Medicine and Health Sciences Commons^™

Prevalence Of Chronic Hepatitis B In Oro Province, Papua New Guinea, Alice Unah Lee, Luke Mair, Bob Kevin, Lily Gandi, Olive Tarumuri, Caroline Lee, Sue Huntley, David Carl Hilmers

Faculty, Staff and Students Publications

Chronic hepatitis B (CHB) affects over 250 million people worldwide. In Papua New Guinea, the prevalence of CHB has been estimated to be over 8%, and it is a leading cause of death. To address this problem, an alliance was formed between the government of Oro Province, a large private employer and an Australian nongovernmental organization, which established a CHB test and treatment programme. Between 2014 and 2019, rapid hepatitis B surface antigen testing was performed on 4068 individuals in Oro Province. The crude prevalence rate was 12.98% and was significantly higher in males (15.26%) than females (10.94%) (P < 0.001). The rate was 4.72% among children aged 10 years and under, 12.81% among women of childbearing age (19–35 years) and 18.48% among health-care workers. These results indicate that the rates of vaccination at birth and later among women of childbearing age and health-care workers must be improved to prevent transmission of CHB.

Improving Low Health Literacy In Poststroke Patients By Educating The Health Care Staff, Marthilde Brzycki

Electronic Theses and Dissertations

Abstract

Lack of health literacy in the poststroke patient population is a serious issue; with the addition of the homeless population to that group, the result may be devastating. According to the American Heart Association and American Stroke Association (AHA/ASA, 2016), stroke is considered the primary cause of death and one of the chief reasons for disability in the United States, and nearly75% of strokes occur in those who are 65 years of age or older. Nurse practitioners are vital, providing necessary training and stroke education to the nursing and other health care staff. This DNP project was initiated to …

Person-Centered Care Education For Caregivers Of Patients With Dementia In Long-Term Care Settings, Dawn Buckmire

Electronic Theses and Dissertations

Person-centered care (PCC) guidelines are being used as a care model to improve health outcomes for residents with impaired cognition. The researcher utilized PCC guidelines to educate caregivers in residential homes to provide care based on the residents’ individualized needs and choices to reduce worsening health conditions and potentially avoidable hospitalizations. The researcher created an educational tool to improve prompt management of health conditions for residents with cognitive impairment and set up a control group (n = 4) and an intervention group (n = 4) to conduct this project. The intervention group received the PCC education guidelines, whereas …

Who Benefits From A Prostate Rectal Spacer? Secondary Analysis Of A Phase Iii Trial, Thomas J. Quinn, Walter Bosch, Et Al.

2020-Current year OA Pubs

PURPOSE: Previously a phase III trial of a hydrogel rectal spacer during prostate radiation therapy found decreased toxicity and a clinically significant improvement in bowel quality of life (QOL) at 3 years by the Expanded Prostate Cancer Index. We performed a secondary analysis to identify men less likely to benefit.

METHODS AND MATERIALS: Clinical and dosimetric data for the 222 patients enrolled on the SpaceOAR phase III trial were analyzed. The volume of rectum treated to 70 Gy (V70) and the quantitative analysis of normal tissue effects in the clinic (QUANTEC) rectal dose goals were used as surrogates for clinical …

Lobbying Expenditures Of The Health Sector During The Covid-19 Pandemic, Adam Olson, John Barrick, William B. Tayler, Shivaram Rajgopal, Ge Bai

Faculty Publications

As of June 30, 2020, Congress had enacted six bills authorizing approximately $3 trillion in COVID-19 pandemic relief, representing the largest relief package in US history. The bills allocate funds to federal agencies, health care providers, COVID-19 testing, Medicaid funding, stimulus checks, unemployment benefits, and small business assistance, among other purposes.1 Prior research has found that health care organizations spend substantial financial resources on influencing legislative outcomes.2,3 In this study, we examine lobbying efforts of the health sector relative to other sectors before and during the COVID-19 pandemic.

