Medicine and Health Sciences Commons^™

Does Exam-Targeted Training Help Village Doctors Pass The Certified (Assistant) Physician Exam And Improve Their Practical Skills? A Cross-Sectional Analysis Of Village Doctors' Perspectives In Changzhou In Eastern China, Xiaohong Li, Jay J. Shen, Fang Yao, Chunxin Jiang, Fengshui Chang, Fengfeng Hao, Jun Lu

School of Public Health Faculty Research

Background Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors’ perceptions of whether that training helps them pass the exam and whether it improves their skills. Methods Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire …

The Logic Of Sexuation In Deleuze And Lacan, Matthew Lovett

Electronic Theses and Dissertations

In The Logic of Sexuation in Deleuze and Lacan, I argue for an account of sexual difference that responds to a tension in feminist philosophy, namely, the problem of the ontological status of the sexed body. In so doing, I turn to the work of Gilles Deleuze and Jacques Lacan. I argue that, rather than being antithetical, the two can be productively read together, in particular with regard to this very question. Ultimately basing my reading in the Deleuzian passive syntheses and dynamic geneses of Difference and Repetition and The Logic of Sense as well as in Lacan’s twentieth …

Synthesis Of Novel 5-Substituted Pyrrolo[2,3-D]Pyrimidine Antifolates As Selective And Potent Anti-Tumor Agents, Mohammad Karim

Electronic Theses and Dissertations

In last few decades many folate analogs have been discovered and several compounds are successfully being used as anticancer agents. Methotrexate (MTX), pemetrexed (PMX), raltitrexed (RTX): are a few examples of classical antifolates that are currently in clinical use. Although these compounds are widely used, all of them show dose limiting toxicity due to their non-specific transport into normal cells as well as malignant cells. Currently, clinically used classical antifolates suffer from this disadvantage because there is no way to selectively transport them into malignant cells. Currently available antifolates are transported via reduced folate career (RFC) as well as Folate …

The Core Relation Between Hospitality (Philoxenia), Dignity And Vulnerability In Orthodox Christian Bioethics: A Contribution To Global Bioethics, Rabee Toumi

Electronic Theses and Dissertations

In a pluralistic world, reaching consensus in matters of bioethics has proved to be difficult, especially with the political polarization that nurtures inimical differences. This dissertation argues that a middle ground can be identified between the plurality of value systems in contemporary bioethics based on an anthropological approach. This middle ground that reflects commonalities of the human condition can be explored in relation to the foundational principles of Orthodox Christian anthropology. To identify this middle ground the analysis discusses the core relation between hospitality, dignity, and vulnerability as a contribution to global bioethics.

In general, based on Orthodox Christian theology …

The Influence Of Socioeconomic Factors On Fear Of Falling And Mobility Outcomes After Lower Limb Loss: A Preliminary Study, Tyler Chin, Heather Fox, Juan Gutierrez Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with …

The Moderation Effect Of Bdnf Genotype And Self-Reported Habitual Physical Activity Levels On Age Of Onset, Disease Progression, And Postural Instability In Parkinson's, Kyle Johnson, Danielle Salgo, Jessica Zorn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Brain-derived neurotrophic factor (BDNF) levels have been reported to play an important role in driving neuroprotection in people with neurologic disorders, and levels of BDNF are known to increase in response to physical activity. Moreover, the level of BDNF produced is also affected by BDNF genotype. It is not known, however, whether one’s BDNF genotype interacts with physical activity throughout life to affect a neuroprotective response in people with Parkinson’s disease (PD). Therefore, the purpose of this study was to determine if BDNF genotype interacts with lifetime self-reported physical activity levels to affect disease severity and progression …

