Medicine and Health Sciences Commons^™

Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #3: Capturing The Start-Up Costs Associated With Social And Behavior Change Interventions, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

A successful social and behavior change (SBC) intervention requires the investment of time and resources in the intervention’s start-up phase, which is defined as the time from the project initiation until the project begins broad implementation. When conducting a costing study of an SBC intervention, it is useful to capture these initial costs separately and allocate them appropriately over the life of the intervention. By examining start-up costs separately, the post-start-up implementation costs can be forecasted more accurately for future budgeting purposes and for determining the appropriate costs for scaling-up interventions. This is the third in a series of briefs …

Relationship Between Sexual Activity, Contraceptive Utilization And Biopsychosocial Characteristics Among Homeless Shelter Adolescents., Brittney A Gaudet, Nina Liu, Allison N Kayne, Taylor L Jarvill, Cecilia Zemanek, Jeffrey M Downen, Hoonani M Cuadrado, Amy B Smith, Marna R Greenberg, Jessica L Jacoby, Joanne N Quinones

Department of Emergency Medicine

Objective: To determine whether biopsychosocial factors are associated with sexual activity and contraceptive utilization among homeless shelter adolescents. Methods: A retrospective study of 440 adolescents at a shelter in Pennsylvania between February 2015 and September 2019 was conducted. The cohort was evaluated to determine what relationship age, gender identity, substance use, and trauma history have with sexual activity and contraceptive utilization. Results: Sexual activity was significantly related to age (mean 15.8+1.4 years in sexually active vs. 14.7+1.6 years in abstinent youth, p<0.001); remote history of self-harm behavior (relative risk ratio (RR) 1.23 [95% CI 1.03-1.46]; p=0.02), history of aggressive behavior (RR 1.21 [95% CI 1.01-1.46]; p=0.04), history of trauma (RR 1.24 [95% CI 1.04-1.48]; p=0.03), and substance use (RR 2.27 [95%CI 1.86-2.77]; p<0.001). There were 55.7% sexually active females vs. 42.50% males reporting contraception use (p=0.01). After adjustment, older age and substance use remained significantly associated with sexual activity (adjusted odds ratio (AOR) 1.58 [95% CI 1.36-1.83]; p<0.001 and AOR 5.18 [95% CI 3.28-8.18]; p<0.001, respectively). Conclusions: Females self-reported sexual activity using contraception more than males. After adjustment, older age and substance use were associated with sexual activity. By better understanding the impact these factors can have on contraceptive utilization, informed policy and practice interventions can be developed and implemented to help increase safe sex practices in spaces where homeless adolescents access healthcare.

Allogenic Fibular Bone Graft Reconstruction With Complete Regeneration Of The Lateral Malleolus After En Bloc Resection Of A Distal Fibular Aneurysmal Bone Cyst: A Case Report, Kalli E. Mortenson, Lawrence M. Fallat

Articles

Aneurysmal bone cysts are expansile lytic lesions that most commonly affect the metaphysis of long tubular bones. These lesions are locally aggressive and predominately occur within the first two decades of life. Currently the most widely used surgical treatment involves intralesional curettage of the affected bone. However, there have been several reports of high recurrence rates with this technique. We present a case of a 12 year old female who presented with an aneurysmal bone cyst of the lateral malleolus of the right ankle. The patient underwent multiple surgeries and ultimately had complete surgical resection of the cystic lesion and …

Third Trimester Plasma Metabolites Associated With Gestational Diabetes: An Ancillary Analysis Of The Healthy Beginnings Trial, Rodrigo D. Rosario

Master's Theses

Introduction: Gestational Diabetes Mellitus (GDM) results in complications affecting both mother and child. The implementation of metabolomics to assess metabolite alterations is needed to better understand its etiology. Prior research by our lab in first trimester samples of GDM patients indicated altered fatty acid utilization and purine degradation products.

Objective: Metabolomics analysis was conducted on third trimester (28 -35 weeks) plasma samples to observe differences associated with GDM.

