Medicine and Health Sciences Commons^™

Risk Of Low Energy Availability In Elite Male Athletes With Spinal Cord Injury, Savannah Glasgow

All Master's Theses

Recent research examining male able-bodied athletes has suggested that males are at risk for low energy availability (LEA); however, there is a paucity of research pertaining to prevalence amongst male athletes with an impairment. Therefore, the purpose of this study was to examine the risk of LEA and prevalence of symptoms related to Relative Energy Deficiency in Sport (RED-S), including risk of disordered eating, hormonal profiles, and bone mineral density (BMD) scans, in male wheelchair para athletes. Collegiate- and national-level male athletes (n = 9) with spinal cord injury (SCI) completed 7-day concurrent diet and training logs, Eating Disorder Examination …

Solidarity Vulnerability And Mistrust, Ana Rosa Linde Arias, Maria Roura, Carlos Eduardo Siqueira

Gastón Institute Publications

Background: The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors (individual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts. Methods: A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities …

Too Much To Ask Too Much To Handle, Ana Rosa Linde Arias, Elisa Tristan-Cheever, Grace Furtado, Carlos Eduardo Siqueira

Gastón Institute Publications

Abstract: Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences for pregnancies have made governments and both national and international agencies issue advice and recommendations to women. This study was designed to understand the impacts of Zika on women who were less directly affected and less vulnerable to Zika. Women were recruited from various locations in Brazil, Puerto Rico, and the United States. Data were collected through semi-structured interviews and analyzed using thematic analysis. Women perceived that public health systems placed an unfair responsibility for preventing health complications from Zika onto women who had limited …

Reinventing Privatization, Fabiana Turino, Jonathan Filippon, Francis Sodré, Carlos Eduardo Siqueira

Gastón Institute Publications

The Brazilian state apparatus was reformed throughout the 1990s, influenced by New Public Management (NPM). NPM was embodied in the health care sector by the creation of Social Health Organizations (Organizacões Sociais de Saúde or OSS), private non-profit entities to provide welfare services. We performed a systematic review of the literature outlining the origins and role of OSS in Brazil. Our selected articles (peer-reviewed) cover the origins/performance of OSS and their services provision between 1998 and 2018, in English or Portuguese. Databases used were Lilacs, Bireme, Medline, Pubmed, and SciELO. We identified 4,732 articles applying a pre-defined set of descriptors, …

Welcome To Cordell Perspectives, Neil M. Richards, Jonathan W. Heusel

Scholarship@WashULaw

The world around us is changing. Let’s talk about it together. Introducing a series of articles and opinions by the world’s leading experts concerning COVID-19 as it relates to precision medicine and data privacy: Welcome to Cordell Perspectives.

Population Density And Spatial Distribution Of Neglected Tropical Diseases In Sierra Leone, Abou B. Funna

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTDs) are the most common health conditions affecting the poorest residents of sub-Saharan Africa (SSA). These infections affect an estimated 2 billion people worldwide, including 500 million people living in SSA. About 85% of NTD infections are a result of helminth infections; hookworm is also a common occurrence among SSA’s poorest people, especially children. Schistosomiasis is the 2nd most prevalent NTD after hookworm. This quantitative correlational study investigated population distribution and the spread of NTDs in Sierra Leone. The focus was on 5 major NTDs: ascariasis, hookworm, schistosomiasis, soil-transmitted helminthiasis, and trichuris. Data were obtained from the …

A Systematic Review Of Culturally Sensitive Strategies To Address Obesity Among Hispanic-American Pediatric Patients In The Primary Care Setting, Rachel Vurbeff

Walden Dissertations and Doctoral Studies

Obesity significantly increases morbidity and mortality, and its incidence amongHispanic-American children and adolescents exceeds that of any other ethnic group in the United States. Without proper intervention, these children and adolescents will experience the burden of costly comorbidities across the lifespan. Guided by Leininger’s theory of culture care diversity and universality, the purpose of this project was to identify evidence-based, culturally sensitive strategies to prevent and treat obesity among Hispanic-American pediatric patients in the primary care setting through a systematic review of the literature utilizing the Joanna Briggs Institute method. The practice-focused question that guided this review focused on finding …

