Medicine and Health Sciences Commons^™

Disparities In Diabetes Rates And Quality Of Care Within Immigrants In The Usa, Anyun Chatterjee, Martin Blanco, George Gray

GW Research Days 2016 - 2020

Immigrants to the USA present an interesting opportunity to test the classical public health question of the impact of place on a health outcome. Diabetes is a prevalent disease in the USA which is slated to rise in rate in the future. Currently, 9.4% of the country is diabetic, and another 28% of the country is prediabetic. We posed the question - is this impact felt disproportionately by immigrants as they live in the US for a decade or more? Our preliminary literature search indicated that this has not been studied extensively, although the impact of American fast food on …

(Video) Differences In Psychosocial And Behavioral Risk Profiles Of Cigarette Smokers And E-Cigarette Users Among Minnesota Adolescents: 2016, Tara E. Jenson

GW Research Days 2016 - 2020

Background/Objectives: Rates of cigarette smoking among adolescents have been trending downward, however rates of adolescent e-cigarette use rates are now twice those of adolescent cigarette smoking nationally. The objective of this study was to examine the association of demographic, socioeconomic, psychosocial and health behavioral factors as surveyed by the Minnesota Student Survey with cigarette smoking and e-cigarette use among Minnesota adolescents.

Methods: This study analyzed the 2016 Minnesota Student Survey (MSS), an anonymous, school-based, cross-sectional survey of students in grades five, eight, nine and eleven. The 2016 MSS contains a total of 168,733 records, 118,198 of which were …

Tumor Surveillance Using Liquid Biome In Pediatric High Grade Gliomas, Erin Bonner, Eshini Panditharatna, Madhuri Kambhampati, Stefaan Van Gool, Wilfried Stuecker, Roger J. Packer, Javad Nazarian

GW Research Days 2016 - 2020

Immunotherapy is currently being used to treat pediatric brain cancer, though its efficacy in treating patients with diffuse intrinsic pontine glioma (DIPG), the deadliest pediatric brain tumor, has not been evaluated. MRI is the gold standard for monitoring tumor response to therapy, but is limited by pseudoresponse and psuedoprogression: post-treatment, immune cells infiltrate the primary tumor causing transient tumor enlargement, which falsely resembles tumor progression on MRI. Thus, it is critical to develop more accurate approaches to monitor tumor response to immunotherapy. Here, we use a liquid biopsy platform we have already established to monitor tumor response to therapy, to …

How The European Union Is Embracing Cross-Border Telemedicine And What The U.S. State Medical Boards Can Learn From It, Sohyun Laura Chang, Jesse M. Pines, Jane H. Thorpe

GW Research Days 2016 - 2020

Despite the fact that there have been many advances in the field of telemedicine, the United States (U.S.) state and federal laws have not kept pace with these technological advancements and may operate as a barrier to growth in the field of telemedicine. On the other hand, the European Union (EU) has developed a robust legal framework for the practice of telemedicine. The aim of this research project is to evaluate what elements of the EU legal experience could be used to support efforts to better align telemedicine law with the practice of telemedicine in the U.S.

Based on the …

Morbid Obesity Is Associated With Postoperative Complications In Laparoscopic Hysterectomy, Margaret Berrigan, Maria Victoria Vargas, Alex Gu, Chapman Wei, Hannah Robinson, Paul Tyan, Gaby Moawad

GW Research Days 2016 - 2020

Background: The prevalence of obesity in American women is 38.3%. Hysterectomy is the second most common surgery in reproductive age women; most of these procedures are performed laparoscopically. From 2011 to 2015, 3.2% of women age 15-44 years underwent hysterectomy; 89.6% of these procedures were performed for management of medical conditions including uterine fibroids, menstrual disorders, uterine prolapse, and endometriosis. The high rates of obesity and hysterectomy in women demand better understanding of the relationship between obesity and postoperative complications following laparoscopic hysterectomy. Methods: We conducted a retrospective cohort study using the American College of Surgeons National Quality Improvement Database …

Resilience Of Children With Chronic Health Conditions: The Impact Of Neuropsychiatric Comorbidities, Sarah Bernstein, Sandra Cushner-Weinstein

GW Research Days 2016 - 2020

BACKGROUND: Resilience, the ability to overcome adversity and effectively recover from stressful experiences, is a complex theory with many contributing factors. Previous studies have shown that condition-specific summer camps for children with chronic health conditions increase resilience and adaptive coping skills, change attitudes toward the illness, and improve quality of life. The aim of this study was to determine how neuropsychiatric comorbid diagnoses such as attention deficit hyperactivity disorder (ADHD), learning disability, and anxiety disorder influence the resilience of children with chronic health conditions.

