Medicine and Health Sciences Commons^™

August 2021, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

SWOSU COVID-19 Vaccination Opportunities

• The Delta variant is nearly twice as contagious as previous variants.

• Some data suggest the Delta variant might cause more severe illness than previous strains in unvaccinated persons.
• Unvaccinated people remain the greatest concern.

• The greatest risk of transmission is among unvaccinated people who are much more likely to contract, and therefore transmit the virus.

Comparison Of Perioperative Analgesia Between Intravenous Paracetamol And Fentanyl For Rigid Hysteroscopy: A Randomised Control Trial, Dileep Kumar, Kamal Kumar, Mohammad Hamid

Department of Anaesthesia

Objective: To compare efficacy of intravenous paracetamol and fentanyl for intra-operative and post-operative analgesia in patients undergoing rigid hysteroscopy.
Method: The prospective randomised control trial was conducted at Aga Khan University Hospital, Karachi, from October 2016 to June 2017, and comprised patients aged 18-65 years with American Society of Anesthesiologists grade I or II undergoing hysteroscopy who were randomised into paracetamol group P and fentanyl group F. Anaesthesia induction technique was standardised and analgesia in group P was paracetamol 15mg/Kg administered 15-30 minutes pre-surgery, and in group F, it was fentanyl 2mcg/kg administered at induction of anaesthesia. Intra-operative pain was …

Anaesthetic Management Of Tracheal Injury Following Blunt Neck Trauma: An Unusual Late Presentation, Muhammad Saad Yousuf, Mohammad Bin Pervez, Saulat Fatimi, Khalid Samad

Department of Anaesthesia

Tracheal injuries, following blunt neck trauma, are life-threatening surgical emergencies with high risk of mortality. A high index of suspicion is necessary to avoid missing an occult injury because delays in diagnosis and definitive treatment are associated with poorer outcomes. We, herein, report a case of a 28-year man who presented in Emergency Department 15 days after blunt neck trauma from an accident involving electric cable. Anaesthetic challenges, airway management and importance of effective close loop communication, during repair of complex tracheal reconstruction, will be discussed in this case report.

New Nurse Reality Shock & Early Burnout: Can Role Transition Education Received During New Nurse Residency Positively Affect Satisfaction?, Bonnie L. Stolzman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Newly licensed nurses are at incredibly high risk for reality shock leading to early burnout which results in many of them resigning their positions or leaving nursing altogether. Common feelings leading to reality shock often involve exhaustion, cynicism, depersonalization, decreased self-efficacy, and decreased job satisfaction. The result of early burnout presents significant financial strain and quality concerns for our already struggling healthcare systems. In the 1960s and early 1970s, Marlene Kramer brought her research regarding newly licensed nurses and their experience of “reality shock” to publication. Kramer felt strongly that reality shock was a key factor that led newly licensed …

When Healthy Turns Harmful: Increasing Understanding Of Potential Risk Factors And Approaches To Decreasing Orthorexic Behaviors, Elizabeth King

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Orthorexia Nervosa (ON) is a relatively new term used to describe individuals who place an excessive value on consuming a “pure” or healthful diet, so much so that their psychological, and potentially physical, health is negatively affected. ON is driven by a focus of consuming high-quality foods rather than limiting the quantity of food. This has sometimes been referred to as “clean eating”, or only consuming “clean” foods. A commonality between ON and other eating disorders (EDs) is that the behaviors are rooted in restriction, where an individual with ON would focus on restricting specific foods, or even entire food …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Health Policy & Community Health: Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

Impact Of Simple Breastfeeding Initiatives Led By Nurses In A Primary Care Setting, Jessica Semin, Carolyn Hanus, Megan Scott, Amy Ford, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Background: Breastfeeding is recognized by health experts as the preferred infant feeding method. Health professionals, especially nurses, play a vital role in influencing mothers’ infant feeding decisions. This quality improvement project designed, implemented, and evaluated by nurses explores how the implementation of three simple initiatives impacted healthcare staff’s attitudes, beliefs, and perceptions related to breastfeeding.