Hearing Care And Management Priority Among Parents Of Children With Down Syndrome: A Grounded Theory, John J. Whicker, Karen F. Muñoz, Nicole J. Pearson, Trenton J. Landon, Lauri H. Nelson, Karl R. White, Michael P. Twohig

Communicative Disorders and Deaf Education Faculty Publications

Objective: This study qualitatively explored the factors that influence how parents of children who are Deaf or hard-of-hearing with Down syndrome prioritize hearing care and management and developed an associated theory to explain that priority.

Design: Grounded theory was used for the purposes of this qualitative study. Data were collected using in-depth interviews which were analyzed using a three-tiered qualitative coding process.

Study Sample: Eighteen mothers of children who are Deaf or hard-of-hearing with Down syndrome participated in this study.

Results: The higher the extent of engaged professional support, perception of benefit for child, parent activation, and family engagement, the …

Smoking And Covid-19, Willie P. Rajvong, Yelena Tarasenko

Eagles Talking About the Public’s Health

No abstract provided.

Standardized Knowledge And Behavior Of Food-Protection Staff To Help Reduce The Potential For Incidences Of Foodborne Illness, Joshua A. Dufresne

College of Graduate Studies: Theses & Dissertations

Background: Environmental public health has always been at the forefront of issues that affect the health and wellbeing of the general public when it comes to food safety. However, with the workforce moving from one of technological laggards toward faster progress toward new and improved systems in performing food service, the question becomes: What are the needs of the environmental health and food safety workforce, and how does one get there? Logically, another question follows: are our current training programs helping to make a difference in the number of foodborne-illness risk-factor violations being issued?

Purpose: This study was to …

Non-Thrust Cervical Manipulations Reduce Short-Term Pain And Decrease Systolic Blood Pressure During Intervention In Mechanical Neck Pain: A Randomized Clinical Trial, Emmanuel Yung, Cheongeun Oh, Michael Wong, Jason K. Grimes, Erica M. Barton, Muhammad I. Ali, Allison Breakey

Physical Therapy Faculty Publications

Objectives: To evaluate the association of resting blood pressure with pain response and evaluate the cardiovascular effects of anterior-to-posterior [AP] versus lateral [LAT] techniques of cervical spine non-thrust manipulation [NTM].

Methods: Forty-three (23 females) participants with non-chronic neck pain (mean age 29.00 ± SD 9.09 years) randomly received AP or LAT NTM to the cervical spine. Blood pressure and heart rate were measured before, during, and after the intervention. Disability and pain were measured pre- and post-intervention.

Results: Resting systolic blood pressure (SBP) was significantly associated with average pain reduction two days later on univariate and multivariate analyses (coefficients −0.029 …

Sustained Acoustic Medicine Combined With A Diclofenac Ultrasound Coupling Patch For The Rapid Symptomatic Relief Of Knee Osteoarthritis: Multi-Site Clinical Efficacy Study, Alex Madzia, Chirag Agrawal, Paddy Jarit, Stephanie Petterson, Kevin Plancher, Ralph Ortiz

Physical Therapy Faculty Publications

Background:

Sustained Acoustic Medicine (SAM) is an emerging, non-invasive, non-narcotic, home-use ultrasound therapy for the daily treatment of joint pain. The aim of this multi-site clinical study was to examine the efficacy of long-duration continuous ultrasound combined with a 1% diclofenac ultrasound gel patch in treating pain and improving function in patients with knee osteoarthritis.

