Medicine and Health Sciences Commons^™

The Effects Of The Affordable Care Act On The Receipt Of Colonoscopies Among Insured Elderly, Min Jee Lee

Theses and Dissertations

Background: The Affordable Care Act (ACA) waived deductibles and eliminated coinsurance for colonoscopies for Medicare beneficiaries beginning on January 1, 2011. This study investigated the effect of the ACA’s removing of financial barriers on the receipt of colonoscopies among insured elderly, who are predominantly covered by Medicare. Moreover, this study examined how income-related disparities in colonoscopy use have changed over the past decade and attempted to quantify various contributions to income-related disparity in the use of colonoscopies among insured elderly. Methods: Five cycles (2008, 2010, 2012, 2014, and 2016) of the Behavioral Risk Factor Surveillance System (BRFSS) were utilized to …

Individual Differences In Music Discrimination And Their Relation To Reading And Reading-Related Skills In Children, Elaina C. Hill

Theses and Dissertations

Research suggests that there may be a relationship between music and reading. Some researchers have found that musical rhythm is related to reading in children, while others have found that it is musical pitch and not rhythm that correlates with reading. Prosody is the melodic element of language that encompasses both pitch and rhythm. In the past, these have been studied separately. In the present study, we analyzed pitch and rhythm discrimination skills, phonological awareness, prosody and reading in thirty-nine seven and eight year old children. We predicted that music and reading skills would be related, and that prosody would …

Mechanistic Study Of P23-Mediated Aryl Hydrocarbon Receptor Expression, Beverly Pappas

University of the Pacific Theses and Dissertations

The aryl hydrocarbon receptor (AHR) is a ligand-activated signaling molecule which is involved in diverse biological functions ranging from cancer metastasis to immune regulation. This receptor forms a cytoplasmic complex with Hsp90, p23, and XAP2. We have previously reported that down-regulation of p23 triggers degradation of the AHR protein, uncovering a potentially dynamic event which controls the cellular AHR levels without ligand treatment. Here we investigate the underlying mechanisms for this p23 effect using wild-type HeLa and the p23 knockdown HeLa cells. Reduction of the Hsp90 and XAP2 contents, however, did not affect the AHR protein levels, implying that this …

Getting On The Same Page: A Grounded Theory Study Of Nurse And Physician Collaborative Practice Development, Julie Cerese

Dissertations

The movement toward an integrated approach to healthcare professionals' education, interprofessional education (IPE), has been advancing over the past 60 years in the United Kingdom, Canada, and more recently in the United States. Support for IPE as a mechanism to positively impact collaborative practice and patient outcomes comes from international and national healthcare and educational leadership agencies as well as professional medicine and nursing thought leaders. Theories have evolved to explain the linkages among IPE, collaborative practice, and positive patient outcomes. Researchers have found support for the short term positive impact of IPE on attitudes, perceptions, clarity about roles and …

The Impact Of Mood On Health Behaviors And Quality Of Life For Women With Cardiovascular Disease, Jacqueline Ann Tulley

Dissertations

Methods/Measurements: A cross-sectional correlational design explored the relationships between symptoms, functional status, health perceptions and QoL in women with CVD. The aims of the study were: 1) to determine the relationship of symptoms (depression/anxiety) to functional status (health-promoting behaviors), health perceptions (illness perception), and QoL; and 2) to determine whether age is a factor contributing to negative mood symptoms, functional status, health perceptions, and QoL after controlling for social support. Measurements were collected at one time-point to address these aims that included the following: biological function (Framingham Recurrent Risk Model and Functional Comorbidity Index), symptoms (Patient Health Questionnaire-8 and Generalized …

Mechanisms And Consequences Of Epigenetic Inheritance Following Parental Preconception Alcohol Exposure, Annadorothea Asimes

