Medicine and Health Sciences Commons^™

Assessment Of Patient Satisfaction With Primary Health Care At The Family Medicine Centre Of Aga Khan University Hospital, Nairobi, Alvin M. Juma

Master of Medicine in Family Medicine

Background: Patient satisfaction is one of the key indicators by which the quality of healthcare service is evaluated. The World Conference of Family Doctors African Chapter's (WONCA-Africa) encourages Family Medicine practices to regularly assess their patients' satisfaction as one of the criteria for benchmarking and auditing the quality of primary care in Africa. The Kenyan government, in a quest to improve primary care provision, has formulated policy to make family physicians essential players in coordinating and enhancing standards of primary care. Objective: This study aimed to assess patient satisfaction with the quality of primary health care services provided by family …

Nutrition Education To Improve Health Outcomes In Community Dwelling Older Adults, Sara Giessinger

Master's Projects and Capstones

Abstract

The proportion of people age 60 and over is growing faster than other age group, and will double by 2050 from approximately 605 million to 2 billion worldwide, in addition to the 80 and over population quadrupling by the same time. Non-communicable diseases such as obesity, cancer, coronary heart and lung disease, diabetes, hypertension, insulin resistance, and hyperlipidemia,represent 63% of deaths annually worldwide. Due to the immense contact nurses have with clients, they play a key role in screening, referrals and education to guide this demographic to improved health outcomes through nutrition and physical activity interventions (Xiaoyue, Parker, Ferguson, …

Overcoming Small Data Limitations In Heart Disease Prediction By Using Surrogate Data, Alfeo Sabay, Laurie Harris, Vivek Bejugama, Karen Jaceldo-Siegl

SMU Data Science Review

In this paper, we present a heart disease prediction use case showing how synthetic data can be used to address privacy concerns and overcome constraints inherent in small medical research data sets. While advanced machine learning algorithms, such as neural networks models, can be implemented to improve prediction accuracy, these require very large data sets which are often not available in medical or clinical research. We examine the use of surrogate data sets comprised of synthetic observations for modeling heart disease prediction. We generate surrogate data, based on the characteristics of original observations, and compare prediction accuracy results achieved from …

Perceived Walkability, Social Capital, And Self-Reported Physical Activity In Las Vegas College Students, Melissa Bartshe, Courtney Coughenour, Jennifer Pharr

School of Public Health Faculty Research

College students are an understudied, vulnerable population, whose inactivity rates exceed those reported by U.S. adults. Walkability in sprawling cities, such as Las Vegas, is challenged due to automobile-oriented development. The purpose of this study was to assess the relationship between perceived neighborhood walkability, social capital, and meeting physical activity recommendations among University of Nevada-Las Vegas college students. Of the 410 participants, 42.2% met physical activity recommendations, 77.1% were female, 37.3% were white, and 79.5% owned a vehicle. Logistic regression showed that social capital (odds ratio (OR) = 1.25, p = 0.04) and gender... (see full text for full abstract

Characterisation Of The Structure And Oligomerisation Of Islet Amyloid Polypeptides (Iapp): A Review Of Molecular Dynamics Simulation Studies, Sandra J Moore, Krushna Sonar, Prashant Bharadwaj, Evelyne Deplazes, Ricardo L Mancera

Research outputs 2014 to 2021

Human islet amyloid polypeptide (hIAPP) is a naturally occurring, intrinsically disordered protein whose abnormal aggregation into amyloid fibrils is a pathological feature in type 2 diabetes, and its cross-aggregation with amyloid beta has been linked to an increased risk of Alzheimer's disease. The soluble, oligomeric forms of hIAPP are the most toxic to β-cells in the pancreas. However, the structure of these oligomeric forms is difficult to characterise because of their intrinsic disorder and their tendency to rapidly aggregate into insoluble fibrils. Experimental studies of hIAPP have generally used non-physiological conditions to prevent aggregation, and they have been unable to …

Keep Calm And Carry On: Parental Opinions On Improving Clinical Dietary Trials For Young Children, Analise Nicholl, Therese O'Sullivan