Immediate Effects Of Cervical Spine Thrust Joint Manipulation On Gait Parameters In Individuals With Neck Pain, Marc Anthony D. Albano, Emily Blok, Beau Gronert, Ryan Masuda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypotheses: 1. To investigate for any change in gait parameters in individuals with neck pain while walking with different functional neck conditions immediately following cervical thrust joint manipulation (TJM) versus a sham intervention. 2. To investigate any association between Global Rating of Change (GROC) scores and gait parameters immediately following cervical thrust joint manipulation versus a sham intervention. The hypotheses were that, a) cervical TJM would have an immediate effect on gait parameters during walking with the neck in at least one of three conditions (neutral, flexion/extension and rotation) among individuals with neck pain; and b) higher scores on the …

Enhancing Quality Ethics Consultations In Pediatric Medicine, Ariel Clatty

Electronic Theses and Dissertations

Medical ethics consultations occur predominantly in the adult realm of medicine, alternatively in Pediatric Medicine there is a widespread lack of training and skilled professionals to service these requests. Most of the literature in pediatric ethics consultations revolves around mirroring adult ethics consultations. This dissertation seeks to identify and address the issues related to quality of ethics consultations in a clinical setting regarding the organizational and research settings for Pediatric Medicine, and how adopting and applying the guiding standards for ethics consultation using the Core Competencies of the American Society of Bioethics and Humanities will better assist all parties to …

Factors Related To Successful Implementation Of An Aac Device For An Individual With Autism, Michaela Worms

Dissertations, Theses, and Projects

Communication impairment is a defining characteristic of autism spectrum disorder (ASD) (American Psychiatric Association, 2013); therefore, the use of augmentative and alternative communication (AAC) has become an essential part of language intervention for children with autism that experience significant difficulties with communication (Flores et al., 2012). Assessing children’s preferences for AAC options may be important with respect to AAC abandonment, which is a problem in the AAC field (Johnson, Inglebret, Jones, & Ray, 2006). This single-subject study identified factors related to successful implementation, acquisition, and usage of an AAC system. The clinician collected baseline data on the client’s spontaneous production …

Inaugural Issue Of The Scholarship Review, H. Luis Vargas , Ph.D.

Counseling and Family Therapy Scholarship Review

H. Luis Vargas, Editor of the Counseling and Family Therapy Scholarship Review, introduces the journal's editors and mission.

The Santa Clara, 2018-05-10, Santa Clara University

The Santa Clara

No abstract provided.

Relationship Between Pre-Pregnancy Maternal Bmi And Optimal Weight Gain In Singleton Pregnancies, Pierre-Yves Robillard, Gustaaf Dekker, Malik Boukerrou, Nathalie Le Moullec, Thomas C. Hulsey

Clinical and Translational Science Institute

Background: There is a peculiar phenomenon: two separate individuals (mother and foetus) have a mutually interactive dependency concerning their respective weight. Very thin mothers have a higher risk of small for gestational age (SGA) infants, and rarely give birth to a large for gestational age (LGA) infant. While morbidly obese women often give birth to LGA infants, and rarely to SGA. Normal birthweight (AGA) infants (>10th and investigate the interaction between maternal booking BMI, gestational weight gain (GWG) and neonatal birthweight centiles. Methods: 16.5 year-observational cohort study (2001e2017). The study population consisted of all consecutive singleton term (37 weeks …

Collaborative Task-Sharing To Enhance The Point-Of-Care Ultrasound (Pocus) Access Among Expectant Women In Kenya: The Role Of Midwife Sonographers, Sudhir Vinayak, Sharon Brownie

Imaging & Diagnostic Radiology, East Africa

Unrealized maternal and child health goals continue to challenge Kenya where adverse outcomes remain high and diagnostic services are limited. The acute shortage of doctors and radiographers requires alternate human resources for health (HRH) with the ability to identify risk factors in pregnancy through Point-Of-Care Ultrasound (POCUS). A specialist radiologist and ultrasonography team partnered with midwives to adopt interprofessional task sharing and capacity building. Faculty from the Radiology Department of our hospital designed and implemented the project which was carried out at three outreach health service centres. Designing and implementing a training model to skill midwife sonographers with the capacity …

Variant Distal Ulnar Nerve Loop: A Previously Undescribed Anatomical Finding., Mayank Patel, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

A previously undescribed variant ulnar nerve loop was discovered during the routine anatomic forearm and hand dissection of an adult female. The major finding was that of a large loop traveling around the distal tendon of the flexor carpi ulnaris. The variation presented here appears to be unique. The exact function of such derailed anatomy is not clear but, if found during surgery, might confound normal dissection methods or, when present, could result in varied clinical presentations regarding the sensory or motor examination of the hand.

