Medicine and Health Sciences Commons^™

The Effectiveness Of "Stepping On" In Reducing Fall Risk In The Elderly Using The 30-Second Chair Stand Test, Brianna Albrecht

Physical Therapy Scholarly Projects

Background: One-third of all adults over the age of 65 years of age falls each year. Falls cost patients financially, physically, and emotionally. Balance and strength deficits contribute to increasing an individual's fall risk. Studies have shown the efficiency of community-based exercise and education programs on reducing the risk of falling.

Objective: The purpose of this study was to determine whether participants in Stepping On experienced an improvement in balance and confidence following completion of the program. The study also evaluated the correlation between self-perceived risk of falling on the CDC Fall Risk Survey and their actual risk …

Traumatic Brain Injury: A Case Study Of An Atypical Rehabilitation Progression Due To Unmodifiable Circumstances, Brianna Gustafson

Physical Therapy Scholarly Projects

Background and Purpose Traumatic brain injuries (TBI) are very prevalent throughout the US. They are often caused by a head injury leading to alterations in brain functioning and often result in lifelong disabilities. Current literature is limited on the aspects of rehabilitation following a TBI because of the many factors that differ within each case. This study will explore an atypical pathway for rehabilitation following a TBI.

Case Description The patient was a 32-year-old male who sustained a TBI following a motor vehicle accident (MVA). The Glasgow Coma Scale (GCS) and Rancho Los Amigo Scale (RLAS) were assessed initially and …

Conservative Treatment Of 'Flail Chest' Following Non-Union Fractures Of The Thoracic Rib Cage With Secondary Shoulder Pathology: A Case Report, Chase Kerber

Physical Therapy Scholarly Projects

Background and Purpose - Fractures of the thoracic ribs are common injuries with a high incidence of secondary co-morbidities which may require a slower rehabilitation progression and result in a delayed return to full function. Patients with these diagnoses often seek physical therapy intervention in order to regain their prior level of function.

Case Description - A 51 year-old male sustained multiple rib fractures, pneumothorax, and a left shoulder injury as a result of falling backwards off a 6 foot platform. He presented to physical therapy for evaluation and treatment with the goal of returning to his occupation as a …

Barefoot Versus Shod Training: Effects On Navicular Drop And Foot Pressure Analysis, Evan Condry, Daniel Himmerick, Tiffany Vanhaaften

Physical Therapy Scholarly Projects

Background and Purpose: Running is a popular form of exercise around the world. The running population generally runs in a rear-foot strike pattern (RFSP), yet there is questioning on the possible benefits of running in a forefoot strike pattern (FFSP). The main goal of FFSP is the possible reduction of running related injuries by reducing the stress on the medial longitudinal arch. The purpose of this research study is to determine if a barefoot running retraining program will have an effect on navicular drop height, plantar pressure area, and peak plantar pressure of the medial aspect of the foot.

Material/Methods …

Assessing Efficiency Of Public Health And Medical Care Provision In Oecd Countries After A Decade Of Reform, Yasar A. Ozcan, Jaya Khushalani

Health Administration Publications

The objective of this study was to examine the change in efficiency of health care systems of 34 OECD countries between 2000 and 2012, a period marked by significant health reform in most OECD countries. This paper uses a novel Dynamic Network Data Envelopment Analysis (DNDEA) model to analyze the efficiency of the public health system and the medical care system of these OECD countries independently along with assessing the efficiency of their overall health system. This helps understand the relative priorities for improving the overall health system. The data for this study was obtained from the OECD Health Facts …

Targeting Hepatocellular Carcinoma Through Tgf-Β Pathway E3 Ligases, Kazufumi Ohshiro, Jian Chen, Shulin Li, Jon White, Asif Rashid, Lopa Mishra

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

The Role Of Uridine-Cytidine Kinase 2 In The Development Of Hepatocellular Carcinoma, Dehai Wu, Song Tao, Keunsoo Ahn, Nicha Wongjarupong, Lewis Roberts

