Medicine and Health Sciences Commons^™

Male Involvement In Family Planning Among Squatter Settlement Residents Of Karachi, Fahmida Khowaja, Mehak Pervaiz, Naushaba Khatoon

Journal of Asian Midwives (JAM)

Background: Worldwide, the Contraceptive Prevalence Rate (CPR) increased from 54.8% to 63.3%. However, Pakistan’s current CPR is estimated to be 35%. Men can play an important role in increasing CPR by providing support to their partners, yet their role has been overlooked in targeted reproductive health strategies. The aim of this study was to assess the awareness and practices of married men regarding Family Planning (FP).
Material and Method: This cross-sectional study was conducted among 419 married men, residing in an urban squatter settlement of Karachi. Participants were selected through non-probability convenience sampling and a structured questionnaire was used to …

Higher Education In Midwifery In Pakistan: A Proposed Framework, Rafat Jan, Arusa Lakhani, Karyn Kaufman

Journal of Asian Midwives (JAM)

Access to a skilled professional midwife is the right of each woman. Research evidence shows that midwives prepared to international standards decrease rates of morbidity and mortality and promote health of both mothers and infants. At present, in Pakistan, there are several midwifery cadres, with different formal education levels, who provide maternal and child health services. There are currently three types of diploma programs each serving a different cadre. Until 2012, there was no opportunity to obtain higher education in midwifery in the country. This absence contributed to non-acceptance and invisibility of midwifery as a profession. As a result, midwives …

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Patent Foramen Ovale Closure In Young Patients With Cryptogenic Stroke: A Case Series And Follow Up From Saudi Population., Aishah Albakr, Noman Ishaque, Rizwana Shahid, Alaa Jamal Al Obaidli, Noora Waleed Alayyaf, Mohammed Almansoori, Sarah Ali Saleh Al Amri

Pakistan Journal of Neurological Sciences (PJNS)

One quarter of cerebral infarctions are cryptogenic and most of these patients are young. Patent Foramen Ovale (PFO) is found to be more prevalent in young persons with cryptogenic stroke and risk of stroke recurrence in such patients ranges from as low as 2% per annum to as high as 12% per annum. Since patients with PFO and cryptogenic stroke are young they need more effective ways to reduce risk of stroke recurrence hence percutaneous closure of PFO seems reasonable approach to deal with this etiology of stroke in such population. We report four cases of cryptogenic stroke in young …

Sometimes Merely As A Means: Why Kantian Philosophy Requires The Legalization Of Kidney Sales, D. Robert Macdougall

Publications and Research

Several commentators have tried to ground legal prohibitions of kidney sales in some form of Kant’s moral arguments against such sales. This paper reconsiders this approach to justifying laws and policies in light of Kant’s approach to law in his political philosophy. The author argues that Kant’s political philosophy requires that kidney sales be legally permitted, although contracts for such sales must remain unenforceable. The author further argues that Kant’s approach to laws, such as those governing kidney distribution, was formed in part by considering and rejecting an assumption frequently employed in the bioethics literature, namely, that legal duties can …

Competency-Based Curriculum Development To Meet The Needs Of People With Disabilities: A Call To Action., Nethra S. Ankam, Md, Glendaliz Bosques, Carley Sauter, Steven Stiens, Maya Therattil, Faren H. Williams, Caleb C. Atkins, R. Samuel Mayer

Department of Rehabilitation Medicine Faculty Papers

People with disabilities constitute 22.2% of the population in the United States, and virtually all physicians have people with disabilities in their clinical practice across a wide range of diagnostic groups. However, studies demonstrate that people with disabilities are inadequately served by the health care system, leading to high costs and poor outcomes. The authors argue that one cause of this discrepancy is that medical students receive limited training in the care of people with disabilities and may therefore not be able to adequately meet the competencies that underlie the Core Entrustable Professional Activities for Entering Residency. To address these …

An Infection Control Journey In Hospital Based Practice Conversion, Cathleen Strzalka, Mph, Cph, Cic, Kelly Zabriskie, Cic

Division of Infectious Diseases and Environmental Medicine Posters

Objective

• Effectively bring physician based practices (PBPs) under hospital licensure
• Ensure safe delivery of care
• Produce successful regulatory surveys

Physician Based Practices And Instrument Sterilization - How Do You Do It?, Kelly Zabriskie, Cic, Cathleen Strzalka, Mph, Cph, Cic

Division of Infectious Diseases and Environmental Medicine Posters

Objective

To develop a process that allows the PBP to operate efficiently and effectively but still be compliant with proper instrument reprocessing rules and regulations.