Methods: Fifty samples taken from the Healthy Beginnings trial and their corresponding data were included in the study. Plasma samples were analyzed using UPLC-MS with metabolomic assays for primary metabolomics, aminomics, and …

Advancing Proper Dataset Partitioning And Classification Of Visual Search And The Vigilance Decrement Using Eeg Deep Learning Algorithms, Alexander J. Kamrud

Theses and Dissertations

Electroencephalography (EEG) classification of visual search and vigilance tasks has vast potential in its benefits. In future human-machine teaming systems, EEG could act as the tool for operator state assessment, enabling AI teammates to know when to assist the operator in these tasks, with the potential to lead to increased safety of operations, better training systems for our operators, and improved operational effectiveness. This research investigates deep learning methods which utilize EEG signals to classify the efficiency of an operator's search and to classify whether an operator is in a decrement during a vigilance type task, and investigates performing these …

Pregnancy And Childbirth Expectations During Covid-19 In A Convenience Sample Of Women In The United States, Tishra Beeson, Amy Claridge, Amie Wojtyna, Debra Rich, Gracie Minks, Adrienne Larson

All Faculty Scholarship for the College of Education and Professional Studies

The COVID-19 pandemic has transformed the health care landscape and shifted individuals’ expectations for and interactions with essential health services, including pregnancy-related care. This study explores alterations to individuals’ pregnancy and childbirth decisions during an infectious disease pandemic. A convenience sample of 380 pregnant individuals with an expected delivery date between April and December 2020 consented to enroll and complete an online questionnaire on their pregnancy and childbirth expectations during the COVID-19 pandemic; a subset of respondents (n = 18) participated in semi-structured phone interviews. Survey data were analyzed quantitatively while interview data were analyzed using a thematic content …

Inspire : Vol 4, Issue 9, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message from the Chair
• Medicine at National and International Forums
• Double Trouble~ Congo and Dengue!
• In-depth- featuring Dr. Moiz Salahuddin
• Featured Faculty- Dr Zain Mushtaq “… A little compassion goes a long way"
• Faculty’s –Favorite poem
• What are Academics Around the World Reading This Month?
• Publications

Mental Health And Well-Being Of Older Adults Living With Hiv In Sub-Saharan Africa: A Systematic Review, Patrick Nzivo Mwangala, Adam Mabrouk, Ryan Wagner, Charles R J C Newton, Amina Abubakar

Institute for Human Development, East Africa

Objective: In this systematic review, we aimed to summarise the empirical evidence on common mental disorders (CMDs), cognitive impairment, frailty and health-related quality of life (HRQoL) among people living with HIV aged ≥50 years (PLWH50 +) residing in sub-Saharan Africa (SSA). Specifically, we document the prevalence and correlates of these outcomes.

Design, data sources and eligibility criteria: The following online databases were systematically searched: PubMed, CINAHL, PsycINFO, Embase and Scopus up to January 2021. English-language publications on depression, anxiety, cognitive function, frailty and quality of life among PLWH50+ residing in SSA were included.

Data extraction and synthesis: We extracted …

Airway Obstacle Course For Teaching Prehospital Providers Airway Techniques., Robert Young, John O Elliott, Brad D Gable

OhioHealth Research Institute Articles

BACKGROUND:  Early airway intervention is a vital step in the management of critically ill patients. Emergency medical service (EMS) providers are often first in the chain of survival with equipment to manage airway problems that arise. Therefore, it is paramount that they receive thorough training in aspects of airway management. Often, the training providers currently undergo does not reflect the environmental challenges inherent in EMS. Our obstacle course not only offers trainees a situational environment that simulates common challenges associated with the prehospital environment, but also provides a break from traditional tabletop and lecture-based training methods.