Effectiveness Of A 24/7 Dad® Curriculum In Improving Father Involvement: Profiles Of Engagement, Roneé E Wilson, Renice Obure, Precious Omokaro, Hamisu M Salihu, Estrellita Lo Berry, Deborah A Austin, Jennifer G Christner

Faculty, Staff and Students Publications

BACKGROUND OR OBJECTIVES: Father involvement is a key component in maintaining healthy families and communities. This study presents quantitative results of the first five years of a comprehensive fatherhood training program offered by REACHUP, Inc. in Florida, United States.

METHODS: The program utilized the 24/7 Dad ® curriculum for the fatherhood training program. Key program outcome was differences in pre and post-test scores on self-awareness, fathering skills, parenting skills, relationship skills, and self-care. Demographic and pretest-posttest data collected between 2013 and 2017 were analyzed using chi-square test for categorical variables, McNemar's test for differences in proportions pre- and post-intervention, paired …

Acute Lymphoblastic Leukemia Presenting Initially As Spinal Cord Compression: When Chemotherapy Alone Is Enough, Albert Jang, Kallie N Kram, Scott N Berger, Mahmoud R Gaballa, Lee B Lu, David R Dunaway, Courtney N Miller-Chism

Faculty, Staff and Students Publications

Spinal cord compression (SCC) is a rare initial presentation and complication of acute lymphoblastic leukemia (ALL) with nearly all reported cases occurring in the pediatric population. We report a 38-year-old previously healthy man who presented with acute on chronic lower back pain, gait instability, urinary retention, and severe thrombocytopenia. Radiologic examination revealed two soft tissue masses of the thoracic spine associated with compression fractures causing spinal canal narrowing and cord compression. Bone marrow biopsy confirmed the diagnosis of ALL. Immediate initiation of high-dose corticosteroids and systemic chemotherapy resolved the patient's symptoms without radiation therapy or surgical intervention. After two courses …

Burden Of Rare Deleterious Variants In Wnt Signaling Genes Among 511 Myelomeningocele Patients, Luke Hebert, Paul Hillman, Craig Baker, Michael Brown, Allison Ashley-Koch, James E Hixson, Alanna C Morrison, Hope Northrup, Kit Sing Au

Faculty, Staff and Student Publications

Genes in the noncanonical WNT signaling pathway controlling planar cell polarity have been linked to the neural tube defect myelomeningocele. We hypothesized that some genes in the WNT signaling network have a higher mutational burden in myelomeningocele subjects than in reference subjects in gnomAD. Exome sequencing data from 511 myelomeningocele subjects was obtained in-house and data from 29,940 ethnically matched subjects was provided by version 2 of the publicly available Genome Aggregation Database. To compare mutational burden, we collapsed rare deleterious variants across each of 523 human WNT signaling genes in case and reference populations. Ten WNT signaling genes were …

Prevalence And Predictors Of Chronic Pain Intensity And Disability Among Adults With Sickle Cell Disease, Nadine Matthie, Coretta Jenerette, Ashley Gibson, Sudeshna Paul, Melinda Higgins, Lakshmanan Krishnamurti

Faculty, Staff and Student Publications

Among 170 adults with sickle cell disease, we evaluated chronic pain impact and disability prevalence, assessed age and gender differences, and identified psychosocial predictors of chronic pain intensity and disability. Most participants had a high level of disability. Chronic pain intensity and disability were significantly associated with pain catastrophizing and chronic pain self-efficacy, and worsened with age. Further research is needed to confirm study findings and develop interventions, including palliative care approaches that address catastrophizing and disability, particularly for young women and middle-aged adults with sickle cell disease. Moreover, consistent clinical assessment of chronic pain and psychosocial health should be …

Efficiency Of Low-Tech Augmentative And Alternative Communication (Aac) Access Methods, Brittany Davis

Dissertations and Theses @ UNI

Augmentative and alternative communication (AAC) implementation and intervention continues to be a critical component of the speech-language pathology scope of practice (ASHA,2020a). As communication has be come increasingly technological, there is a growing need for individuals using AAC to participate remotely using their preferred method of AAC (DeRuyter et al., 2007). Research on use of low-tech AAC systems in telecommunication and the instruction of low-tech communication AAC methods via telepractice is limited. This paper focuses on participants’ experience with learning a modality of communication, low-tech AAC,over Zoom (Zoom Communications Video Communications Inc.,2020). Using a descriptive-comparative design to evaluate efficiency, three …