Hand Hygiene Observations… Not So Secret Anymore, Mary Ehly, Bsn, Rn, Cic, Courtney Mitchell, Mph, Cic, Charlotte Sacksteder, Ba, Kelly Zabriskie, Bs, Cic

Division of Infectious Diseases and Environmental Medicine Posters

Objective

To create a hand hygiene surveillance program to reduce bias, be more reliable, yield a greater number of observations, and provide real time feedback

Early Versus Delayed Flow Diversion For Ruptured Intracranial Aneurysms: A Meta-Analysis, Rimal Hanif Dossani, Devi P. Patra, Jennifer Kosty, Fareed Jumah, Okkes Kuybu, Nasser Mohammed, Muhammad Waqas, Muhammad Riaz, Hugo Cuellar

Section of Neurosurgery

Objective: The use and timing of flow diversion for aneurysmal subarachnoid hemorrhage is controversial. The objective of this study is to perform a meta-analysis and systematic review to compare overall complication rate between early versus delayed flow diversion for ruptured aneurysms.
Methods: A literature search for all eligible articles was performed using PubMed, Cochrane, and Web of Science databases. The primary outcome was the overall complication rate (any complication in the perioperative period), and secondary outcomes were 1) hemorrhage and 2) stroke/death (all hemorrhagic/ischemic strokes and/or death).
Results: Thirteen articles including 142 patients met inclusion criteria. Eighty-nine (62.7%) patients underwent …

Serum Biomarkers For Glioblastoma Multiforme, Ayesha Quddusi, Muhammad Shahzad Shamim

Section of Neurosurgery

A number of different serum biomarkers are currently being evaluated for their potential use as diagnostic and prognostic biomarkers in Glioblastoma Multiforme. Amongst these, a vast number of different microRNAs have been studied, that are up-regulated or downregulated in relation to Glioblastoma Multiforme. Different studies have found numerous associations of these different microRNAs with recurrence, Karnofsky Performance Score, Progression Free Survival and Overall Survival. Other than microRNAs, serum Glial Fibrillary Acid Protein, cytokines and YLK-40, as well as a number of other candidate serum biomarkers are being studied.More studies, with larger sample sizes are required before these serum biomarkers can …

Role Of Ajwa Date (Phoenix Dactyl L) Derived Polyphenols In Male Infertility, Naseer Ahmed, Rehana Rehman, Anwar Gilani

Department of Biological & Biomedical Sciences

Madam, prevalence of male infertility with its associated social and health problems calls for an insight for its elucidation.¹ Over the past few decades, there have been many experimental and clinical studies on the pathophysiology of oxidative stress and its impact on fertility disorders, both in men and women. Oxidative stress impairs sperm function and count, damage to DNA and accelerates the cellular apoptotic functions leading to the inability to achieve conception or lack of development of the embryo. ²34563

Avoiding The Esophageal Branches Of The Recurrent Laryngeal Nerve During Retractor Placement: Precluding Postoperative Dysphagia During Anterior Approaches To The Cervical Spine., Christian Fisahn, Emre Yilmaz, Joe Iwanaga, Cameron K Schmidt, Eric Benca, Jens R Chapman, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Study Design: Anatomical cadaver study.

Objectives: Postoperative dysphagia is a significant complication following anterior approaches to the cervical spine and the etiology of this complication is poorly understood. Herein, we studied the esophageal branches of the recurrent laryngeal nerves to improve understanding of their anatomy and potential involvement in dysphagia.

Methods: Ten fresh frozen cadaveric human specimens were dissected (20 sides). All specimens were adults with no evidence of prior surgery of the anterior neck. The recurrent laryngeal nerves were identified under a surgical microscope and observations and measurements of their esophageal branches made.

