Medicine and Health Sciences Commons^™

Pediatric In-Patient Days Predictive Model, Dana Nicholson Bledsoe

MUSC Theses and Dissertations

The study objective is to develop a predictive model for pediatric inpatient days based on ambulatory outpatient visits and emergency department visits. This model aims to study the relationship between ambulatory visits and inpatient days, and determine if in-patient days can be predicted based on sub-specialty practice. Such a model does not currently exist, and when created and validated such a model could be utilized for various important management decisions, including refined insight into inpatient capacity and operational efficiency for self-governing children’s hospitals with large sub-specialty practices. The data set was a sample of convenience from one health system in …

Adolescent Girls Empowerment Program (Agep), Population Council

Poverty, Gender, and Youth

For Zambian girls, social isolation, economic vulnerability, and lack of appropriate health information and services are critical problems that prevent a healthy transition from girlhood to womanhood. The challenges that girls are confronted with—high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, lack of agency and participation—are linked together through their root causes. Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program for vulnerable adolescent girls in Zambia. This brief summarizes …

The Headache Champion Program, Courtney Wellman, Kristin Allender

Posters

BACKGROUND

Approximately 10% of school age children suffer from migraines, making migraines one of the top five health problems experienced by youth today

School nurses often are the first healthcare provider seen by youth with migraine; visits to the school nurse for headaches amounted to one-third of the enrolled student population in a large local school district. (see reference)

Empowering school nurses through education and resources to identify and manage migraines therefore may have significant benefits to children with migraines and their families.

OBJECTIVE

To improve migraine care in the community through establishing a headache specialist mentorship program for select …

Peer Accountability Improves Performance For Daily Chg Bathing To Reduce Clabsis, Sara Crawford, Stacy Pennington, Jeremy Affolter, Kathlyn Baharaeen, Paul N. Bauer, Tara Benton, Shekinah Hensley, Tiffany Mullen, Michelle Waddell

Posters

No abstract provided.

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Adolescent Girls Empowerment Program (Agep): Sexual And Gender-Based Violence, Karen Austrian, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Acceptability and experience of sexual and gender-based violence is alarmingly high among adolescent girls in Zambia. Even more striking is the very young age from which notions of violence are ingrained and experience with violence begins. This brief summarizes the Adolescent Girls Empowerment Program (AGEP) evaluation which demonstrated that in the Zambian context, a program focused on changing norms among girls themselves is not enough to impact attitudes toward and experience of violence. Social and cultural norms are shaped by households, schools, communities, and all of the adults that girls interact with in these places—even the mentors of their own …

Child Domestic Work And Transitions To Commercial Sexual Exploitation: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

There are an estimated 17.2 million child domestic workers in the world, and the vast majority are girls. Domestic work keeps children out of school, confined to the home, socially isolated, and burdened with excessive domestic duties. Furthermore, evidence is emerging that domestic work is a feeder profession for sex work. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in Ethiopia. The domestic work conditions described in this brief create unbearable conditions for girls who enter into commercial sex work as an alternative, hoping for an improvement in their work situation. The study found that a …

Forced Child Unions: From Legal Reform To Social Disruption—Formative Research In Five Communities In Chisec, Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

Evidence has shown that child early and forced marriage/unions (CEFM/U) are harmful to the rights and development of girls and adolescents. It has also shown that increasing the minimum marriage age is not enough to eradicate this phenomenon because of the underlying practices of social institutions at the community level. This report details an investigation undertaken when a modification to the Civil Code was approved, then modified, in order to increase the minimum age of marriage in Guatemala. The investigation aimed to identify the norms, practices, and attitudes prevailing in the school, family, religion, government, and economy with regard to …

Girlsread! E-Reader Curriculum, Natalie Jackson Hachonda, Nicole Haberland, Abdul-Kahad Alhassan, Beatrice Ani-Asamoah, Pamela Nyirenda, Barbara Mensch

Poverty, Gender, and Youth

Zambian adolescent girls are at risk for premature school leaving and HIV infection due to a host of contextual factors including child marriage, early childbearing, harmful gender norms, and intimate partner violence. This report describes the GirlsRead! program, whose overall goal is to enhance learning and increase progression to secondary school among Zambian adolescent girls in grade 7, the last year of primary school. Through GirlsRead!, the Population Council, together with FAWEZA and Worldreader are aiming to improve school retention by bolstering girls’ learning outcomes, furthering social connections, improving critical thinking skills, increasing agency, and fostering community norms supportive of …

