Medicine and Health Sciences Commons^™

Metastatic Breast Cancer In Kenya: Presentation, Pathologic Characteristics, And Patterns-Findings From A Tertiary Cancer Center, Etoroabasi Ekpe, Asim Jamal, Jasmit Shah, Judith S. Jacobson, Shahin Sayed

Internal Medicine, East Africa

Purpose: The purpose of this research was to describe the sociodemographic and clinical characteristics of Kenyan women with metastatic breast cancer diagnosed and treated at Aga Khan University Hospital in Nairobi, Kenya from 2012 to 2018.

Patients and Methods: We reviewed charts of Kenyan women with metastatic breast cancer and analyzed sociodemographic data, breast cancer risk factors, and tumor characteristics associated with stage at diagnosis, receptor status (ie, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 [HER2]), and site of metastasis using χ2, analysis of variance, two-sample t tests, and logistic regressions.

Results: A total of 125 …

Acinetobacter Infections: A Retrospective Study To Determine In Hospital Mortality Rate And Clinical Factors Associated With Mortality, Rajiv Patel, Jasmit Shah, Gunturu Revathi, Wangari Siika, Reena Shah

Internal Medicine, East Africa

A retrospective case series of acinetobacter infections at a tertiary hospital in Nairobi was conducted to determine the mortality rate and factors associated with mortality. Over an eight-year period, 80 clinically significant infections were identified. The majority of infections were ventilator-associated pneumonia (40%) and bloodstream infections (30%). Eighty-six percent of the isolates were multi-drug resistant. The mortality rate in the study cohort was 45%. Twelve patients grew Acinetobacter spp. within 48 h of hospitalization, and three of these patients had no prior healthcare contact. The mean Sequential Organ Failure Assessment score was associated with mortality from acinetobacter infections.

The Quality Of Transdisciplinary Team Assessment Practices For Mobile Technology As Augmentative And Alternative Communication, Laura Jeanne Mansfield

Doctoral Dissertations and Projects

While research acknowledges the impact the rapid growth in mobile technology is having on the field of augmentative and alternative communication (AAC), little has been done to investigate the impact this development has had on assessment practices for matching an individual with the appropriate technology. The purpose of this descriptive and causal-comparative research study was to gather demographic and descriptive data on mobile technology as AAC and to investigate the quality of transdisciplinary teamwork assessment practices as evaluated by speech-language pathologists (SLPs) for the provision of mobile technologies as AAC devices across SLP practice settings. A random sample of 60 …

Coding Rupture Indicators In Couple Therapy (Crict): An Observational Coding Scheme, Annalisa Ward Carr

Theses and Dissertations

The therapeutic alliance, a construct representing agreement and collaboration on therapy goals, therapy tasks, and the emotional bond between client(s) and therapist, is a robust predictor of therapy outcomes in individual, couple, and family therapy. One way to track the therapeutic alliance is through ruptures and repairs. Ruptures are breaks, tensions, or tears in the therapeutic alliance. Ruptures and repairs influence the therapeutic alliance and consequently therapeutic outcomes. Currently, there is a lack of research addressing ruptures and repairs in couple therapy. The first step in researching alliance ruptures is to have a reliable way to assess alliance ruptures. This …

Commentary: The History Of Neurosurgery At Albany Medical College And Albany Medical Center Hospital, Albany, New York., Pouya Entezami, Michael R. Gooch, Adedamola Adepoju, Julie Pilitsis, Tyler J. Kenning, Alan Boulos, David L. Semenoff

Department of Neurosurgery Faculty Papers

The origins of the Department of Neurosurgery at Albany Medical College closely parallel the development of early America and the establishment of modern health care.The tales of Washington Irving, the works of the Hudson River School of painters, and summers in the Catskill Mountains or Adirondacks are the stories that color the history of Upstate New York (Figure1). As a social, industrial, and political hub of the American colonies, New England’s need for centers providing structured medicine led to the creation of Albany Medical College in1839, one of the earliest such institutions in the young nation.1 Rapid progress in nearly …

