Medicine and Health Sciences Commons^™

อุบัติการณ์และปัจจัยที่ส่งผลต่อการกระจายของมะเร็งปอดชนิดเซลล์ไม่เล็กไปสมองในคนไข้ที่มีการกลายพันธุ์ของอีจีเอฟอาร์, รัตนาวดี เตียวเจริญ

Chulalongkorn University Theses and Dissertations (Chula ETD)

ที่มา: การกระจายของมะเร็งไปสมองยังคงเป็นปัญหาสำคัญของผู้ป่วยมะเร็งปอดชนิดเซลล์ไม่เล็กที่มีการกลายพันธุ์ของ Epidermal Growth Factor Receptor (EGFR) วัตถุประสงค์: เพื่อหาอุบัติการณ์และปัจจัยที่ส่งผลต่อการกระจายของมะเร็งไปสมองในผู้ป่วยกลุ่มนี้ วิธีการศึกษา: การศึกษาแบบย้อนหลัง หาปัจจัยทางคลินิก พยาธิวิทยา และตรวจหาตัวบ่งชี้ทางชีวภาพ (E-cadherin และ vimentin) จากชิ้นเนื้อของผู้ป่วย วิเคราะห์หาปัจจัยที่สัมพันธ์ต่อการเกิดมะเร็งกระจายไปสมอง ผลการศึกษา: จากผู้ป่วย 449 ราย ตรวจพบ EGFR mutation 67.7% และตรวจพบมะเร็งกระจายไปสมอง 49% ผลจาก multivariate analysis พบว่าอายุน้อยกว่า 60 ปี และมีอวัยวะที่โรคกระจายไป ≥3 ตำแหน่งเป็นปัจจัยที่สัมพันธ์กับการเกิดมะเร็งกระจายไปสมองตั้งแต่แรก ในขณะที่อายุน้อย เป็นเพียงปัจจัยเดียวที่สัมพันธ์กับการเกิดมะเร็งกระจายไปสมองในภายหลัง vimentinย้อมติดในกลุ่มผู้ป่วยที่มีมะเร็งกระจายไปสมองมากกว่าผู้ป่วยที่ไม่มีมะเร็งกระจายไปสมอง (67.4% และ 32.6% ตามลำดับ, OR 2.88, 95% CI 1.35 – 6.16; p= 0.006) และบอกการพยากรณ์โรคที่แย่กว่าในผู้ป่วยที่มี EGFR mutation สรุปผลการศึกษา: อุบัติการณ์ของมะเร็งกระจายไปสมองในผู้ป่วยมะเร็งปอดที่มี EGFR mutation เท่ากับ 49% ผู้ป่่วยอายุน้อยและมีโรคกระจายไปหลายอวัยวะมีโอกาสเกิดมะเร็งกระจายไปสมองได้สูง vimentinสามารถเอามาใช้คาดการณ์การเกิดมะเร็งกระจายไปสมองรวมทั้งแสดงให้เห็นถึงการพยากรณ์โรคที่แย่กว่า

Anti-Cancer Effects Of Renieramycin T On Human Non-Small Cell Lung Cancer Cells, Korrakod Petsri

Chulalongkorn University Theses and Dissertations (Chula ETD)

Mcl-1 targeted therapy is promising strategy for lung cancer treatment since it is contributed to aggressive lung cancer and chemotherapeutic resistance. At present, many compounds targeting on Mcl-1 are currently under different clinical stages of development for cancer treatment. Herein, we report the Mcl-1 targeting activity of renieramycin T (RT), an alkaloid isolated from the blue sponge Xestospongia sp. RT was shown to target on Mcl-1 through ubiquitin-proteasomal degradation in lung cancer cells including chemotherapeutic resistant primary lung cancer cells. Additionally, RT also affects the activation of p53 and decrease of Bcl-2 which can lead to apoptosis of cancer cells. …

Nurse Practitioners Views On Leadership And Research, Mary Ryder, Elisabeth Jacob, Joyce Hendricks

ECU Posters

Nurse practitioners are clinical leaders focused on improving healthcare delivery for patient populations. The NP role is misunderstood. NPs lack confidence to be independently research ctive. Research by NPs requires support from nurses in academia. The NP role is similar in Ireland and Australia

Physiological Profile Of Rural Structural Firefighters In Southeast Georgia, Emily Langford

College of Graduate Studies: Theses & Dissertations

Many occupational tasks associated with firefighting require a great deal of cardiovascular and muscular demands. However, it is often noted that firefighters throughout the country are not meeting the fitness levels required of the profession. As a result, the proportion of on-duty injury and cardiac death is greater than the general population or similar service professions. Purpose: The purpose of this study was to provide an extensive physiological profile of rural firefighters in southeast Georgia. Methods: Forty firefighters from one department in southeast Georgia underwent a comprehensive health screening, measuring anthropometrics (i.e., height, weight, waist and hip circumference), body …