Balancing Conscience: A Response To Fernandes & Ecret, Ian D. Wolfe, Maryam Guiahi

Manuscripts, Articles, Book Chapters and Other Papers

There are many lessons that bioethics can learn from the Holocaust. Forefront are the lessons from the Nuremberg trials and the formation of research ethics. An often-overlooked lesson is how the Nazi regime was able to construct a hierarchy in such a way that influenced people to act in horrendous ways. Fernandes & Ecret, writing in Conatus – Journal of Philosophy 4, no. 2 (2019), highlight the influence of hierarchy on the moral silence of nurses and physicians within the Nazi regime. While we greatly enjoyed the paper, and think it is an important contribution, we find several misrepresentations of …

Adenosine At The Interphase Of Hypoxia And Inflammation In Lung Injury, Xiangyun Li, Nathanial K Berg, Tingting Mills, Kaiying Zhang, Holger K Eltzschig, Xiaoyi Yuan

Faculty, Staff and Student Publications

Hypoxia and inflammation often coincide in pathogenic conditions such as acute respiratory distress syndrome (ARDS) and chronic lung diseases, which are significant contributors to morbidity and mortality for the general population. For example, the recent global outbreak of Coronavirus disease 2019 (COVID-19) has placed viral infection-induced ARDS under the spotlight. Moreover, chronic lung disease ranks the third leading cause of death in the United States. Hypoxia signaling plays a diverse role in both acute and chronic lung inflammation, which could partially be explained by the divergent function of downstream target pathways such as adenosine signaling. Particularly, hypoxia signaling activates adenosine …

Anesthesiology Resident Performance On The Us Medical Licensing Examination Predicts Success On The American Board Of Anesthesiology Basic Staged Examination: An Observational Study, Travis H Markham, Johanna B De Haan, Sara Guzman-Reyes, John F Zaki, Semhar J Ghebremichael, Carlos Artime, Evan G Pivalizza

Faculty, Staff and Student Publications

BACKGROUND: Correlation has been found between the US Medical Licensing Examination (USMLE) Step 1 examination results and anesthesiology resident success on American Board of Anesthesiology (ABA) examinations. In 2014, the ABA instituted the BASIC examination at the end of the postgraduate year-2 year. We hypothesized a similar predictive value of USMLE scores on BASIC examination success.

METHODS: After the Committee for the Protection of Human Subjects at UTHealth Institutional Review Board approved and waived written consent, we retrospectively evaluated USMLE Step examination performance on first-time BASIC examination success in a single academic department from 2014-2018.

RESULTS: Over 5 years, 120 …

Stakeholder Alliances Are Essential To Reduce The Scourge Of Plastic Pollution, Patrick H Kee, Melanie R Moody, Shao-Ling Huang, Hyunggun Kim, Xing Yin, Tao Peng, Susan T Laing, Melvin E Klegerman, Mohammad H Rahbar, Deborah Vela, Curtis Genstler, Kevin J Haworth, Christy K Holland, David D Mcpherson

Faculty, Staff and Student Publications

Late in-stent restenosis remains a significant problem. Bare-metal stents were implanted into peripheral arteries in miniature swine, followed by direct intra-arterial infusion of nitric oxide-loaded echogenic liposomes (ELIPs) and anti-intercellular adhesion molecule-1 conjugated ELIPs loaded with pioglitazone exposed to an endovascular catheter with an ultrasonic core. Ultrasound-facilitated delivery of ELIP formulations into stented peripheral arteries attenuated neointimal growth. Local atheroma-targeted, ultrasound-triggered delivery of nitric oxide and pioglitazone, an anti-inflammatory peroxisome proliferator-activated receptor-γ agonist, into stented arteries has the potential to stabilize stent-induced neointimal growth and obviate the need for long-term antiplatelet therapy.