Materials and Methods: The project was led by three Doctor of Nursing Practice (DNP) students with guidance from their DNP prepared advisor. It took place in a primary care setting at a federally qualified health center. Prior to and after implementation, staff were …

Surgeon Decision-Making For Individuals With Obesity When Indicating Total Joint Arthroplasty, William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee

School of Medicine Faculty Publications

Background: Obesity is a risk factor for complications after total joint arthroplasty (TJA). This study analyzed the impact of individual surgeon demographics, financial concerns, and other factors in determining patient candidacy for TJA based on body mass index (BMI). Methods: A 21-question survey was approved by the American Association of Hip and Knee Surgeons Research Committee for distribution to its membership. Objective questions asked about surgeon or hospital BMI thresholds for offering TJA. Subjective questions asked about physician comfort discussing topics including obesity, bariatric surgery, and weight loss before TJA, as well as insurance and age considerations. Results: For TJA …

Respite For Acute Care Nurses With The Use Of A Resilience Room, Marisella Perales

Doctor of Nursing Practice

Background and Significance of the Problem. Nurses are exposed to higher levels of occupational stress in acute care units when compared to other departments within the hospital (Faraji et al., 2019). A qualitative assessment identified a need for resources to be provided for acute care nurses experiencing occupational stress. Purpose. To establish an area for respite and increase nurses’ knowledge about a Resilience Room and a support system to manage occupational stress. Objectives. To educate 75% of acute care nurse on respite care, have 50% of the nurses report utilization of Resilience Room, and increase the nurses use of a …

A Qualitative Exploration Of The Patient Care Experience As Perceived By Hispanic Patients Receiving Care At A Safety-Net Facility, Silvinia Cuizon

Dissertations

Purpose: The purpose of this study was to understand how English- and Spanish-speaking Hispanic patients seeking kidney and liver transplant care at a safety-net facility perceive and interpret the care experience with the goal of generating a grounded theory model to guide care delivery and improve perception of care for this population.

Background/Rationale: The patient experience is the current federally mandated hospital quality indicator that measures the range of interactions patients have with their hospital admission, which has fiscal and clinical implications for the delivery of care. Many safety-net health care delivery systems, which primarily serve traditionally underserved populations, and …

Lipocalin 2 Promotes Inflammatory Breast Cancer Tumorigenesis And Skin Invasion, Emilly S. Villodre, Xiaoding Hu, Richard Larson, Pascal Finetti, Kristen Gomez, Wintana Balema, Shane R. Stecklein, Ginette Santiago-Sanchez, Savitri Krishnamurthy, Juhee Song

Health & Biomedical Sciences Faculty Publications

Inflammatory breast cancer (IBC) is an aggressive form of primary breast cancer characterized by rapid onset and high risk of metastasis and poor clinical outcomes. The biological basis for the aggressiveness of IBC is still not well understood and no IBC-specific targeted therapies exist. In this study, we report that lipocalin 2 (LCN2), a small secreted glycoprotein belonging to the lipocalin superfamily, is expressed at significantly higher levels in IBC vs non-IBC tumors, independently of molecular subtype. LCN2 levels were also significantly higher in IBC cell lines and in their culture media than in non-IBC cell lines. High expression was …

Probabilistic Measures Of Hiv-1 Transmission In Different Hiv-1 Key Population Groups Of Larkana, Pakistan, Syed Rizwan-Ul-Hasa, Abiha Abdullah, Shakil Arshad Siddiqui, Shakil Ahmed, Sharaf Ali Shah, Fatima Mir, Syed Hani Abidi

Medical College Documents

Objective: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling.
Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: 'true' or 'false'; 2) the chance of giving a 'true' result is the same for each replication; and 3) the replications are independent - 'true' in one will not impact the likelihood of 'true' in another.
Results: …

Developing Outpatient, Clinic-Based Education For Patients With Diabetes And Prediabetes, Ruth Ann Slayton

Electronic Theses and Dissertations

Abstract Education and support provided to the newly diagnosed prediabetic or Type 2 Diabetic are inadequate in the outpatient arena. In rural areas, instruction for diabetes is minimal to nonexistent, and patients are paying for this with their health and lives many times. The financial burden of diabetes in the United States is astronomical. The loss of life and life quality is significantly high as well. A systems-based approach to education in the rural health clinic would be of great benefit and has proven to be enough to reverse or avoid the progression of the disease. A clinic or field-based …