Exacerbation Recovery Patterns In Newly Diagnosed Or Maintenance Treatment-Naïve Patients With Copd: Secondary Analyses Of Ticari 1 Trial Data, David M. Mannino, Emmanuelle M. Clerisme-Beaty, Joanne Franceschina, Naitee Ting, Nancy K. Leidy

Preventive Medicine and Environmental Health Faculty Publications

Background: Little is known about the recovery patterns from acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in newly diagnosed or maintenance treatment-naïve patients with COPD. This study describes the course of AECOPD in these patients at the time of treatment for the symptoms of acute respiratory tract infection (RTI).

Methods: This study was a secondary analysis of data from a 12-week, randomized clinical trial (TICARI 1) testing the efficacy and safety of once-daily tiotropium 18 µg maintenance therapy versus placebo in newly diagnosed or maintenance treatment-naïve COPD patients with acute RTI symptoms for ≤7 days. Patients received standard care …

Low-Fat Abiraterone Food Effect Is Of Little Consequence, Jill M. Kolesar, Glenn X. Liu

Pharmacy Practice and Science Faculty Publications

No abstract provided.

Resolving The Water Pollution Crisis In The Philippines: The Implications Of Water Pollution On Public Health And The Economy, Gabriella Andrews

Pepperdine Policy Review

Imagine being told that the water in all your faucets, the water you drink and use to bathe, contains toxins such as mercury and feces. Now imagine that your local government knew about these dangers but actively refused to share them until most of the people you knew and loved had fallen ill.

This hypothetical scenario is the current reality in the Philippines. An eighth of the country’s rivers are considered too toxic for human and animal ingestion or contact and are unable to support most forms of life. Moreover, fewer than half of the total number of rivers in …

Screening Amblyopic Risk Factors In A Pediatric Population Using An Automated Vision Screener, Rebecca Dawn Slominski

Evidence-Based Practice Project Reports

Amblyopia is the most common visual disorder in children and is potentially curable if detected early and treated properly in the first few years of life. Amblyopia is the leading cause of monocular vision loss in children (Bradfield, 2013). It is a developmental neuroplasticity which derives from birth causing structural and functional changes in the eye and brain. With this structural and functional disruption, visual blur occurs due to refractive amblyopia, strabismic amblyopia, cataracts (form-deprivation amblyopia), or a combination of any of these (Solebo, Cumberland, & Rahi, 2015). Refractive errors related to amblyopia can also occur. The purpose of this …

Assistive Utensil: A Spork For Hand Tremors And Spatial Awareness, Ana Font Hernandez, Jacob Kabariti, Troy Taylor

Publications and Research

In this poster, we present a 3D printed solution for hand tremors and special awareness. Our spork is an assistive device designed and 3D printed for patients suffering from scleroderma, systemic sclerosis, Parkinson's, multiple sclerosis, drug withdrawal, etc. The scale-based handle will act as a counterweight to offset the contents on the other end and reduce shakiness. The larger grip allows an easy and comfortable hold. The product will be 3D printed for a customizable fit and at an affordable price. Lastly, the product will include a haptic feedback sensor to assist the visually impaired in locating food contents on …

Differential Tissue Response To Growth Hormone In Mice, Ryan Berry, Graham R. Mcginnis, Ronadip R. Banerjee, Martin E. Young, Stuart J. Frank