Htx-011 Reduced Pain Intensity And Opioid Consumption Versus Bupivacaine Hcl In Bunionectomy: Phase Iii Results From The Randomized Epoch 1 Study., Eugene R. Viscusi, Joseph S. Gimbel, Richard A. Pollack, Jia Hu, Gwo-Chin Lee

Department of Anesthesiology Faculty Papers

BACKGROUND AND OBJECTIVES: There is a need for local anesthetics that provide consistent analgesia through 72 hours after surgery. This study evaluates the use of HTX-011 (bupivacaine and meloxicam in Biochronomerpolymer technology), an extended-release, dual-acting local anesthetic, in reducing both postoperative pain over 72 hours and postoperative opioid use when compared with bupivacaine hydrochloride (HCl) and saline placebo. Inclusion of low-dose meloxicam in HTX-011 is designed to reduce local inflammation caused by surgery, potentiating the analgesic effect of bupivacaine. Previously, significant synergy has been observed with bupivacaine and meloxicam with both given locally together.

METHODS: EPOCH 1 was a randomized, …

Microrna-374a, -4680, And -133b Suppress Cell Proliferation Through The Regulation Of Genes Associated With Human Cleft Palate In Cultured Human Palate Cells, Akiko Suzuki, Aimin Li, Mona Gajera, Nada Abdallah, Musi Zhang, Zhongming Zhao, Junichi Iwata

Faculty, Staff and Student Publications

BACKGROUND: Cleft palate (CP) is the second most common congenital birth defect; however, the relationship between CP-associated genes and epigenetic regulation remains largely unknown. In this study, we investigated the contribution of microRNAs (miRNAs) to cell proliferation and regulation of genes involved in CP development.

METHODS: In order to identify all genes for which mutations or association/linkage have been found in individuals with CP, we conducted a systematic literature search, followed by bioinformatics analyses for these genes. We validated the bioinformatics results experimentally by conducting cell proliferation assays and miRNA-gene regulatory analyses in cultured human palatal mesenchymal cells treated with …

The Influence Of Vitamin D Supplementation On Local And Systemic Inflammatory Markers In Periodontitis Patients: A Pilot Study, Mohamed M Meghil, Lance Hutchens, Anas Raed, Neha A Multani, Mythilypriya Rajendran, Haidong Zhu, Stephen Looney, Mahmoud Elashiry, Roger M Arce, Mark E Peacock, Yanbin Dong, Christopher W Cutler

Faculty, Staff and Student Publications

OBJECTIVES: Vitamin D deficiency/insufficiency is a worldwide public health issue that has been linked to numerous inflammatory disorders, including periodontitis. There is increasing support for a role for adequate vitamin D levels in overall health. Populations with darker skin color have a higher prevalence of vitamin D deficiency/insufficiency and periodontitis. The purpose of this small pilot study was to investigate the influence of 12 weeks of 25(OH)D vitamin D supplementation (VDS) on mediators of systemic inflammation in dark-skinned, periodontitis patients.

MATERIALS AND METHODS: A total of 23 patients with moderate to severe periodontitis were randomly assigned to the vitamin D …

Spousal Factors Associated With Antenatal Psychosocial Stress: A Case Control Study, Asha K. V Ms

Manipal Journal of Nursing and Health Sciences

Stress during pregnancy affects both mother and foetus resulting in unfavourable pregnancy outcomes. Studies regarding the factors linked with increased stress during pregnancy aids to improve the mental status of the mother during gestation and can lead to a reduction in negative pregnancy outcomes. The objective of the study was to identify spousal factors associated with antenatal psychosocial stress among pregnant women seeking prenatal care from a teaching hospital at the Thiruvananthapuram district of Kerala. Methods: Case control design was used for the study. The tools used for data collection were the Antenatal Psychosocial Stress scale (APSS) and a semi-structured …

Effect Of Breast Massage On Breast Milk Volume And Experience On The Expression Of Breast Milk Among Mothers Of Preterm Neonates, Sharmila Jose Ms, Sonia R B D'Souza Dr, Sreedevi C Ms