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

The Scaffolding Protein Iqgap1 Promotes Hepatic Proliferation And Protects The Liver From Injury, Hanna Erickson, Sayeepriyadarshini Anakk

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

Cca Development In The Background Of Congenital Hepatic Fibrosis/Caroli Disease, Eleanna Kaffe Mrs, Carlo Spirli, Luca Fabris, Massimiliano Cadamuro, Mario Strazzabosco

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

Commonly Used H1 And H2 Histamine Receptor (Hr) Blockers Decrease Cholangiocarcinoma Xenograft Tumor Growth, Angiogenesis And Emt, Lindsey Kennedy, Laura Hargrove, Jennifer Demieville, Walker Karstens, Steven Smith, Heather Francis

Hepatobiliary Cancers: Pathobiology and Translational Advances

No abstract provided.

Perfluorocarbon Emulsions Radiosensitise Brain Tumors In Carbogen Breathing Mice With Orthotopic Gl261 Gliomas, Lisa A. Feldman, Marie-Sophie Fabre, Carole Grasso, Dana Reid, William C. Broaddus, Gregory M. Lanza, Bruce D. Spiess, Joel R. Garbow, Melanie J. Mcconnell, Patries M. Herst

Neurosurgery Publications

Background

Tumour hypoxia limits the effectiveness of radiation therapy. Delivering normobaric or hyperbaric oxygen therapy elevates pO2 in both tumour and normal brain tissue. However, pO2 levels return to baseline within 15 minutes of stopping therapy.

Aim

To investigate the effect of perfluorocarbon (PFC) emulsions on hypoxia in subcutaneous and intracranial mouse gliomas and their radiosensitising effect in orthotopic gliomas in mice breathing carbogen (95%O2 and 5%CO2).

Results

PFC emulsions completely abrogated hypoxia in both subcutaneous and intracranial GL261 models and conferred a significant survival advantage orthotopically (Mantel Cox: p = 0.048) in carbogen breathing mice injected intravenously (IV) with …

Antimicrobial Stewardship Practices In Virginia, Kimberly B. Lee, Jesus Aaron Ramirez, Rebeccah Collins, John Bucheit, Kakotan Sanogo, Michael P. Stevens

Family Medicine and Population Health Publications

The Society of Healthcare Epidemiology of America, the Centers for Disease Control and Prevention, and the President's Council of Advisors on Science and Technology recognize the need to combat antimicrobial resistance through the promotion of antimicrobial stewardship programs. Health care facilities in Virginia were surveyed using a 23-item survey focused on facility characteristics and antimicrobial stewardship strategies. Antimicrobial stewardship activities were highly variable and many are missing key personnel and resources.

Medical Literary Messenger (Vol. 4, No. 2, Spring/Summer 2017)

Medical Literary Messenger

Solicitude / Dan Campion -- R & R / Claude Clayton Smith -- Alopecia Areata / Will Justice Drake -- Guide to Nether-Land / Tanmoy Das Lala -- The Wolf / Rebecca Taksel -- Life Support / Lindsay Rutherford -- Tuesday Mermaids / Connie Zumpf -- Transition / Vernita Hall -- Admissions / Kathryn Eberly -- The Vote / Alisa Olmsted -- Health & Healing in Honduras / Michael P. Stevens and Nadia Masroor -- Lamentation of a Night-Shift Nurse / Mallory Drake -- Blues from the Stepdown Ward / Terry Sanville -- Nectarines / Lindsay Rutherford -- Alzheimer’s / …

Management Of Children With Chronic Wet Cough And Protracted Bacterial Bronchitis Chest Guideline And Expert Panel Report, Anne B. Chang, John J. Oppenheimer, Miles M. Weinberger, Bruce K. Rubin, Cameron C. Grant, Kelly Weir, Richard S. Irwin, Chest Expert Cough Panel

Pediatrics Publications

BACKGROUND: Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged
METHODS: We used the CHEST expert cough panel's protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients' values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made.