Methods:

The Consolidated Standards of Reporting Trials (CONSORT) were followed. Thirty-two (32) patients (18-males, 14-females) 54 years of average age with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence (KL) grade II/III) were enrolled for treatment with the SAM device and diclofenac …

Uncovering The Complex Genetics Of Human Personality: Response From Authors On The Pgmra Model, Igor Zwir, Pashupati Mishra, Coral Del-Val, C. Charles Gu, Gabriel A. De Erausquin, Terho Lehtimäki, C. Robert Cloninger

School of Medicine Publications

Following publication of our two articles [1, 2], a critique of the methodology of Phenotype-Genotype Many-to-Many Relations Analysis (PGMRA) [1, 3, 4] questioned the validity of our results from the perspective of polygenic risk scores (PRS) [5]. We appreciate the importance of these questions, and here provide a concise discussion of the assumptions and mathematical constraints of both approaches. We thank this commentator and others who have discussed our articles with us for their thoughtful questions and critiques

Transition To Practice: Perceptions Of Nursing By Foreign Educated Physicians Enrolled In An Fnp Program, Gail K. Baumlein, Debbie Conner

All Faculty and Staff Scholarship

This study explores changes in the perceptions of nursing of the FNP students as they progressed through the 27 month FNP program. Literature revealed a limited number of studies of this unique population, including the barriers to role transition; citing language, understanding the U.S. healthcare system, cultural transitions, and discrimination as concerns.

An Image Of Perfection

AWE (A Woman’s Experience)

No abstract provided.

La Posible Consolación De La Música, Antoni Pizà

Publications and Research

Resumen:

La música, y por extensión el arte en general, no ofrece remedios terapéuticos adecuados frente al dolor provocado por situaciones de desespero personal. Sin embargo, esto no ha evitado que muchos oyentes y músicos profesionales intentaran usar la música como terapia. Este ensayo presenta una amplia muestra de composiciones, de J. S. Bach a Terry Riley, que se han usado como terapia de superación personal. Como puede preverse y a pesar de notables excepciones, el lenguaje de los clásicos, sobre todo si está basado en la armonía funcional, tiende a alcanzar esta misión mejor que las formas angulares e …

A Five-Sample Confirmatory Factor Analytic Study Of Burnout-Depression Overlap, Renzo Bianchi, Irvin Sam Schonfeld, Jay Verkuilen

Publications and Research

Objective: It has been asserted that burnout—a condition ascribed to unresolvable job stress—should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined.

Methods: Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom–Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)—General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ‐9.

Results: In all five samples, the latent factors pertaining to burnout’s components correlated on average more highly with the latent Depression …

Recanalization Of The Chronically Occluded Internal Carotid Artery: Review Of The Literature., Mario Zanaty, Jorge A. Roa, Pascal Jabbour, Edgar A. Samaniego, David M. Hasan

Department of Neurosurgery Faculty Papers

Introduction: We reviewed the literature on interventions for patients with medically refractory chronically occluded internal carotid artery (COICA) to assess the risks and/or benefits after recanalization via an endovascular technique (ET) or hybrid surgery (HS, i.e., ET plus carotid endarterectomy).

Methods: A systematic search of the electronic databases was performed. Patients with COICA were classified into 4 different categories according to Hasan et al classification.

Results: Eighteen studies satisfied the inclusion criteria. Only 6 studies involved an HS procedure. We identified 389 patients with COICA who underwent ET or HS; 91% were males. The overall perioperative complication rate was 10.1% …

Early Surgery For Traumatic Spinal Cord Injury: Where Are We Now?, Jefferson R. Wilson, Christopher D. Witiw, Jetan Badhiwala, Brian K. Kwon, Michael G. Fehlings, James Harrop

Department of Neurosurgery Faculty Papers

Study Design: Narrative review.

Objective: There is a strong biological rationale to perform early decompression after traumatic spinal cord injury (SCI). With an enlarging clinical evidence base, most spine surgeons internationally now favor early decompression for the majority of SCI patients; however, a number of pertinent questions remain surrounding this therapy.

Methods: A narrative review evaluating the status of early surgery for SCI. In particular, we addressed the following questions: (1) Which patients stand to benefit most from early surgery? 2) What is the most appropriate time threshold defining early surgery?

