Medicine and Health Sciences Commons^™

Renal Function And Diabetic Foot Ulcer, El-Saied Shaheen, Feisal Goda, Helmy M. Elshazly

Journal of Medicine in Scientific Research

Introduction Diabetic nephropathy has been identified as an essential risk factor for foot ulceration and amputation. Renal failure has been reported to independently predict the risk of nonhealing ischemic and neuroischemic foot lesions and major amputation. Objective In this study, we aimed at assessing the renal function of diabetic foot infected patients. Patients and methods We included 120 patients with type 2 diabetes mellitus, patients participated from the medical and surgical unit, Shebin El Kom Teaching Hospital, Egypt. They were divided into two main group; group 1 included 80 patients with an active diabetic foot ulcer (DFU) and group 2 …

Mitral Annular Calcification Predicts Coronary Artery Disease In End-Stage Renal Disease Patients On Hemodialysis, Amir S. Michael

Journal of Medicine in Scientific Research

Background Mitral annulus calcifi cation ( MAC) is a chronic, degenerative process of the fi brous support structure of the mitral valve. The reported prevalence of MAC is between 8 and 15%, but it signifi cantly increases with age and in patients with multiple cardiovascular risk factors or chronic kidney disease. Aim The aim of this study was to determine whether MAC predicts coronary artery disease in a group of end-stage renal disease patients. Patients and Methods Twenty-three patients with ESRD on hemodialysis referred for coronary angiography were prospectively studied. Results This study included 23 patients, MAC was seen in …

Anti-Acetylcholine Receptor Antibodies As A Diagnostic Marker For Myasthenia Gravis, Aisha El-Shimy, Hala I. Mohamed, Iman Kamel, Magdy Khalaf, Youssof Abd El Motamad

Journal of Medicine in Scientific Research

Background Myasthenia gravis (MG) is a common primary disorder of neuromuscular transmission, which is characterized by fluctuating weakness of a certain voluntary muscles, particularly those innervated by motor nuclei of the brain stem, that is, ocular and mastication muscles, and caused by antibodies binding to components in the neuromuscular junction. Most MG cases demonstrate elevated serum levels of acetylcholine receptor (ACh-R) antibodies, which cause partial or complete inhibition of receptor function and complement-mediated focal lysis of the postsynaptic membrane. ACh-R antibodies are detected in the serum of more than 80–90% patients with generalized MG, in ~50% with ocular myasthenia, and …

D-Dimer, Von Willibrand Factor, And Adamts13 In Renal Transplant Recipients, Ahmed Hassan, Azza A. I. Elmenyawi

Journal of Medicine in Scientific Research

Introduction Chronic kidney disease and renal transplants are associated with activation of coagulation. Microvascular thrombosis and fibrinolytic disorders have been recognized as main causes of allograft rejection in renal transplant recipients. Aims The aim was to evaluate D-dimer, Von Willibrand factor (VWF), and ADAMTS13 activity plasma levels in renal transplant recipients and investigate the association of these parameters and creatinine plasma levels, estimated glomerular filtration rate (eGFR), and time after transplantation. Participants and methods A total of 40 renal transplant recipients clinically stable at National Institute of Urology and Nephrology, 5–192 months after transplantation were enrolled in the study. Dimer, …

Effect Of Digital Wireless Technology On The Language Development Of Children With Cochlear Implants, Abir Omara, Azza Azzam, Azza Samy, Eman Ghorab, Iman El-Rouby, Soha Hamada

Journal of Medicine in Scientific Research

Introduction Hearing is the principal sensory modality by which language and speech are acquired. For that reason, a child with hearing loss whose family chooses an auditory approach for learning language must have as much exposure to high-quality auditory stimulation as possible. Both hearing aids and cochlear implants (CI) are best in quiet and close places, but not so good at a distance, in noise or when sounds bounce around. Children with CI have significant difficulty in hearing conversational speech in the presence of background noise. They may have difficulty understanding soft speech signals due to distance and reverberation. Assistive …

Post-Traumatic Multiplanar Knee Deformity Correction Using Taylor Spatial Frame Fixator, Sameh S. Alsafty