RESULTS: Combining data from the …

Impaired Myocardial Relaxation With Exercise Determines Peak Aerobic Exercise Capacity In Heart Failure With Preserved Ejection Fraction, Cory Trankle, Justin M. Canada, Leo Buckley, Salvatore Carbone, Dave Dixon, Ross Arena, Benjamin Van Tassell, Antonio Abbate

Pharmacotherapy and Outcomes Science Publications

Background

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome characterized by impaired exercise capacity due to shortness of breath and/or fatigue. Assessment of diastolic dysfunction at rest and with exercise may provide insight into the pathophysiology of exercise intolerance in HFpEF.

Aims

To measure echocardio-Doppler-derived parameters of diastolic function as they relate to various indices of aerobic exercise capacity in HFpEF.

Methods

We selected 16 subjects with clinically stable HFpEF, no evidence of volume overload, but impaired functional capacity by cardiopulmonary exercise testing [peak oxygen consumption (VO₂)]. We measured the transmitral E and A flow …

A Comparison Of Parameter Covariance Estimation Methods For Item Response Models In An Expectation-Maximization Framework, Joshua N. Pritikin

Psychiatry Publications

The Expectation-Maximization (EM) algorithm is a method for finding the maximum likelihood estimate of a model in the presence of missing data. Unfortunately, EM does not produce a parameter covariance matrix for standard errors. Both Oakes and Supplemented EM are methods for obtaining the parameter covariance matrix. SEM was discovered in 1991 and is implemented in both opensource and commercial item response model estimation software. Oakes, a more recent method discovered in 1999, had not been implemented in item response model software until now. Convergence properties, accuracy, and elapsed time of Oakes and Supplemental EM family algorithms are compared for …

Symptom Domain Groups Of The Patient-Reported Outcomes Measurement Information System Tools Independently Predict Hospitalizations And Re-Hospitalizations In Cirrhosis, Kavish R. Patidar, Leroy R. Thacker, James B. Wade, Melanie B. White, Edith A. Gavis, Andrew Fagan, Richard K. Sterling, Michael Fuchs, Mohammad S. Siddiqui, Scott Matherly, Richard T. Stravitz, Arun J. Sanyal, Puneet Puri, Velimir A. Luketic, Jasmohan S. Bajaj

Psychiatry Publications

Background

Patient-Reported Outcomes Measurement Information System (PROMIS) tools can identify health-related quality of life (HRQOL) domains that could differentially affect disease progression. Cirrhotics are highly prone to hospitalizations and re-hospitalizations, but the current clinical prognostic models may be insufficient, and thus studying the contribution of individual HRQOL domains could improve prognostication.

Aim

Analyze the impact of individual HRQOL PROMIS domains in predicting time to all non-elective hospitalizations and re-hospitalizations in cirrhosis.

Methods

Outpatient cirrhotics were administered PROMIS computerized tools. The first non-elective hospitalization and subsequent re-hospitalizations after enrollment were recorded. Individual PROMIS domains significantly contributing toward these outcomes were generated …

A Power Calculator For The Classical Twin Design, Brad Verhulst

Psychiatry Publications

Power is a ubiquitous, though often overlooked, component of any statistical analyses. Almost every funding agency and institutional review board requires that some sort of power analysis is conducted prior to data collection. While there are several excellent on line power calculators for independent observations, twin studies pose unique challenges that are not incorporated into these algorithms. The goal of the current manuscript is to outline a general method for calculating power in twin studies, and to provide functions to allow researchers to easily conduct power analyses for a range of common twin models. Several scenarios are discussed to demonstrate …

Somatic Symptom Disorder In Dermatology, James L. Levenson, Aditi A. Sharma, Alex G. Ortega-Loayza