Results: Although heterogeneity exists, the evidence generally seems to …

Minimizing Blood Loss In Spine Surgery., Christopher Mikhail, Zach Pennington, Paul M Arnold, Darrel S Brodke, Jens R Chapman, Norman Chutkan, Michael D Daubs, John G Devine, Michael G Fehlings, Daniel E Gelb, George M Ghobrial, James S Harrop, Christian Hoelscher, Fan Jiang, John J Knightly, Brian K Kwon, Thomas E Mroz, Ahmad Nassr, K Daniel Riew, Lali H Sekhon, Justin S Smith, Vincent C Traynelis, Jeffrey C Wang, Michael H Weber, Jefferson R Wilson, Christopher D Witiw, Daniel M Sciubba, Samuel K Cho

Department of Neurosurgery Faculty Papers

Study Design: Broad narrative review.

Objective: To review and summarize the current literature on guidelines, outcomes, techniques and indications surrounding multiple modalities of minimizing blood loss in spine surgery.

Methods: A thorough review of peer-reviewed literature was performed on the guidelines, outcomes, techniques, and indications for multiple modalities of minimizing blood loss in spine surgery.

Results: There is a large body of literature that provides a consensus on guidelines regarding the appropriate timing of discontinuation of anticoagulation, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and herbal supplements prior to surgery. Additionally, there is a more heterogenous discussion the utility of preoperative autologous …

Implementation Of A Spine-Centered Care Pathway At A Regional Academic Spine Center., George M Ghobrial, Jefferson Wilson, Daniel Franco, Kristen Vogl, Alexander R Vaccaro, James S Harrop

Department of Neurosurgery Faculty Papers

Study Design: Retrospective case series.

Objective: To describe the early implementation of an inpatient spinal surgery unit and measure the impact on cost and length of stay (LOS).

Methods: A retrospective case review was performed for frequent spine-related diagnosis-related groups (DRGs) cared for by a dedicated multidisciplinary team: combined anterior/posterior (AP) spinal fusion with major complicating or comorbid condition (MCC), combined (AP) spinal fusion with CC, combined (AP) spinal fusion without complicating or comorbid (CC)/MCC, cervical spinal fusion with MCC, cervical spinal fusion with CC, and cervical spinal fusion without CC/MCC. Four time periods were compared: historical control, initial pathway …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Effects Of A Single Mutation In Chikungunya Virus Non-Structural Protein On Virus Infection In Aedes Albopictus And Mammalian Cell Lines, Yin Ling Jolene Fu

Student Works (2020-2029)

Chikungunya virus (CHIKV) has caused large-scale epidemics of fever, rash and arthritis since 2004. This unprecedented re-emergence has been mainly associated with mutations in genes encoding structural envelope proteins, providing increased fitness in the secondary vector Aedes (Ae.) albopictus. In the 2008-2013 CHIKV outbreaks across Southeast Asia, an R82S mutation in non-structural protein 4 (nsP4) emerged early in Malaysia or Singapore and quickly became predominant. To determine whether this nsP4-R82S mutation provides a selective advantage in host cells which may have contributed to the epidemic, the fitness of infectious clone-derived CHIKV with nsP4- 82R and nsP4-82S were compared in Ae. …

Functional Significance Of Senescence And Autophagy In Cancer-Associated Fibroblasts From Oral Squamous Cell Carcinoma, May Leng Tan

Student Works (2020-2029)

Oral squamous cell carcinoma (OSCC) is a malignancy that arises from the epithelial cells within the oral cavity. It accounts for approximately 355,000 new cases worldwide and is exceptionally prevalent in particular geographical areas such as Papua New Guinea, the Indian subcontinent and South-East Asian countries. Despite advances in surgical management and therapeutic approaches, the five-year survival rate of OSCC patients has not improved significantly over the past few decades. The mortality associated with OSCC is particularly high often due to late presentation, locoregional recurrence, distant metastases and the development of second primary tumours. A comprehensive understanding of the molecular …

Impacts Of Self-Perceived Malocclusion On The Oral Health-Related Quality Of Life Of Young Adults In Malaysia, Mohd Tajudin Zawani

Student Works (2020-2029)