METHODS:  An airway obstacle …

Assesment Of Antibiotic Resistant Gene Expression In Clinical Isolates Of Pseudomonas Aeruginosa, Dustin Esmond

Biology Theses

Increasing prevalence of nosocomial infections by antimicrobial resistant pathogens resulting in higher mortality rates and financial burden is of great concern. Pseudomonas aeruginosa represents one of six highly virulent “ESKAPE” pathogens that exhibit considerable intrinsic drug resistance as well as mechanisms for acquiring further resistance. As many of these mechanisms are regulated through gene expression, we sought to identify regulatory strategies and patterns at play in 23 clinical isolates collected from Baku, Azerbaijan and Tyler, Texas, USA. Real-time quantitative polymerase chain reaction was performed on six gene targets implicated in resistance and contrasted with antibiotic phenotypes. We found AmpC cephalosporinase …

Evaluating The Treatment Effectiveness And Efficiency Of The Df2 Protocol Using Invisalign® For Treatment Of Class Ii Malocclusion: A Retrospective Comparison Study, Bryan J. Otis

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This retrospective study evaluated the treatment effectiveness and efficiency of the DF2 protocol for correction of class II malocclusions in comparison to conventional protocol using Invisalign®.

Materials and Methods: Clinical and cephalometric data of patients that were treated for class II malocclusion between July 30, 2014 and July 22, 2021 were reviewed and selected. The selected patients were matched for age, sex, and treatment complexity and divided into two groups: Group 1 (G1) —DF2 protocol and Group 2 (G2)—conventional class II Invisalign®. Clinical variables to represent the skeletal and dentoalveolar changes during treatment were assessed using pre-treatment (T1) …

Comparison Of Transcriptional Profiles Of Treponema Pallidum During Experimental Infection Of Rabbits And In Vitro Culture: Highly Similar, Yet Different, Bridget D De Lay, Todd A Cameron, Nicholas R De Lay, Steven J Norris, Diane G Edmondson

Faculty, Staff and Student Publications

Treponema pallidum ssp. pallidum, the causative agent of syphilis, can now be cultured continuously in vitro utilizing a tissue culture system, and the multiplication rates are similar to those obtained in experimental infection of rabbits. In this study, the RNA transcript profiles of the T. pallidum Nichols during in vitro culture and rabbit infection were compared to examine whether gene expression patterns differed in these two environments. To this end, RNA preparations were converted to cDNA and subjected to RNA-seq using high throughput Illumina sequencing; reverse transcriptase quantitative PCR was also performed on selected genes for validation of results. The …

Reconsidering Perioperative Antibiotic Use In Elective Laparoscopic Cholecystectomy, Kayla B. Briggs, James Fraser, Wendy Jo Svetanoff, Charles L. Snyder, Pablo Aguayo, David Juang, Rebecca M. Rentea, Jason D. Fraser, Shawn D. St. Peter Md, Tolulope A. Oyetunji

Posters

Introduction: Prophylactic preoperative antibiotics (PPA) are questionable in cases with a low rate of surgical site infection (SSI). We report institutional PPA usage and SSI rates after elective laparoscopic cholecystectomy in a children’s hospital. Methods: Children <18 years old who underwent outpatient laparoscopic cholecystectomy between 7/2010 and 8/2020 were included. SSI was defined as clinical signs of infection, requiring antibiotics, within 30 days of surgery. Results: 502 patients met inclusion criteria; 50% were pre-operatively diagnosed with symptomatic cholelithiasis, 47% biliary dyskinesia, 2% hyperkinetic gallbladder, and 1% gallbladder polyp(s). The majority were female (78%) and Caucasian (80%). 60% (n=301) of patients received PPA while 40% (n=201) did not; 1.3% (n=4) of those who received PPA developed SSI compared to 5.5% (n=11) of those who did not (p=0.01). Though PPA use was associated with an 84% reduction in risk of SSI on multivariate analysis (p=0.01), all SSIs were superficial. One child required readmission for intravenous antibiotics while the remainder were treated with outpatient antibiotics. Gender, age, BMI, ethnicity, and preoperative diagnosis did not influence the likelihood of receiving PPA (Table 1). Conclusion: Given the relatively low morbidity of the superficial SSI, conservative use of PPA should be carefully considered in outpatient laparoscopic cholecystectomy to avoid contributing to antibiotic-related complications.