Psychiatry Publications

Somatic symptom disorder (SSD) is defined by the prominence of somatic symptoms associated with abnormal thoughts, feelings, and behaviors related to the symptoms, resulting in significant distress and impairment. Individuals with these disorders are more commonly encountered in primary care and other medical settings, including dermatology practice, than in psychiatric and other mental health settings. What defines the thoughts, feelings, and behaviors as abnormal is that they are excessive, that is, out of proportion to other patients with similar somatic symptoms, and that they result in significant distress and impairment. SSD may occur with or without the presence of a …

Molecular Genetic Influences On Normative And Problematic Alcohol Use In A Population-Based Sample Of College Students, Bradley T. Webb, Alexis C. Edwards, Aaron R. Wolen, Jessica E. Salvatore, Fazil Aliev, Brien P. Riley, Cuie Sun, Vernell S. Williamson, James N. Kitchens, Kimberly Pedersen, Amy Adkins, Megan E. Cooke, Jeanne E. Savage, Zoe Neale, Seung B. Cho, Danielle M. Dick, Kenneth S. Kendler

Psychiatry Publications

Background: Genetic factors impact alcohol use behaviors and these factors may become increasingly evident during emerging adulthood. Examination of the effects of individual variants as well as aggregate genetic variation can clarify mechanisms underlying risk.

Methods: We conducted genome-wide association studies (GWAS) in an ethnically diverse sample of college students for three quantitative outcomes including typical monthly alcohol consumption, alcohol problems, and maximum number of drinks in 24 h. Heritability based on common genetic variants (h2SNP) was assessed. We also evaluated whether risk variants in aggregate were associated with alcohol use outcomes in an independent sample of young …

Electroconvulsive Therapy In Geriatric Patients: A Literature Review And Program Report From Virginia Commonwealth University, Richmond, Virginia, Usa, Andrew D. Snyder, Vasu Venkatachalam, Ananda Pandurangi

Psychiatry Publications

Electroconvulsive therapy (ECT) is an effective therapeutic intervention in the elderly patients with major depression, especially those with psychosis, suicidality, catatonia, nutritional compromise, and resistance to medications. Response rates can be as high as 80%. We present an extensive review of the relevant literature, provide a description of the ECT program at Virginia Commonwealth University in Richmond, Virginia, USA, and present results of our experience with ECT in fifty elderly patients. The treatments were safe, well tolerated, and produced high response rates, variably between 68% and 84%. Patients in the long‑term maintenance ECT program continue to show sustained benefits from …

Macra And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Nitesh Patil, Alberto Coustasse Dr.Ph, Md, Mba

Management Faculty Research

Introduction: Every year, the cost of healthcare within the United States has continued to increase while the quality of patient care has decreased. To reconstruct the delivery of care, Congress has introduced the Medicare Access and CHIP Reauthorization Act of 2015 which has reinvented Medicare physician reimbursement systems. The purpose of this research was to study the Medicare Access and CHIP Reauthorization Act and its implementation to determine how it would financially impact rural hospitals.

Methodology: The methodology for this study consisted of a qualitative literature review. Twenty-seven research publications were utilized throughout the study. Data limited to the English …

Benefits Of The 340b Drug Discount Program, Jarrett Gerlach, Sarah Mcsweeney, Angela Swearingen, Nitesh Patil, Alberto Coustasse

Management Faculty Research

Introduction: The 340B Drug Discount Program required drug manufacturers provide discounted outpatient drugs to healthcare organizations which serve vulnerable patient populations to allow these institutions to offer more services to more people. As the 340B program expanded, controversy has centered on which entities have benefited from the program. Many healthcare organizations sold 340B drugs to well-insured patients at full price, and thus have been financially rewarded. Amendments to the program have permitted 340B providers to utilize contract pharmacies to dispense 340B medication, which has furthered the debate over which stakeholders are benefiting from the program.