Dissertations

Recent advances in genomics research have revealed that preconception behaviors and experiences of mothers and fathers, including diet, environmental toxicants, and drug abuse, can impact future offspring through epigenetic mechanisms. This means that the risky behaviors of young people, such as the extremely popular practice of binge drinking, have potentially far-reaching consequences for generations to come. While there has been considerable research into fetal alcohol exposure and parental alcoholism, there has yet to be sufficient investigation into the mechanism of epigenetic inheritance or the functional consequences of parental preconception binge pattern alcohol abuse. The hypothesis tested herein is that parental …

Divergent Pro-Leukemic Effects Of Myd88 And Ticam-1/Trif Mediated Toll-Like Receptor Signaling, Joseph Michael Cannova

Dissertations

The goal of this study is to determine the role of Toll-like receptor (TLR) signaling in acute myeloid leukemia (AML). AML is a hematopoietic malignancy that predominately affects the elderly. The median age of AML diagnosis is 67 years old. The standard of care of AML is treatment with cytotoxic chemotherapy, which elderly patients are often unable to tolerate. To identify novel pathways as potential targets for treatment, a microarray on AML primary patient samples was performed to determine the expression of key inflammatory genes. This microarray, and other published datasets, showed that TLR are overexpressed in myelomonocytic (M4) and …

Perceptions Of Pediatric Hospital Safety Culture In The U.S.: A Secondary Data Analysis Of The 2016 Hospital Survey On Patient Safety Culture, Pamela J. Gampetro

Dissertations

This study explored differences in conceptualizing safety cultures in pediatric hospitals and specialty units from an interprofessional perspective on a national level. Errors in the pediatric population can quickly cause harm and frequently lead to adverse events (AEs). Research has explored the problems of patient harm and identified strategies to prevent those harms; but sustainable improvements, particularly in pediatric settings, have not been achieved. This cross-sectional descriptive study used national data from the Hospital Survey on Patient Safety Culture's 2016 dataset developed by the Agency for Healthcare Research and Quality measuring 12 dimensions of safety culture. The extracted sample included …

The Molecular Pathophysiology Of Sepsis-Associated Disseminated Intravascular Coagulation And Its Pharmacologic Modulation, Amanda Temple Walborn

Dissertations

Sepsis is a life-threatening syndrome characterized by a dysregulated host response to infection. Sepsis patients are at risk of disseminated intravascular coagulation (DIC), a severe blood coagulation disorder. In DIC, inappropriate coagulation leads to the deposition of fibrin in the microvasculature and subsequent organ failure. This consumes platelets and coagulation factors, leaving patients at risk of severe or fatal bleeding. No treatments are approved for DIC in the United States.

In order to test the hypothesis that DIC would be best described by a combination of biomarkers representative of multiple physiological processes, an array of biomarkers, representative of hemostasis, inflammation, …

Metabolomic Profiles In Breast Cancer: A Pilot Case-Control Study In The Breast Cancer Family Registry, Marcelle Dougan, Yuqing Li, Lisa Chu, Robert Haile, Alice Whittemore, Summer Han, Steven Moore, Joshua Sampson, Irene Andrulis, Esther John, Ann Hsing

Faculty Publications

Background Metabolomics is emerging as an important tool for detecting differences between diseased and non-diseased individuals. However, prospective studies are limited. Methods We examined the detectability, reliability, and distribution of metabolites measured in pre-diagnostic plasma samples in a pilot study of women enrolled in the Northern California site of the Breast Cancer Family Registry. The study included 45 cases diagnosed with breast cancer at least one year after the blood draw, and 45 controls. Controls were matched on age (within 5 years), family status, BRCA status, and menopausal status. Duplicate samples were included for reliability assessment. We used a liquid …

Multi-Drug Resistant Escherichia Coli In Diarrhoeagenic Foals: Pulsotyping, Phylotyping, Serotyping, Antibiotic Resistance And Virulence Profiling, C.A. Kennedy, Ciara Walsh, M. Karczmarczyk, S. O'Brien, N. Akasheh, M. Quirke, S. Farrell-Ward, T. Buckley, U. Fogherty, K. Kavanagh, C.T. Parker, T. Sweeney, S. Fanning