The Use Of Medical Marijuana For The Relief Of Chronic Pain, Jacquelyn M. Paylor

Electronic Theses and Dissertations

Abstract For thousands of years, medical cannabis has been used for relief of chronic pain and personal ailments. It changes users’ mental capacities and perceptions while treating and providing relief from pain and muscle spasms. As a recreational and spiritual substance, this Schedule I drug requires special consideration and certification to administer. Increasing complaints of chronic pain have led doctors to prescribe opioids for pain relief. As prescriptions for opioids have increased, the number of opioid-related mortality and morbidity incidents have also risen. The high rates of opioid-related near deaths and overdoses have led policy makers, clinicians, pharmacists, and providers …

Preclinical Behavioral Assessment Of Chronic, Intermittent Low-Dose Psilocybin In Rodent Models Of Depression And Anxiety, Harmony I. Risca

Dissertations

Recent studies have demonstrated the clinical efficacy of psychedelic-assisted psychotherapy for treatment-resistant depression and anxiety. Amidst the overall success of recent clinical trials using a single high dose of psilocybin, anecdotal reports indicate anxiolytic and antidepressant effects following a repeated low dose regimen. As therapeutic outcomes are often tightly intertwined with the individual’s subjective experience, animal models are used as objective measures to investigate the underlying mechanisms responsible for the putative antidepressant/anxiolytic effects of psychedelics. Three rodent models predictive of anxiolytic or antidepressant effects were used to evaluate effects of chronic intermittent low dose (CILD) psilocybin treatment; the Light/Dark conflict …

An Examination Of Types Of Health Insurance And The Reported Prevalence Of Autism In The United States, Jennifer L. Thompson

Dissertations

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of …

Integrated Analysis Of A Phase 2 Study Of Cemiplimab In Advanced Cutaneous Squamous Cell Carcinoma: Extended Follow-Up Of Outcomes And Quality Of Life Analysis, Danny Rischin, Leonel Hernandez-Aya, Et Al

2020-Current year OA Pubs

BACKGROUND: To provide pooled longer term data from three groups of a phase 2 study of cemiplimab in patients with advanced cutaneous squamous cell carcinoma (CSCC), and to determine duration of response (DOR) and impact on quality of life (QoL).

METHODS: Patients received cemiplimab 3 mg/kg every 2 weeks (group 1, metastatic CSCC [mCSCC], n=59; group 2, locally advanced CSCC, n=78) or cemiplimab 350 mg every 3 weeks (group 3, mCSCC, n=56). Primary endpoint was objective response rate (ORR) per independent central review (ICR). QoL was repeatedly measured at day 1 of each treatment cycle (groups 1 and 2: 8 …

The Relationship Between Participation In Recreational Therapy Physical Activity And Symptoms Of Mental Health Issues In Veterans, Krista F. Mcdonagh

Graduate Doctoral Dissertations

Background/Objective: The growing prevalence of mental health issues in veterans has triggered a wide-spread effort to identify and provide complementary intervention strategies to increase help-seeking behavior in this population. Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) have become two of the most common mental health issues as a result of the demanding environment of military life. This study looks specifically at therapeutic recreation-based physical activity opportunities as a complementary treatment option for veterans at an increased risk for mental health issues.

Method: A correlational survey research design was used to examine relationships between factors of participation in different …

A Digitial Health Action Process Approach Intervention To Promote Resistance Training In Healthy Adult Novices, Justin M. Kompf

Graduate Doctoral Dissertations

Introduction: There is little research to date that has been conducted testing theory-based interventions to increase resistance training. We assessed the relative efficacy of Health Action Process Approach (HAPA) based digital intervention for performing resistance training (RT). Methods: The RTinHome study was a three-phase study which recruited adults aged 18-35 not meeting the strength training recommendations. In Phase I, all participants received two Zoom based training sessions over a one-week period. In Phase II, participants were randomized to a no contract control or to a 4-week, HAPA based digital coaching intervention. In Phase III (follow-up) there was no contact with …

Diagnosing Total Joint Arthroplasty-Associated Periprosthetic Joint Infections In Immunocompromised Patient Populations, Philip Zakko, Erin A. Baker, Christian M. Huber, Corinn Gehrke, Brett J. Friedman, Michael A. Flierl

Conference Presentation Abstracts

The 2018 ICM/MSIS classification system was used to assess PJI diagnosis in immunocompromised vs. non-immunocompromised patient populations to determine applicability of the scoring criteria.