Results: For each recurrent laryngeal nerve, …

Glycine Supplementation Extends Lifespan Of Male And Female Mice., Richard A Miller, David E Harrison, Clinton Michael Astle, Molly A. Bogue, Joel Brind, Elizabeth Fernandez, Kevin Flurkey, Martin Javors, Warren Ladiges, Christiaan Leeuwenburgh, Francesca Macchiarini, James Nelson, Alexey G Ryazanov, Jessica Snyder, Timothy M Stearns, Douglas E Vaughan, Randy Strong

Faculty Research 2019

Diets low in methionine extend lifespan of rodents, though through unknown mechanisms. Glycine can mitigate methionine toxicity, and a small prior study has suggested that supplemental glycine could extend lifespan of Fischer 344 rats. We therefore evaluated the effects of an 8% glycine diet on lifespan and pathology of genetically heterogeneous mice in the context of the Interventions Testing Program. Elevated glycine led to a small (4%-6%) but statistically significant lifespan increase, as well as an increase in maximum lifespan, in both males (p = 0.002) and females (p < 0.001). Pooling across sex, glycine increased lifespan at each of the three independent sites, with significance at p = 0.01, 0.053, and 0.03, respectively. Glycine-supplemented females were lighter than controls, but there was no effect on weight in males. End-of-life necropsies suggested that glycine-treated mice were less likely than controls to die of pulmonary adenocarcinoma (p = 0.03). Of the 40 varieties of incidental pathology evaluated in these mice, none were increased to a significant degree by the glycine-supplemented diet. In parallel analyses of the same cohort, we found no benefits from TM5441 (an inhibitor of PAI-1, the primary inhibitor of tissue and urokinase plasminogen activators), inulin (a source of soluble fiber), or aspirin at either of two doses. Our glycine results strengthen the idea that modulation of dietary amino acid levels can increase healthy lifespan in mice, and provide a foundation for further investigation of dietary effects on aging and late-life diseases.

Effect Of Native Type I Collagen With Polyhexamethylene Biguanide Antimicrobial On Wounds: Interim Registry Results., Michael A Bain, Kerry T Thibodeaux, Marcus S Speyrer, Emily Carlson, George John Koullias

Articles, Abstracts, and Reports

Background: Biofilm can impair wound healing by maintaining an elevated, but ineffective, inflammatory state. This article describes interim results from the prospective RESPOND postmarketing registry evaluating the use of a native type 1, porcine collagen matrix with the embedded antimicrobial polyhexamethylene biguanide (PCMP) in the management of chronic wounds.

Methods: Adults ≥18 years of age with ≥1 appropriate wound were eligible for inclusion. Data that were final on January 26, 2018 were included in this analysis. At week 0, wounds were cleaned, debrided, and prepared as necessary and PCMP was applied, with a dressing to fix it in place. Patients …

The Effect Of Dietary Nitrate And Anthocyanins On Anaerobic Exercise Performance, Yun Chieh Huang, Aurora Sanchez, Paul Tsai

Loma Linda University Research Reports

Background: Previously, beetroot and tart cherry supplementations have been investigated for their effects on exercise performance and recovery separately. Beetroot containing nitrate has been used to improve blood flow to enhance exercise tolerance. Tart cherry extract containing anthocyanins has been shown to lower inflammation and improve recovery time in exercise performance.

Objective: The purpose of this study was to investigate a possible synergistic effect of nitrate and anthocyanins on exercise performance in healthy individuals.

Design: This was a double-blind, randomized crossover study with a duration of twenty-nine days. Inclusion criteria included healthy individuals, able to exercise on …

Knowledge, Attitudes, And Perceptions Of Nurse Practitioners About Antibiotic Stewardship, Robert M. Hamilton

Theses and Dissertations

Background: Antibiotic stewardship (ABS) is a set of strategies to optimize the use of antibiotics with the goal of reducing antibiotic resistance, improving patient outcomes and decreasing unnecessary costs. ABS affects all venues of patient care, including outpatient, inpatient, and long-term care. While many strategies for ABS exist and best practice continues to evolve, successful ABS programs utilize a multidisciplinary approach. Nurse practitioners (NPs) play an essential role in health care education and represent a valuable potential resource for ABS efforts. The purpose of this study is to describe the knowledge, attitudes, and perceptions of NPs towards ABS.Methods: A convenience …

Mismatch Negativity Event Related Potential Elicited By Speech Stimuli In Geriatric Patients, Dana Lynn Pierce

Theses and Dissertations

Hearing loss, as a result of old age, has been linked to a decline in speech perception despite the use of additional listening devices. Even though the relationship between hearing loss and decreased speech perception has been well established, research in this area has often focused on the behavioral aspects of language and not on the functionality of the brain itself. In the present study, the mismatch negativity, an event related potential, was examined in order to determine the differences in speech perception between young adult participants, geriatric normal hearing participants, and geriatric hearing-impaired participants. It was hypothesized that a …