The Fms21 (Pila)-Fms20 Locus Encoding One Of Four Distinct Pili Of Enterococcus Faecium Is Harboured On A Large Transferable Plasmid Associated With Gut Colonization And Virulence, Louis Maximilian Buja, Dwayne A Wolf, Bihong Zhao, Bindu Akkanti, Michelle Mcdonald, Laura Lelenwa, Noah Reilly, Giulia Ottaviani, M Tarek Elghetany, Daniel Ocazionez Trujillo, Gabriel M Aisenberg, Mohammad Madjid, Biswajit Kar

Faculty, Staff and Student Publications

This paper collates the pathological findings from initial published autopsy reports on 23 patients with coronavirus disease 2019 (COVID-19) from 5 centers in the United States of America, including 3 cases from Houston, Texas. Findings confirm that COVID-19 is a systemic disease with major involvement of the lungs and heart. Acute COVID-19 pneumonia has features of a distinctive acute interstitial pneumonia with a diffuse alveolar damage component, coupled with microvascular involvement with intra- and extravascular fibrin deposition and intravascular trapping of neutrophils, and, frequently, with formation of microthombi in arterioles. Major pulmonary thromboemboli with pulmonary infarcts and/or hemorrhage occurred in …

Transcriptional Insights Into Pathogenesis Of Cutaneous Systemic Sclerosis Using Pathway Driven Meta-Analysis Assisted By Machine Learning Methods, Xiao Xu, Meera Ramanujam, Sudha Visvanathan, Shervin Assassi, Zheng Liu, Li Li

Faculty, Staff and Student Publications

Pathophysiology of systemic sclerosis (SSc, Scleroderma), an autoimmune rheumatic disease, comprises of mechanisms that drive vasculopathy, inflammation and fibrosis. Understanding of the disease and associated clinical heterogeneity has advanced considerably in the past decade, highlighting the necessity of more specific targeted therapy. While many of the recent trials in SSc failed to meet the primary end points that predominantly relied on changes in modified Rodnan skin scores (MRSS), sub-group analysis, especially those focused on the basal skin transcriptomic data have provided insights into patient subsets that respond to therapies. These findings suggest that deeper understanding of the molecular changes in …

Developing And Evaluating A Remote Quality Assurance System For Point-Of-Care Ultrasound For An Internal Medicine Residency Global Health Track, Steven Fox, Michelle Fleshner, Collin Flanagan, Thomas Robertson, Ayako Wendy Fujita, Divya Bhamidipati, Abdulrahman Sindi, Raghunandan Purushothaman, Thuy Bui

Faculty, Staff and Student Publications

Background: A quality assurance system is vital when using point-of-care ultrasound (POCUS) to ensure safe and effective ultrasound use. There are many barriers to implementing a quality assurance system including need for costly software, faculty time, and extra work to log images. Methods: With minimal funding or protected faculty time, we successfully developed an effective remote quality assurance system between residents rotating internationally and faculty in the US. Results: 270 total exams were logged using this system (41 per resident over a 7 week period). Over the course of the implementation period, a significant increase was seen in average image …

Recent Advances In The Treatment Of Clostridioides Difficile Infection: The Ever-Changing Guidelines, Shruti Khurana, Alyssa Kahl, Kevin Yu, Andrew W Dupont

Faculty, Staff and Student Publications

No abstract provided.

Large Sinus Of Valsalva Aneurysm Complicated By Thrombus Formation, Milan Ravishankar, Ali Ghergherehchi, Jing Liu, Ernesto Jimenez, Umair Khalid

Faculty, Staff and Students Publications

Sinus of Valsalva aneurysm (SOVA) is an unusual cardiac anomaly that is potentially fatal with rupture. It is often asymptomatic but has various presentations. We describe a case of a 67-year-old male who presented with atypical chest pain. Transthoracic echocardiogram and cardiac computed tomography scan confirmed a large SOVA complicated by thrombus formation and compression of the left atrium and left ventricular outflow tract. The patient successfully underwent a Bentall procedure-surgical aortic aneurysm repair with mechanical aortic valve conduit. We discuss several clinical decision-making branch points to highlight the complexity of managing this condition. Even in asymptomatic or minimally symptomatic …