Manipal Journal of Nursing and Health Sciences

Prematurity is a serious and unmet challenge in perinatal health care. The incidence of premature births in India in 2010 was about 13%. As survival rates of preterm infants improve, prime attention is given on the management of nutrition and the mothers are motivated to supply expressed breastmilk to improve the quality of survival. Methods: The study included mothers of preterm neonates who belonged to the 27 to 34 weeks of gestational age. Recruitment to the study was based on breast engorgement screening using a breast engorgement screening scale on the second and the third postnatal day. The study had …

Physiological Needs Of Immobilized Patients As Perceived By Family Members, Rahul Bisht Mr, Rajesh Kumar Sharma Mr, Sanchita Pagazhendi Dr, Kamli Prakash Ms

Manipal Journal of Nursing and Health Sciences

Introduction: The term family caregiver which is associated with informal caregiver refers to an unpaid dear, friend or neighbour, who provides care to a person having an associated acute or chronic condition and desires to manage a variety of tasks, from simple ones such as bathing, dressing, and taking medications to nasogastric tube feeding and ventilator care. Objective: The objectives were to assess the perception of family members regarding psychological needs of immobilized patients. Methods and material: A descriptive survey was undertaken to assess the perception of family members regarding physiological needs of immobilized patients admitted to a selected hospital …

Effect Of Pre-Exam Absenteeism On Academic Performance Among First Year Bds Students, Sai Silesh Kumar Goothy, Srinivasa Bharath Mr, Susmitha Paladugu Ms, Avinash Prasad Yamalapalli Mr

Manipal Journal of Nursing and Health Sciences

Being away from college without a valid reason is called absenteeism. Absenteeism refers to a student’s intentional or habitual absence from work. Pre-exam absenteeism is being absent just before the examinations. Most of the students bunk classes a day prior to the examinations to cover the portion at the last minute. The present study was undertaken to observe the impact of pre-exam absenteeism on academic performance among first year BDS students. Hundred and one first-year BDS students were recruited in the present study. The students who were absent a day prior to the examination were grouped as absentees. Their internal …

The Impact Of Social Networking On Adolescents, Krupa Susan Koshy Ms, Sunita Solomon-Calvin Ms, Smitha Bobby Ms, Sophia Vinitha Ms

Manipal Journal of Nursing and Health Sciences

Background: Social Networking Sites (SNSs) such as Facebook and WhatsApp, etc. has a great influence on young minds across the globe. Nowadays, SNSs are one of the most growing media of communication among rural and urban adolescents. The study was conducted to assess the knowledge of adolescents on the impact of social networking in selected rural and urban schools, Bangalore. Objective: The objective was to compare and assess the level of knowledge of adolescents in selected urban and rural schools about the impact of social networking. Method: A descriptive study was conducted and structured knowledge questionnaire on the impact of …

Inhibitor In Hemophilia And Its Management-A Case Report, Anjalin D'Souza Ms, Dinesh M. Nayak Dr, Annamma Kurien Dr

Manipal Journal of Nursing and Health Sciences

Hemophilia is a genetic disease with a deficiency of factor VIII or IX. People with inhibitors require special care and treatment due to complexity of the disease. Treatment is expensive due to high dose infusion and unavailability of factor in developing countries like India. This case report focuses on role of comprehensive care and follow-up of an adolescent with inhibitors.

Enhancing Cell Seeding And Osteogenesis Of Mscs On 3d Printed Scaffolds Through Injectable Bmp2 Immobilized Ecm-Mimetic Gel, Farahnaz Fahimipour, Erfan Dashtimoghadam, Mohammad Mahdi Hasani-Sadrabadi, Jessica Vargas, Daryoosh Vashaee, Doug Lobner, Tahereh S. Jafarzadeh Kashi, Behnam Ghasemzadeh, Lobat Tayebi

Biomedical Sciences Faculty Research and Publications

Objective

Design of bioactive scaffolds with osteogenic capacity is a central challenge in cell-based patient-specific bone tissue engineering. Efficient and spatially uniform seeding of (stem) cells onto such constructs is vital to attain functional tissues. Herein we developed heparin functionalized collagen gels supported by 3D printed bioceramic scaffolds, as bone extracellular matrix (ECM)-mimetic matrices. These matrices were designed to enhance cell seeding efficiency of mesenchymal stem cells (MSCs) as well as improve their osteogenic differentiation through immobilized bone morphogenic protein 2 (BMP2) to be used for personalized bone regeneration.