Research outputs 2014 to 2021

Recruitment can be an issue for paediatric research. We aimed to investigate parental opinions of paediatric clinical assessments, and to combine findings with recent literature to inform the design of a clinical dietary trial. We used convenience sampling to recruit 17 parents of children aged 2⁻6 years from two community playgroups in Perth, Western Australia. Three focus groups considered proposed child assessments, study design, and potential study enrolment. Qualitative thematic analysis of focus group transcripts used NVivo 11 (QSR, Melbourne, VIC, Australia). Four main parental concerns emerged, presented here with solutions combining parent responses and relevant literature. (1) Parent and …

Chronically Implanted Intracranial Electrodes: Tissue Reaction And Electrical Changes., Andrew Campbell, Chengyuan Wu

Department of Neurosurgery Faculty Papers

The brain-electrode interface is arguably one of the most important areas of study in neuroscience today. A stronger foundation in this topic will allow us to probe the architecture of the brain in unprecedented functional detail and augment our ability to intervene in disease states. Over many years, significant progress has been made in this field, but some obstacles have remained elusive-notably preventing glial encapsulation and electrode degradation. In this review, we discuss the tissue response to electrode implantation on acute and chronic timescales, the electrical changes that occur in electrode systems over time, and strategies that are being investigated …

Mirna-205 Nanoformulation Sensitizes Prostate Cancer Cells To Chemotherapy, Prashanth K.B. Nagesh, Pallabita Chowdhury, Elham Hatami, Vijaya K. N. Boya, Vivek K. Kashyap, Sheema Khan, Bilal B. Hafeez, Subhash C. Chauhan, Meena Jaggi, Murali M. Yallapu

School of Medicine Publications

The therapeutic application of microRNA(s) in the field of cancer has generated significant attention in research. Previous studies have shown that miR-205 negatively regulates prostate cancer cell proliferation, metastasis, and drug resistance. However, the delivery of miR-205 is an unmet clinical need. Thus, the development of a viable nanoparticle platform to deliver miR-205 is highly sought. A novel magnetic nanoparticle (MNP)-based nanoplatform composed of an iron oxide core with poly(ethyleneimine)-poly(ethylene glycol) layer(s) was developed. An optimized nanoplatform composition was confirmed by examining the binding profiles of MNPs with miR-205 using agarose gel and fluorescence methods. The novel formulation was applied …

The "Lightning Bolt" Sign On Computed Tomography During Percutaneous Renal Mass Cryoablation, Qian Yu, Driss Raissi

Radiology Faculty Publications

Ice‑ball fracture is a rare and often overlooked entity that may lead to intraprocedural hemorrhage after percutaneous cryoablation of renal masses. There is scant literature on ice‑ball fractures associated with percutaneous renal cryoablation. Immediate recognition of the lightning bolt sign during intraprocedural computed tomography can help identify patients who may have developed this complication.

The Impact Of Emotional Intelligence And Affective Behavior On Paramedic Student Field Internship Success, Jim Lambert

Dissertations

Purpose: The purpose of this correlational study was to examine the relationship between emotional intelligence (EI) scores, as defined by Bradberry and Greaves (2009) and paramedic student success during the field internship phase of their education as determined by the California Paramedic Field Internship Major Evaluation (FE) Rating Criteria.

Methodology: This quantitative, nonexperimental, correlational study utilized data collected from the Emotional Intelligence Appraisal—Me Edition and the California Paramedic FE reports provided by paramedic preceptors in the field. Data were collected from 30 paramedic interns from 3 paramedic programs in Southern California and analyzed using the Pearson product moment …

Interaction Between The Microbiome And Tp53 In Human Lung Cancer., K Leigh Greathouse, James R White, Ashely J Vargas, Valery V Bliskovsky, Jessica A Beck, Natalia Von Muhlinen, Eric C Polley, Elise D Bowman, Mohammed A Khan, Ana I Robles, Tomer Cooks, Bríd M Ryan, Noah Padgett, Amiran H Dzutsev, Giorgio Trinchieri, Marbin A Pineda, Sven Bilke, Paul S Meltzer, Alexis N Hokenstad, Tricia M Stickrod, Marina R Walther-Antonio, Joshua P Earl, Joshua C Mell, Jaroslaw E Krol, Sergey V Balashov, Archana S Bhat, Garth D Ehrlich, Alex Valm, Clayton Deming, Sean Conlan, Julia Oh, Julie A Segre, Curtis C Harris