Community Perceptions On Access To And Communication Gaps Regarding Dementia-Specific Health Resources And Services, Randi G. Bastian

College of Graduate Studies: Theses & Dissertations

The people of Appalachia have less access to healthcare resources subsequently leading to deficits in healthcare, health education, and health research. There is a need to address the communication of healthcare resources among populations with low economic status such as the Appalachian communities in Northeast Tennessee. Alzheimer’s disease and related dementias (ADRD) uniquely challenges the healthcare industry while further dividing communities already experiencing hardship in healthcare resources. The Baby Boomer generation is advancing into the age range frequently affected by ADRD, 65 and over. In preparation, healthcare continuum must acknowledge and set out to address dementia-specific care challenges. “Keep …

Exploring The Narratives Of Black Male Nurses In Southeast Georgia: Implications For The Implementation Of Culturally Responsive Pedagogy In Nursing Curriculum, Celine M. Pfund

College of Graduate Studies: Theses & Dissertations

ABSTRACT

This dissertation inquiry explores the narratives of two Black male nurses in southeast Georgia. The framework for my research includes a variety of different theoretical components including works from both major nursing and curriculum studies scholars. The nursing workforce remains homogenized despite major recruiting. The intention of my research was to explore the experiences of Black male nurses to identify challenges, barriers, and systems of oppression that they may have encountered working in a profession dominated by White females in order to facilitate development of culturally responsive pedagogy in nursing. Methodologically, I mainly drew upon James Spradley’s work on …

Food Insecurity Among College Students At A Historically Black College & University: Prevalence, Social Support & Coping Skills, And Academic Outcomes, Rebecca L. Larson

College of Graduate Studies: Theses & Dissertations

Introduction: College students experience food insecurity (FI) at higher rates than the U.S. adult population. Food insecurity among college students is frequently associated with several sociodemographic factors; limited social support and coping skills; poor mental and physical health; and poor academic outcomes. The purpose of this study was to determine the prevalence of FI among students at Fort Valley State University (FVSU), a Historically Black College & University, factors associated with FI, the impact of FI on academic outcomes, and the influence of social support and coping skills on the relationship between FI and academic outcomes.

Methods: A stratified random …

Public Health Workforce Perceived Impact Of Emerging Issues In Public Health, Kristie C. Waterfield

College of Graduate Studies: Theses & Dissertations

Background: In an era where public health has been viewed as a global, multi-disciplinary field, the public health workforce has remained united to unfailingly holding fast to the mission of protecting, promoting, and improving the health of the public. However, the practice of public health is consistently evolving, and the workforce is continually facing a mirage of challenges. In order to overcome these challenges, practitioners need to be up-to-date on the necessary knowledge and skills to effectively deliver the core public health services.

Purpose: The purpose of this research was to explore the perceived impact of emerging trends in public …

Synthesis Of N-Heterocyclic Molecules And Their Applicability Towards Ion Sensing: Polymeric Chemosensors, Aikohi M. Ugboya

College of Graduate Studies: Theses & Dissertations

Critical to biological and environmental processes are anions because often times their relative concentration in our body can be an indicator of one’s well-being. Therefore, highly sensitive and cost-efficient methods for ions recognition is necessary for human health. In recent times, polymeric chemosensors have become a vital tool for sensing ions because of its higher sensitivity and good mechanical properties compared to their monomeric counterparts. These sensors are designed to produce a measurable response in the presence of a targeted ion such as an electrochemical or optical signal. The unique structure and the photophysical properties of the 1,2,3-triazole core coupled …

Burnout: Moving Beyond The Status Quo, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

Burnout has been defined as a job-induced syndrome combining emotional exhaustion, depersonalization/cynicism, and a sense of reduced personal accomplishment. In this article, we expand on past analyses of burnout by reviewing key, yet overlooked, problems affecting the construct. We concomitantly examine the implications of these problems for the overall validity of burnout research. Our work shows that burnout research is undermined by 4 main problems. First, what constitutes a case of burnout is unclear. Second, the basic conceptualization and operationalization of burnout are ill aligned. Third, burnout is unlikely to be the specifically job-induced syndrome it has been posited to …

Relationship Of Sociodemographic Factors With Serum Levels Of Vitamin D In A Healthy Population Of Pakistan, Khalida Iqbal, Najmul Islam, Naseema Mehboobali, Ali Asghar, Saleem Perwaiz Iqbal, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