Pc202. Evolution Of Vascular Complications In Transfemoral Transcatheter Aortic Valve Replacement, Brant W Ullery, Ruyun Jin, Eric B Kirker, Patrick Ryan, Leland Siwek, James Brevig, Robert W. Hodson, Kateri Spinelli

Articles, Abstracts, and Reports

Objective Vascular complications (VCs) after transfemoral transcatheter aortic valve replacement (TAVR) have historically been common and associated with significant morbidity and mortality. We evaluated our large multicenter experience to provide new insight on the incidence, predictors, management, and clinical impact of VCs after TAVR.

Methods Retrospective TVT registry and chart review was performed for 1573 patients undergoing commercial transfemoral TAVR across seven centers within our hospital network between 2012 and 2016. VCs and bleeding complications (BCs) were defined by Valve Academic Research Consortium-2 definitions. Incidence of 30-day VCs and BCs, treatment strategy, and outcomes were reported. A mixed-effects model with …

Downregulation Of Cenpf Remodels Prostate Cancer Cells And Alters Cellular Metabolism., Muhammad Shahid, Minhyung Kim, Min Young Lee, Austin Yeon, Sungyong You, Hyung L Kim, Jayoung Kim

Articles, Abstracts, and Reports

Metabolic alterations in prostate cancer (PC) are associated with progression and aggressiveness. However, the underlying mechanisms behind PC metabolic functions are unknown. The authors' group recently reported on the important role of centromere protein F (CENPF), a protein associated with the centromere-kinetochore complex and chromosomal segregation during mitosis, in PC MRI visibility. This study focuses on discerning the role of CENPF in metabolic perturbation in human PC3 cells. A series of bioinformatics analyses shows that CENPF is one gene that is strongly associated with aggressive PC and that its expression is positively correlated with metastasis. By identifying and reconstructing the …

A Comprehensive Review Of The Sinuvertebral Nerve With Clinical Applications., Brian Shayota, T L Wong, Donald Fru, Glen David, Joe Iwanaga, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The anatomy and clinical significance of the sinuvertebral nerve is a topic of considerable interest among anatomists and clinicians, particularly its role in discogenic pain. It has required decades of research to appreciate its role, but not until recently could these studies be compiled to establish a more complete description of its clinical significance. The sinuvertebral nerve is a recurrent nerve that originates from the ventral ramus, re-entering the spinal canal via the intervertebral foramina to innervate multiple meningeal and non-meningeal structures. Its complex anatomy and relationship to discogenic pain have warranted great interest among clinical anatomists owing to its …

Hdl Subclass Proteomic Analysis And Functional Implication Of Protein Dynamic Change During Hdl Maturation, Yuling Zhang, Scott M. Gordon, Hang Xi, Seungbum Choi, Merlin Abner Paz, Runlu Sun, William Yang, Jason Saredy, Mohsin Khan, Alan Thomas Remaley, Jing-Feng Wang, Xiaofeng Yang, Hong Wang

Saha Cardiovascular Research Center Faculty Publications

Recent clinical trials reported that increasing high-density lipoprotein-cholesterol (HDL-C) levels does not improve cardiovascular outcomes. We hypothesize that HDL proteome dynamics determine HDL cardioprotective functions. In this study, we characterized proteome profiles in HDL subclasses and established their functional connection. Mouse plasma was fractionized by fast protein liquid chromatography, examined for protein, cholesterial, phospholipid and trigliceride content. Small, medium and large (S/M/L)-HDL subclasseses were collected for proteomic analysis by mass spectrometry. Fifty-one HDL proteins (39 in S-HDL, 27 in M-HDL and 29 in L-HDL) were identified and grouped into 4 functional categories (lipid metabolism, immune response, coagulation, and others). Eleven …

Cardiothoracic Surgery Residency Training In Surgical Ablation For Atrial Fibrillation., Zachary M Deboard, Thomas K Varghese, John R Doty, Craig H Selzman

Articles, Abstracts, and Reports

Background: As no standardized curriculum exists for training cardiothoracic surgery residents in surgical ablation for atrial fibrillation there is potential for variation in operative technique, patient selection, and overall application. Thus we sought to assess the exposure of current residents in order to identify areas for improvement in their education.