Faculty Research 2018

BACKGROUND: Lung cancer is the leading cancer diagnosis worldwide and the number one cause of cancer deaths. Exposure to cigarette smoke, the primary risk factor in lung cancer, reduces epithelial barrier integrity and increases susceptibility to infections. Herein, we hypothesize that somatic mutations together with cigarette smoke generate a dysbiotic microbiota that is associated with lung carcinogenesis. Using lung tissue from 33 controls and 143 cancer cases, we conduct 16S ribosomal RNA (rRNA) bacterial gene sequencing, with RNA-sequencing data from lung cancer cases in The Cancer Genome Atlas serving as the validation cohort.

RESULTS: Overall, we demonstrate a lower alpha …

A Robust Pax7egfp Mouse That Enables The Visualization Of Dynamic Behaviors Of Muscle Stem Cells., Elisia D Tichy, David K Sidibe, Christopher D Greer, Nicholas M Oyster, Panteleimon Rompolas, Nadia Rosenthal, Helen M Blau, Foteini Mourkioti

Faculty Research 2018

BACKGROUND: Pax7 is a transcription factor involved in the specification and maintenance of muscle stem cells (MuSCs). Upon injury, MuSCs leave their quiescent state, downregulate Pax7 and differentiate, contributing to skeletal muscle regeneration. In the majority of regeneration studies, MuSCs are isolated by fluorescence-activated sorting (FACS), based on cell surface markers. It is known that MuSCs are a heterogeneous population and only a small percentage of isolated cells are true stem cells that are able to self-renew. A strong Pax7 reporter line would be valuable to study the in vivo behavior of Pax7-expressing stem cells.

METHODS: We generated and characterized …

Mutant Klf1 In Adult Anemic Nan Mice Leads To Profound Transcriptome Changes And Disordered Erythropoiesis., Danitza Nébor, Joel H. Graber, Steven L. Ciciotte, Ray F. Robledo, Julien Papoin, Emily Hartman, Kevin R Gillinder, Andrew C Perkins, James J Bieker, Lionel Blanc, Luanne L. Peters

Faculty Research 2018

Anemic Nan mice carry a mutation (E339D) in the second zinc finger of erythroid transcription factor KLF1. Nan-KLF1 fails to bind a subset of normal KLF1 targets and ectopically binds a large set of genes not normally engaged by KLF1, resulting in a corrupted fetal liver transcriptome. Here, we performed RNAseq using flow cytometric-sorted spleen erythroid precursors from adult Nan and WT littermates rendered anemic by phlebotomy to identify global transcriptome changes specific to the Nan Klf1 mutation as opposed to anemia generally. Mutant Nan-KLF1 leads to extensive and progressive transcriptome corruption in adult spleen erythroid precursors such that stress …

Low Peripheral T Follicular Helper Cells In Perinatally Hiv-Infected Children Correlate With Advancing Hiv Disease., Bret Mccarty, Mussa Mwamzuka, Fatma Marshed, Matthew Generoso, Patricia Alvarez, Tiina Ilmet, Adam Kravietz, Aabid Ahmed, William Borkowsky, Derya Unutmaz, Alka Khaitan

Faculty Research 2018

Background: T follicular helper (Tfh) cells are crucial for B cell differentiation and antigen-specific antibody production. Dysregulation of Tfh-mediated B cell help weakens B cell responses in HIV infection. Moreover, Tfh cells in the lymph node and peripheral blood comprise a significant portion of the latent HIV reservoir. There is limited data on the effects of perinatal HIV infection on Tfh cells in children. We examined peripheral Tfh (pTfh) cell frequencies and phenotype in HIV-infected children and their associations with disease progression, immune activation, and B cell differentiation.