High prevalence of vitamin D deficiency has been reported from Pakistan. Association of sociodemographic factors with vitamin D status has received little attention in this region. Therefore, we embarked on investigating the relationship of sociodemographic factors with vitamin D levels in a healthy Pakistani population. Venous blood from 226 healthy participants (age range 19-69 years) was collected and analyzed for serum concentrations of 25(OH) vitamin D [25(OH)D] and other related biomarkers. Demographic characteristics of the study participants were collected. Vitamin D deficiency (25(OH)D levels less than 20 ng/ml) was found to be 75% in this cohort. Gender, sunlight exposure and …

The Relationship Between Psychological Factors And The Gait Analysis Of A Total Knee Arthroplasty Patient: A Case Study, Tyler S. Rogers

Honors Program Theses

Rehabilitation through the use of physical therapy for the total knee arthroplasty (TKA), or knee replacement,procedure can be an arduous process. The purpose of this study is to identify any relationships between various psychological factors and angular variables observed during the functional activity of gait for TKA patients. Application of these results may be utilized by physical therapists to maximize the quality of personal patient care provided while allowing patients the opportunity to successfully return to the functional activity of walking. Psychological factors that were examined included those noted in the self-determination theory studied by Ryan & Patrick (2009): motivation, …

Identifying Interactions Between Chikungunya Virus And Aedes Aegypti Salivary Gland Proteins, Alfred Jiang

Public Health Theses

Chikungunya virus (CHIKV), an emerging threat to global health, has been responsible for extensive arboviral epidemics in Southeast Asia and the Americas in recent years. In order to develop effective therapeutics and preventative measures, we must first gain a deeper understanding of both the host and vector factors that define the pathogen’s life cycle and transmissibility. Currently, the entry receptor and potential co-factors that facilitate CHIKV infection in the arthropod vector are unknown, highlighting a critical knowledge gap in our understanding of the viral life cycle. Furthermore, while secreted mosquito salivary proteins have been shown to modulate host infection through …

Putting The T In Mlp: The Role Of Trust In Medical Legal Partnerships, Jenny Ajl

Public Health Theses

The United States spends more on healthcare than any other country, while health outcomes lag behind many nations. This is often attributed to the disproportionately low spending on social services, and social determinants of health (SDOH) need to be addressed in order to improve the nation’s health. SDOH are increasingly understood to be key factors in predicting health outcomes. Medical legal partnerships (MLPs) are one intervention that seek to address SDOH. The MLP model comprises three core components: providing legal care for patients, improving systems of healthcare, and creating policy change outside the healthcare system. In this qualitative study, we …

Nicotine Dependence And Alternative E-Cigarette Use Behaviors: Dripping And Vape Tricks, Harmanpreet Bhatti

Public Health Theses

Background: E-cigarette use among youth is concerning due to the risk of exposure to hazardous chemicals and future combustible cigarette use. Alternative e-cigarette use behaviors, or dripping (i.e., applying drops of e-liquids directly onto heated coils) and vape tricks (i.e., blowing shapes or large clouds of visible exhaled aerosol), may also increase this risk. However, little is known about the risk of nicotine dependence among adolescents who engage in these behaviors. Therefore, the aim of this study was to determine the association between these alternative e-cigarette use behaviors and nicotine dependence among adolescents.

Research Design: Cross-sectional data were collected from …

So You Think You Can Exercise: The Gap Between Exercise Confidence And Physical Activity Among Samoan Adults, Diksha Brahmbhatt

Public Health Theses

Samoa is experiencing one of the highest prevalence of overweight and obesity in the world, placing its population at increased risk of developing several noncommunicable diseases including type 2 diabetes and cardiovascular disease. The role of physical activity in reducing the burden of these diseases and overweight is well-established. Exercise self-efficacy or confidence is a predictor, if not determinant, of recreational physical activity. The purpose of this study, therefore, is to assess the relationship between exercise confidence and levels of recreational physical activity among Samoan adults. We confirm that exercise confidence is correlated with time spent exercising. However, despite considerable …

Safety Of Opat In Older Versus Younger Adults, Kaylen Elizabeth Brzozowski

Public Health Theses

Introduction Outpatient parenteral antimicrobial therapy (OPAT) is considered practical, safe, and cost-effective, but roughly 20% of all adult patients on OPAT experience an adverse event (AE). Frequency of AEs and healthcare utilization, defined as emergency department visits and infectious disease office visits, phone calls, and emails, may be greatest in the first two weeks of OPAT. Given that older adults (age ≥ 65) have greater cognitive decline, ADL limitations, and comorbidities than younger adults, we sought to evaluate the frequency and timing of AEs in older adults on OPAT. We examine patients on OPAT at Yale New Haven Hospital (YNHH) …