Articles

Extraintestinal pathogenic E. coli (ExPEC) possess the ability to cause extraintestinal infections such as urinary tract infections, neonatal meningitis and sepsis. While information is readily available describing pathogenic E. coli populations in food-producing animals, studies in companion/sports animals such as horses are limited. In addition, many antimicrobial agents used in the treatment of equine infections are also utilised in human medicine, potentially contributing to the spread of antibiotic resistance determinants among pathogenic strains. The aim of this study was to phenotypically and genotypically characterise the multidrug resistance and virulence associated with 83 equine E. coli isolates recovered from foals with …

Enhanced Teamwork Communication Model For Electronic Clinical Pathways In Healthcare, Wasef Mater, Monther Aldwairi, Roliana Ibrahim

All Works

© 2018 Matar et al. Background: One of the main challenges to hospital patient flow and treatment includes the lack of a patient-centered approach, which in turn contributes to non-effective teamwork communication. Objectives: To introduce patient-centered approach by implementing electronic clinical pathways to support more effective teamwork communication. To study how to enhance teamwork communication in healthcare by implementing electronic clinical pathways. Methods: We propose a research model, integrating the Donbedian model and the socio-technical theory, to investigate the factors that influence teamwork communication in healthcare. This research applied a quantitative approach using a survey method that was designed along …

The Epidemiology And Economic Burden Of Obesity And Related Cardiometabolic Disorders In The United Arab Emirates: A Systematic Review And Qualitative Synthesis, Hadia Radwan, Rami A. Ballout, Hayder Hasan, Nader Lessan, Mirey Karavetian, Rana Rizk

All Works

Copyright © 2018 Hadia Radwan et al. Background. Noncommunicable diseases (NCDs) are considered as a global health problem and considered as a public health priority with the more considerable increasing trend of obesity and cardiometabolic disorders rates in the Middle Eastern countries. This systematic review aims at assessing the prevalence, incidence rates, and trends, as well as the cost of obesity and related cardiometabolic disorders in the United Arab Emirates (UAE). Methods. A highly sensitive strategy was used to retrieve original observational studies, addressing the epidemiology and cost of obesity and related cardiometabolic disorders in the UAE, irrespective of nationality …

Micromelanomas Identified With Time-Lapse Total Body Photography And Dermoscopy, Elizabeth D. Drugge, Elgida R. Volpicelli, Rebecca M. Sarac, Sophie R. Strang, Dirk M. Elston, Rhett J. Drugge

NYMC Faculty Publications

No abstract provided.

Psychodynamic Psychiatrists' Experiences Of Being Stalked, Douglas Ingram

NYMC Faculty Publications

Despite the estimated 15% likelihood that a psychiatrist will become the victim of stalking, there is little formal recognition of its prevalence or its impact on well-being. Through narrative accounts, ten psychiatrists with psychodynamic orientations speak of their experiences including how each managed the anxieties consequent to stalking. These include a variety of adaptive psychic operations as well as concrete actions to curtail stalking.

Find Cancer Early: Evaluation Of A Community Education Campaign To Increase Awareness Of Cancer Signs And Symptoms In People In Regional Western Australians, Emma J. Croager, Victoria Gray, Iain S. Pratt, Terry Slevin, Simone Pettigrew, C. D'Arcy Holman, Max K. Bulsara, Jon D. Emery

Health Sciences Papers and Journal Articles

Introduction: Cancer outcomes for people living in rural and remote areas are worse than for those living in urban areas. Although access to and quality of cancer treatment are important determinants of outcomes, delayed presentation has been observed in rural patients.