Methods: In a Kenyan cohort of 76 perinatally HIV-infected children, comprised of …

Variant Of The Anconeus Epitrochlearis Muscle: A Case Report., Chrissie Massrey, Joe Iwanaga, Basem Ishak, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The anconeus epitrochlearis is a muscle variant sometimes present at the elbow. It is present in up to 34% of individuals and has been implicated in some cases of cubital tunnel syndrome. We report an unusual variant of this muscle with additional proximal attachments in the arm. We will review and discuss the background and the clinical relevance of such a muscle.

Awareness And Knowledge Of Cochlear Implants Among Speech-Language Pathologists, Kimberly Ward, Kimberly Grubbs, Amitava Biswas

Faculty Publications

Speech-Language Pathologists work closely with individuals who have received cochlear implants across a multitude of settings which include early childhood education centers, schools, hospitals and skilled nursing facilities. However, previous research suggests that Speech-Language Pathologists do not have the adequate skills or knowledge to work with clients who have received cochlear implants. To assess whether Speech-Language Pathologists in the state of Mississippi had similar results as in the previous studies, a questionnaire was used to assess knowledge on cochlear implants. The results are consistent with previous studies which suggest that there is an overall lack in cochlear implant competency, specifically …

Nicu Nurses' Suggestions For Improving End-Of-Life Care Obstacles, Renea L. Beckstrand, Rebecca F. Isaacson, Janelle L. B. Macintosh, Karlen E. Luthy, Lacey Eden

Faculty Publications

Background: Neonatal deaths (infants less than 28 days old) account for two thirds (66.7%) of all infant deaths with most occurring in an ICU setting. NICU nurses are frequently involved in end-of-life (EOL) care and face unique obstacles.

Objective: The objective of this study was to obtain NICU nurses’ suggestions for improving obstacles in EOL care in NICUs.

Methods: Suggestions were obtained through mailed survey research in qualitative study design. Returned surveys yielded 121 nurse respondents who gave a total of 138 suggestions.

Results: A total of 10 cohesive themes were identified: (1) environmental design issues, (2) improved communication between …

Lafora Disease Masquerading As Hepatic Dysfunction, Faisal Inayat, Waqas Ullah, Hanan T. Lodhi, Zarak H. Khan, Ghulam Ilyas, Nouman Safdar Ali, Hafez Mohammad A. Abdullah

Abington Jefferson Health Papers

Lafora disease is fatal intractable progressive myoclonic epilepsy. It is frequently characterized by epileptic seizures, difficulty walking, muscle spasms, and dementia in late childhood or adolescence. We chronicle here an unusual case of an asymptomatic young male soccer player who presented with elevated liver enzymes. Neurological examination was unremarkable. The diagnostic workup for hepatitis, infectious etiologies, autoimmune disorders, hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, and other related diseases was inconclusive. He subsequently underwent an uneventful percutaneous liver biopsy. Based on the pathognomonic histopathological findings, Lafora disease was considered the likely etiology. The present study is a unique illustration of this …

Integrating Oral Health Into Social Marketing Campaigns: Program Development And Description For San Francisco Children’S Oral Health Strategic Plan, Carsen Bentley

Pacific Journal of Health

Integrating oral health into an existing San Francisco Department of Public Health (SFDPH) social marketing campaign was a specific goal of the San Francisco Children’s Oral Health Strategic Plan 2014-2017 with the purpose to more fully integrate oral health promotion into the City’s overall health promotion efforts. In the winter of 2015, utilizing a collaborative approach, oral health was successfully integrated in the Open Truth campaign, promoting decreased consumption of sugar sweetened beverages in order to improve health outcomes, including decreasing tooth decay.