Methods

A 3D gel based on heparin-conjugated collagen matrix capable of …

Practical Guidance For Engaging Patients In Health Research, Treatment Guidelines And Regulatory Processes: Results Of An Expert Group Meeting Organized By The World Health Organization (Who) And The European Society For Clinical And Economic Aspects Of Osteoporosis, Osteoarthritis And Musculoskeletal Diseases (Esceo), Maarten De Wit, Cyrus Cooper, Peter Tugwell, Nathalie Bere, John Kirwan, Philip G. Conaghan, Charlotte Roberts, Isabelle Aujoulat, Nasser Al-Daghri, Islene Arajujo De Carvalho, Mary Barker, Nicola Bedlington, Maria Luisa Brandi, Olivier Bruyère, Nansa Burlett, Philippe Halbout, Mickaël Hiligsmann, Famida Jiwa, John A. Kanis, Andrea Laslop, Wendy Lawrence, Daniel Pinto, Concepción Prieto Yerro, Véronique Rabenda, René Rizzoli, Marieke Scholte-Voshaar, Mila Vlaskovska, Jean-Yves Reginster

Physical Therapy Faculty Research and Publications

There is increasing emphasis on patient-centred research to support the development, approval and reimbursement of health interventions that best meet patients’ needs. However, there is currently little guidance on how meaningful patient engagement may be achieved. An expert working group, representing a wide range of stakeholders and disciplines, was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the World Health Organization (WHO). Through a structured, collaborative process the group generated practical guidance to facilitate optimal patient engagement in clinical development and regulatory decisions. Patient engagement is a relational process. The …

Differential Effects Of Aging And Physical Activity On Corticospinal Excitability Of Upper And Lower Limb Muscles, Vianney Rozand, Jonathon William Senefeld, Christopher W. Sundberg, Ashleigh E. Smith, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Corticospinal tract excitability can be altered by age, physical activity (PA), and possibly sex, but whether these effects differ between upper and lower limb muscles is unknown. We determined the influence of age, PA, and sex on corticospinal excitability of an upper limb and a lower limb muscle during submaximal contractions by comparing stimulus-response curves of motor evoked potentials (MEPs). Transcranial magnetic stimulation (TMS) was used to evoke stimulus-response curves in active muscles by incrementally increasing the stimulator intensity from below the active motor threshold (AMT) until a plateau in MEP amplitudes was achieved. Stimulus-response curves were analyzed from the …

Cluster Set Loading In The Back Squat: Kinetic And Kinematic Implications, Alexander Wetmore, John P. Wagle, Matt L. Sams, Christopher Taber, Brad H. Deweese, Kimitake Sato, Michael H. Stone

Exercise Science Faculty Publications

Cluster set loading in the back squat: Kinetic and kinematic implications. J Strength Cond Res XX(X): 000–000, 2018—As athletes become well trained, they require greater stimuli and variation to force adaptation. One means of adding additional variation is the use of cluster loading. Cluster loading involves introducing interrepetition rest during a set, which in theory may allow athletes to train at higher absolute intensities for the same volume. The purpose of this study was to investigate the kinetic and kinematic implications of cluster loading as a resistance training programming tactic compared with traditional loading (TL). Eleven resistance-trained men (age = …

Impact Of Beta-Adrenergic Agonist Supplementation And Heat Stress On The Microbiome And Gastrointestinal Transcriptome Of Sheep, Erin Margaret Duffy