Methods: Formative research with people from rural Western Australia (WA) led to the Find Cancer Early campaign. Find Cancer Early was delivered in three regions of WA, with two other regions acting as controls. Staff delivered the campaign using a community engagement approach, including promotion in local media. Television communications were not used to minimize contamination in the control …

Mortality In A Cohort Of Remote-Living Aboriginal Australians And Associated Factors, Zoe Hyde, Kate Smith, Leon Flicker, David Atkinson, Osvaldo P. Almeida, Nicola T. Lautenschlager, Anna Dwyer, Dina Logiudice

Health Sciences Papers and Journal Articles

Objectives: We aimed to describe mortality in a cohort of remote-living Aboriginal Australians using electronic record linkage.

Methods: Between 2004 and 2006, 363 Aboriginal people living in remote Western Australia (WA) completed a questionnaire assessing medical history and behavioural risk factors. We obtained mortality records for the cohort from the WA Data Linkage System and compared them to data for the general population. We used Cox proportional hazards regression to identify predictors of mortality over a 9-year follow-up period.

Results: The leading causes of mortality were diabetes, renal failure, and ischaemic heart disease. Diabetes and renal failure accounted for 28% …

Monitoring And Managing Fatigue In Basketball, Toby Edwards, Tania Spiteri, Benjamin Piggott, Joshua Bonhotal, G. Gregory Haff, Christopher Joyce

Health Sciences Papers and Journal Articles

The sport of basketball exposes athletes to frequent high intensity movements including sprinting, jumping, accelerations, decelerations and changes of direction during training and competition which can lead to acute and accumulated chronic fatigue. Fatigue may affect the ability of the athlete to perform over the course of a lengthy season. The ability of practitioners to quantify the workload and subsequent fatigue in basketball athletes in order to monitor and manage fatigue levels may be beneficial in maintaining high levels of performance and preventing unfavorable physical and physiological training adaptations. There is currently limited research quantifying training or competition workload outside …

Patterns In Participation: Factors Influencing Parent Attendance At Two, Centre-Based Early Childhood Interventions, Steve Heath, Adam Wigley, John Hogben, Janet Fletcher, Peta Collins, Gemma Boyle, Stephanie Eustice

Health Sciences Papers and Journal Articles

Interventions training parents of at-risk children have received considerable empirical support but their effectiveness is undermined by low attendance rates. This research sought to clarify why parents, even with the best of intentions, fail to follow through to full participation in workshop programs; and to provide insight into ways to improve parental engagement. We examined participation in Parents as Partners, a school-based, early childhood intervention. Demographic and ongoing educational, social, emotional and behavioural data for 136 parent-child dyads were gathered from parents, teachers and children. Mitigation of a wide range of factors previously identified as barriers to attendance was also …

Knowledge, Attitudes, And Practice Of Oncologists And Oncology Health Care Providers In Promoting Physical Activity To Cancer Survivors: An International Survey, Sarah Hardcastle, Robert Kane, Paola Chivers, Dana A. Hince, Andrew Dean, Dominic Higgs, Paul A. Cohen

Health Sciences Papers and Journal Articles

Objective: To investigate knowledge, attitudes and practices of oncologists towards physical 2 activity (PA) in cancer survivors, and the association between oncologists’ own PA behavior 3 and PA promotion. Methods: Oncologists (n=123) completed a survey based on the Theory of 4 Planned Behavior (TPB). Participants reported PA promotion behavior, PA involvement, 5 attitudes, intentions, social norm, Perceived Behavioral Control (PBC), confidence and 6 knowledge of exercise prescription. Structural equation modelling (SEM) evaluated these 7 associations. Results: Less than half of oncologists reported regularly promoting PA to 8 patients (46%), with 20% providing written information and 23% referrals. Only 26% were …

Design And Development Of A Theory-Informed Peer-Led Falls Prevention Education Programme To Translate Evidence Into Practice: A Systematic Approach, Linda Khong, Richard G. Berlach, Keith D. Hill, Anne-Marie Hill