Voices For Food: Methodologies For Implementing A Multi-State Community-Based Intervention In Rural, High Poverty Communities., Suzanne Stluka, Lindsay Moore, Heather A Eicher-Miller, Lisa Franzen-Castle, Becky Henne, Donna Mehrle, Daniel Remley, Lacey Mccormack

Health and Nutritional Sciences Faculty Publications

BACKGROUND: Rural communities experience unique barriers to food access when compared to urban areas and food security is a public health issue in rural, high poverty communities. A multi-leveled socio-ecological intervention to develop food policy councils (FPCs), and improve food security in rural communities was created. Methods to carry out such an intervention were developed and are described.
METHODS: A longitudinal, matched treatment and comparison study was conducted in 24 rural, high poverty counties in South Dakota, Indiana, Missouri, Michigan, Nebraska and Ohio. Counties were assigned to a treatment (n = 12) or comparison (n = 12) group. Intervention activities …

“My Sexuality…It Creates A Stress”: Hiv-Related Communication Among Bisexual Black And Latino Men, New York City, Kirk D. Henny, Kathryn Drumhiller, Madeline Y. Sutton, Jose Nanín

Publications and Research

Men who have sex with men and women (including bisexual men) comprise 35% of all men who have sex with men (MSM) in the U.S. It is estimated that 121,800 men who have been bisexually active within the past year are living with HIV in the U.S. Communication about HIV may result in risk-reduction behaviors. However, little is known about the nature or context for HIV prevention communication among bisexual men, particularly for blacks and Hispanic/Latinos who are disproportionately at greater HIV risk. Therefore, we explored patterns and contexts of HIV-related communications occurring within personal social networks among bisexual black …

Depression Following A Traumatic Brain Injury: Uncovering Cytokine Dysregulation As A Pathogenic Mechanism, Colleen N. Bodnar, Josh M. Morganti, Adam D. Bachstetter

Spinal Cord and Brain Injury Research Center Faculty Publications

A substantial number of individuals have long-lasting adverse effects from a traumatic brain injury (TBI). Depression is one of these long-term complications that influences many aspects of life. Depression can limit the ability to return to work, and even worsen cognitive function and contribute to dementia. The mechanistic cause for the increased depression risk associated with a TBI remains to be defined. As TBI results in chronic neuroinflammation, and priming of glia to a secondary challenge, the inflammatory theory of depression provides a promising framework for investigating the cause of depression following a TBI. Increases in cytokines similar to those …

Examining Relationships Between Age At Diagnosis And Health-Related Quality Of Life Outcomes In Prostate Cancer Survivors., Christine J. Kurian, Amy Leader, Melissa S.Y. Thong, Scott W. Keith, Charnita Zeigler-Johnson

Department of Medical Oncology Faculty Papers

BACKGROUND: Patient reports of health related quality of life can provide important information about the long-term impact of prostate cancer. Because patient symptoms and function can differ by age of the survivor, the aim of our study was to examine patient-reported quality of life and prostate symptoms by age at diagnosis among a registry of Dutch prostate cancer survivors.

METHODS: A population of 617 individuals from the Patient Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship (PROFILES) database was surveyed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and prostate symptom …

Setting The Stage: Reviewing Current Knowledge On The Health Of New Zealand Immigrants—An Integrative Review, Blessing Kanengoni, Sari Andajani-Sutjahjo, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search …

Developmental Dependence For Functional Eye Regrowth In Xenopus Laevis, Cindy X. Kha, Kelly Ai-Sun Tseng

Life Sciences Faculty Research

A key challenge in designing tissue repair strategies is knowing whether and how developmental mechanisms are used for successful repair of mature/adult tissues. Although it is known that developmental components are used in repair, it remains mostly unclear which ones are required and whether they act similarly as during development. This issue is further complicated by the fact that it is difficult to assess the similarities and differences between development and the repair of mature tissues, since the two contexts are highly dissimilar. A potentially useful yet underutilized approach is to understand developmental regrowth (defined here as the ability to …

Prevalence Of Chronic Obstructive Pulmonary Disease (Copd) Among Rheumatoid Arthritis: Results From National Inpatient Database., Rashmi Dhital, Sijan Basnet, Prakash Paudel, Yam Prasad Acharya, Dilli Ram Poudel

