Medicine and Health Sciences Commons^™

Investigating Falls In Adults With Intellectual Disability Living In Community Settings And Their Experiences Of Post-Fall Care Services: Protocol For A Prospective Observational Cohort Study, Portia Ho, Caroline Bulsara, Shane Patman, Max Bulsara, Jenny Downs, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Background: Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain uncertain. Furthermore, people with ID rely heavily on familial and professional care support to address health problems, such as after having a fall. No studies have explored the post-fall care that people with ID receive.

Method: This research will be carried out in two phases using a convergent mixed methods …

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Exploring The Legacy Of Imogene King In The Making Of A Nurse Educator, Leader, And Nurse Theorist, Margaret Mary Kotowski

Dissertations

Imogene King was a pioneer in the profession of nursing. Known primarily for her work as a nurse theorist, King’s career encompassed a great deal more. King was a nurse educator who impacted the lives and careers of hundreds of students through her direct teaching, her mentorship, and generous spirit when it came to share knowledge. King was also a leader in the profession of nursing taking an active role in the various state American Nurse Associations (ANA) where she lived. The ANA awarded her with the prestigious Jessie M. Scott Award for her outstanding work in education. Also, an …

Collaboration Across The Curriculum: Urban Planning & Public Health, Lula Geyre

Senior Honors Theses and Projects

The way our communities are designed impacts our health. and there is an increasing need for collaboration between urban planners and public health professionals. Yet, it is not clear to what extent universities are preparing public health and planning students to work together. Our research will shed light on this important topic by evaluating the course requirements for both of these disciplines in accredited institutions and look at how they are addressing interprofessional issues such as land development, transportation policies, air/water quality, and community growth issues. The current study explores the availability of interdisciplinary courses in accredited undergraduate and graduate …

Oncology Of Different Populations And The Ethical Impact Of The Hela Cell Case And Physician Assisted Suicide On Patient Autonomy, Neha Bakshi

Senior Honors Theses and Projects

An in depth analysis of different types of cancers in various populations such as pediatrics, adults of all ages, and babies that are still in the womb. Discusses the importance of funding research and finding new methods of treatment. This explains the ethical impact of the Henrietta Lacks case and Physician Assisted Suicide (PAS) on patient autonomy and the importance of allowing patients to decide if they want to start or even continue cancer treatments.

Enhancing Collaboration Regarding Long-Term Therapy Planning For Children With Chronic Conditions Using Participatory Action Research, Victoria Ann Mcquiddy

Occupational Therapy Program Student Theses, Dissertations and Capstones

Children with chronic conditions often participate in therapy, but there is little information about how often or for how long therapy services should be provided. Participatory action research (PAR) methods were utilized in this study and, therefore, involved both parents and occupational and physical therapists throughout the study. Parental interviews were conducted to understand parent perception of self-management and how parents felt their child’s therapist was doing or could do to facilitate self-management, particularly as it related to discharge planning or having their child take a break from ongoing therapy. Through analysis of parent interviews completed by the therapist team …

Fine Motor Skills And The Occupations Of Young Adults With Multiple Sclerosis, Mary Squillace

Occupational Therapy Program Student Theses, Dissertations and Capstones

Objective: Multiple sclerosis (MS) is one of the most common neurological diseases affecting adults of working age, and those of younger ages of onset have been increasingly recognized. Twenty-seven percent of people with MS (PwMS) are age 30 years old or younger. The burden of MS for young adults puts them at risk for poorer outcomes regarding their education, family planning, vocation, and social skills as they transition to adulthood. Fine motor (FM) skill impairment might impede performance within the daily occupations of young adults who are transitioning into adulthood. Few studies focus on the occupations and occupational performance of …

Comprehensive Occupational Therapy In A Breast Cancer Program, Nicole Renee Scheiman