Migration And Child Domestic Work: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

Domestic work is frequently the initial survival strategy for rural Ethiopian girls migrating to urban areas. Following migration from rural areas, most girls enter the workforce as domestic workers, because it is a readily available form of work requiring little or no education. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in urban and rural areas in six Ethiopian regions which demonstrated that this is a common phenomenon. Originating from poor rural areas and armed with little in the way of education, domestic workers receive low pay and frequently work in abusive situations, including sexual abuse. …

Nisitu (Nisikilize Tujengane): Listen To Me, Let’S Grow Together, Population Council

Poverty, Gender, and Youth

Evidence from several studies, including in Kenya, supports the idea that empowerment and asset-building interventions targeting multiple levels of the socio-ecological environment can improve education, health, economic and social capital, gender-equitable attitudes, and violence outcomes for girls. This brief describes efforts by researchers to test the effects of engaging boys and men alongside girl-centered programming to improve the lives of adolescent girls. In 2017, the Population Council and partners undertook formative research to understand from girls: 1) what are the most influential types of males in their lives; 2) how and what they influence; and 3) what behavior changes among …

Building Resilience In Communities Most Vulnerable To Environmental Stressors, Jessie Pinchoff

Poverty, Gender, and Youth

Evidence suggests that the frequency and intensity of environmental hazards such as floods, cyclones, and droughts may be increasing, leading to high volatility in many parts of the world. The impact of these events falls unequally on the most vulnerable individuals, households, and communities. To fully understand and address the needs of vulnerable communities, the Population Council is building on its existing research, deep global research expertise, and proven approaches in reaching and working with vulnerable populations to examine how humans interact with their environments and explore how to test and develop successful strategies for building resilience. This report presents …

Accelerating Action To End Child Marriage In Bangladesh, Sajeda Amin, Jyotirmoy Saha, Masuma Billah, Nargis Sultana, Eashita Haque, Surojit Kundu

Poverty, Gender, and Youth

Despite considerable social and economic progress in Bangladesh, child marriage remains the norm. The Population Council is partnering with UNFPA and the Ministry of Women and Children Affairs to empower girls with gender, life, and livelihood skills, and to engage communities to address fundamental normative drivers of child marriage. The objective of the baseline study is to generate a set of indicators against which change can be measured, and to provide specific information about the status of adolescents in the study area in ways that can guide intervention strategies and inform programs and policies. Baseline findings will provide a benchmark …

Las Uniones Infantiles Forzadas: De La Reforma Legal A La Disrupción Social—Investigación Formativa En Cinco Comunidades En Chisec Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

La evidencia ha demostrado que el matrimonio y las uniones infantiles forzadas (M/UIF) son nocivos a los derechos y el desarrollo de las niñas y adolescentes. También se ha demostrado que aumentar la edad mínima del matrimonio no es suficiente para erradicar este fenómeno que subyace en la práctica de las instituciones sociales a nivel comunitario. Se ha realizada esta investigación en el momento en que se aprobó la modificación al Código Civil, seguido de una modificación para aumentar la edad mínima para el matrimonio en Guatemala, con el propósito de identificar las normas, prácticas, y actitudes vigentes en la …

What Works To Improve Outcomes For Kenya's Adolescent Girls?, Population Council

Poverty, Gender, and Youth

This fact sheet outlines results from the Adolescent Girls Initiative–Kenya, a study that evaluates the long-term impact of a multi-sectoral intervention targeted at adolescent girls aged 11 to 15 years from Kibera and rural Wajir. The intervention consists of four different components: a community-based violence-prevention program, an education conditional cash transfer (CCT), health-focused girls' empowerment clubs, and wealth creation for girls via financial education and savings. Results indicate that the approach was a cost-effective way to create positive change across a range of well-being factors for young adolescent girls, including education, health, and economic outcomes.

Community-Level Assessment Of Heatwaves In Odisha State, India: Effects, Resilience And Implications, Sangram Kishor Patel

Poverty, Gender, and Youth

Heatwaves constitute a potential threat to many of India’s states, including Odisha, and their impact could become acute without adaptive capacity. This research brief explores the perceived causes and experiences of climate change and heatwave by stakeholders in the district. It summarizes reported effects on livelihoods, food security, and livestock; water and sanitation; and health, and reviews coping strategies offered by respondents. The report includes a number of recommendations to meet the needs of the population as indicated by the findings.