Kinesiology and Nutrition Sciences Faculty Research

Growth hormone (GH) has been shown to act directly on multiple tissues throughout the body. Historically, it was believed that GH acted directly in the liver and only indirectly in other tissues via insulin‐like growth hormone 1 (IGF‐1). Despite extensive work to describe GH action in individual tissues, a comparative analysis of acute GH signaling in key metabolic tissues has not been performed. Herein, we address this knowledge gap. Acute tissue response to human recombinant GH was assessed in mice by measuring signaling via phospho‐STAT5 immunoblotting. STAT5 activation is an easily and reliably detected early marker of GH receptor engagement. …

Women’S Lives In Times Of Zika: Mosquito-Controlled Lives?, Ana Rosa Linde, C. Eduardo Siqueira

Gastón Institute Publications

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it …

Organic Cation Transporter 3: A Cellular Mechanism Underlying Rapid, Non-Genomic Glucocorticoid Regulation Of Monoaminergic Neurotransmission, Physiology, And Behavior, Paul J. Gasser, Christopher A. Lowry

Biomedical Sciences Faculty Research and Publications

Corticosteroid hormones act at intracellular glucocorticoid receptors (GR) and mineralocorticoid receptors (MR) to alter gene expression, leading to diverse physiological and behavioral responses. In addition to these classical genomic effects, corticosteroid hormones also exert rapid actions on physiology and behavior through a variety of non-genomic mechanisms, some of which involve GR or MR, and others of which are independent of these receptors. One such GR-independent mechanism involves corticosteroid-induced inhibition of monoamine transport mediated by “uptake₂” transporters, including organic cation transporter 3 (OCT3), a low-affinity, high-capacity transporter for norepinephrine, epinephrine, dopamine, serotonin and histamine. Corticosterone directly and acutely inhibits …

2491: Parental Concerns About Child Participation In S Reflect A Need To Move Beyond Traditional Notions Of Trust And Race, Jennifer Cunningham-Erves, Tilicia Mayo-Gamble, Consuelo H. Wilkins

Health Policy & Community Health: Faculty Publications

OBJECTIVES/SPECIFIC AIMS: The objective of this study was to identify factors influencing parental willingness of adolescent participation in clinical trials. METHODS/STUDY POPULATION: We applied community engaged research principles to conduct a theory-based, cross-sectional study of parental willingness. Parents (N=307) were given a survey from November 2014 to April 2015. Factors influencing parental willingness were identified using binary logistic regression. SPSS version 22.0 was used to perform analyses, and p

Filming Trauma Simulations For Medical Education: A Comparison Of First-Person View Vs. Remotely Shot Video, Christopher Capicotto, Memu-Lye Kamara, John Krutsick, Arthur Sesso

Research Day

With advancements in video technology, first-person view places observers in the vantage point of the camera operator. Lightweight wearable products, such as GoPro cameras, are capable of capturing high-resolution footage. In a 3-phase project, first-person view (FPV) footage was compared to remotely-shot video (RSV) of identical trauma scenarios viewed by medical students and residents at PCOM.

Students responded to a trauma simulation by assessing the patient, obtaining a history and stabilizing the patient. This scenario was run once using RSV and again using FPV to capture the encounter. Both formats were screened for medical students in Phase I and Phase …

Connecting Homeless Women To Primary Care Providers: The Effects Of A Student Advocacy Model, Hillary Brown, Rachael Blackmon, Christopher Gable, Jenny Glusman, Kerin M. Claeson

Research Day

Introduction: The negative impact of homelessness on health, and the barriers that homeless individuals must overcome to access healthcare are well-documented. Primary care physicians often express difficulty in maintaining stable relationships with homeless patients, and access to free care clinics alone does not predict successful adherence to medical treatment. Motivation to seek care is also often cited as a barrier to adequate care.