Objectives: To assess the prevalence, severity and extent of impacts of self-perceived malocclusion on the oral health-related quality of life (OHRQoL) related to dental aesthetics among young Malaysian adults, to compare between those with and without self-perceived malocclusion and to investigate the influence of demographics on the outcome. Methods: Multi-stage random sampling method was used to recruit 589 subjects from tertiary institutions in Malaysia. Study instruments comprised the Aesthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN) and Malaysian version of the Psychosocial Impact of Dental Aesthetics (PIDA) to measure selfperceived malocclusion and its impacts. Analyses included multifactorial ANOVA …

Anticancer Activity Of Ficus Deltoidea And Tualang Honey On Oral Cancer Cells: An In Vivo Study, Alkoshab May Ameen Saeed

Student Works (2020-2029)

The use of natural products have been gaining interest, notably in the area of cancer therapy and in this study, natural products rich in antioxidants such as Tualang Honey (Malaysian wild local honey) and Ficus deltoidea (Malaysian local herbal plant), were selected to assess their chemo-preventive and chemotherapeutic activities on oral cancer. The aim of this study is to evaluate the chemo-preventive and chemotherapeutic activities of Ficus deltoidea (FD) and Tualang Honey (TH) in an animal model induced for oral cancer using 4-Nitroquinoline1-oxide (4NQO). A total of 70 male Sprague-Dawley (SD) rats were distributed into ten groups (n=7 per group); …

Expression Of Ki-67, Fscni And Tnfrsf 12a In Histologically Non-Involved Mucosal Surgical Margins As Predictive Markers For Local Relapse In Oral Squamous Cell Carcinoma, Zainul Abidin Nur Fauziani

Student Works (2020-2029)

Introduction: The presence tumour-related genetic alterations in histologically noninvolved mucosal surgical margins was linked to development of local relapse in OSCC. Aims: The present study aimed to determine the association between expression of Ki67, FSCN1 and TNFRSF12A in histologically non-involved mucosal surgical margins of OSCC patients and local relapse. Materials and methods: The study involved a total of 34 OSCC cases including 15 cases of patients who had relapse within the 5 years followup period and 19 cases of patients who did not had relapse. Two-stage sampling was carried out to select the margins’ site, followed by the representative sections …

Clinicopathological Study Of Oral Lichen Planus And Oral Linchenoid Reaction, Gubod Eb Robson

Student Works (2020-2029)

Introduction: Oral lichen planus is a chronic inflammatory disease that affects the mucosa of the oral cavity. Oral lichenoid reactions/ lesions share many clinical and histopathological features with oral lichen planus, and represent a response to extrinsic or causative factors (drugs, allergens). Aim: The purpose of this study was to evaluate the clinical and histopathological features of oral lichen planus and oral lichenoid reactions/ lesions. Objectives: The objectives of this study were to assess the clinical and histopathological features of patients diagnosed with oral lichen planus and oral lichenoid reaction/ lesions. This study also sought to investigate the association between …

Occupational Burnout Among Healthcare Professionals In Obstetrics And Gynecology Department Of A Public Hospital In Islamabad, Pakistan, Kashif Sabin

Student Works (2020-2029)

The general purpose of this study was to investigate the extent of burnout experienced by healthcare professionals working in obstetrics & gynaecology units in public hospital of Islamabad, Pakistan. Specifically, this research attempted to explore the contributing factors of burnout, by correlating the burnout scores of exhaustion and disengagement, with the sociodemographic variables. The main objectives of the study were: (i) to assess the levels of burnout as determined by the extent of exhaustion and disengagement among the study participants, and (ii) to compare the mean scores of exhaustion and disengagement among healthcare professionals based on different demographic characteristics: (a) …

Attitude Towards Patient Undergraduate Medical Students In The University Of Malaya, Jeevitha Rajasingam

Student Works (2020-2029)

In the last two decades, patient safety awareness has become one of the emerging themes. To prevent from doing harm to patients, safe medical practices should be implemented and followed strictly. Therefore, a basic understanding of human factor principles need to be instilled into all health care workers. Medical universities play a vital role in fostering patient safety attitudes of their students towards the importance of patient safety during their practise. However, the medical curricula still face challenges regarding the correct timing and appropriate methods of instruction in their understanding of their principles. Experiments have shown that patient safety classes …