Health Sciences Papers and Journal Articles

Peer-led education has been shown to be an effective approach for raising community-dwelling older adults’ beliefs, knowledge and intention to engage in falls prevention strategies in a recent intervention trial. This article outlines the design and development of the intervention, which was a peer-led falls prevention education programme designed to promote older adult’s motivation to change their behaviour in the area of falls prevention. The elements of the programme that contributed to its efficacy are also described. The programme was designed using a four-step approach and was based on the constructs of a theoretical framework (the COM-B model). Feedback from …

Comparison Of Neuroprotective Efficacy Of Poly-Arginine R18 And R18d (D-Enantiomer) Peptides Following Permanent Middle Cerebral Artery Occlusion In The Wistar Rat And In Vitro Toxicity Studies, Diego Melani, Megan C. Bakeberg, Jane L. Cross, Vince W. Clark, Ryan S. Anderton, David J. Blacker, Neville W. Knuckey, Bruno P. Meloni

Health Sciences Papers and Journal Articles

We have previously demonstrated that arginine-rich and poly-arginine peptides possess potent neuroprotective properties, with poly-arginine peptide R18 identified as being highly effective at reducing infarct volume following middle cerebral artery occlusion (MCAO) in the Sprague Dawley rat. Since peptides synthesised using D-isoform amino acids have greater stability than L-isoform peptides due to increased resistance to proteolytic degradation, they represent potentially more effective peptide therapeutics. Therefore we compared the neuroprotective efficacy of R18 and its D-enantiomer R18D following permanent MCAO in the Wistar rat. Furthermore, as increased peptide stability may also increase peptide toxicity, we examined the effects of R18 and …

Added Value Of Second Biopsy Target In Screen-Detected Widespread Suspicious Breast Calcifications, Nathalie M. Falkner, Dana A. Hince, Gareth Porter, Ben Dessauvagie, Sanjay Jeganathan, Max Bulsara, Glen Lo

Health Sciences Papers and Journal Articles

Introduction: There is controversy on the optimal work‐up of screen‐detected widespread breast calcifications: whether to biopsy a single target or multiple targets. This study evaluates agreement between multiple biopsy targets within the same screen‐detected widespread (≥25 mm) breast calcification to determine if the second biopsy adds value.

Methods: Retrospective observational study of women screened in a statewide general population risk breast cancer mammographic screening program from 2009 to 2016. Screening episodes recalled for widespread calcifications where further views indicated biopsy, and two or more separate target areas were sampled within the same lesion were included. Percentage agreement and Cohen's Kappa …

The Effect Of Individual Radiographers On Rates Of Attendance To Breast Screening: A 7-Year Retrospective Study, S. Savaridas, J. Brook, J. Codde, M Bulsara, W. Wylie

Health Sciences Papers and Journal Articles

AIM: To establish whether individual radiographers had significantly different rescreening rates whilst controlling for other known confounding factors.

MATERIALS AND METHODS: Women aged 50e69 years were identified from a state-wide screening database at their first screening attendance during the study period (2007e2013). The radiographer performing this index screen and potential confounding factors were recorded and subsequent screening behaviour was assessed. Clients with abnormal screens and those known to have died during the time period were excluded. A univariate analysis of the data from 160,028 women was assessed using the chi-square test to compare those women who attended their next mammography …

Perinatal Hypoxic-Ischemic Encephalopathy And Neuroprotective Peptide Therapies: A Case For Cationic Arginine-Rich Peptides (Carps), Adam B. Edwards, Ryan S. Anderton, Neville W. Knuckey, Bruno P. Meloni

Health Sciences Papers and Journal Articles

Perinatal hypoxic-ischemic encephalopathy (HIE) is the leading cause of mortality and morbidity in neonates, with survivors suffering significant neurological sequelae including cerebral palsy, epilepsy, intellectual disability and autism spectrum disorders. While hypothermia is used clinically to reduce neurological injury following HIE, it is only used for term infants (>36 weeks gestation) in tertiary hospitals and improves outcomes in only 30% of patients. For these reasons, a more effective and easily administrable pharmacological therapeutic agent, that can be used in combination with hypothermia or alone when hypothermia cannot be applied, is urgently needed to treat pre-term (_36 weeks gestation) and …