Adolescent Girls Initiative–Kenya: Midline Results Report, Karen Austrian, Erica Soler-Hampejsek, Joyce Mumah, Beth Kangwana, Yohannes Dibaba Wado, Benta Abuya, Valsa Shah, John A. Maluccio

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. In addition to low educational attainment and health risks, other factors that impact education and health outcomes include household poverty, lack of economic independence, limited income-earning opportunities, illiteracy, violence, and social isolation. Younger adolescent girls who live in environments laden with these vulnerabilities are at risk of experiencing negative outcomes such as school dropout, early sexual initiation, unintended pregnancy, early marriage, and sexual and gender-based violence. The Adolescent Girls Initiative–Kenya (AGI-K) delivered multisectoral interventions to over 6,000 girls aged 11–15 in …

Decreasing Cardiac Arrests In The Pediatric Intensive Care Unit, Jeremy Affolter, Kathlyn Baharaeen, Mari Hanson, Lisa Laddish, Amy Bohm, Lindsey Bradbury, Megan Mcghee, Anne Leroy, Hannah Cunningham, Michelle Waddell, Tiffany Mullen, Kimberly Lucas, William Douglas, Angel Pope, Marita Thompson, Paul N. Bauer, Erica Molitor-Kirsch, Tara Benton, Laura Miller-Smith

Posters

No abstract provided.

Efficacy Of A Platelet-Rich Plasma Injection For The Treatment Of Proximal Hamstring Tendinopathy: A Pilot Study, Gavin M. Levy, Phil Lucas, Nigel Hope

Sciences Papers and Journal Articles

Objectives: To determine the efficacy of an ultrasound-guided platelet-rich plasma (PRP) injection in the treatment of patients with proximal hamstring tendinopathy (PHT).

Design: Pilot prospective cohort study

Methods: Administration of a single PRP injection under ultrasound guidance to 29 patients with PHT confirmed on magnetic resonance imaging (MRI). Pain, function and sporting activity were measured via the Victorian Institute of Sport Assessment-Proximal Hamstring Tendons (VISA-H) questionnaire, administered before injection and at 8-weeks follow-up.

Results: The study sample consisted of 22 females and 7 males with a mean age of 45.2 years (95% CI40.8–49.5). When comparing pre-injection VISA-H scores (mean: 43.90; …

A Rare Case Of Presacral Epidermoid Cyst In An Adult Male: Emphasis On Diffusion Weighted Magnetic Resonance Sequences In Preoperative Imaging., Muhammad I. Alvi, Fatima Mubarak, Kumail Khandwala, Muhammad Nanish Barakzai, Aisha Memon

Department of Radiology

Epidermoid cyst of the presacral space is a rare congenital lesion of ectodermal origin. Presacral epidermoid cysts have been previously reported in women, however are extremely rare in males. We report a case of presacral epidermoid cyst in a 55-year-old male who presented to our emergency department with acute urinary retention and history of chronic constipation. A non-contrast computed tomography scan was performed with suspicion of urolithiasis, which revealed a well circumscribed low attenuation presacral mass. Magnetic resonance imaging (MRI) of the pelvis was subsequently performed to further characterize the lesion. The mass was returning hypointense T1 and hyperintense T2 …

Scalable Feature Selection And Extraction With Applications In Kinase Polypharmacology, Derek Jones

Theses and Dissertations--Computer Science

In order to reduce the time associated with and the costs of drug discovery, machine learning is being used to automate much of the work in this process. However the size and complex nature of molecular data makes the application of machine learning especially challenging. Much work must go into the process of engineering features that are then used to train machine learning models, costing considerable amounts of time and requiring the knowledge of domain experts to be most effective. The purpose of this work is to demonstrate data driven approaches to perform the feature selection and extraction steps in …

Interactive Clinical Event Pattern Mining And Visualization Using Insurance Claims Data, Zhenhui Piao