Department of Animal Science: Dissertations, Theses, and Student Research

Improving animal growth and efficiency are critical points of research as the world’s population and demand for agriculture products increase. Therefore, adaptions or changes in the gut are of interest to maximize growth efficiency and wellbeing of livestock. The gastrointestinal tract of the rumen plays many critical roles with the assistance of the associated microbial community. One way to improve animal performance is supplementation of β-adrenergic agonists (β-AA) which are commonly fed to cattle during the last 20-40 days of the finishing period, improving muscle growth by decreasing adipose deposition and increasing muscle accretion. Two β-AA, Ractopamine HCl (β1-AA) and …

Inspire : Vol 2, Issue 7, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message From The Chair
• ‘Life and Steth: Health Challenges of Pakistan’
• Dept. of Medicine Bids Farewell to One of its Own
• Peripherally Inserted Central Catheters (PICC) and Patients with Kidney Disease by Dr Sonia Yaqub
• Department of Medicine at National and International Forums
• Women in Medicine (WIM) at UC Davis Health Featured Faculty Profile Dr Ainan Arshad; “ Set small targets and celebrate little achievements as they come.”
• What Are Academics Around the World Reading This Month?
• Publications

Extension For Community Healthcare Outcomes-Palliative Care In Africa Program: Improving Access To Quality Palliative Care, Sriram Yennurajalingam, Charles E. Amos, John Weru, Edwina Beryl, Addo Opare-Lokko, Joseph Anthony Arthur, Kristy Nguyen, Olaitan Soyannwo, Runcie C.W. Chidebe, Janet L. Williams, Zhanni Lu, Ellen Baker, Sanjeev Arora, Eduardo Bruera, Suresh Reddy

Internal Medicine, East Africa

Purpose: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes- Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC.

Methods: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region. Participants were then recruited, and monthly telementoring sessions were held for …

Hypopituitarism Other Than Sellar And Parasellar Tumors Or Traumatic Brain Injury Assessed In A Tertiary Hospital, Sarwar Malik, Zareen Kiran,, Owais Rashid, Minaz Mawani, Asma Gulab, Qamar Masood, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Objective: Data regarding the etiology, clinical and biochemical patterns in hypopituitarism is scant for Pakistan. We describe the characteristics of patients with hypopituitarism other than sellar and parasellar tumors or traumatic brain injury from a tertiary care center in Pakistan.

Methods: We conducted a retrospective descriptive study in the Aga Khan University Hospital, Karachi, Pakistan. We studied all patients presenting with hypopituitarism, between January 2004 and December 2013. Clinical, hormonal and imaging data pertinent to the study was collected according to inclusion criteria.

Results: Forty-two patients presented to the endocrinology clinics at the Aga Khan University Hospital during the study …

Use Of Online Educational Modules To Improve Occupational Therapy Students’ Knowledge And Perceptions Of Their Emotional Intelligence Skills: An Evidence-Based Pilot Study, Jennifer Calabrese, Jennifer E. Lape, Theresa Delbert

Journal of Occupational Therapy Education

Many current students studying in health care professions lack skills in communication, socialization, and decision-making that can lead to an inability to recognize and manage emotions, indicating a need for emotional intelligence training in university health field curricula. This article presents an evidence-based study that used a new approach to education using online emotional intelligence modules within a graduate occupational therapy program to supplement the program’s curriculum. The study was completed over six and one-half weeks and included 28 second-year graduate occupational therapy students. A pre/post-survey design was used to determine participants’ knowledge and their perceptions of their own emotional …

Acute-On-Chronic Liver Failure: Consensus Recommendations Of The Asian Pacific Association For The Study Of The Liver (Apasl): An Update, Shiv Kumar Sarin, Ashok Choudhury, Manoj K. Sharma, Rakhi Maiwall, Mamun Al Mahtab, Salimur Rahman, Saeed Hamid, Amna S. Butt, Wasim Jafri, Zaigham Abbas

Section of Gastroenterology

The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during …

Risk And Resilience Pertaining To Mental Health Of Youth Attending A College In Kathmandu Who Were Exposed To The 2015 Earthquakes During Their Adolescence: A Mixed Method Study, Vinita Sharma

USF Tampa Graduate Theses and Dissertations

Background: Adverse mental health outcomes have been previously reported among survivors of natural disasters. Available studies mostly focus on risk factors and not resilience. In 2015, a series of earthquakes caused massive loss of lives and livelihood in Nepal. Epidemiological data pertaining to youth mental health in Nepal is limited. Information about the post-earthquake mental health of youth who were exposed to earthquakes during their adolescence in Nepal is scarce.