The Etiology Of Pneumonia In Hiv-Uninfected Children In Kilifi, Kenya: Findings From The Pneumonia Etiology Research For Child Health (Perch) Study, Juliet O. Awori, Alice Kamau, Susan Morpeth, Sidi Kazungu, Micah Silaba, Joyce Sande, Angela Karani, Sammy Nyongesa, Salim Mwarumba, Robert Musyimi

Imaging & Diagnostic Radiology, East Africa

Background: In the 1980s, Streptococcus pneumoniae and Haemophilus influenzae were identified as the principal causes of severe pneumonia in children. We investigated the etiology of severe childhood pneumonia in Kenya after introduction of conjugate vaccines against H. influenzae type b, in 2001, and S. pneumoniae, in 2011.

Methods: We conducted a case–control study between August 2011 and November 2013 among residents of the Kilifi Health and Demographic Surveillance System 28 days to 59 months of age. Cases were hospitalized at Kilifi County Hospital with severe or very severe pneumonia according to the 2005 World Health Organization definition. Controls …

Normal-Tension Glaucomatous Optic Neuropathy Is Related To Blood Pressure Variability In The Maracaibo Aging Study, Jesus D. Melgarejo, Gladys E. Maestre, Luis J. Mena, Joseph H. Lee, Michele Petitto, Carlos A. Chavez, Gustavo Calmon, Egle Silva, Lutgarde Thijs, Lama A. Al-Aswad

School of Medicine Publications

Hypoperfusion of the optic nerve might be involved in the pathogenesis of normal-tension glaucomatous optic neuropathy (GON). Mean arterial pressure (MAP) drives ocular perfusion, but no previous studies have addressed the risk of GON in relation to blood pressure (BP) variability, independent of BP level. In a cross-sectional study, 93 residents of Maracaibo, Venezuela, underwent optical coherence tomography, visual field assessments and 24-h ambulatory BP monitoring between 2011 and 2016. We investigated the association of normal-tension GON with or without visual field defects with reading-to reading variability of 24-h MAP, as captured by variability independent of the MAP level (VIMmap). …

A Randomized Controlled Trial Of Psychological Outcomes Of Mobile Guided Resonant Frequency Breathing In Young Adults With Elevated Stress During The Covid-19 Pandemic, Al Amira Safa Shehab

Dissertations, Theses, and Capstone Projects

Deep breathing practices have shown promise in reducing stress, anxiety, and depression in different populations, including young adults. Specifically, resonant frequency breathing can exert an impact on stress response systems through the vagus nerve and the hypothalamo-pituitary-adrenal (HPA) axis. This may induce reductions in stress and improvement in emotion regulation. Young adults, including college students, tend to be at a higher risk for psychological distress, as they face several psychosocial challenges. The COVID-19 pandemic has imposed new and unique stressors that resulted in higher levels of stress and emotional symptoms and it has been shown that this may have placed …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

Health-Illness Transition Experiences Among Patients With Pancreatic Cancer, Jessica Goldberg

Dissertations, Theses, and Capstone Projects

Pancreatic cancer is one of the most commonly diagnosed cancers and is associated with a poor prognosis measured in terms of months and with significant palliative care needs, including psychological distress. Self-management describes a patient’s ability to manage the sequelae of serious illness, which can have an impact on quality of life and psychological health. One of the fundamental self-management skills is the management of transitions. A transition is a change in life situation or status that causes a shift in a patient’s identity, role, behavior, or interpersonal relationships. Patients with cancer experience multiple, often overlapping transitions that can influence …

Food-As-Medicine: An Everyday Strategy Of Health, Rachel Rebecca Bogan

Dissertations, Theses, and Capstone Projects

Using food-as-medicine, a valuable strategy of health, as its focus, this dissertation examines why and how New Yorkers use food to negotiate their health. I argue that while using food medicinally is a common health practice, food-as-medicine operates unequally among different groups of New Yorkers. I attribute this inequity, in part, to how those in power, including public health experts, biomedical doctors, and the food industry, operationalize food-as-medicine as a health remedy and to a neoliberal, healthist context that ties people’s morally “correct” uses of food-as-medicine to their abilities to access “good” citizenship and optimal health.