Kettle Test Efficacy In Predicting Cognitive And Functional Outcomes In Geriatric Rehabilitation, Kristie J. Harper, Karleen Llewellyn, Angela Jacques, Katharine Ingram, Sara Pearson, Annette Barton

Health Sciences Papers and Journal Articles

Background/aim: Limited research has been available to support the use of the Kettle Test in a subacute rehabilitation setting with patients diagnosed with a variety of medical conditions. The Kettle Test is an occupation based performance measure designed to detect cognitive processes and function. The aim of this research was to measure the correlation between three cognitive tests, the Mini-Mental State Examination (MMSE), Cognitive Functional Independence Measure (Cognitive FIM) and the Kettle Test. Secondly, to assess the efficacy of these tests in predicting functional outcomes via the motor subscale of the Functional Independence Measure (mFIM).

Methods: A prospective single-centre cohort …

"I Am Tired Of Having To Prove That My Husband Was Dead." Dealing With Practical Matters In Bereavement And The Impact On The Bereaved, Pippa Blackburn, Caroline Bulsara

Health Sciences Papers and Journal Articles

This paper reports on experiences of dealing with practical matters after death. Semi structured interviews with bereaved individuals were thematically analyzed. Within the theme of coping, dealing with practical matters was a significant stressor and was found to be extremely challenging, time consuming, and to negatively impact on mental and emotional well-being. This study adds new insights on the challenges experienced by the bereaved when attending to practical matters and may help to inform the design of bereavement support, inform standard operating procedures of businesses, and government bereavement leave legislation.

Hablando De La Herida: Honoring Spanish-Speaking Parents’ Experiences Obtaining School-Based Speech And Language Services For Their Children, Amalia W. Hernández

LMU Theses and Dissertations

This study examines the experiences of Spanish-speaking Latino/a parents in their attempts to obtain school-based speech and language services for their children; the impact of these experiences on parents; and parent perspectives on how school-based speech-language pathologists can co-create collaborative relationships. Through a detailed analysis of a focus group and individual interviews of 31 Spanish-speaking parents of children in the REAAD! (Reaching Educational Achievement and Development) Literacy Enrichment Program at a university in Los Angeles, California, this study provided a space for parents to share their experiences and offer insights regarding what shaped their experiences. Through the theoretical lens of …

Stigmatizing Effects Of Visible Versus Invisible Disabilities, Noel A. Ysasi, Alicia B. Becton, Roy K. Chen

School of Rehabilitation Services & Counseling Faculty Publications

The concept of disability is complex and has been interpreted in a variety of ways. The degree to which a disorder is "disabling" depends on the interchange between the condition and other factors including the individual's environment. Modern society's emphasis on self-sufficiency and productivity contribute to the tendency to devalue those who are perceived as unable from these valued characteristics. Research suggests the visibility of a condition may lead to stigmatization, a concept generally associated with feelings of shame due to discontentment and devaluation of others. The authors present literature related to persons with visible and invisible disabilities, and the …

Positive Approaches To Overcoming The Stigma Of Disability, Noel A. Ysasi, Roy K. Chen, Megan E. Jones

School of Rehabilitation Services & Counseling Faculty Publications

People with disabilities often face prejudice and discrimination because of their physical and/or mental deviance from norms subjectively defined by society. The stigma associated with having a disability can have a negative impact on the quality of life among this population. The purpose of this paper is to discuss theory-based strategies and approaches that people with disabilities can adopt to overcome and mitigate the adverse effects of a stigmatizing disability. Specifically, the paper uses the hope theory and positive psychology theory as foundations to pave way for weaving spiritual well-being, resilience, and optimism into psychoeducation efforts to help people with …