Purpose: The purpose of this study was to address risk and resilience factors related to mental health among college-attending Nepali youth (18-20 years) exposed to the 2015 earthquake during their …

Role Of Epigenome And Microbiome In Endocannabinoid-Mediated Regulation Of Inflammation During Diet-Induced Obesity, Kathryn Miranda

Theses and Dissertations

Obesity is an inflammatory disease involving accumulation of adipose tissue, gut microbiota dysbiosis, and over-activation of the endocannabinoid system (ECS). Mechanisms involved in ECS regulation of obesity-induced inflammation are not well understood. Presented here are three chapters involving microRNA (miR) regulation of inflammatory adipose tissue macrophages (ATM) during high-fat diet (HFD)-induced obesity and cannabinoid receptor-mediated regulation of gut microbiota dysbiosis.

ATMs are innate immune cells that drive chronic low-grade inflammation during obesity. Polarization between pro-(M1) and anti-(M2-like) inflammatory phenotypes influence insulin sensitivity and energy expenditure; however, the mechanisms involved are unclear. In study one, we characterized miRs involved in ATM …

Developing A School-Age Language Screening For Sli, Logan Douglass

Theses and Dissertations

Purpose: This study explored past tense marking in oral reading as a clinical marker of specific language impairment (SLI). A School-Age Language Screening Assessment (SALSA) was evaluated to determine whether it can be used to improve the identification of school-age children with SLI. The first aim was to calculate overall accuracy with children with TL and SLI on reading regular and irregular past tense verbs in oral reading of connected text. The second aim was to determine the overall diagnostic accuracy of SALSA.

Method: 96 children with TL and 3 children with SLI (N = 99) in grades 2-4 were …

Sociocultural Factors Influencing Cervical Cancer Prevention And Control Behaviors In Cusco, Peru, Venice Elizabeth Haynes

Theses and Dissertations

Cervical cancer is one of the most preventable types of cancer; however, it continues to pose significant health challenges for women in low and middle-income countries (LMICs), particularly in Peru. Studies previously conducted in Peru have examined factors associated with cervical cancer screening, screening access, availability, and geographical determinants on cervical cancer incidence and mortality. These studies have suggested the need to explore sociocultural factors and the roles of men and women in screening decisions associated with excessive cervical cancer burden and low rates of screening among Peruvian women. The goal of the dissertation research was to explore influences of …

Speech Entrainment To Improve Spontaneous Speech In Broca's Aphasia., Helga Thors

Theses and Dissertations

Speech entrainment, a treatment method that requires participants to mimic the speech of an audiovisual model in real time, has been shown to benefit individuals with non-fluent aphasia when they speak about trained topics. It is unclear if it improves spontaneous speech, which does not pertain to trained items, in the same way. In an effort to investigate this matter, the current study examined the effects of speech entrainment on spontaneous speech that does not relate to trained items, it also estimated effect sizes associated with improvements in speech production as a result of this treatment approach, and explored participant …

Evaluating Impacts Of A Multilevel Resilience-Based Psychosocial Intervention On Mental Health Of Children Affected By Parental Hiv In China, Yanping Jiang

Theses and Dissertations

Background: Children affected by parental HIV are commonly exposed to multiple risk factors, including parental illness and death, other traumatic life events, HIV stigma, and poverty, all of which in turn put them at elevated risk of experiencing poor mental health outcomes. Previous research has suggested the promise of psychosocial interventions in improving mental health for children affected by parental HIV through an integrated and multilevel resilience-based approach. However, there are few multilevel resilience-based interventions for this group, and the efficacy of such interventions on mental health outcomes has not been fully examined. Furthermore, very few studies have examined whether …