Methods: The current study assesses the effects of a student-driven, decentralized primary care, and advocacy model on the chronic health conditions and task motivation of female patients. We do this through a pre/post model survey for women …

Associations Between First Year Medical Students’ Lifestyles, Resting Blood Pressure, And Resting Ecgs, Christina Spino-Oleck, Bram Sakdiponephong, Karen Davis, Kaela Frizzell, Charlotte H. Greene Phd, Bruce Kornberg

Research Day

Introduction: There is considerable evidence that psychological stressors can impact cardiovascular

health. Medical students experience a high degree of stress based upon their responses to survey questionnaires, although there are few physiological studies that support this association that are targeted specifically to medical students. Medical students in general represent an underrepresented age group in the context of cardiovascular treatment guidelines. Therefore, medical students are a pertinent cohort for study based upon these findings.

Objective:The purpose of this study was to analyze whether medical student lifestyles impact normal baseline cardiovascular measurements of blood pressures and electrocardiograms in this population. …

The Role Of Autophagy During Myocardial Ischemia/Reperfusion Injury, Aloysius Ibe, Alisa Kim, Hannah Kim, Marquese Daniels, Lindon H. Young, Robert J. Barsotti, Qian Chen

Research Day

Autophagy is a housekeeping process to remove damaged cytoplasmic constituents. However, a debate persists on whether autophagy is beneficial or detrimental when an ischemic/reperfusion (I/R) insult occurs in the heart. This study tested the effects of autophagy enhancers (e.g. rapamycin and trehalose) and autophagy inhibitor (e.g. 3-methyladenine) on heart function and infarct size after global I (30 minutes) and R (45 minutes) when given prior to ischemia (pre-treatment) or at the beginning of reperfusion (post-treatment). We found that Rapamycin (25nM) pre-treatment and post-treatment significantly restored final left ventricular developed pressure (LVDP) to 75.4±9.1% and 60±5% of initial baseline respectively (both …

Standardizing The Operative Note: A Way To Improve The Quality Of Data Collection To Optimize Patient Care, Kurt Bamberger, Leigh Gerson, James Haran

Research Day

INTRODUCTION: The standard surgical operative note serves an essential role in documenting the details of an operation; however common key details of the operative note are often omitted. This study investigated the effectiveness of implementing a Laparoscopic Cholecystectomy (LC) specific, intraoperative data collection template directly in the electronic health record to be used as an addition to the standard dictated operative note. We hypothesized that intraoperative data collection would lead to a more complete operative report.

METHODS: In this single center study, we retrospectively analyzed 211 operative notes prior to implementing an intraoperative template and 680 operative notes post template …

Evaluating The Impact Of Collaborative Care And Rehabiliation On Concussion Patients: Clinical Observations And Literary Review, Kevin Charan, Sarah Levin Allen

Research Day

Current research suggests that 1.6 - 3.8 million people each year suffer from concussions (Chin et al. 2016). The impact of concussions on the brain cannot be seen with traditional brain imaging, but screening tools can indicate whether the physical and cognitive symptoms presented are consistent with a concussion diagnosis. In addition to physical symptom reporting, concussion rehabilitation has shifted to focus on additional mental health factors. The aims of this capstone project were to gain a more in-depth understanding of the neurobiological and psychosocial factors influencing the recovery from a concussion, understand the rehabilitative process of a concussion, as …

Comprehensive User Engagement Sites (Cues): Is This A Viable Option For The Opioid Epidemic In Philadelphia?, Siddardth Umapathy, Samuel Schadt, John Dubensky, Matthew Dimeglio, Sonul Gulati, Kevin Cooney, Olivia Nguyen, Priscilla Rodriguez, Marvin Lee, Peter Clark

Research Day

INTRODUCTION: Opioid drug abuse has become an increasing concern throughout the United States, especially within the Philadelphia region. In 2017, the number of deaths by drug overdose were four times that of deaths by homicide. In addition, a total of 935 cases of secondary conditions due to needle sharing such as HIV and HCV occurred during the past year. The opioid epidemic has caused a public health emergency and any measures that could decrease the morbidity and mortality associated with opioid abuse are vital. A current proposal to combat this issue in Philadelphia is the implementation of a Comprehensive User …