Hypogonadism, Type-2 Diabetes Mellitus, And Bone Health: A Narrative Review, Vittoria Russo, Rui Chen, Reina Armamento-Villareal

Faculty, Staff and Students Publications

One of the complications from chronic hyperglycemia and insulin resistance due to type 2 diabetes mellitus (T2DM) on the hypothalamic-pituitary-gonadal axis in men is the high prevalence of hypogonadotropic hypogonadism (HH). Both T2DM and hypogonadism are associated with impaired bone health and increased fracture risk but whether the combination results in even worse bone disease than either one alone is not well-studied. It is possible that having both conditions predisposes men to an even greater risk for fracture than either one alone. Given the common occurrence of HH or hypogonadism in general in T2DM, a significant number of men could …

Gait Entrainment In Coupled Oscillator Systems: Clarifying The Role Of Energy Optimization In Human Walking, Ryan T. Schroeder

Theses: Doctorates and Masters

Empirical evidence suggests that parameters of human gait (e.g. step frequency, step length) tend to minimize energy expenditure. However, it is unclear if individuals can adapt to dynamic environments in real time, i.e. continuously optimize energy expenditure, and to what extent. Two coupled oscillator systems were used to test the learned interactions of individuals within dynamic environments: (1) experienced farmworkers carrying oscillating loads on a flexible bamboo pole and (2) individuals walking on a treadmill while strapped to a mechatronics oscillator system providing periodic forces to the body. Reductionist trajectory optimization models predicted energy-minimizing gait interactions within the coupled oscillator …

Development, Assessment And Application Of A Novel Algorithm To Automatically Detect Change Of Direction Movement And Quantify Its Associated Mechanical Load In Elite Australian Football, Aaron Balloch

Theses: Doctorates and Masters

The ability to change direction rapidly and efficiently is critical to team-sport performance, including Australian football (AF), where a player’s capacity to rapidly decelerate, move laterally and re-accelerate is critical when evading opponents, tackling, or reacting to the unpredictable bounce of the ball or movement of another player. The biomechanical loading requirements of change of direction (COD) movement are angle and velocity dependant. Cumulative COD movement can impart high levels of neuromuscular and metabolic fatigue which can adversely affect the efficiency of subsequent movement efforts. Despite widespread use of microtechnology devices (the vast majority containing a global navigation satellite system …

Determining Ground-Level Composition And Concentration Of Particulate Matter Across Regional Areas Using The Himawari-8 Satellite, Miles Sowden

Theses: Doctorates and Masters

Speciated ground-level aerosol concentrations are required to understand and mitigate health impacts from dust storms, wildfires and other aerosol emissions. Globally, surface monitoring is limited due to cost and infrastructure demands. While remote sensing can help estimate respirable (i.e. ground level) concentrations, current observations are restricted by inadequate spatiotemporal resolution, uncertainty in aerosol type, particle size, and vertical profile. One key issue with current remote sensing datasets is that they are derived from reflectances observed by polar orbiting imagers, which means that aerosol is only derived during the daytime, and only once or twice per day.

Sub-hourly, infrared (IR), geostationary …

The Effects Of Environmental Temperature On High-Intensity Interval Training, Jason R. Boynton

Theses: Doctorates and Masters

Endurance athletes typically spend the large majority of training (> 70%) at low intensities (i.e. below lactate threshold) coupled with short and intermittent bouts of high-intensity exercise or interval training (HIIT). Despite HIIT being a relatively small part of training in terms of duration, it has a substantial effect on the adaptations to endurance training. While it is well-established endurance exercise performance is affected in both hot and cold environmental conditions, the effect ambient temperature (TA; frequently referred to as environmental temperature) has on HIIT as performed by an endurance athlete population is not well understood. Therefore, the overall purpose …

Injury Surveillance In Community Cricket And The Exploration Of Insurance Claims Systems, Geordie Mcleod

Theses: Doctorates and Masters

The aims of this industry funded PhD thesis were 1) To understand the injury causes, trends and burden in community cricket and 2) To examine the Cricket Australia National Club Risk Protection Program (NCRPP) insurance scheme for suitability as an injury surveillance tool for community cricket.