METHODS: Children with chronic health conditions including autism, epilepsy, cerebral palsy, Tourette’s syndrome, sickle cell anemia, …

The Trans Pacific Partnership Agreement, Intellectual Property And Medicines: Differential Outcomes For Developed And Developing Countries, Deborah Gleeson, Joel Lexchin, Ruth Lopert, Burcu Kilic

Health Policy and Management Faculty Publications

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP …

Acute Gastric Volvulus Causing Splenic Avulsion And Hemoperitoneum, Yana Cavanagh, Neal Carlin, Ruhin Yuridullah, Sohail Shaikh

NYMC Residents/Fellows Publications

Gastric volvulus is an abnormal, potentially life-threatening, torsion of the stomach. The presence of complications such as hemoperitoneum increases the diagnostic urgency; however it can also mask the presentation of gastric volvulus. We encountered a 66-year-old female who presented with symptomatic gastric outlet obstruction and was found to have hemoperitoneum and splenic avulsion on imaging. In our case, hemoperitoneum was a clinical red herring as initial imaging concentrated on the presence of hemoperitoneum and was nondiagnostic of gastric volvulus. Interestingly, our patient experienced complete resolution of her presenting symptomatology following placement of a nasogastric tube. Furthermore, endoscopic evaluation revealed no …

Oncology Section Edge Task Force On Cancer: Measures Of Cancer-Related Fatigue—A Systematic Review, Mary Insana Fisher, Claire Davies, Hannah Lacy, Deborah Doherty

Physical Therapy Faculty Publications

Background: Cancer-related fatigue (CRF) is one of the most common side effects of cancer and cancer treatment. Being able to accurately screen for and assess CRF will improve access to and prescriptions for interventions. Valid and reliable measures to screen for and assess CRF need to be identified.

Purpose: To identify and recommend reliable, valid, and clinically useful tools to screen for and assess CRF among those treated for cancer.

Methods: A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility of each method identified. Task force members independently reviewed each measure using …

Sans-Papiers, Sans-Santé: A Study Of Undocumented Migrant Women’S Access To Reproductive And Obstetric Health Care In Switzerland, Sarah Kinch

Independent Study Project (ISP) Collection

In recent years, Switzerland has seen increasing numbers of foreign-born residents, making it one of the many countries affected by the European Migrant Crisis. Of these newly-settled migrants, many live in the country illegally, otherwise known as undocumented migrants or “Sans-Papiers.” While Switzerland grants its Sans-Papiers population a right to health, thus making medical insurance and care legal for the undocumented community, many still see increased adverse health outcomes among the population. As more than half of the Sans-Papiers living in Switzerland are female, women are therefore increasingly at risk for worse reproductive and obstetric health. This study sought to …

How Occupational Therapy Can Help Children With Dyslexia In The Classroom Environment, Erin Wright

MOT Student Capstones

Objectives: Occupational therapists focus on increasing the occupational performance of individuals, especially students in the school system. Reading is a major occupation of a student's life. Since there is evidence that reading disorders, such as dyslexia, involve the visual system, occupational therapists can help support these students in the school system by improving their visual perceptual and ocular motor skills. The focus of this paper and project is to provide teachers and staff members in a Lower School information on the correlation between the lack of visual skills and dyslexia. Methods: Conduct a presurvey of teacher feedback on their levels …

Exploration And Education Of Occupation-Based Interventions Of Meal Preparation In Skilled Nursing Facilities For Occupational Therapy Practitioners, Lauren L. Bridgers