Methods: A survey was emailed to residents inquiring about their training experience in surgical ablation for atrial fibrillation. Residents were asked about case volume, procedural variety, and guideline-based clinical scenarios where they felt ablation would be appropriate. Residents were also queried about their abilities to perform various lesion sets and …

2019-2020 Fall Bulletin, University Of Mississippi Medical Center

Bulletins/Catalogs

2019-2020 Fall Bulletin

Grab Control! Choosing The Right Comparison Group In An Observational Study., Joseph R Dettori, Daniel C Norvell, Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

Promoting Adherence To Influenza Vaccination Recommendations In Pediatric Practice., Lloyd N. Werk, Maria Carmen Diaz, Adriana Cadilla, James P. Franciosi, Jobayer Hossain

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

OBJECTIVES: In the United States, nonadherence to seasonal influenza vaccination guidelines for children and adolescents is common and results in unnecessary morbidity and mortality. We conducted a quality improvement project to improve vaccination rates and test effects of 2 interventions on vaccination guidelines adherence.

METHODS: We conducted a cluster randomized control trial with 11 primary care practices (PRACTICE) that provided care for 11 293 individual children and adolescents in a children's health care system from September 2015 through April 2016. Practice sites (with their clinicians) were randomly assigned to 4 arms (no intervention [Control], computerized clinical decision support system [CCDSS], …

Socioeconomic Status And Risk Of Cardiovascular Disease In 20 Low-Income, Middle-Income, And High-Income Countries: The Prospective Urban Rural Epidemiologic (Pure) Study, Annika Rosengren, Andrew Smyth, Sumathy Rangarajan, Chinthanie Ramasundarahettige, Shrikant I. Bangdiwala, Khalid F. Alhabib, Alvaro Avezum, Kristina Bengtsson Boström, Jephat Chifamba, Romaina Iqbal

Community Health Sciences

Background: Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status-wealth and education-differ among high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
Methods: In this large-scale prospective cohort …

The Relationship Between Nursing-Faculty Incivility And New-Graduate-Nurse Self-Confidence During Transition To Practice: A Correlational Study, Martha Kershaw

CUP Ed.D. Dissertations

Decreased self-confidence is seen in nursing students who experience nursing-faculty-to-nursing-student-incivility and in new-graduate-nurses during their transition to practice. Using a quantitative correlational design, I examined the relationship between nursing-faculty-to-nursing-student incivility and new-graduate-nurse self-confidence including the extent to which the relationship exists and whether the relationship existed for some groups more than others, specifically male and female nurses, and nurses who graduated from associate’s degree and Bachelor of Science programs. Through the surveys completed by 212 registered nurses who had been practicing less than three years, the participants reported on their experience with nursing-faculty-to-nursing-student incivility using the Perceived Faculty Incivility Scale …

The Validation Of Swahili Version Of The International Prostate Symptom Score Questionnaire, Miten Ramesh Patel

Master of Surgery

Background: Benign prostatic hyperplasia is a common condition encountered in men who are 50 years and above, presenting in hospitals for evaluation of lower urinary tract symptoms. The International Prostate Symptom Score is one of the questionnaires used to assess these symptoms. However, this questionnaire has not yet been validated among patients with Benign Prostate Hypertrophy in the Tanzanian setting. Objectives: The primary objective of this study was to assess the validity of the Swahili version of the IPSS questionnaire among patients with benign prostatic hyperplasia. Methods: We employed a cross-sectional study design in patients that presented at the Aga …

Analysis Of Candida Auris Fungemia At A Single Facility In Kenya, Rodney Adam, Gunturu Revathi, Nancy Okinda, Melanie Fontaine, Jasmit Shah, Elizabeth Kagotho, Mariana Castanheira, Michael A. Pfaller, Daniel Maina

Pathology, East Africa

Objectives: Candida auris emerged as a human pathogen in 2009 and has subsequently been identified around the world as a cause of invasive candidiasis. We did an analysis from a single institution in order to analyze risk factors and outcomes for C. auris candidemia.

Methods: Patients with candidemia were identified by the electronic medical record and reviewed for risk factors and outcome. Candida isolates were identified by Vitek2 as Candida haemulonii, but species determinations for 21 of the isolates using published molecular and proteomic methods identified all as C. auris.

Findings: From September 2010 to December 2016, C. auris accounted …