Occupational Therapy Program Student Theses, Dissertations and Capstones

The purpose of this capstone project is to develop an evidenced-based, innovative, and comprehensive occupational therapy evaluation and intervention protocol for breast cancer care. The contents of this paper will include an introduction into the current care provided to survivors, literature review on best practice in breast cancer care, outline of the procedures completed to discover what best practice care should be, results of these procedures, discussion of the results, and conclusion with proposed program and recommendations for further investigation. The concern investigated is the inconsistencies in care provided to survivors from the time of diagnosis throughout their lifespan or …

Estimating The Prevalence Of Hepatitis C In Sub-Saharan Africa, William Howard Adams

Dissertations

Hepatitis C (HCV) is a virus transmitted via contact with contaminated products such as razor-blades or by engaging in high-risk activities (i.e., such as sexual or injecting drug-use activities). Today, there are an estimated 115 million people world-wide living with HCV. Despite recent advancements in antiviral treatments that can ameliorate (or even cure) HCV, treatment remains laborious and costly and is often unavailable in resource-poor areas such as Sub-Saharan Africa (SSA). The primary aim of this study was to estimate the prevalence of HCV in SSA.

A meta-analysis was conducted on the HCV epidemic in SSA. A literature search for …

Heteromerization Of G Protein-Coupled Receptors In Human Vascular Smooth Muscle Cells: Identification Of Hetero-Oligomeric Receptor Complexes Between Α1-Adrenergic Receptors, Arginine Vasopressin Recptor 1a, Chemokine (C-X-C Motif) Receptor Type 4, And Atypical Chemokine Receptor 3., Lauren J. Albee

Dissertations

G protein-coupled receptor (GPCR) heteromerization is rapidly evolving field. Traditionally, GPCRs were thought to behave has independent entities or protomers. However, that line of reasoning has since been brought into question. Currently, it appears that many, if not all, GPCRs signal and function as heteromeric receptor complexes. The roles of GPCR heteromerization are vast and can include: maturation and trafficking; dynamic regulation; allostery and cooperativity; signal transduction; and receptor internalization.

The majority of studies identifying and characterizing GPCR heteromers were performed using recombinant receptors. Only four receptor pairs have been identified and validated in native tissues. The overall objective of …

Clearance Concepts: Fundamentals And Application To Pharmacokinetic Behavior Of Drugs, Reza Mehvar

Pharmacy Faculty Articles and Research

Clearance concepts were introduced into the pharmacokinetics discipline in the 1970s and since then have played a major role in characterization of the pharmacokinetic behavior of drugs. These concepts are based on the relationship between organ extraction ratio or clearance and physiologic parameters such as the organ blood flow and the intrinsic capability of the eliminating organ to remove the free (unbound) drug from the body. Several theoretical models have been developed, which define these relationships and may be used to predict the effects of changes in the physiological parameters on various pharmacokinetic parameters of drugs, such as drug clearance. …

Design And Evaluation Of Gemini Surfactant-Based Lipoplexes Modified With Cell-Binding Peptide For Targeted Gene Therapy, Waleed Mohammed-Saeid, Rania Soudy, Richa Tikoo, Kamaljit Kaur, Ronald E. Verrall, Ildiko Badea

Pharmacy Faculty Articles and Research

Purpose Achieving successful gene therapy requires delivery of a gene vector specifically to the targeted tissue with efficient expression and a good safety profile. The objective of this work was to develop, characterize and determine if a novel gemini surfactant-based lipoplex systems, modified with a cancer-targeting peptide p18-4, could serve this role. Methods The targeting peptide p18-4 was either chemically coupled to a gemini surfactant backbone or physically co-formulated with the lipoplexes. The influence of targeting ligand and formulation strategies on essential physicochemical properties of the lipoplexes was evaluated by dynamic light scattering and small angle X-ray scattering techniques. In …

The Western Diet: A Smoking Gun For Chronic Obstructive Pulmonary Disease And Asthma?, Conor Kerley

Other resources

No abstract provided.

