Medicine and Health Sciences Commons^™

The Impact Of The Nursing Shortage On The Quality Of Care Of Veterans, Brian Alexander Fainguersch

Honors College Theses

No abstract provided.

Primary Causes And Risk Factors Leading To Nurse Burnout In The Healthcare Field, Alexa D'Angelo

Honors College Theses

Nurse burnout has become a growing issue among hospitals throughout the world. It is a subject that greatly effects both the mental and physical health of current and future nurses going into the field. This study explored the most popular and well-known causes and risk factors of nurse burnout throughout hospitals. Through the use of structured interviews, three participants were chosen with backgrounds in varying specialties. The interviews consisted of ten predetermined questions, with room for the participants to elaborate. Along with the interviews, data was gathered from current, up to date literature on the research topic of nurse burnout. …

Overlapping Vulnerabilities In Workers Of The Electronics Recycling Industry Formal Sector: A Commentary, Diana M. Ceballos, Daniel Côté, Bouchra Bakhiyi, Michael A. Flynn, Joseph Zayed, Sabrina Gravel, Robert F. Herrick, France Labrèche

Éditoriaux, lettres à l'éditeur

No abstract provided.

Context Of Injury Among Abusive And Accidental Injuries In Children, Lindsay Eysenbach

Yale Medicine Thesis Digital Library

Child physical abuse is a significant public health challenge with an incidence of approximately 6.4 hospitalized cases per 100,000 children. Many abused children, however, will go undiagnosed by physicians evaluating these injuries. Assessing whether a child has been abused is a high-stakes decision: a missed case leaves a child vulnerable to future injury, but an inaccurate diagnosis of abuse may be greatly disruptive and stigmatizing to children and their families. Previous research has established key physical examination and radiographic findings that are associated with abusive injury. A gap in the literature, however, is the role of additional injury circumstances and …

Genetic Investigation Reveals Novel Pathways For Disease Pathogenesis In Inherited And Mosaic Skin Disorders, Shayan Cheraghlou

Yale Medicine Thesis Digital Library

Introduction

Genetic mosaicism underlies many inherited and acquired cutaneous disorders. Despite the barriers to genetic analysis of mosaic disorders, next generation sequencing has led to substantial progress in understanding their pathogenesis, which has significant implications for clinical management and genetic counselling. Advances in paired and deep sequencing technologies in particular have made study of mosaic disorders more feasible. In this study, we aim to utilize next generation sequencing technologies in order to evaluate the genetic cause of three mosaic cutaneous disorders: epidermolytic acanthoma (EA), progressive symmetric erythrokeratodermia (PSEK), and mosaic childhood acantholytic dyskeratosis.

Methods

Using genomic DNA extracted from paraffin-embedded …

The Cost-Effectiveness Of Culture Vs Naat Based Screening Of Pregnant Women For Group B Streptococcus To Reduce Early-Onset Sepsis Of The Newborn, Bertie Geng

Yale Medicine Thesis Digital Library

While great progress has been made to reduce its incidence, group B streptococcus (GBS) is still a leading cause of neonatal disease. Current standard of care recommends antepartum rectovaginal GBS culture of all pregnant women at 36 weeks of gestation in order to identify candidates for intrapartum prophylaxis to reduce vertical transmission. The purpose of the study is to assess three alternative nucleic acid amplification (NAAT) screening strategies for GBS: antepartum NAAT at 36 weeks, intrapartum NAAT, or a combined intrapartum and antepartum approach in which patients with penicillin allergies undergo antepartum culture screening and all other patients undergo intrapartum …

Obstructive Sleep Apnea And Pain Intensity In Young Patients, Wardah Athar

Yale Medicine Thesis Digital Library

Obstructive sleep apnea and pain intensity in young patients

Wardah Athar; Mary E. Card; Antonios Charokopos; Kathleen Akgün; Eric C. DeRycke; Sally G Haskell; Henry K. Yaggi; Lori A. Bastian. Yale University School of Medicine, New Haven, CT.

Objective: This study aims to examine whether young patients who are diagnosed with obstructive sleep apnea (OSA) are more likely to report higher pain intensity when compared to young patients without OSA.

Design/Participants: To do so, we conducted a cross-sectional analysis of a cohort study of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans who had at least one clinical encounter …

A Systematic Review Of Cost-Effectiveness Analyses On Endovascular Thrombectomy In Ischemic Stroke Patients, Xiao Wu

Yale Medicine Thesis Digital Library

The purpose of this study was to examine the practice of recent cost-effectiveness analyses (CEA) on endovascular treatment (EVT) in ischemic stroke patients, with a particularly focus on methodological conduct of accounting for costs and utilities.