Theses and Dissertations--Computer Science

With exponential growth on a daily basis, there is potentially valuable information hidden in complex electronic medical records (EMR) systems. In this thesis, several efficient data mining algorithms were explored to discover hidden knowledge in insurance claims data. The first aim was to cluster three levels of information overload(IO) groups among chronic rheumatic disease (CRD) patient groups based on their clinical events extracted from insurance claims data. The second aim was to discover hidden patterns using three renowned pattern mining algorithms: Apriori, frequent pattern growth(FP-Growth), and sequential pattern discovery using equivalence classes(SPADE). The SPADE algorithm was found to be the …

Enhanced Corrosion Resistance And Cytocompatibility Of Biomimetic Hyaluronic Acid Functionalised Silane Coating On Az31 Mg Alloy For Orthopaedic Applications, Sankalp Agarwal, Marie Noëlle Labour, David A. Hoey, Brendan Duffy, James Curtin, Swarna Jaiswal

Articles

This paper reports the corrosion resistant and cytocompatible properties of the hyaluronic acid-silane coating on AZ31 Mg alloy. In this study, the osteoinductive properties of high molecular weight hyaluronic acid (HA, 1–4 MDa) and the corrosion protection of silane coatings were incorporated as a composite coating on biodegradable AZ31 Mg alloy for orthopaedic applications. The multi-step fabrication of coatings first involved dip coating of a passivated AZ31 Mg alloy with a methyltriethoxysilane-tetraethoxysilane sol-gel to deposit a dense, cross-linked and corrosion resistant silane coating (AZ31-MT). The second step was to create an amine-functionalised surface by treating coated alloy with 3-aminopropyl-triethoxy silane …

Stories Of Strength: Chicago Latin@S' Navigation Of Health, Well-Being, And Chronic Disease, Lilian L. Milanés

Theses and Dissertations--Anthropology

Health inequalities take many forms related to race, gender, socioeconomic status, ethnic, language and many other axes throughout communities around the world. Type two diabetes, high blood pressure, and high cholesterol are examples of conditions (among many others) that disproportionately affect Latino@s in the U.S.. The research of this dissertation is based on fieldwork conducted throughout several predominantly Latin@ neighborhoods in Chicago, IL. This dissertation examines how Latin@s in Chicago navigate health and well-being, and how they engage in agentive strategies in the face of chronic disease. I recorded individual life histories and semi-structured interviews, focus groups, and participant observation …

Parent Rated Importance Of Active Play And Organised Physical Activity For Young Children, Casey Murphy

Theses

Background: Children participate in less daily physical activity, both organised and informal, often referred to as active play (AP), than in the past. For young children, parents are primarily responsible for planning their child’s day including their engagement in physical activity.

Purpose: As there has been little research in this area, the purpose of this study was to examine how parents rated the importance of their child’s level of AP and organised physical activity (OPA), how this affected the amount of time their child participated in these activities, and whether their child’s physical activity (PA) related to their own level …

The Identification Of The Role And Competencies Of The Graduate Nurse In Recognising And Responding To The Deteriorating Patient In An Acute Ward Environment: A Mixed Methods Study, Steven Hardman

Theses

The identification of the role and competencies of the graduate nurse in recognising and responding to the deteriorating patient in an acute ward environment: A mixed method study. Patients’ physiological condition can be unstable for prolonged periods before transfer to critical care units. Thus, it is imperative that ward based nurses are able to recognise, respond and initially manage patients with a deteriorating condition. Unfortunately, warning signs of physiological decline are often missed, or ignored by both experienced and newly graduated registered nurses. Complex systems and processes to recognise and respond to clinical deterioration have been developed to try to …

Nursing Home Infection Control Program Characteristics, Cms Citations, And Implementation Of Antibiotic Stewardship Policies: A National Study., Patricia W. Stone, Carolyn T.A. Herzig, Mansi Agarwal, Monika Pogorzelska-Maziarz, Andrew W. Dick

College of Nursing Faculty Papers & Presentations

Recently, the Centers for Medicare & Medicaid Services (CMS) final rule required that nursing homes (NHs) develop an infection control program that includes an antibiotic stewardship component and employs a trained infection preventionist (IP). The objectives of this study were to provide a baseline assessment of (1) NH facility and infection control program characteristics associated with having an infection control deficiency citation and (2) associations between IP training and the presence of antibiotic stewardship policies, controlling for NH characteristics. A cross-sectional survey of 2514 randomly sampled US NHs was conducted to assess IP training, staff turnover, and infection control program …