Musculoskeletal Injuries And Conditions In The Orthopaedic Surgeon: A Survey, Katherine Swank, Jamie Furness, Erin A. Baker, Corinn Gehrke, Rachel S. Rohde

Conference Presentation Abstracts

Musculoskeletal conditions are common in orthopaedic surgeons and may lead to morbidity and missed work.

The Routine Use And Cost Analysis Of Acid-Fast Bacilli And Fungal Cultures In Foot And Ankle Surgery: A Retrospective Study, Zein S. El-Zein, Scott Diamond, Margaret C. Bohr, Erin A. Baker, Mackenzie M. Fleischer, Corinn Gehrke, Paul T. Fortin, Zachary Vaupel

Conference Presentation Abstracts

This study highlighted low rates of positive AFB/fungal cultures in our foot and ankle surgery department and demonstrated that routine use of such cultures poses substantial costs to the hospital.

Media In A Time Of Crisis: Newspaper Coverage Of Covid-19 In East Asia;, Colm A. Fox

Research Collection School of Social Sciences

How have newspapers covered Covid-19 in Asia? To answer this question, I studied East Asian English-language newspapers published between January and July 2020. First, I measured the level of news media attention on Covid-19 among all reports. Second, I analyzed the tone and content of 330 editorials. I divided the analysis into two time periods: the initial crisis breakout period, when the number of infections was rising or high, and the crisis abatement period, when new infections declined to manageable levels. Findings show that although newspapers were slow to begin addressing the pandemic, their early editorials carried an alarming tone, …

Psychology And The Threat Of Contagion: Feeling Vulnerable To A Disease Moderates The Link Between Xenophobic Thoughts And Support For Ingroup-Protective Actions, Heejung S. Kim, Kimin Eom, Roxie Chuang, David K. Sherman

Research Collection School of Social Sciences

The widespread threat of contagious disease disrupts not only everyday life but also psychological experience. Building on findings regarding xenophobic responses to contagious diseases, this research investigates how perceived vulnerability to a disease moderates the psychological link between people’s xenophobic thoughts and support for ingroup-protective actions. Three datasets collected during the time of Ebola (N = 867) and COVID-19 (Ns = 992 and 926) measured perceived disease risk, group-serving biases (i.e., xenophobic thoughts), and support for restrictive travel policies (i.e., ingroup-protective actions). Using correlational and quasi-experimental analyses, results indicated that for people who perceive greater disease risk, the association between …

A Multi-Country Test Of Brief Reappraisal Interventions On Emotions During The Covid-19 Pandemic, Ka Wang, Amit Goldenberg, Charles Dorison, Et Al., Nadyanna Mohamed Majeed, Andree Hartanto

Research Collection School of Social Sciences

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across …

Examining The Patient And Caregiver Experience With Diazepam Nasal Spray For Seizure Clusters: Results From An Exit Survey Of A Phase 3, Open-Label, Repeat-Dose Safety Study, Patricia Penovich, James W Wheless, R Edward Hogan, Cynthia Guerra, David F Cook, Enrique Carrazana, Adrian L Rabinowicz

2020-Current year OA Pubs

BACKGROUND: Ideal rescue treatments for acute treatment of seizure clusters should be easy to administer, so it is important to assess user perceptions of these treatments. Diazepam nasal spray is designed to have a rapid, noninvasive, and socially acceptable route of administration. Patient and caregiver (including care partner) responses to surveys from a phase 3 safety study of diazepam nasal spray are reported.