We performed a literature search in Ovid Embase, Ovid MEDLINE, and Web of Science for CEAs published in the last 10 years on EVT. Cost or comparative effectiveness analyses were excluded.

Twenty-two studies were included in the final analysis, from the United States, Canada, Europe, Asia, and Australia. They all concluded EVT to be cost-effective, but with significant variations in methodology. Fifteen studies employed …

Establishing A Myocardial Ischemia-Reperfusion Injury Model In Mice And Rats Using Left Anterior Descending Artery Ligation And Isolated Heart Experiments, Alexander Papa

PCOM Biomedical Studies Student Scholarship

Myocardial infarction (MI) is a leading cause of death globally, with over 730,000 cases each year in the United States alone. Factors involved in the prognosis of an MI include identification of the artery occluded, the time to reperfusion, the size of the infarct, and the degree of cardiomyocyte death. Thus, the treatment of MI typically involves targeting one or more of these factors. Timely opening of an occluded artery to reperfuse the ischemic tissue remains the mainstay treatment through either thrombolytic therapy, arterial stenting, or percutaneous coronary intervention. However, reperfusion itself may cause further damage through the generation of …

The Role Of Autophagy In Hydrogen Peroxide- Or Methylglyoxal- Induced Cardiac Myocyte Damage, Amogh Sehgal

PCOM Biomedical Studies Student Scholarship

Oxidative stress (e.g., increased hydrogen peroxide [H₂O₂] levels) and dicarbonyl stress (e.g. increased methylglyoxal [MG]) serve as initiators for the pathogenesis of cardiovascular diseases and diabetic complications. Increased H₂O₂-derived free radicals and MG can be highly reactive and attack cellular components resulting in cell damage and even cell death. Normally, endogenous antioxidants and glyoxalase degrade H₂O₂ and MG, respectively. Additionally, autophagy facilitates the break-down of damaged cellular components allowing the components to be recycled by the cells. Researchers are still unclear about whether autophagy exacerbates cell damage or protects …

Safety, Feasibility, And Efficacy Of Early Rehabilitation In Patients Requiring Continuous Renal Replacement: A Quality Improvement Study, Kirby P. Mayer, Amanda R. Hornsby, Victor Ortiz Soriano, Timothy C. Lin, Jennifer T. Cunningham, Hanwen Yuan, Caroline E. Hauschild, Peter E. Morris, Javier A. Neyra

Physical Therapy Faculty Publications

Introduction: Early rehabilitation in critically ill patients is associated with improved outcomes. Recent research demonstrates that patients requiring continuous renal replacement therapy (CRRT) can safely engage in mobility. The purpose of this study was to assess safety and feasibility of early rehabilitation with focus on mobility in patients requiring CRRT.

Methods: Study design was a mixed methods analysis of a quality improvement protocol. The setting was an intensive care unit (ICU) at a tertiary medical center. Safety was prospectively recorded by incidence of major adverse events including dislodgement of CRRT catheter, accidental extubation, bleeding, and hemodynamic emergency; and minor adverse …

Challenges Of Diagnosis And Management Of Postpartum Choriocarcinoma In Resource Limited Settings: A Case Report From A Tertiary Hospital Of Western Kenya, Amubuomombe Philippe, Benjamin Elly, Andrew Cheruiyot, Sahara Shurie, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Choriocarcinoma is a rare occurrence in pregnancy. It is a highly curable malignant tumour that arises from trophoblastic cells within the uterus. However, the timely diagnosis of choriocarcinoma following birth is challenging, especially in low resource settings because most clinicians are not aware about the existence of the disease following uneventful pregnancy and birth. This report discusses the case of a 28 years old patient, para 2, diagnosed with choriocarcinoma two months after uneventful vaginal delivery at term. She underwent a total abdominal hysterectomy, followed by chemotherapy treatment; and succumbed to her disease. It highlights difficulties encountered on diagnosis and …

Low Sensitivity Of The Carehpv™ Assay For Detection Of Oncogenic Human Papillomavirus In Cervical Samples From Hiv-Infected And Hiv-Uninfected Kenyan Women, Titus Maina, Aaron Ermel, A. Moormann, Susan Cu-Uvin, Elkanah Omenge, Philip Tonui, K Chelimo, B Rosen, Peter Itsura, K. Muthoka

Obstetrics and Gynaecology, East Africa

Background: Human papillomavirus (HPV) infection causes cervical cancer (CC), a common malignancy among Kenyan women. New CC screening methods rely on oncogenic HPV (“highrisk”, or HR-HPV) detection, but most have not been evaluated in swabs from Kenyan women.