Purpose of the Study: The …

Medicare And The Affordable Care Act: Fraud Control Efforts And Results, Sarah Clemente, Ronald Mcgrady, Rob Repass, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of HEAT …

Maryland's All-Payer Health Care System: A Light At The End Of A Tunnel, Lama Bakhamis, Taeko Matsumoto, Mary Tran, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing. This study showed positive change in moving Maryland health care delivery …

The Effects Of Vaccinations On Public Health, Caitlin Reveal

Bridges: A Journal of Student Research

This is a review of scholarly literature of the importance of vaccinations and the effects of vaccination uptake and vaccination refusal on public health. It assesses how vaccinations came to exist and what they do in the human body. It highlights reasons parents opt not to vaccinate their children and the side effects vaccinations may cause. There is a major emphasis on the effectiveness of vaccinations, especially in schools, where children are much more likely to be exposed to diseases than the general public. Because health care workers are often at the front line of contracting and/or transmitting diseases, the …

Is It Possible To Change The Way College Students Think About Stress? The Benefits Of A Stress Management Course, Jennifer Wegmann, Rachel A. Moshman, Lily Rubin

Research Days Posters 2016-2019

The purpose of this study was to analyze the effects of a stress management course on college students’ stress mindsets. Stress mindset encompasses the beliefs one holds about stress. Those who view stress as beneficial have a stress-is-enhancing mindset, while those who view stress as detrimental have a stress-is-debilitating mindset. Subjects enrolled in a physical activity course (control group, n=25) and a stress management course (n=24) possessed a neutral stress mindset at baseline. Students in the intervention group showed a significant shift to a more stress-is-enhancing mindset by the end of the semester. Students in the control group did not …

Improved Protocols For Pre-Processing Raman Spectra Of Formalin Fixed Paraffin Preserved Tissue Sections, Hugh Byrne, Fiona Lyng, Ola Ibrahim, Adrian Maguire, Aidan Meade, Steven Flint, M. Toner

Articles

Although formalin fixed paraffin preserved (FFPP) tissues are a major resource for retrospective studies of disease progression, their use in vibrational spectroscopy studies has been undermined by issues of contributions of substrate and paraffin wax which persist in the spectra and can compromise spectral analysis. Recognising the microcrystalline nature of the wax in the tissue, which are inhomogeneously oriented with respect to the polarisation of the Raman source laser, in this study, we have developed a novel method for removing the paraffin wax contributions to the spectra using matrices of multiple wax spectra. FFPP tissue sections from the oral mucosa …

Group Iv Nociceptors Develop Axonal Chemical Sensitivity During Neuritis And Following Treatment Of The Sciatic Nerve With Vinblastine, Rosann M. Govea, Mary F. Barbe, Geoffrey M. Bove

Biomedical Sciences Faculty Publications

We have previously shown that nerve inflammation (neuritis) and transient vinblastine application lead to axonal mechanical sensitivity in nociceptors innervating deep structures. We have also shown that these treatments reduce axonal transport, and proposed that this leads to functional accumulation of mechanically sensitive channels in the affected part of the axons. While informing the etiology of mechanically induced pain, axonal mechanical sensitivity does not address the common report of ongoing radiating pain during neuritis, which could be secondary to the provocation of axonal chemical sensitivity. We proposed that neuritis and vinblastine application would induce sensitivities to noxious chemicals, and that …

Comparison Between Rigid Double Upright And Lace-Up Ankle Braces On Ankle Range Of Motion, Functional Performance, And User Satisfaction Of Brace Characteristics, Kristin Dierker, Elizabeth Levay, Joseph A. Brosky, Robert V. Topp

School of Nursing and Health Science: Faculty Scholarship

Background: Braces are often used before returning to activity following ankle sprains and also prophylactically in sports considered the high risk for ankle sprains. The purpose of this study was to compare range of motion (ROM) limitations, functional performance, and satisfaction of rigid double upright and lace-up braces. Subjects: In total, 30 healthy adults >18 years of age (Mean, 22.6 6 2.7 years) without lower extremity injury and involved in regular physical activity participated in this study.

Materials/Methods: Ankle ROM assessment and lower extremity performance testing (figure-of-8 hop, side hop, 6-m single-limb crossover, and square hop) was administered under the …