I chose to write …

Intent To Stay, Moral Distress, And Nurse Practice Environment Among Long-Term Care Nurses, Amil Tan

Dissertations, Theses, and Capstone Projects

Background: Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed at least in part to moral distress and a negative nurse practice environment. Licensed nurses working in long-term care facilities experience ethical challenges such as lack of resources, use of restraints, end-of-life issues, and caring for residents with dementia that, if not resolved, can lead to moral distress- especially if left unresolved. Long-term care administrators and nurse managers increasingly strive to improve leadership support for long-term care staff that will positively affect the nurse practice environment.

Aim/Purpose: The purpose …

Cross-Linguistic Morphosyntactic Influence In Bilingual Speakers Of Jamaican Creole And Jamaican English, Taryn R. Malcolm

Dissertations, Theses, and Capstone Projects

Bilingualism in Jamaica is of considerable consequence, as most individuals are early bilinguals, speaking both a variety of Jamaican Creole (JC) from birth and having standardized English (sE) as the language of instruction in education. Immigrants from Jamaica to the United States are an ideal population to examine how cross-linguistic influence (CLI) impacts morphosyntax as JC and sE differ in morphosyntactic constructions, including verb tense- marking, subject-verb agreement, and copula use. While much of the work in the field of CLI has examined spoken language pairs with varying degrees of similarity (or difference) between the languages, examining CLI in a …

The Structural And Functional Role Of Photosensing In Rgs-Lov Proteins, Zaynab Jaber

Dissertations, Theses, and Capstone Projects

Light provides organisms with energy and spatiotemporal information. To survive and adapt, organisms have developed the ability to sense light to drive biochemical effects that underlie vision, entrainment of circadian rhythm, stress response, virulence, and many other important molecularly driven responses. Blue-light sensing Light-Oxygen-Voltage (LOV) domains are ubiquitous across multiple kingdoms of life and modulate various physiological events via diverse effector domains. Using a small molecule flavin chromophore, the LOV domain undergoes light-dependent structural changes leading to activation or repression of these catalytic and non-catalytic effectors. In silico analyses of high-throughput genomic sequencing data has led to the marked expansion …

Longitudinal Changes Of Regional Myelin Water Fraction During First Year After Moderate-To-Severe Diffuse Traumatic Brain Injury, Likowsky L. Desir

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) is a worldwide health issue with a highly heterogeneous disease characterization, including widespread white matter damage in the brain. Most non-invasive white matter imaging methods currently available, including diffusion tensor imaging (DTI), cannot reliably measure the degree of neurodegeneration due to various confounds, making it challenging to select an endpoint measure for neuroprotective clinical trials. The present study investigates longitudinal white matter changes, measured by a novel imaging metric, apparent myelin water fraction (aMWF), and its relationship with neuropsychological measures during the first year after TBI. Data from 15 adult patients with moderate-to-severe TBI and 30 …

Efficiency Of The Acoustic Change Complex For Various Stimulus Presentation Strategies In Infants, Lisa Goldin

Dissertations, Theses, and Capstone Projects

The acoustic-change-complex (ACC) is an objective measure that can be used to study whether sounds are encoded at the level of the cortex. The goals of this study were: 1) To determine if the ACC can be elicited in infants, and 2) To establish whether eliminating the silent interval between stimuli and using a continuously alternating stimulus is more efficient in infants than the traditional interrupted stimulus presentation method. If the continuously alternating stimulus is more efficient, then 3) To determine why the continuously alternating stimulus is more efficient.

Twenty-one infants aged 2 months to 13 months old served as …

Factors Associated With Health-Promoting Behaviors Of Adult Protective Service Workers And Professionals Who Support Vulnerable Adults, Cynthia Sterling-Fox

Dissertations, Theses, and Capstone Projects

Background: Adult protective services encompass social services provided to vulnerable adults: abused, neglected and exploited elderly and adults with significant disabilities in the United States. Adult Protective Services (APS) workers investigate allegations of abuse, neglect, and exploitation of vulnerable adults. APS workers work closely with multidisciplinary teams and professionals in various fields to assist with the investigations. APS workers and other professionals are exposed to individual and work environment stressors that result in a lower professional quality of life. There is evidence, however, that health-promoting behaviors mitigate the negative effects of stressors.