MOT Student Capstones

The objectives of this project were to educate and promote client-centered, meaningful occupation based interventions in the skilled nursing facility setting in order to increase independence and safety with meal preparation required for independent living for the adult population. This project explored the evidence-based knowledge and current implementation of occupation-based meal preparation tasks of current occupational therapy practitioners through a pre-questionnaire. Based on the occupational therapy practitioners' pre-questionnaire results, an educational training was provided via telehealth to restate the distinct value of occupation-based meal preparation. A post-questionnaire was obtained to reassess the knowledge and current implementation of occupation-based meal preparation …

Mindfulness As A Tool To Decrease Stress In Parents Of Children With Special Needs, Ashley N. Garwood

MOT Student Capstones

The occupational role for a parent and/or caregiver of a child with special needs can be a stressful role. These individuals often assume the responsibilities of many different professions, with little time for their own health and wellness. This project aimed to investigate the use of mindfulness as a stress management tool for such parents and caregivers. The objectives of this project were to provide parents and caregivers of children with special needs a simple and realistic tool to decrease perceived stress, and to improve their overall role satisfaction. Attendants were provided with two educational training sessions in order to …

Caring For Caregivers Of Children With A Traumatic Brain Injury: Support Group, Caroline T. Boyd

MOT Student Capstones

This Capstone project discusses a piloted support group for Eastern North Carolina at Vidant Medical Center for caregivers of children with a traumatic brain injury (TBI). Through collaboration with Vidant Medical Center interprofessionals, my fieldwork supervisor, and literature reviews of scholarly articles I designed outcome objectives and an itinerary for four piloted support group sessions. Support group topics included health maintenance, stress management, leisure exploration, parenting children with a TBI, and learning self-care management skills. Pre-and post-questionnaires were created and provided to participants. These questionnaires included questions concerning level of understanding of TBI, knowledge of community resources, level of stress, …

Occupatioanl Therapy In A Rural Public-School System: Exploring The Needs Of Elementary Schools Regarding Written Expression, Kaitlyn A. James

MOT Student Capstones

This capstone focused on the topic of written expression in a rural public school system setting, Edgecombe County Public Schools (ECPS). After investigating the needs of teachers in ECPS specifically and researching the evidence behind writing programs and current best practices, the end goal of this capstone was to make a formal recommendation for a writing program to the involved stakeholders in ECPS. Literature examined for this project included research from scholarly journals, presentations, evidenced-based databases, and credible web-based and academic resources. Gaining feedback from the teachers provided insight that specifically targeted areas of daily instruction while providing additional perspective …

Tipsheet: Student Mental Health And Resources, Unl Office Of The Executive Vice Chancellor

United States Public Health Resources

Stress, depression, anxiety, alcohol abuse, eating disorders, and other mental health challenges affect at least 1 in 5 college students*. Faculty can be an important source of support for UNL students. Here are some strategies for supporting student mental health:

1. Communicate the importance of mental health. Mental health is just as important as physical health. When someone breaks a leg they go to the hospital. Mental illness is the same thing. If someone is feeling depressed they should seek treatment. Normalize mental health by talking about getting support if you notice your students struggling with stress, depression, anxiety, etc. …

The Interplay Of Type I And Type Ii Interferons In Murine Autoimmune Cholangitis As A Basis For Sex-Biased Autoimmunity, Heekyong R. Bae, Deborah L. Hodge, Guo Xiang Yang, Patrick S.C. Leung, Sathi Babu Chodisetti, Julio C. Valencia, Michael Sanford, John M. Fenimore, Ziaur S.M. Rahman, Koichi Tsuneyama, Gary L. Norman, M E. Gershwin, Howard A. Young

United States Public Health Resources

We have reported on a murine model of autoimmune cholangitis, generated by altering the AU-rich element (ARE) by deletion of the interferon gamma (IFN-γ) 3' untranslated region (coined ARE-Del−/−), that has striking similarities to human primary biliary cholangitis (PBC) with female predominance. Previously, we suggested that the sex bias of autoimmune cholangitis was secondary to intense and sustained type I and II IFN signaling. Based on this thesis, and to define the mechanisms that lead to portal inflammation, we specifically addressed the hypothesis that type I IFNs are the driver of this disease. To accomplish these goals, we crossed ARE-Del−/− …

Improving The Interprofessional Relationship Between Nurses And Speech–Language Pathologists: Expansion Of A Project, Christina Hamling, Kristy Weissling, Jan Tubbs, Jenna Dubas

UCARE: Research Products

The research presented on this poster explored the impact of extraprofessional education on undergraduate nursing and speech-language pathology students with an overall goal of improving the interprofessional relationship between the two fields. Utilizing quantitative and qualitative methods in the form of a pre-test, educational materials, live guided observation, and post-tests, the researchers found an increase in the nursing students ability to identify the role of the speech-language pathologist in a medical setting. There was also an increase in the speech-language pathology student’s ability to understand how and when to communicate with nurses in a medical setting.