A Multi-Discipline Method To Assess The Human Performance In Manufacturing Industry For Safety And Quality Optimization, Lorenzo Comberti, Micaela Demichela, Maria Chiara Leva

Books/Book Chapters/ Proceedings

Nowadays the majority of organizations operating in manufacturing field recognize the importance of including the Human Factor contribution in the industrial process optimization (Hong et al. 2007). Technical measures and work organization procedures have been optimized in order to reduce the defects and waste generation but the Human Performance prediction still represents for Managers a difficult task to deal with. The prediction of the human performances of all workers involved in a production system would help Managers in better allocating the human resources. In order to reach this objective, a model to quantify the human capability of managing a complex …

Evaluating The Needs Of Cancer Survivors Through Focus Groups And Surveillance Data, Maria George Mph, Taylor Seaton Ms, Diana Haggerty M.S., Debbie Webster Bsn, Rn, Lmsw

Michigan Journal of Public Health

Introduction

As cancer prevention and treatment advances, cancer survival rates continue to increase. The growing population of cancer survivors have unique needs that must be addressed to improve quality of life throughout the cancer-care continuum.

Methods

Using data compiled from the Michigan cancer registry, the Michigan Behavioral Risk Factor Survey (MiBRFS), and focus groups, several areas of need amongst cancer survivors were identified. The cancer registry provides information on incidence and survival rates to help understand the burden of cancer; this Quantitative data from the Michigan cancer registry and MiBRFS can supplement the qualitative data gained from the focus groups. …

Biting The Hand That Heals: Mistreatment By Patients And The Well-Being Of Healthcare Workers, Aysegul Karaeminogullari, Berrin Erdogan, Talya N. Bauer

Business Faculty Publications and Presentations

Purpose The purpose of this paper is to explore the relationship between stress due to mistreatment by patients and caregivers’ own well-being indicators (anxiety, depression, and behavioral stress indicators). Based on predictions consistent with the job demands-resources model, it is anticipated that satisfaction with job resources would moderate the relationship between mistreatment by patients and well-being indicators. Design/methodology/approach Hypotheses were tested with a sample of 182 employees in a leading training and research university hospital in Istanbul, Turkey. Results were partially replicated for a separate sample of 122 healthcare workers. Data were collected using the survey methodology. Findings The findings …

Standard Ablation Versus Magnetic Resonance Imaging-Guided Ablation In The Treatment Of Ventricular Tachycardia., Tarek Zghaib, Esra G Ipek, Rozann Hansford, Hiroshi Ashikaga, Ronald D Berger, Joseph E Marine, David D Spragg, Harikrishna Tandri, Stefan L Zimmerman, Henry Halperin, Scott Brancato, Hugh Calkins, Charles Henrikson, Saman Nazarian

Articles, Abstracts, and Reports

No abstract provided.

Congenital Ventricular Diverticulum Or Aneurysm: A Difficult Diagnosis To Make., Lloyd Halpern, Carl Garabedian, Neil K Worrall

Articles, Abstracts, and Reports

A pouch protruding from the free wall of the left ventricle may be either a congenital ventricular diverticulum (CVD) or aneurysm (CVA). Being aware of these rare congenital anomalies is critical in making the diagnosis. Differentiating the two is important for treatment decisions. We describe a patient with dextrocardia, Tetralogy of Fallot, and a congenital left ventricular apical diverticulum diagnosed following the induction of anesthesia. CVD and CVA may present in the antenatal period through late adulthood with differing morphology, location, and symptoms. Echocardiography is paramount in the diagnosis and characterization of these lesions. If this anomaly is encountered after …

Radiation Recall Myelitis Following Paclitaxel Chemotherapy: The First Reported Case., Shearwood Mcclelland, Paul H Cooper, Anupama K Acheson, Jeremy N Ciporen, Jerry J Jaboin, Timur Mitin

Articles, Abstracts, and Reports

Introduction: Stereotactic body radiotherapy (SBRT) of the spine has become an increasingly utilized modality in the United States, most commonly for metastatic disease (McClelland et al., 2017). Spinal SBRT in patients with spinal instrumentation has been sparsely examined. We report a patient who developed myelitis following spinal SBRT to a region with existing hardware.

