (ISP) Collection

There is a wealth of literature about the negative effects of the executive order called the Global Gag Rule, officially known as the Mexico City Policy, and its various manifestations. Despite this, there is a gap in the research about how institutions in affected countries respond to the Global Gag Rule’s family planning restrictions. This qualitative study seeks to provide some insight into how Romanian institutions responded during President George W. Bush’s reinstatement of the policy by using a model of social resilience. Through a literature review of three subjects (social resilience, the Global Gag Rule, and Romania’s family planning …

Health Literacy Skills Of Aging Populations And Its Impact On The Prevention Of Cardiovascular Disease, Peter Gorman

Independent Study Project (ISP) Collection

Cardiovascular disease (CVD) represents a threat to both the economic and social well being of Switzerland. Cardiovascular disease is easily a preventable disease, yet continues to take over the world. One’s ability to read and comprehend health information from medical professionals is a vital component of maintaining and improving an individuals’ overall health. Health literacy can have an impact on the effectiveness of preventive interventions in health behaviors and the success of health outcomes. Studies have shown that well-educated and financially improved persons have a higher health competence than lower educated persons.1 Given that cardiovascular disease is the number one …

Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell

Independent Study Project (ISP) Collection

In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …

Winning Off The Field: How Social Media Analytics Measure The Sports Industry, Ryan Mcgarvey

Honors Theses

Since Facebook became available to the public, social media (SM) has become the most popular online activity. Currently, 91% of adults are active SM users. Of this 91% of adults on SM, more than 20% of their time online is spent on networking sites like Facebook and Twitter (Weiguo and Gordon, 2014). These powerful tools connect people around the world and show no signs of slowing down.

SM has become a popular online activity for individuals, especially for those involved in business. SM is seen as a tool to aid businesses in spreading their own message, at little to no …