Journal of Medicine in Scientific Research

Background Multiplanar knee deformity needs correction in different axes; this can be achieved by the Ilizarov system, which utilizes the hinges and translation mechanism; this needs an effort or orientation and gradual correction. The Taylor spatial frame (TSF) fixator solves this problems; it consist of two rings or partial rings connecting by six telescopic struts at special universal joints. Patients and methods The study included six patients with complex post-traumatic knee deformity. They had genu varus, recurvatum, and shortening; two female individuals and four male individuals, with an age range from 16 to 20 years comprised our study sample. The …

Results Of Compression Plating Versus Locked Intramedullary Nailing Fixation In The Treatment Of Humeral Shaft Fractures In Adults, Ahmad Shawakat Rizk, Hassan Hussein Ahmad Abdallah, Mohammed Gamal El Din Al Ashahab, Said Ibrahim Said Abdelmotalb

Journal of Medicine in Scientific Research

Background Most humerus shaft fractures can be treated successfully using the conservative methods. When choosing surgical fixation, there is a debate between the use of plate and screws and intramedullary nails. Aims The aim of this study was to compare the results of the dynamic compression plate and the antegrade interlocked humeral nail in the fixation of humerus shaft fractures. Patients and methods A total of 40 patients were selected by a randomized method to be treated by either method; there were 20 patients in each group and patients were followed up for at least 6 months until union. Result …

Evaluation Of Knowledge, Attitude, And Practice Of Adverse Drug Reactions Reporting Among Doctors And Nursing Staff Of A Rural Tertiary Care Teaching Hospital Of Maharashtra, Sanyukta M. Patil, Satish E. Bahekar

Journal of Medicine in Scientific Research

Context The adverse drug reactions (ADRs) are of great concern for any health care set ups as they directly or indirectly cost in terms of disability, prolongation of hospital stay, or even death. Hence, regular and timely reporting of ADR is of great importance, especially in treating doctors and nursing staff. Aims The main aim of this study was to assess the knowledge, attitude, and practice (KAP) of ADR reporting among doctors and nurses of tertiary care teaching hospital. Settings and design This was a prospective, cross-sectional questionnaire-based study that included 50 doctors and 50 nurses from the clinical departments …

Implementation Of National Action Plans On Noncommunicable Diseases, Bhutan, Cambodia, Indonesia, Philippines, Sri Lanka, Thailand And Viet Nam, Titiporn Tuangratananon, Sangay Wangmo, Nimali Widanapathirana, Suladda Pongutta, Shaheda Viriyathorn, Walaiporn Patcharanarumol, Kouland Thin, Somil Nagpal, Christian Edward L. Nuevo, Retna Siwi Padmawati, Maria Elizabeth Puyat-Murga, Laksono Trisnantoro, Kinzang Wangmo, Nalida Wellappuli, Phuong Hoang Thi, Tuan Khuong Anh, Thinley Zangmo, Viroj Tangcharoensathien

Health Sciences Faculty Publications

By 2016, Member States of the World Health Organization (WHO) had developed and implemented national action plans on noncommunicable diseases in line with the Global action plan for the prevention and control of noncommunicable diseases (2013–2020). In 2018, we assessed the implementation status of the recommended best-buy noncommunicable diseases interventions in seven Asian countries: Bhutan, Cambodia, Indonesia, Philippines, Sri Lanka, Thailand and Viet Nam. We gathered data from a range of published reports and directly from health ministries. We included interventions that addressed the use of tobacco and alcohol, inadequate physical activity and high salt intake, as well as health-systems …

Structured Diet And Exercise Guidance In Pregnancy To Improve Health In Women And Their Offspring: Study Protocol For The Be Healthy In Pregnancy (Bhip) Randomized Controlled Trial, Maude Perreault, Stephanie A. Atkinson, Michelle F. Mottola, Stuart M. Phillips, Keyna Bracken, Eileen K. Hutton, Feng Xie, David Meyre, Rita E. Morassut, Harry Prapavessis, Lehana Thabane