Methods: A 55-year-old woman with Stage IV breast cancer developed a T4 vertebral body metastasis and underwent tumor debulking with posteriorly instrumented T3-T5 fusion. Postoperatively she proceeded with SBRT to the T3-T5 vertebral bodies, receiving 30 Gy in 6 Gy/fraction. Seven months later, she required paclitaxel …

Surgical Standards For Management Of The Axilla In Breast Cancer Clinical Trials With Pathological Complete Response Endpoint., Judy C Boughey, Michael D Alvarado, Rachael B Lancaster, W Fraser Symmans, Rita Mukhtar, Jasmine M Wong, Cheryl A Ewing, David A Potter, Todd M Tuttle, Tina J Hieken, Jodi M Carter, James W Jakub, Henry G Kaplan, Claire L Buchanan, Nora T Jaskowiak, Husain A Sattar, Jeffrey Mueller, Rita Nanda, Claudine J Isaacs, Paula R Pohlmann, Filipa Lynce, Eleni A Tousimis, Jay C Zeck, M Catherine Lee, Julie E Lang, Paulette Mhawech-Fauceglia, Roshni Rao, Bret Taback, Margaret Chen, Kevin M Kalinsky, Hanina Hibshoosh, Brigid Killelea, Tara Sanft, Gillian L Hirst, Smita Asare, Jeffrey B Matthews, Jane Perlmutter, Laura J Esserman

Articles, Abstracts, and Reports

Advances in the surgical management of the axilla in patients treated with neoadjuvant chemotherapy, especially those with node positive disease at diagnosis, have led to changes in practice and more judicious use of axillary lymph node dissection that may minimize morbidity from surgery. However, there is still significant confusion about how to optimally manage the axilla, resulting in variation among practices. From the viewpoint of drug development, assessment of response to neoadjuvant chemotherapy remains paramount and appropriate assessment of residual disease-the primary endpoint of many drug therapy trials in the neoadjuvant setting-is critical. Therefore decreasing the variability, especially in a …

Secukinumab In The Treatment Of Psoriatic Arthritis: Efficacy And Safety Results Through 3 Years From The Year 1 Extension Of The Randomised Phase Iii Future 1 Trial., Philip J Mease, Arthur Kavanaugh, Andreas Reimold, Hasan Tahir, Jürgen Rech, Stephen Hall, Piet Geusens, Pascale Pellet, Evie Maria Delicha, Shephard Mpofu, Luminita Pricop

Articles, Abstracts, and Reports

Objective: To assess the long-term (3 year) efficacy and safety of secukinumab in patients with active psoriatic arthritis (PsA) in the extension phase of the FUTURE 1 study (NCT01892436).

Methods: Following the 2-year core trial, eligible patients receiving subcutaneous secukinumab 150 or 75 mg entered a 3-year extension phase. Results are presented for key efficacy and safety endpoints at week 156.

Results: In total, 460 patients entered the extension study; 308 patients originally randomised to secukinumab were assessed for efficacy. Sustained improvements in all efficacy endpoints were achieved with secukinumab through week 156. Overall, 76.8%/54.9% (secukinumab 150 mg) and 65.2%/39.0% …

Triheptanoin: A Rescue Therapy For Cardiogenic Shock In Carnitine-Acylcarnitine Translocase Deficiency., Sidharth Mahapatra, Amitha Ananth, Nancy Baugh, Mihaela Damian, Gregory M Enns

Articles, Abstracts, and Reports

Carnitine-acylcarnitine translocase (CACT) deficiency is a rare long-chain fatty acid oxidation disorder (LC-FAOD) with high mortality due to cardiomyopathy or lethal arrhythmia. Triheptanoin (UX007), an investigational drug composed of synthetic medium odd-chain triglycerides, is a novel therapy in development for LC-FAOD patients. However, cases of its safe and efficacious use to reverse severe heart failure in CACT deficiency are limited. Here, we present a detailed report of an infant with CACT deficiency admitted in metabolic crisis that progressed into severe cardiogenic shock who was successfully treated by triheptanoin. The child was managed, thereafter, on triheptanoin until her death at 3 …