Methods: HPV typing was performed on 155 cervical swabs from Kenyan women using the Roche Linear Array® (LA) and careHPV™ (careHPV) assays. Detection of 14 oncogenic HPV types in careHPV assay was compared to LA results.

Results: Compared to LA, sensitivity and specifi city of careHPV assay was 53.0% and 80.9%, respectively. The sensitivity and specifi city of careHPV …

Breast Cancer Recurrence Rate In Patients Treated For Early Breast Cancer, Cecilia Munguti

Master of Medicine in General Surgery

Background: Breast cancer, the leading cause of cancer in Kenya among women, has a prevalence of 57.1 per 100,000 women and an annual mortality of 3.7 per 100,000. Early breast cancer is curable, but has a residual risk of recurrence of 10.4% in the first 5 years. Fifty percent of the recurrences occur after the first 5 years after diagnosis. Recurrent breast cancer is associated with poorer prognosis and higher mortality rates. Objectives: The primary objective was to determine the breast cancer recurrence rates for women managed for DCIS and early breast cancer at Aga Khan University Hospital. Secondary objectives …

The Quality Of Life Of Patients With Early Breast Cancer And Their Partners One Year After Breast Conserving Surgery Versus Modified Radical Mastectomy: A Single Centre Five Year Review, Senoga Andrew

Master of Medicine in General Surgery

Background: Breast cancer accounts for the highest incidence rate (40.3/100000) and fourth highest mortality rate (17.8/100000) among cancers in Kenya. Forty percent of breast cancer cases in Kenya are early breast cancer and this is will increase with scaled up awareness campaigns and screening. Breast conserving surgery (BCS) followed by radiotherapy (BCT) and modified radical mastectomy (MRM) are the commonest forms of surgical techniques utilized in treatment of early breast cancer with similar overall survival and recurrence rates. These treatments impact variably on the quality of life of the patients and their spouses who are their immediate emotional and social …

Prevalence And Factors Associated To Incidental Prostate Carcinoma Among Patients Undergoing Turp For Benign Prostatic Enlargement., Isaac Herman Mawalla

Master of Medicine in General Surgery

Background: Prostate carcinoma carries higher morbidity and mortality when diagnosed late. Prostate cancer screening is paramount, however, there are no specific clinical signs for early-stage prostate cancer. As an independent variable, prostate-specific antigen is an established predictor of cancer. Incidental prostate cancer is detected by histological examination of resected biopsy tissue that had been previously diagnosed as benign. In the current PSA-use era the prevalence of incidental prostate cancer ranges from 1.4 to 13%. The prevalence in Tanzania as published by Gunda et al was 21.71%. This is alarmingly high. However, in his study, patients with high prostate-specific antigens were …

Perceptions Of Surgeons On Surgical Antibiotic Prophylaxis Use At Aga Khan Hospital, Dar Es Salaam., Elizabeth Elibariki Mmari

Master of Medicine in General Surgery

Introduction: Surgical site infections are a major cause of morbidity and mortality among operated patients. The use of antibiotic prophylaxis in prevention and reduction of incidence of surgical site infection is widespread. In spite of the accessibility of universal and national guidelines for surgical prophylaxis, recent studies surveying the present routine of prophylaxis have demonstrated overutilization of a wide range antibacterial medications for a single patient. Few studies have shown qualitatively factors influencing this, and perceptions of surgeons on surgical antibiotic prophylaxis use. Unfortunately, none of these studies have been done in Tanzania. Objective: To describe the perceptions of surgeons …

Referral Patterns Affecting Age At Orchidopexy For Undescended Testis At A Tertiary Hospital In Nairobi., Muthua Ken Njoroge

Master of Medicine in General Surgery

BACKGROUND: Undescended Testis is the most common urological congenital anomaly with significant burden of disease especially in our local context. Management relies on early diagnosis, in the perinatal period, and prompt referral to an appropriate surgical unit. Spontaneous descent, while possible, doesn’t occur beyond 6 months and thus surveillance should not proceed beyond this age. Current guidelines recommend surveillance up to 6 months, referral by 9 months and, most importantly, orchidopexy by 1 year of age. Despite these clear guidelines, achieving them has proven difficult globally with low rates of orchidopexy by 1 year. The most common cited cause has …

The Status Of Smokeless Tobacco Use And Its Associated Factors Among The Business Guilds Population Of Chabahar, Seyed Saeed Mazloomy Mahmoodabad, Mohammad Saeed Jadgal, Iraj Zareban, Hossein Fallahzadeh