Reading Hospital Internal Medicine Residency

Rheumatoid arthritis (RA) is being increasingly recognized as an important contributor to chronic obstructive pulmonary disease (COPD). Although smoking is a major risk factor, other factors may play a role. We used National Inpatient Sample (NIS) from 2013 to explore this relationship. We used propensity matching with a 1:3 nearest-neighbor-matching algorithm to match 1 RA hospitalization to 3 age- and-sex-matched comparators. In the age- and-sex-matched population, RA had a higher odds of COPD (OR 1.20, 95% CI: 1.17-1.22,

Immunoglobulin G4 Sclerosing Cholangitis: An Unusual Cause Of Obstructive Jaundice-Case Report And Literature Review., Pragya Shrestha, Brian Le, Brent Wagner, William Pompella, Paras Karmacharya

Reading Hospital Internal Medicine Residency

IgG4-related sclerosing cholangitis (IgG4-SC) is one of the most common extra-pancreatic manifestation of IgG4-related disease (IgG4-RD) and is clinically distinct from primary sclerosing cholangitis (PSC). IgG4-RD is an increasingly recognized immune-mediated fibroinflammatory systemic disease, mostly affecting middle-aged and older male populations that can affect multiple organs. The presence of extra-biliary clinical manifestations of IgG4-RD, such as parotid and lacrimal swelling, lymphadenopathy, autoimmune pancreatitis, and retroperitoneal fibrosis, if present could provide important clues to diagnosis. High serum IgG4 levels, characteristic radiological (e.g., sausage-shaped pancreas or periaortitis) or biopsy findings (high percentage of IgG4+ plasma cells, lymphoplasmacytic infiltrate, storiform fibrosis, or obliterative …

Recurrent Autoimmune Hemolytic Anemia In Splenic Marginal Zone Lymphoma., Oreoluwa Oladiran, Rashmi Dhital, Anthony Donato

Reading Hospital Internal Medicine Residency

Autoimmune hemolytic anemia (AIHA) is a condition associated with an extensive differential diagnosis that includes lymphoid malignancies. Although AIHA occurs in about 10-25% of patients with chronic lymphocytic leukemia, it is also reported to occur in all of the other lymphoid subtypes. In this article, we report a case of recurrent AIHA in a 67-year-old woman with two acute episodes of hemolysis separated by 3 years of hematologic remission. Both episodes were severe enough to require blood transfusion, oral steroids, and rituximab. Bone marrow biopsy and immunophenotyping using flow cytometry done during both admissions confirmed the presence of splenic marginal …

Clinical Audit To Assess Delays In Chemotherapy Administration At Daycare Oncology Center At A Tertiary Care Hospital In Karachi, Pakistan, Arifa Arifa Aziz, Zarka Samoon, Afsheen Feroz, Nadia Ayoub, Safia Awan, Madhia Beg

Department of Radiation Oncology

Aim: There were delays reported by patients in chemotherapy administration in daycare oncology. Therefore, we decided to audit all processes which are involved in chemotherapy administration. The objective was to improve our service by decreasing the time between admission and initiation of chemotherapy and identify the reasons for delays. Materials and Methods: The audit was conducted in three parts. In Review I, audit tool was developed and information documented of 109 patients receiving chemotherapy at daycare center from April 14 to May 13, 2015. Five processes were assessed out of which delay in initial assessment by the nurse was the …

The Effect Of The Nematode Trapping Fungus Duddingtonia Flagrans Against Gastronintestinal Nematodes Of Exotic Ruminant Hoofstock At Disney's(R) Animal Kingdom Lodge, Kristen Renee Young

LSU Master's Theses

Gastrointestinal nematodes (GIN) can severely affect the performance of ruminant animals and may lead to an animal’s death in a severe, untreated infection. Zoological parks, which have used anthelmintic drugs for treatment of GIN, are now seeing evidence of drug resistant parasites (Garretson et al., 2009). Duddingtonia flagrans, a nematophagous fungus, has shown a reduction in larvae of coprocultures of exotic ruminants through feed administration at Disney's^® Animal Kingdom Lodge (DAKL) and has potential to biologically control forage larvae (Terry, 2013). This study evaluated the effectiveness of Duddingtonia flagrans, administered to exotic ruminant hoofstock at a daily …