Physical Activity Across The Lifespan And Liver Cancer Incidence In The Nih-Aarp Diet And Health Study Cohort., Hannah Arem, Erikka Loftfield, Pedro F Saint-Maurice, Neal D Freedman, Charles E Matthews

Epidemiology Faculty Publications

While liver cancer rates in the United States are increasing, 5-year survival is only 17.6%, underscoring the importance of prevention. Physical activity has been associated with lower risk of developing liver cancer, but most studies assess physical activity only at a single point in time, often in midlife. We utilized physical activity data from 296,661 men and women in the NIH-AARP Diet and Health Study cohort to test whether physical activity patterns over the life course could elucidate the importance of timing of physical activity on liver cancer risk. We used group modeling of longitudinal data to create physical activity …

30-Day Readmission Rate And Its Causes In General Surgical Patients, Rizwan Sultan, Umme Hani Abdullah, Tabish Chawla

Section of General Surgery

Objective: To find out the 30-day readmission rate for different surgical procedures and determine the causes for readmissions.
Study Design: An audit report.
Place and duration of study: Department of Surgery, The Aga Khan University Hospital, Karachi, in the calendar year 2014.
Methodology: Records were retrospectively reviewed for 30-day readmission rate and their cause in general surgical patients who underwent a general surgical procedure at The Aga Khan University Hospital, Karachi, in the year 2014.
Results: Out of 217 (6.4%) readmissions in 3,387 patients, more than 50% unplanned readmissions were avoidable. The highest readmission rate was after placement of feeding …

Resolution Of Gestational Gigantomastia With Termination Of Pregnancy, Syed Sarmad Bukhari, Haris Manan, Mah Muneer Khan, Syed Shahmeer Raza

Section of Neurosurgery

Less than 100 cases of gestational gigantomastia have been described in literature. The aetiology and risk factors are not well-established. Various treatments have been used with some consensus. We present the case of a 47-year-old female who presented to us with bilateral gigantomastia in her 16th week of gestation. She had massively enlarged breasts which were very painful. Relevant laboratory investigations were normal. An incisional biopsy done prior to, and two trucut samples at presentation to us, showed normal breast tissue proliferation. In the absence of adequate pain control, it was decided to electively terminate the pregnancy and give a …

Effects Of A Formal Educational Class On The Quality Of Life In Patients Diagnosed With Hypothyroidism, Tahimina Popal, Dnp, Bsn, Msn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypothyroidism is a chronic disease that requires self-care skills such as healthy diet, exercise, and a daily medication regimen where timing of food intake is essential. Adequate education is essential for patients with hypothyroidism to be able to manage their disease, and to live with the best quality of life possible. Many studies have been conducted to assess the perceived health status of patients with hypothyroidism, but few have examined the effects of a formal educational program on the quality of life.

Objectives: The purpose of this study is to determine if a formal hypothyroidism educational class will improve …

Improving Primary Care Utilization For Transgender Patients At An Fqhc, Timothie J. Rochon, Dnp, Rn, Cnm

Doctor of Nursing Practice Projects

Background: Transgender and Gender-Nonconforming (TGNC) populations comprise approximately 6% of the U.S. population. Socially and within the medical treatment system TGNC individuals face widespread stigmatization and discrimination which negatively impacts their mental, physical, and emotional health and contributes to health disparities. Real and perceived barriers to safe and effective healthcare are worsened by the scarcity of primary care providers knowledgeable in caring for these populations.

Objectives: The aim of this quality improvement project was to examine the impact of inclusive gender-affirming integration on the utilization of preventive and primary care services.