Anatomy and Cell Biology Publications

BackgroundEvidence from epidemiological and animal studies support the concept of programming fetal, neonatal, and adult health in response to in utero exposures such as maternal obesity and lifestyle variables. Excess gestational weight gain (GWG), maternal physical activity, and sub-optimal and excess nutrition during pregnancy may program the offspring's risk of obesity. Maternal intake of dairy foods rich in high-quality proteins, calcium, and vitamin D may influence later bone health status. Current clinical practice guidelines for managing GWG are not founded on randomized trials and lack specific active intervention ingredients. The Be Healthy in Pregnancy (BHIP) study is a randomized controlled …

A Simulated Learning Experience In Advanced Care Planning Conversations, Brandy Ellis

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Background: The CDC (2012) reports that 1/3 of Americans have no advance care planning (ACP), which is essential for maintaining autonomy when people are no longer able to communicate wishes directly. IOM (2014) reports that providers have limited training in communication techniques and low confidence in holding advanced care planning conversations. Nursing simulation is an effective method of teaching clinical skills in a safe environment. The development of a high fidelity (HF) standardized patient simulation, using the Jeffries Simulation Framework, combined with evidence-based practice classroom curriculum, may increase knowledge and confidence in holding ACP conversations for nurse practitioner students.

Methods: …

Large-Scale Genome-Wide Meta-Analysis Of Polycystic Ovary Syndrome Suggests Shared Genetic Architecture For Different Diagnosis Criteria, Felix Day, Tugce Karaderi, Michelle R. Jones, Cindy Meun, Chunyan He, Alex Drong, Peter Kraft, Nan Lin, Hongyan Huang, Linda Broer, Reedik Magi, Richa Saxena, Triin Laisk, Margrit Urbanek, M. Geoffrey Hayes, Gudmar Thorleifsson, Juan Fernandez-Tajes, Anubha Mahajan, Benjamin H. Mullin, Bronwyn G. A. Stuckey, Timothy D. Spector, Scott G. Wilson, Mark O. Goodarzi, Lea Davis, Barbara Obermayer-Pietsch, André G. Uitterlinden, Verneri Anttila, Benjamin M. Neale, Marjo-Riitta Jarvelin, Bart Fauser

Internal Medicine Faculty Publications

Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. Affected women frequently have metabolic disturbances including insulin resistance and dysregulation of glucose homeostasis. PCOS is diagnosed with two different sets of diagnostic criteria, resulting in a phenotypic spectrum of PCOS cases. The genetic similarities between cases diagnosed based on the two criteria have been largely unknown. Previous studies in Chinese and European subjects have identified 16 loci associated with risk of PCOS. We report a fixed-effect, inverse-weighted-variance meta-analysis from 10,074 PCOS cases and 103,164 controls of European ancestry and characterisation of PCOS related …

Dichotomous Scoring Of Tdp-43 Proteinopathy From Specific Brain Regions In 27 Academic Research Centers: Associations With Alzheimer's Disease And Cerebrovascular Disease Pathologies, Yuriko Katsumata, David W. Fardo, Walter A. Kukull, Peter T. Nelson

Biostatistics Faculty Publications

TAR-DNA binding protein 43 (TDP-43) proteinopathy is a common brain pathology in elderly persons, but much remains to be learned about this high-morbidity condition. Published stage-based systems for operationalizing disease severity rely on the involvement (presence/absence) of pathology in specific anatomic regions. To examine the comorbidities associated with TDP-43 pathology in aged individuals, we studied data from the National Alzheimer’s Coordinating Center (NACC) Neuropathology Data Set. Data were analyzed from 929 included subjects with available TDP-43 pathology information, sourced from 27 different American Alzheimer’s Disease Centers (ADCs). Cases with relatively unusual diseases including autopsy-proven frontotemporal lobar degeneration (FTLD-TDP or FTLD-tau) …

An Open-Data-Driven Agent-Based Model To Simulate Infectious Disease Outbreaks, Elizabeth Hunter, Brian Mac Namee, John D. Kelleher

Articles

Agent-based models are a tool that can be used to better understand the dynamics of an infectious disease outbreak. An infectious disease outbreak is influenced by many factors including vaccination or immunity levels, population density, and the age structure of the population. We hypothesize that these factors along with interactions of factors and the actions of individuals would lead to outbreaks of different size and severity even in two towns that appear similar on paper. Thus, it is necessary to implement a model that is able to capture these interactions and the actions of individuals. Using openly available data we …