Postpartum Weight Trajectories In A Cohort Of 127 Samoan Women: Does Breastfeeding Protect Against Postpartum Weight Retention?, Grace Castillo

Public Health Theses

Rising global obesity rates impact every aspect of health, including maternal-fetal health. Samoa has a disproportionate burden of obesity, with more than half of Samoan women entering pregnancy obese. Given Samoan women’s high parity (4), postpartum weight retention (PPWR) may be a significant source of weight gain over women’s lifetimes. Little is currently known about PPWR among Samoan women, so this analysis sought to document PPWR trajectories, assess factors – like breastfeeding -- associated with PPWR. Data of 127 mother-infant dyads from the 2017 Foafoaga O le Ola cohort were used in analysis. Researchers collected demographic and lifestyle data, as …

Attachment Security And Psychological Health In Adult Child Caregivers And Their Parents With Alzheimer’S Disease And Related Dementias, Wei Aiko Chang

Public Health Theses

Objective: Attachment theory is a helpful framework for examining one of the most fundamental needs in parent-child dyads across the lifespan and how attachment security might protect both dyad members’ psychological health, especially in times of crisis. In this study of adult child caregivers and their parents with early stage Alzheimer’s disease and related dementias (ADRD), we examined the associations between both dyad members’ attachment security, the adult child’s depressive symptoms, and quality of life of the parent with ADRD.

Method: Thirty-four individuals (parents) with ADRD and their 34 adult-child caregivers each completed the 12-item Experiences in Close Relationship Scale …

Persistence Of Ebola Virus In Survivors & Risks Of Sexual Transmission: A Systematic Review, Allison Cheung

Public Health Theses

Background: Longitudinal cohort studies of Ebola virus disease (EVD) survivors from the 2014-2016 West African outbreak have found evidence of Ebola virus (EBOV) and EBOV RNA persistence in the bodily fluids of survivors, particularly in semen. This new evidence has raised the possibility of sexual transmission of EBOV by EVD survivors. The current interim guidance issued by the World Health Organization (WHO) recommends safer sex practices for at least 12 months after acute disease onset (ADO). However, based on new evidence, these recommendations may require revision.

Objective: The main aim of this article is to present and evaluate evidence on …

Estimating Mortality After Natural Disasters In Low- And Middle-Income Countries: A Systematic Review, Joseph Clingerman

Public Health Theses

Background

The outcomes of natural disasters produce many complex uncertainties and statistics, many of which have no metrics to assess how accurate they are. In particular, mortality estimates in low- and middle-income countries encompass many variables in their inherently challenging physical, political, and logistical landscapes. Given that there has been no known systematic review of assessing mortality estimation methodologies, the author aimed to provide a systematic review of known methodologies and provide a framework to assess mortality estimation methodologies.

Methods

The author performed a systematic search of electronic databases from the past two decades up to January 2019. In addition, …

Exposure To Atmospheric Metals Using Moss Bio-Indicators And Neonatal Health Outcomes In Portland, Oregon, Saskia Comess

Public Health Theses

Background: Exposures to certain metals are associated with adverse birth outcomes, including inhibited fetal growth and congenital defects. Previous studies focused on metals such as lead and arsenic, and primarily assessed exposure using biological monitoring, which does not provide insights into sources. Examining exposure to metals via atmospheric pathways is challenging due to a lack of high-resolution air-pollution data. We applied a unique map of atmospheric metal pollution, derived from bio-indicator moss samples, as a screening tool to study neonatal health risks of atmospheric metal pollution in Portland, Oregon, a city of 640,000 people with several metal-emitting industrial sources.

Methods: …

The Contribution Of The Residential Environment To Indoor Air Pollutants, Jessica Deslauriers

Public Health Theses

Rationale: Little is known about the home environment and associated indoor exposures to brown carbon and black carbon, components that make up fine particulate air pollution.

Objective: Identify how features of the residential environment contribute to indoor measurements of brown and black carbon.

Methods: Between November 2012 and December 2014, 125 veterans who were part of a COPD cohort were recruited for this study. At roughly 3 month intervals, participants received a particle sampler to measure air pollutants in their home for a 1-week period. The filters within the samplers were analyzed for levels of black and brown carbon using …

Quantifying Influenza Exposure Within Hospitals And Nursing Homes, Drew Taylor Dickinson

Public Health Theses

Abstract

Background: Influenza acquisition in hospitals and nursing homes (NHs) highlights the need for infection prevention to protect patients from contagious diseases while under the care of a healthcare facility. We quantified influenza exposure in both settings and compared facility-onset influenza rates in order to determine if risks of acquiring influenza differed by type of healthcare facility since infection prevention practices are less standardized and less rigorous in NHs.