Methods: A one group pre- and post-intervention design was …

;, Anthony Santangelo

Vázquez-Valarezo Poetry Award

The poem tells a personal story between my best friend and me during our freshman year at Augustana. Through her struggles with mental health, I learned to understand and accept people different than me. One of the main reasons I wrote this is to demonstrate the detriments of mental health stigma and the mindset that must be adopted to combat this.

An Evolving Understanding Of A Spectrum “Disorder”, Samuel C. Eads 18

Honor Scholar Theses

The 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) affected millions of people. Individuals who had previously received a diagnosis of Asperger’s syndrome (AS), or any other pervasive developmental disorder (PDD) with the exception of Rett syndrome (RTT)1, suddenly found themselves placed on the autism spectrum. While some individuals with PDDs viewed this diagnostic change as beneficial, others felt that they had been stripped of a part of their identity. By merging several disorders, the DSM created the “umbrella diagnosis” of autism spectrum disorder (ASD), which features an incredibly varied etiology and diverse clinical …

Direct Care Nursing Aide Turnover In Long-Term Care Facility, Qilian Luo

Muskie School Capstones and Dissertations

This capstone project, Direct Care Nursing Aide Retention in a Long-Term Care Facility, will uses both qualitative and quantitative analyses to identify the possible contributors to high nursing aide turnover rates in Maine. The quantitative analyses of this project are based on the staffing payroll data of one Maine assisted living facility. The final product of this capstone project will be shared with the study facility, in the hope that they may find uses for its content.

Cardiac Magnetic Resonance Imaging In A Young Patient With Left Ventricular Spongiform Cardiomyopathy: A Case Report And Review Of Literature, Bilal Hussain, Fateh Ali Tipoo Sultan

Section of Cardiology

Left ventricular spongiform or non compaction cardiomyopathy is one of the rarer forms of cardiomyopathy with a reported prevalence of 0.014-0.05% in adults. It is characterized by severe left ventricular systolic dysfunction occurring secondary to the failure of the myocardium to fuse resulting in non-compacted myocardium with a trabeculated appearance of the myocardium. Initially described on the basis of 2-D echocardiography, the identification of left ventricular non compaction has now improved with the introduction of sophisticated imaging modalities such as cardiac magnetic resonance imaging that allows better visualization of the non-compacted myocardium assisting in accurate diagnosis. We report a case …

Predictors Of Low Birth Weight And 24-Hour Perinatal Outcomes At Muhimbili National Hospital In Dar Es Salaam, Tanzania: A Five-Year Retrospective Analysis Of Obstetric Records, Benjamin Anathory Kamala, Andrew Hans Mgaya, Matilda Michael Ngarina, Hussein Kidanto

Faculty of Health Sciences, East Africa

Introduction: The global prevalence of low birth weight (LBW) is 16%, representing more than 20 million infants worldwide, of which 96% are born in low-income countries. This study aimed to determine the prevalence, predictors and perinatal outcomes of LBW newborns.

Methods: We conducted a retrospective analysis of data obtained from the hospital's obstetric and neonatal database. Descriptive statistics and multivariate logistic regression were performed with 95% confidence intervals (CI).

Results: The prevalence of LBW was 21% (n = 8,011) and two-thirds of these were delivered at term. Seven percent of newborns were stillbirths and 2% died within 24hrs after birth. …

A Word From The Writing Team (April 2018), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• Our New Name
• Now Offering Group Consultations
• Writing Café

Constrictive Pericarditis Presenting As Bilateral Pleural Effusion: A Report Of Two Cases, Manesh Kumar Gangwani, Salman B. Mahmood,, Fariha Hasan, Javaid Khan

Section of Pulmonary & Critical Care

Constrictive pericarditis is a rare presentation. We need a very high index of clinical suspicion to diagnose the disease. It most commonly presents secondary to tuberculosis (TB) in the developing world and post-radiation therapy in the developed world. Classically, it presents with symptoms of heart failure and as pericardial thickening or calcification on imaging studies. In hospital settings, constrictive pericarditis is not usually considered as a differential in patients presenting with pleural effusion. According to the literature, associated pleural effusions in cases of constrictive pericarditis could be left-sided. Herein, we present two unusual presentations of cases with bilateral pleural effusions. …