Rheumatoid Meningitis Sine Arthritis., Cathy Lee-Ching, Lawrence C. Kenyon, Matthew Berk, Chantel Park

Department of Medicine Faculty Papers

Rheumatoid meningitis is a rare and very serious extra-articular manifestation of rheumatoid arthritis. We present a case of a 7()year-old female with no history of arthritis who developed stroke-like symptoms, seizures, psychosis and compulsive behavior. Serial brain magnetic resonance images (MRI) over four months demonstrated progressive interhemispheric meningeal thickening. She had mild lymphocytic pleocytosis on the cerebrospinal fluid analysis and serum anti-cyclic citrullinated peptide antibodies resulted positive in high titers. She underwent a brain biopsy showing necrotizing granulomas consistent with rheumatoid meningitis. Her symptoms resolved with treatment with glucocorticoids and cyclophosphamide. She has not been diagnosed with rheumatoid arthritis even …

Child Obesity And The Interaction Of Family And Neighborhood Socioeconomic Context, Ashley W. Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but …

Effectiveness Of A Youth-Led Early Childhood Care And Education Programme In Rural Pakistan: A Cluster-Randomised Controlled Trial, Aisha Khizar Yousafzai, Muneera Rasheed, Arjumand Rizvi, Fariha Shaheen, Liliana A. Ponguta, Chin R. Reyes

Department of Paediatrics and Child Health

Background: The United Nation's Sustainable Development Goals encompass lifelong learning from birth to youth to adulthood (Goal 4) and economic opportunities for young people (Goal 8). The targets include improving access to quality early childhood care and education (ECCE) as well as learning and training opportunities for adolescents and youth. Cross-generational models for young children and youth may offer opportunities to address the interconnections between goals and targets for the next generation. We investigated whether an ECCE programme for young children (3.5-6.5 years) delivered by female youth (18-24 years) in rural Pakistan would be effective on children's school readiness.
Methods: …

Outcomes And Experiences Of An Rn To Bsn Online Cohort: An Academic-Practice Partnership, Donna Copenhaver Dr., Marilyn Dubree Msn, Rn, Chris Wilson Msn, Rn-Bc, Martha Buckner Phd, Cathy R. Taylor Drph, Kathy Jordan Msn, Rn

International Journal of Health Sciences Education

Abstract

This article describes the result of an academic-practice partnership between a School of Nursing (SON) and a University Medical Center (UMC) for the purpose of promoting BSN education in response to the Institute of Medicine’s recommendation that 80% of RNs hold a baccalaureate degree or higher by 2020. The mutually beneficial partnership worked together to offer a pilot online RN-BSN nursing program, increase the number of BSNs in the workforce, and to collect information from RN-BSN students returning to school about their challenges, recommendations for future programs, and why they were interested in returning to school. The BSN graduates …

As A Pediatrician, I Don’T Know The Second, Third, Or Fourth Thing To Do: A Qualitative Study Of Pediatric Residents’ Training And Experiences In Behavioral Health, Rachel Petts Phd, Jeffrey D. Shahidullah Phd, Paul W. Kettlewell Phd, Kathryn A. Dehart Md, Kris Rooney Md, Ilene G. Ladd Ms, Tyler Bogaczyk Bs, Sharon L. Larson Phd

International Journal of Health Sciences Education

Despite a mandated 1-month rotation in developmental-behavioral pediatrics (DBP), pediatric residents report inadequate training in behavioral health care. As a first step in much needed curriculum development in this area, this study sought to assess learner experiences regarding the management of behavioral health problems during residency. Four focus groups were conducted for residents in years 1-3 of training in 2 residency programs in a northeastern state. Transcripts were analyzed and coded by researchers through qualitative classical content analysis. The exploratory analysis revealed 9 key themes: time requirements, rapport building, resources and referrals for behavioral health, psychiatric medications, diagnosis vs. treatment, …

Patient Deception In Health Care: Physical Therapy Education, Beliefs, And Attitudes, Drew A. Curtis, Han-Hung Huang, Kendra L. Nicks