Internet Journal of Allied Health Sciences and Practice

Purpose: Use of smokeless tobacco is a major preventable cause of premature death and diseases. It leads to over 5 million deaths annually worldwide. This study aimed to investigate the status of smokeless tobacco use and its associated factors among the business guilds population of Chabahar City, Iran. Method: The present descriptive cross-sectional study was conducted on 320 users of various types of smokeless tobacco selected by simple random sampling method. Data were collected using a researcher-made demographic questionnaire, smokeless tobacco inventory, attitude questionnaire, and behavior questionnaire. The validity and reliability of these tools were confirmed in the previous studies. …

Can The Forward-Step-Down Test Be Used Reliably In The Clinical Setting To Assess Movement Changes Resulting From Maximal Exertion? A Pilot Study, Erin Mccallister, Daniel W. Flowers

Internet Journal of Allied Health Sciences and Practice

Introduction: Visual assessment of lower extremity mechanics is used frequently in clinical practice, and objective scoring of the visual assessment is beneficial to improve objectivity of patient evaluation. In addition, lower extremity mechanics change with fatigue and these changes may increase the risk of lower extremity injury. The Forward-Step-Down Test (FSDT) is one such objective tool, but its ability to detect changes in movement quality in response to exertion are not known. Methods: This study utilized a repeated-measures design, where the participants were scored on the FSDT before performing the Bruce protocol for an exertion stimulus. The participants were re-scored …

Adoption Of The Health Information Exchange (Hie) System And The Role Of The Healthcare Leadership, Muhammad Faisal Ashfaque

Theses and Dissertations

The advancement in technology calls for improvement in service delivery in healthcare systems, especially in the present health pandemic of the COVID-19. At present, healthcare systems utilize several electronic health techniques. However, there is a need for the creation of interoperability that can assist healthcare organizations in exchanging data more effectively through the global adoption of healthcare information exchange (HIE). The current research examines the adoption of HIEs and healthcare leadership roles to realize a fully functional interoperable patient HIE. This study utilized the systematic document analysis method to review qualitative data on the different aspects of healthcare leadership, implementation …

Dietary Fat Intakes In Irish Children: Changes Between 2005 And 2019, Aileen O’Connor, Maria Buffini, Anne Nugent, Laura Kehoe, Albert Flynn, Janette Walton, John Kearney, Breige Mcnulty

Articles

Objective:To examine current dietary fat intakes and compliance in Irish childrenand to examine changes in intakes from 2005 to 2019.Design:Analyses were based on data from the Irish National Children’s FoodSurvey (NCFS) and the NSFS II, two cross-sectional studies that collected detailedfood and beverage intake data through 7-day and 4-day weighed food diaries,respectively.Setting:NCFS and NCFS II, Republic of Ireland.Participants:A nationally representative sample of 594 (NCFS) and 600 (NCFS II)children aged 5–12 years. Current intakes from the NCFS II were compared withthose previously reported in the NCFS (www.iuna.net).Results:Current intakes of total fat, SFA, MUFA, PUFA andtransfat as a percentageof total energy are …

A Review Of The Influence Of Fathers On Children's Eating Behaviours And Dietary Intake, Stephanie Rahill, Aileen Kennedy, John Kearney

Articles

The role of fathers in child rearing has changed in recent years due to an increase in maternal employment. Despite this, the majority of research has focused on maternal influences and behaviours in relation to child feeding. Therefore, the aims of the narrative review were: 1) to examine the role and responsibility of fathers in child feeding and the factors associated with paternal responsibility in child feeding; 2) to establish how paternal modelling, paternal diets, and paternal feeding practices relate to children's eating behaviours and dietary intake; and 3) to explore the role of maternal perceptions on paternal feeding roles, …

Using Velocity To Predict The Maximum Dynamic Strength In The Power Clean, G. Gregory Haff, Amador Garcia-Ramos, Lachlan P. James

Research outputs 2014 to 2021

The primary aim of the present study was to examine the commonly performed training exercise for athlete preparation. Twenty-two recreationally trained males (age: 26.3 ± 4.1 y, height: 1.80 ± 0.07 m; body mass (BM): 87.01 ± 13.75 kg, 1-repetitoon maximum(1-RM)/BM: 0.90 ± 0.19 kg) participated in the present study. All subjects had their 1-RM power clean tested with standard procedures. On a separate testing day, subjects performed three repetitions at 30% and 45%, and two repetitions at 70% and 80% of their 1-RM power clean. During all trials during both sessions, peak velocity (PV) and mean velocity (MV) were …