Catecholaminergic Polymorphic Ventricular Tachycardia Patients With Multiple Genetic Variants In The Paces Cpvt Registry., Thomas M Roston, Omid Haji-Ghassemi, Martin J Lapage, Anjan S Batra, Yaniv Bar-Cohen, Chris Anderson, Yung R Lau, Kathleen Maginot, Roman A Gebauer, Susan P Etheridge, James E Potts, Filip Van Petegem, Shubhayan Sanatani

Articles, Abstracts, and Reports

BACKGROUND: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is often a life-threatening arrhythmia disorder with variable penetrance and expressivity. Little is known about the incidence or outcomes of CPVT patients with ≥2 variants.

METHODS: The phenotypes, genotypes and outcomes of patients in the Pediatric and Congenital Electrophysiology Society CPVT Registry with ≥2 variants in genes linked to CPVT were ascertained. The American College of Medical Genetics & Genomics (ACMG) criteria and structural mapping were used to predict the pathogenicity of variants (3D model of pig RyR2 in open-state).

RESULTS: Among 237 CPVT subjects, 193 (81%) had genetic testing. Fifteen patients (8%) with …

Lower Serum Iga Is Associated With Copd Exacerbation Risk In Spiromics., Nirupama Putcha, Gabriel G Paul, Antoine Azar, Robert A Wise, Wanda K O'Neal, Mark T Dransfield, Prescott G Woodruff, Jeffrey L Curtis, Alejandro P Comellas, M Bradley Drummond, Allison A. Lambert, Laura M Paulin, Ashraf Fawzy, Richard E Kanner, Robert Paine, Meilan K Han, Fernando J Martinez, Russell P Bowler, R Graham Barr, Nadia N Hansel

Articles, Abstracts, and Reports

BACKGROUND: Decreased but measurable serum IgA levels (≤70 mg/dL) have been associated with risk for infections in some populations, but are unstudied in COPD. This study tested the hypothesis that subnormal serum IgA levels would be associated with exacerbation risk in COPD.

METHODS: Data were analyzed from 1,049 COPD participants from the observational cohort study SPIROMICS (535 (51%) women; mean age 66.1 (SD 7.8), 338 (32%) current smokers) who had baseline serum IgA measured using the Myriad RBM biomarker discovery platform. Exacerbation data was collected prospectively (mean 944.3 (SD 281.3) days), and adjusted linear, logistic and zero-inflated negative binomial regressions …

Therapeutic Benefit Of Apremilast On Enthesitis And Dactylitis In Patients With Psoriatic Arthritis: A Pooled Analysis Of The Palace 1-3 Studies., Dafna D Gladman, Arthur Kavanaugh, Juan J Gómez-Reino, Jürgen Wollenhaupt, Maurizio Cutolo, Georg Schett, Eric Lespessailles, Benoit Guerette, Nikolay Delev, Lichen Teng, Christopher J Edwards, Charles A Birbara, Philip J Mease

Articles, Abstracts, and Reports

Objective: The Psoriatic Arthritis Long-term Assessment of Clinical Efficacy (PALACE) clinical trial programme findings demonstrated that apremilast, an oral phosphodiesterase 4 inhibitor, is effective for treating psoriatic arthritis (PsA). Enthesitis and dactylitis are difficult-to-treat features of PsA leading to disability and affecting quality of life. PALACE 1, 2 and 3 data were pooled to assess the efficacy of apremilast on enthesitis and dactylitis outcomes in patients with these conditions at baseline.