International Journal of Health Sciences Education

A good professional-patient relationship is important to clinical practice, which may be compromised by deception. Deception research in physical therapy is scant. The current study investigated how the topic of patient deception is addressed in Doctor of Physical Therapy (DPT) educational curriculum, explore DPT students’ beliefs about deception and attitudes toward patient deception, and examine the effects of a pedagogical intervention on DPT students’ beliefs about deception and attitudes toward patient deception. The first objective was pursued by a descriptive survey sent to 217 DPT programs in the US. The second and third objectives were achieved by one-group pretest-posttest design …

The Effect Of Competency-Based Education On Medical And Nursing Students' Academic Performance, Technical Skill Development, And Overall Satisfaction And Preparedness For Future Practice: An Integrative Literature Review, Haris Saud, Ruth Chen

International Journal of Health Sciences Education

Purpose: This article provides an integrative review of competency-based education (CBE) in medical and nursing programs and examines the effect of CBE on students’ academic performance, technical skill development, and overall satisfaction and preparedness for future practice.

Background: In recent decades, CBE has increasingly been discussed in medical and nursing education programs. The impact of the CBE curriculum on learning outcomes including academic performance, technical skill development, overall satisfaction, and preparedness for future practice has not been fully elucidated.

Method: A review of the literature was conducted, and multiple databases were searched for studies that analyzed the impact of CBE …

An Evaluation Of The Impact Of Medication On Behavioral Intervention Effectiveness For Adults With Traumatic Brain Injury, Sulay Martinez

Capstone Projects

A systematic search of the literature was conducted to identify articles implementing both pharmacological and behavioral interventions with subjects with traumatic brain injury (TBI). Limitations of pharmacological interventions were evaluated and compared to the implications for behavioral interventions for adults with TBI. Results of this study indicate further research is necessary to adequately evaluate the effects of medication on behavioral intervention effectiveness for adults with TBI.

Design And Development Of An Mph Program For Online Delivery, Steven R. Hawks, Julie A. Gast

Journal on Empowering Teaching Excellence

The Master of Public Health (MPH) degree is growing in popularity and is now delivered fully online by a large number of highly respected, fully accredited universities. This paper offers an overview of program design and development strategies that promote successful online delivery of MPH programs. Design and development challenges are discussed in terms of new accreditation standards, student demand, faculty development, user needs, course content, and plan of study. The development of an online MPH program at Utah State University with a concentration in health education and promotion is used to highlight and consider various aspects of this important …

Low Sucrose, Omega-3 Enriched Diet Has Region-Specific Effects On Neuroinflammation And Synaptic Function Markers In A Mouse Model Of Doxorubicin-Based Chemotherapy, Tonya S. Orchard, Monica M. Gaudier-Diaz, Panchita Phuwamongkolwiwat-Chu, Rebecca Andridge, Maryam B. Lustberg, Joshua Bomser, Rachel M. Cole, Martha A. Belury, A. Courtney Devries

Clinical and Translational Science Institute

Chemotherapeutic agents such as doxorubicin may negatively affect long-term brain functioning in cancer survivors; neuroinflammation may play a causal role. Dietary approaches that reduce inflammation, such as lowering sucrose and increasing eicosapentaenoic acid plus docosahexaenoic acid (EPA + DHA), may attenuate chemotherapy-induced neuroinflammation and synaptic damage, thereby improving quality of life. Ovariectomized, C57BL/6 mice were assigned to a chemotherapy (9 mg/kg doxorubicin + 90 mg/kg cyclophosphamide) or vehicle two-injection regimen, with injections two and four weeks after starting diets. In Study 1, mice received low sucrose diets with EPA + DHA or No EPA + DHA for four to six …

Gender Differences In Patient-Reported Outcomes Among Adults With Atherosclerotic Cardiovascular Disease, Victor Okunrintemi, Javier Valero-Elizondo, Benjamin Patrick, Joseph Salami, Martin Tibuakuu, Saba Ahmad, Oluseye Ogunmoroti, Shiwani Mahajan, Safi U. Khan, Martha Gulati, Khurram Nasir, Erin D. Michos