METHODS: The study enrolled patients aged 6-65 years with seizure clusters. Surveys distributed to patients and caregivers at study end, completion, or discontinuation collected data on comfort using diazepam nasal spray outside the home, timing of administration …

Il-7 Expands Lymphocyte Populations And Enhances Immune Responses To Sipuleucel-T In Patients With Metastatic Castration-Resistant Prostate Cancer (Mcrpc), Russell K Pachynski, Chihiro Morishima, Et Al

2020-Current year OA Pubs

BACKGROUND: Sipuleucel-T (sip-T) is a Food and Drug Administration (FDA)-approved autologous cellular immunotherapy for metastatic castration-resistant prostate cancer (mCRPC). We hypothesized that combining sip-T with interleukin (IL)-7, a homeostatic cytokine that enhances both B and T cell development and proliferation, would augment and prolong antigen-specific immune responses against both PA2024 (the immunogen for sip-T) and prostatic acid phosphatase (PAP).

METHODS: Fifty-four patients with mCRPC treated with sip-T were subsequently enrolled and randomized 1:1 into observation (n=26) or IL-7 (n=28) arms of a phase II clinical trial (NCT01881867). Recombinant human (rh) IL-7 (CYT107) was given weekly×4. Immune responses were evaluated using …

Variances In Bcg Protection Against Covid-19 Mortality: A Global Assessment, Zouina Sarfraz, Azza Sarfraz, Krunal Pandav, Sarabjot Singh Makkar, Saman Hasan Siddiqui, Gaurav Patel, Tania Platero-Portillo, Bishnu Mohan Singh, Mohamed Iburahim Haja Maideen, Deepika Sarvepalli, Muzna Sarfraz

Department of Paediatrics and Child Health

The BCG vaccine is known to impart nonspecific immunological benefits alongside conferring protection to tuberculosis in endemic regions. It is also known to protect against bladder cancer and other respiratory tract infections. During the coronavirus disease 2019 (COVID-19) pandemic, the BCG vaccine has gained attention due to its role in conferring protective immunity. We demonstrate the potential immunological protective mechanisms that play a role against COVID-19. We conduct a global assessment of the countries that have the highest and lowest mortality rates determined by an a priori methodology. Lastly, we discuss the potential limitations of incorporating BCG vaccines as potential …

Detection Of Typhoid Carriers By Duodenal Fluid Culture In A Tertiary Care Hospital, Karachi: A Cross-Sectional Study, Sonia Qureshi, Mohammad Tahir Yousafzai, Shafquat Rozi, Shahida Qureshi, Aneeta Hotwani, Kamran Sadiq, Om Parkash, Abdul Momin Kazi, Furqan Kabir, Hadi Usmani, Farah Naz Qamar

Department of Paediatrics and Child Health

We aimed to detect typhoid carriers by performing duodenal fluid culture in patients in a tertiary care hospital in Pakistan. A cross-sectional study was conducted during 2017 at the Aga Khan University Hospital, Karachi. Patients who underwent upper gastrointestinal endoscopy were included. Participants were interviewed, and duodenal fluid samples were taken for culture to detect Salmonella typhi (S. typhi) and paratyphi. A polymerase chain reaction on 100 randomly selected sub-samples was also conducted. A total of 477 participants were enrolled. The mean age was 42.4±15.5 years. History of typhoid fever was present in 73 (15.3%) participants. Out of the 477 …

Effectiveness Of Typhoid Conjugate Vaccine Against Culture-Confirmed Salmonella Enterica Serotype Typhi In An Extensively Drug-Resistant Outbreak Setting Of Hyderabad, Pakistan: A Cohort Study, Mohammad Tahir Yousafzai, Sultan Karim, Sonia Qureshi, Abdul Momin Kazi, Hina Memon, Amber Junejo, Zohra Khawaja, Najeeb Ur Rehman, Muhammad Sajid Ansari, Rafey Ali, Heera Mani Lohana, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Salmonella enterica serotype Typhi (S Typhi) is a major public health problem in low-income and middle-income countries. We aimed to investigate the effectiveness and impact of the typhoid conjugate vaccine Typbar-TCV against S Typhi among children in an outbreak setting of extensively drug-resistant (XDR) S Typhi in Pakistan.
Methods: This cohort study was done from Feb 21, 2018, to Dec 31, 2019. A census survey of all households located in the Qasimabad and Latifabad subdistricts of Hyderabad, Pakistan, was done at baseline, and 174 005 households were registered in the census. The Typbar-TCV immunisation campaign was initiated at temporary …