Purpose: Using the Health Promotion Theory by Nola …

Enhanced Platinum (Ii) Drug Delivery For Anti-Cancer Therapy, Marek T. Wlodarczyk

Dissertations, Theses, and Capstone Projects

Over the years, anti-cancer therapies have improved the overall survival rate of patients. Nevertheless, the traditional free drug therapies still suffer from side effects and systemic toxicity, resulting in low drug dosages in the clinic. This often leads to suboptimal drug concentrations reaching cancer cells, contributing to treatment failure and drug resistance. Among available anti-cancer therapies, metallodrugs are of great interest. Platinum (II)-based agents are highly potent and are used to treat many cancers, including ovarian cancer (OC). Cisplatin (cis-diaminedichloroplatinum (II)) is the first Food and Drug Administration (FDA)-approved metallodrug for treatment of solid tumors, and its mechanism …

Indications For A "Surgery First" Approach For The Treatment Of Lower Extremity Arterial Disease, Mohineesh Kumar, Steven D. Rimar, Graham W. Long, Diane M. Studzinski, O W. Brown

Conference Presentation Abstracts

No abstract provided.

Carp Edema Virus A Rising Threat To Global Carp Population, Xolani Phaya, Jing-Xiang Zhou, Zhuo Yu Wang, Hao Wang, Jie Liang

The Thai Journal of Veterinary Medicine

Carp edema virus (CEV), a poxvirus from the family Poxviridae, was first detected in 1974 in Japan and has since spread to most parts of the world. CEV is the etiological agent of koi sleepy disease (KSD), which has adverse health effects on both koi and common carp fish species. Equally, KSD leads to detrimental financial distress to carp farmers and further threatens both food security and ecology. The onset and severity of CEV/KSD is influenced by water temperature and handling stress. The prominent clinical sign of KSD in both koi and common carp is lethargy, which is manifested when …

The First Report Of Antimicrobial Residues In Cultured Tilapia Fillets In Three Provinces Of Lao Pdr, Seangphed Phommachanh, Bundit Tengjaroenkul, Peerapol Sukon, Lamyai Neeratanaphan, Kanit Chukanhom

The Thai Journal of Veterinary Medicine

The objective of this study was to investigate antimicrobial residues in the fillets of Nile tilapia fish (n=180) from 3 provinces (Vientiane, Savannakhet Province and Champasak Province) in Lao PDR in the summer, rainy and winter seasons. Clean meat test (CMT) was used for screening the antimicrobial residue samples. Then, the antimicrobial residue groups were examined and identified by the european six-plate test (ESPT), and the concentration of each positive antimicrobial residue from the ESPT was further assessed by high-performance liquid chromatography (HPLC). The evaluation results of the three antimicrobial detection methods were 19.44% (35/180) for the CMT, 22.86% (8/35) …

Molecular Identification Of Paramphistomum Epiclitum (Trematoda: Paramphistomidae) Infecting Buffaloes In An Endemic Area Of Pakistan, Maria Komal, Kiran Afshan, Sabika Firasat, Màrius V. Fuentes

The Thai Journal of Veterinary Medicine

This study determined the molecular characterization of Paramphistomum epiclitum using the second internal transcribed spacer (ITS-2) grouping and secondary structure analysis from buffaloes in Khyber Pakhtunkhwa province, Pakistan. Paramphistomes were collected from the rumen of 25 infected buffaloes and their DNA was separated. DNA was intensified, followed by sequencing. Phylogenetic examinations were carried out using the Maximum Composite Likelihood approach. The results revealed extensive intraspecific and interspecific varieties among different paramphistomid species. The sequences in the present study (GenBank accession number: MW481321 and MW481322) were compared to 46 reference sequences of Paramphistomum and other trematode data from GenBank. The results …