Clinical and Translational Science Institute

Background Atherosclerotic cardiovascular disease (ASCVD) accounts for approximately one third of deaths in women. Although there is an established relationship between positive patient experiences, health‐related quality of life, and improved health outcomes, little is known about gender differences in patient‐reported outcomes among ASCVD patients. We therefore compared gender differences in patient‐centered outcomes among individuals with ASCVD. Methods and Results Data from the 2006 to 2015 Medical Expenditure Panel Survey, a nationally representative US sample, were used for this study. Adults ≥18 years with a diagnosis of ASCVD, ascertained by International Classification of Diseases, Ninth Revision (ICD‐9) codes and/or self‐reported data, …

High-Resolution Deconstruction Of Evolution Induced By Chemotherapy Treatments In Breast Cancer Xenografts., Hyunsoo Kim, Pooja A Kumar, Francesca Menghi, Javad Noorbakhsh, Eliza Cerveira, Mallory Ryan, Qihui Zhu, Guruprasad Ananda, Joshy George, Henry C Chen, Susan Mockus, Chengsheng Zhang, Yan Yang, James G. Keck, Radha Krishna Murthy Karuturi, Carol J Bult, Charles Lee, Edison Liu, Jeffrey H Chuang

Faculty Research 2018

The processes by which tumors evolve are essential to the efficacy of treatment, but quantitative understanding of intratumoral dynamics has been limited. Although intratumoral heterogeneity is common, quantification of evolution is difficult from clinical samples because treatment replicates cannot be performed and because matched serial samples are infrequently available. To circumvent these problems we derived and assayed large sets of human triple-negative breast cancer xenografts and cell cultures from two patients, including 86 xenografts from cyclophosphamide, doxorubicin, cisplatin, docetaxel, or vehicle treatment cohorts as well as 45 related cell cultures. We assayed these samples via exome-seq and/or high-resolution droplet digital …

Functional Outcomes In Early (T1/T2) Supraglottic Cancer: A Systematic Review, Benjamin Van Der Woerd, Krupal B. Patel, Anthony C. Nichols, Kevin Fung, John Yoo, Danielle S. Macneil

Anatomy and Cell Biology Publications

ObjectivesOrgan preserving surgery (OPS) and radiotherapy (RT) are both accepted treatment options for early stage supraglottic cancer (SGC). Radiation has supplanted surgery in most cases, because of the perception that surgery results in poorer functional outcomes. However, evidence suggests that OPS with a neck dissection may be associated with improved survival. Our objective was to conduct a systematic review of the literature to compare functional outcomes of OPS and RT for early SGC.MethodsWe searched Medline, EMBASE and Cochrane Central Register of Controlled Trials to identify studies. Studies were included if they reported functional outcomes on 10 or more patients with …

Relationships Between Aprn State Practice Authority, Perceived Autonomy, Professionalism, And Interprofessional Team Function Among A National Sample Of Aprns In The U.S., Patricia Rae Gilman

Nursing ETDs

Healthcare that includes high performing interprofessional clinical teams (IPTs) is one recommended strategy to provide optimal quality and cost-effective care delivery. Highly functional IPTs are characterized by effective communication, trust, respect, collaboration, information-sharing, and conflict resolution and are more efficient than individual providers working alone. Internally, IPT members’ relationships and understanding of both one’s own professional identity and others’ role and responsibilities are crucial to team functionality and effectiveness. Externally, factors including regulatory practice environments might influence the effectiveness and performance of both individual team members and the team overall. Inconsistencies between states’ practice authority (SPA) for advanced practice nurses …

Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley

Nursing ETDs

The prevalence of diabetes mellitus (DM) is higher in American Indians/Alaska Natives (AI/AN) than in any other racial or ethnic group in the United States (U.S. Department of Health and Human Services [USDHHS] Centers for Disease Control and Prevention [CDC], 2018). In response to this escalating health issue, the U.S. government funded a number of DM education and treatment programs focusing on AI/AN populations. The purpose of this study was to evaluate the New Onset Diabetes Education Program (NODEP) based at Northern Navajo Medical Center (NNMC) in Shiprock, N.M.

The Navajo philosophy of learning was used as a guiding framework. …

The Effects Of Psychotropic Medications On Developing Brains, Abass Jafuneh

Nursing Capstones

No abstract provided.