Autoregulation In Resistance Training: Addressing The Inconsistencies, Leon Greig, Ben Hayden Stephens Hemingway, Rodrigo R. Aspe, Kay Cooper, Paul Comfort, Paul A. Swinton

Research outputs 2014 to 2021

© 2020, The Author(s). Autoregulation is a process that is used to manipulate training based primarily on the measurement of an individual’s performance or their perceived capability to perform. Despite being established as a training framework since the 1940s, there has been limited systematic research investigating its broad utility. Instead, researchers have focused on disparate practices that can be considered specific examples of the broader autoregulation training framework. A primary limitation of previous research includes inconsistent use of key terminology (e.g., adaptation, readiness, fatigue, and response) and associated ambiguity of how to implement different autoregulation strategies. Crucially, this ambiguity in …

What Do We Know About The Nexus Between Culture, Age, Gender And Health Literacy? Implications For Improving The Health And Well-Being Of Young Indigenous Males, Anthony Merlino, James A. Smith, Mick Adams, Jason Bonson, Richard Osborne, Barry Judd, Murray Drummond, David Aanundsen, Jesse Fleay, Benjamin Christie

Research outputs 2014 to 2021

Health literacy, although diversely defined, refers to the abilities, relationships and external environments required for people to successfully promote health. Existing research suggests that health literacy is related to health inequities, including individual and community capacity to navigate health. A diverse range of factors shape health literacy abilities and environments, especially culture, gender and age. However, the nexus between these variables and their cumulative impact on health literacy development remains largely unexplored. Commentary that explores these dynamics among young Indigenous males is particularly scant. In turn, strategies to bridge health equity gaps have been obscured. This article brings together disparate …

Contextualizing Performance Of Coordinated Care Network Of Veteran Services In Virginia, Marina Saitgalina, Donta Council

School of Public Service Faculty Publications

Coordinated care network is an approach to human service delivery that is recognized to improve client outcomes at a reduced cost. However, general mixed findings on the effectiveness of coordinated care networks warrant research contextualization. This article seeks to discover factors influencing the performance of a coordinated care network delivering social services to veterans and their families. The study provides a contextual analysis of a coordinated care network launched in 2016 in southeastern Virginia for two samples of 1,512 and 375 veterans and their families. Results of the regression analyses indicate that initial progress has been made both in efficiency …

Prevalence And Correlates Of Transactional Sex Among Women Of Low Socioeconomic Status In Portland, Or, Timothy Menza, Lauren Lipira, Amisha Bhattarai, Victoria Cali-De Leon, E. Roberto Orellana

School of Social Work Faculty Publications and Presentations

Background: Women who report transactional sex are at increased risk for HIV and other sexually transmitted infections (STIs). However, in the United States, social, behavioral, and trauma-related vulnerabilities associated with transactional sex are understudied and data on access to biomedical HIV prevention among women who report transactional sex are limited.

Methods: In 2016, we conducted a population-based, cross-sectional survey of women of low socioeconomic status recruited via respondent-driven sampling in Portland, Oregon. We calculated the prevalence and, assessed the correlates of, transactional sex using generalized linear models accounting for sampling design. We also compared health outcomes, HIV screening, and knowledge …

A Multi-Stage Machine Learning Approach To Predict Dengue Incidence: A Case Study In Mexico, Annalisa Appice, Yulia R. Gel, Iliyan Iliev, Vyacheslav Lyubchich, Donato Malerba

Faculty Publications

© 2013 IEEE. The mosquito-borne dengue fever is a major public health problem in tropical countries, where it is strongly conditioned by climate factors such as temperature. In this paper, we formulate a holistic machine learning strategy to analyze the temporal dynamics of temperature and dengue data and use this knowledge to produce accurate predictions of dengue, based on temperature on an annual scale. The temporal dynamics are extracted from historical data by utilizing a novel multi-stage combination of auto-encoding, window-based data representation and trend-based temporal clustering. The prediction is performed with a trend association-based nearest neighbour predictor. The effectiveness …

Community Engagement And Outreach Programs For Lead Prevention In Mississippi, Amal K. Mitra, Charkarra Anderson-Lewis

Faculty Publications

The objective of the project was to encourage health promotion through education, outreach, and community-based training. The people attending health fairs (n = 467), community events (n = 469), and Kindergarten classes (n = 241) were the study participants. Hands-on training was offered at homebuilding retail stores (n = 25). U.S. Department of Housing and Urban Development (HUD)’s online visual training was given to realtors (n = 220), and inspectors, contractors, and Do-It-Yourself (DIY) workers (n = 75). Training workshops were attended by home-buyers and rental home owners at the Neighborhood Association Meetings ( …