Methods: Patients with enthesitis (n=945) or dactylitis (n=633) at baseline were analysed after receiving double-blind treatment with placebo, apremilast 30 mg two times per day or apremilast 20 mg …

Patient-Reported Outcomes In A Phase Ii, North American Study Of Alectinib In Patients With Alk-Positive, Crizotinib-Resistant, Non-Small Cell Lung Cancer., Sai-Hong Ignatius Ou, Mark A Socinski, Shirish Gadgeel, Leena Gandhi, Howard West, Alberto Alejandro Chiappori, Victor Cohen, Gregory J Riely, Vlatka Smoljanovic, Walter Bordogna, Elaine Wright, Kendra Debusk, Ali Zeaiter, Alice T Shaw

Articles, Abstracts, and Reports

Background: In a phase II North American study (NP28761; NCT01871805), the anaplastic lymphoma kinase (ALK) inhibitor alectinib demonstrated both systemic and central nervous system (CNS) efficacy with good tolerability in patients with

Patients and methods: PROs and health-related quality of life (HRQoL) benefits were assessed using two self-administered questionnaires (the European Organisation for Research and Treatment of Cancer 30-Item Quality of Life Questionnaire-Core (EORTC QLQ-C30), and the 13-item EORTC QLQ-lung cancer-specific module) at enrolment and every 6 weeks until week 66, disease progression or death.

Results: Clinically meaningful mean improvements (≥10 point change from baseline) were observed in 10 domains, …

Feasibility And Acceptability Of Hiv Self-Testing Among Men Who Have Sex With Men In Nigeria, Population Council

HIV and AIDS

HIV self-testing (HIVST) provides an alternative to facility-based HIV testing services, particularly for key populations such as men who have sex with men (MSM), who face barriers to testing due to stigma, discrimination, and criminalization. This brief reports on a study in Nigeria that demonstrates high acceptability for HIVST among MSM. Lessons learned from this study indicate that the scale-up of HIVST in Nigeria must include provision of adequate pre- and post-test counseling information, as well as the availability of helpline support to improve linkage to care for those who test positive. Future research should explore how HIV retesting can …

The Need For Certified Diabetes Educators And Community Health Workers In Community-Based Diabetes Self-Management Education For High Risk Groups, Frances J. Feltner, Sydney P. Thompson, Melissa Slone

Center of Excellence in Rural Health Workforce Reports

The number of Americans with diabetes is projected to double, or triple by 2050 according to the Center for Disease Control (CDC). The CDC reports that as many as 1 in 3 U.S. adults could have diabetes by 2050, currently 1 in 10 U.S. adults has diabetes. Longer lifespans and an older, more diverse population are consider contributing factors for the current trend. Research shows that in spite of prevention efforts and medical advances, the prevalence of diabetes will increase by 54% between 2015 and 2030; annual deaths attributed to diabetes will climb by 38%; and total annual medical and …

Promoting Cognitive Conflict In Health Care Ethics: Moral Reasoning With Boundary Cases, Julia Bursten, Samantha Finkelstein

Philosophy Faculty Publications

As many college students are at a time of tremendous personal and academic growth, introductory philosophy courses have the potential to equip students with practical critical reasoning skills. Despite this, many introductory courses in this domain emphasize students’ learning about pre-existing dialectics in the abstract, rather than over self-reflection and development of personal philosophical perspectives. In doing so, we may be failing to support the needs of pre-professional students looking to prepare themselves for their careers ahead. In this practitioner paper, we report our efforts as a practicing philosophy instructor (Bursten) and a learning scientist (Finkelstein) to iterate on the …

Using The Health Belief Model To Assess Undergraduate College Students Knowledge And Perceptions Of Human Papillomavirus In Order To Better Understand Vaccine Intentions, Kelly Mcmahon

All Graduate Theses, Dissertations, and Other Capstone Projects

According to the Centers for Disease control and Prevention (CDC)(2016b), Human Papillomavirus (HPV) is the most commonly sexually transmitted infection in the United States. HPV is so prevalent that nearly all sexually active people will obtain a strain of HPV at some point in their lives (CDC, 2016d). Approximately one in four Americans are currently infected in the United States with HPV, and approximately 14 million new infections of HPV spread each year in the United States (CDC, 2016b).

Ultimately the HPV vaccination is a form of cancer prevention. With the vaccination uptake, the burden of HPV related health problems …