This thesis sought to identify and understand the injury profile of community cricketers through existing literature and injury datasets, being, Victorian Injury Surveillance Unit (VISU) hospital data, Accident Compensation Corporation (ACC) and NCRPP insurance claims data. This thesis also undertook a novel assessment of data validity and completeness from various sources, against industry standards …

Exercise And Nutrition Induced Weight Loss For Prostate Cancer Patients, Rebekah Louise Wilson

Theses: Doctorates and Masters

This thesis encompasses six main chapters - two reviews and four experimental chapters, in addition to a general introduction and discussion.

Review 1 (Chapter 2) is a discussion of the negative impact of obesity on prostate cancer prognosis and common prostate cancer treatments.

Review 2 (Chapter 3) is an evaluation of the current literature examining prostate cancer patients receiving androgen deprivation therapy (ADT) and how exercise and nutrition interventions can be used to induce fat loss, while preserving or improving lean mass.

Study 1 (Chapter 4) is an examination of the efficacy of a weight loss program in altering body …

A Whole-School Approach To Promoting Staff Wellbeing, Leanne Lester, Carmel Cefai, Valeria Cavioni, Amy Barnes, Donna Cross Professor

Australian Journal of Teacher Education

A caring school community can enhance whole-school wellbeing including the wellbeing of school staff, which directly impacts on student academic, social and emotional wellbeing. This study firstly examines the validity and reliability of a proposed whole-school staff wellbeing evaluation tool which uses a set of whole-school wellbeing indicators to identify strengths and areas for improvement within the school environment which may be impacting on staff wellbeing. Secondly, the association between factors found within the whole-school staff wellbeing tool with staff self-reported mental health are examined, and finally, the influence of person characteristics and role of factors on perceived whole-school staff …

Influence Of Work Values On Rural-Practice Intentions Among American Students Attending A Rural University, Nicholas Best

Murray State Theses and Dissertations

Rural areas in the United States frequently face difficulties regarding the prevalence of healthcare-related professionals. To better address this issue, it is important to understand how various demographic factors as well as individual work values influence the workplace setting decisions of future "helping" professionals. Previous research has studied the impact of various work values and how they relate to working with underserved populations (Aviram & Katan, 1991; Krous & Nauta, 2005). The current study aimed to compare various demographic factors and work value's ability to predict intentions to work in rural areas among students attending Murray State University (N …

Cannabidiol In The Horse: Pharmacokinetics And Effects Of A Pelleted Supplement On Reactivity And Movement, Anna L. Draeger

Murray State Theses and Dissertations

A multitude of claims exist regarding therapeutic benefits of cannabidiol (CBD) in human and animal medicine. Though supportive evidence of CBD as a nutraceutical option exists, lack of regulation means that product safety, consistency, and efficacy cannot be guaranteed. Trials for specific conditions and species are needed. The objective of this study was to evaluate CBD safety and use effects on reactivity and movement in the horse. Project 1 examined the bioavailability of a single 50 mg dose of an oil and pelleted CBD product. One of 2 Quarter Horse geldings received the oil product. The second received the pelleted …

Placas Pleurales Por Inhalación De Fibras De Asbesto. Reporte De Dos Casos Y Revisión De Literatura, Diemen Delgado-García, Alfonso Mercado, María De Lourdes Preciado-Serrano, Gabriel Davalos-Picazo, Ashley Delgado

Psychological Science Faculty Publications

Introducción: Las placas pleurales por fibras de asbesto se caracterizan por lesiones compuestas por tejido fibroso que se ubican en la pleura parietal. Suelen aparecer hasta en un 3% a 58% de los trabajadores que estuvieron expuestos a fibras de asbesto, y en un 0,5% a 8% en población general. El objetivo de este artículo es presentar dos casos clínicos de pacientes a los que se les detectó en la radiografía de tórax alteraciones pleurales posiblemente asociadas a la exposición a fibras de asbesto.

Casos clínicos: Caso 1. Paciente de sexo masculino de 49 años, trabajador de la construcción con …