Elevated Blood Lead Levels, Cancer Incidence, And All-Cause Mortality In Adults, Sherri L. Davidson

All ETDs from UAB

Epidemiologic studies have indicated an association between lead exposure and cancer. Although lead exposure has declined in recent decades, from removal of lead in gasoline and paint, lead exposure remains a health concern from environmental and occupational sources including aging water systems. In a retrospective cohort study, Adult Blood Lead Epidemiology and Surveillance (ABLES) records in Alabama were linked to cancer incidence data in the Alabama Statewide Cancer Registry and mortality data from the Alabama Center for Health Statistics, using a probabilistic linkage program. Blood lead level (BLL) measurements were used to categorize exposure levels. Odds ratios approximated relative risks. …

Mintbase V2.0: A Comprehensive Database For Trna-Derived Fragments That Includes Nuclear And Mitochondrial Fragments From All The Cancer Genome Atlas Projects., Venetia Pliatsika, Phillipe Loher, Rogan Magee, Aristeidis G. Telonis, Eric R. Londin, Megumi Shigematsu, Yohei Kirino, Isidore Rigoutsos

Computational Medicine Center Faculty Papers

MINTbase is a repository that comprises nuclear and mitochondrial tRNA-derived fragments ('tRFs') found in multiple human tissues. The original version of MINTbase comprised tRFs obtained from 768 transcriptomic datasets. We used our deterministic and exhaustive tRF mining pipeline to process all of The Cancer Genome Atlas datasets (TCGA). We identified 23 413 tRFs with abundance of ≥ 1.0 reads-per-million (RPM). To facilitate further studies of tRFs by the community, we just released version 2.0 of MINTbase that contains information about 26 531 distinct human tRFs from 11 719 human datasets as of October 2017. Key new elements include: the ability …

Overcoming Obesity-Induced Immunotherapeutic Impairment, Shannon Boi

All ETDs from UAB

Obesity affects ~40% of United States adults and is linked to the development of multiple health-related complications. Obesity is a major risk factor for developing renal cell carcinoma (RCC), the most common type of renal cancer. Metastatic RCC has poor five-year survivals, therefore, new, efficacious therapeutics are needed. One avenue is immunomodulation to generate tumor-specific, systemic anti-tumor responses that are long-lasting against local, metastatic, and recurrent tumors. Despite encouraging results, immunotherapeutic treatment of RCC is underwhelming. Cytokine therapies are largely toxic, while newly FDA-approved ‘checkpoint blockade’ (CB) antibodies have responses <50%. Here, we present a strategy employing a T cell priming therapy (AdTR/CpG) upstream of CB administration. Combinatorial use resulted in improved anti-tumoral immune responses, significantly reduced tumor burdens, and extended overall survival in pre-clinical RCC. Importantly, this approach was more efficacious than either single agent(s). Pre-clinical therapy development is often accomplished using lean, healthy animals–thus, to improve translatability we examined immune responses in the context of obesity as a major patient comorbidity. Subsequently, we investigated AdTR/CpG/CB in diet-induced obese (DIO) mice. Tumor/treatment-naïve DIO mice exhibited obesity-associated features; i.e., increased leptin/insulin and serum cytokines. These effects were not dependent on high-fat diet administration as mice resistant to weight gain had minimal alterations in these factors, and were similar to mice maintained on standard chow. As previously identified, 80% of DIO mice bearing renal tumors failed to respond to AdTR/CpG. AdTR/CpG/CB-treatment dramatically improved response rates against DIO tumors, however, decreased obese responder percentages were observed in both combinatorial therapies and was independent of high fat diet administration alone. Impaired response rates were not model or immunotherapy-specific as similar reductions in tumor clearance were seen in models of melanoma and sarcoma. Furthermore, responses were not due to initial T cell priming or unequal precursor CD8+ T cell frequencies. Detrimental changes in the tumor microenvironment underscored failure in obese mice and revealed therapeutic success was defined by a T cell-myeloid cell-inversion profile, supported by immunogenetic and flow cytometric analyses. Thus, we demonstrate a novel combinatorial approach for improving checkpoint-based outcomes, and identify the ability of host obesity to impede therapy-induced anti-tumor immunity.