Methods: We conducted a retrospective cohort study of California hospital and NH inpatients during the 2015-2016 influenza season, defined as the peak influenza month, plus the two adjacent months, using claims …

Proximity To Nearest Major Road And Time To Pregnancy In The Early Pregnancy Study, Nina Hatch

Public Health Theses

Purpose: Current literature suggests that air pollution may affect reproductive outcomes, but little research has evaluated the association between air pollution and fertility. Our aim is to further examine the relationship between distance to major roadway, a proxy for traffic-related air pollution, and fecundability.

Methods: Our analysis was conducted within the North Carolina Early Pregnancy Study (n=221). Our outcome was pregnancy attempt time, an estimate of fecundability, or the per cycle probability of conception. Our primary definition of conception included early pregnancy loss, spontaneous miscarriage, ectopic and molar pregnancy, and singleton or twin pregnancies. In a secondary analysis, we defined …

Gaps In Mental Healthcare Use And Perceived Quality Between Privately Insured Lgb And Heterosexual Individuals In The United States, Yuki Hayashi

Public Health Theses

Previous research has identified significantly heightened levels of mental health issues and psychological distress among lesbian, gay, and bisexual (LGB) individuals in the U.S., as well as greater mental health service utilization among this population. Using a nationally representative sample of privately insured adults in the U.S., we investigate differences in mental healthcare utilization, characteristics of mental healthcare received, and perceived quality of care between LGB and heterosexual individuals. Key results find that privately insured LGB men and women are significantly more likely than their heterosexual counterparts to have used outpatient mental healthcare as well as out-of-network (OON) outpatient mental …

Multi-State Analysis Of Unconventional Oil And Gas Development And Rates Of Sexually Transmitted Infections In The United States, Nicholaus Peter Johnson

Public Health Theses

Background

Advances in unconventional oil and gas development (UOGD), including hydraulic fracturing and horizontal drilling, have helped position the United States as a world leader in the production of both crude oil and natural gas hydrocarbons. This significant increase in production would not have been possible, however, without the assemblage of a workforce that is predominantly young, male, and mobile. This is significant given that a number of studies have associated similar types of mobile workforces – especially those employed by resource extractive industries – with impacts on the sexual health of the host communities in which these workers operate …

Perspectives Of Type 2 Diabetes Patients On Their Interactions With Providers, Marleen Z. Jones-Pool

Public Health Theses

Effective patient-provider communication has been shown to help achieve optimal health results, particularly in patients with diabetes. While previous studies have identified patient-perceived barriers in communicating with their providers, this study highlights factors in the patient-provider interaction that may contribute to effective health communication. As part of a larger mixed-methods study, 10 semi-structured interviews were conducted with patients with self-reported diabetes at a primary health center. These interviews sought to understand patient-perceived communication factors that influenced their interactions with their providers. Interviews were recorded and transcribed verbatim. Interview transcripts were then coded and analyzed utilizing a grounded theory approach. Findings …

The Association Between Self-Reported History Of Experiencing Violence & Mental Health Status Among Urban Refugees And Asylum Seekers In Malaysia, Rayne Soyoung Kim

Public Health Theses

Background: In displaced populations, studies have shown that there are significant associations between exposure to violence and reporting mental illness. There is little known regarding this relationship in countries like Malaysia, which serves as a transitional point where refugees wait to be resettled.

Objective: To assess the cross-sectional association of exposure to violence with mental health status in the urban refugee and asylum-seeking population in Malaysia.

Methods: 286 self-identified refugees and asylum seekers, recruited by using time-location sampling, were given interviewer-administered surveys, including questions regarding exposure to violence and mental health symptoms. Multivariable logistic regression analyses were performed to evaluate …

Evaluating The Feasibility And Effectiveness Of Self-Monitoring Of Health – A Pilot Study Among Samoan Women, Erica Kocher

Public Health Theses

Background:

Samoa, like many low- and middle-income countries, faces a high burden of obesity and non-communicable disease. Self-monitoring technologies to help individuals track their health have proven effective in high-income countries, but have not generally been tested in low-income settings. To investigate the feasibility and potential effectiveness of using step-counters and digital scales in Samoa, we conducted a pilot randomized controlled trial.

Methods:

The trial enrolled 44 Samoan women (31-40 years) without chronic conditions (non-hypertensive, non-diabetic, etc.) and who reported motivation to become more active. After a 1-week baseline period to measure physical activity in the absence of any feedback, …