Medicine and Health Sciences Commons^™

Ultrasound Simulation For Regional Anesthesia, Kayla Brown, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Regional anesthesia is an essential skill in the practice of Nurse Anesthesia, and future employment demands expertise. Literature supports the addition of simulation training to existing didactic and apprenticeship education to improve clinical expertise. The purpose of this project was to trial simulation training, focused on anatomical visualization with ultrasound for regional anesthesia, as a means to improve student performance and confidence.

Methods • Facility project approval and exemption determination by IRB. • Hands-On Test: Ultrasound to obtain visualization for axillary (cohort 1), interscalene (cohort 2) block on live-model. Expert CRNA observed performance to determine if image was clinically …

Intraoperative Opioid Administration Among Cancer Patients, Amanda Barrett, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cancer prevalence continues to rise. In vitro and in vivo studies have demonstrated that opioid receptor agonists may be associated with poor outcomes for cancer patients. Laboratory studies have shown that opioids cause immunosuppression; tumor cell progression, recurrence and metastasis. The surgical environment further decreases immune function, causes an inflammatory response and promotes cancer cell mobilization. Anesthesia providers are in a unique position to influence postoperative outcomes. Opioid free anesthetic delivery is a growing trend amongst anesthesia providers and is supported by the literature. The purpose of this project is to compare intraoperative opioid administration rates for patients with …

Effectiveness Of Educational Intervention On Diabetic Knowledge & Hba1c Levels On Kenyan Adults With T2dm, Sabina Jeruto Bett

Doctor of Nursing Practice Projects

Background

Type II diabetes mellitus (T2DM) is a common chronic metabolic disease affecting millions of people globally, which causes many long-term complications such as high blood pressure, chronic kidney disease, improper wound healing and loss of sight. Literature supports that most people, in general and diabetic patients specifically, in Africa, including Kenya are currently not taught about the importance of proper management of their disease. Therefore, many have difficulty following treatment plans, resulting in improper eating, poor glucose control, and diabetic complications. The limited knowledge concerning T2DM contributes to the negative impact this serious disease has on those who live …

To Extubate Or Not To Extubate: Risk Factors For Extubation Failure And Deterioration With Further Mechanical Ventilation, Jingui Xie, Guang Cheng, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Background: Extubation is a critical step in the intensive care unit (ICU). In this study, we aim to investigate the risk factors for both extubation failure and deterioration with further mechanical ventilation (MV). Methods: Data were collected from a cardiothoracic ICU in a tertiary hospital. The risk factors for extubation failure and deterioration with further MV were investigated by multivariate logistic regression. Results: A total of 676 patients were enrolled in the study. Patients with extubation failure had a longer ICU length of stay and a higher mortality rate than patients without extubation failure. An age greater than 65 years, …

Preoccupation With Failure And Adherence To Shared Baselines: Measuring High-Reliability Organizational Culture, Jason M Etchegaray, Eric J Thomas, Jochen Profit

Faculty, Staff and Student Publications

OBJECTIVE: To create, administer, and psychometrically examine a survey to measure two new organizational culture factors - preoccupation with failure and adherence to shared baselines - in healthcare settings.

METHOD: Direct care providers (n = 4484) from a large healthcare system in the Southern United States completed a survey as part of their annual safety culture assessment.

RESULTS: We provide evidence about the internal consistency (Cronbach's alpha ranged from .80 to .89) factor structure, concurrent validity (correlation with overall patient safety grade ranged from .60 to .67, p

CONCLUSIONS: We established evidence for internal consistency and validity of two new …

The Society Of Abdominal Radiology At 10 Years: Reflections, Status Report, And Look To The Future, Manju Ambelil, David M Saulino, Atilla Ertan, Andrew W Dupont, Mamoun Younes

Faculty, Staff and Student Publications

CONTEXT.—: Recent studies examining immunohistochemical staining of colorectal biopsies for cytomegalovirus (CMV) reported that some cases showed only occasional small positive nuclei that were called equivocal for CMV.

OBJECTIVES.—: To determine the extent and clinical significance of equivocal CMV staining in colorectal biopsies.

DESIGN.—: Two-hundred twenty-one consecutive cases of colon and rectal biopsies that were stained for CMV by immunohistochemistry were retrieved from our files and reviewed. Staining results were recorded as negative, unequivocal, or equivocal. Results were correlated with clinicopathologic data, results of polymerase chain reaction studies for CMV, and treatment history.

RESULTS.—: Fifty-two cases (24% of all tested, …

Antimicrobial Sensitivity Pattern, Demographic Findings And Risk Factors Amongst Meningitis And Non-Meningitis Invasive Streptococcus Pneumoniae At Aga Khan University Hospital Clinical Laboratory, Karachi, Pakistan, Seema Irfan, Joveria Farooqi, Afia Zafar, Haresh Kumar

Department of Pathology and Laboratory Medicine

Objective: To determine the resistance rate of penicillin and ceftriaxone amongst invasive meningitis and nonmeningitis isolates of streptococcus pneumoniae. Methods: The prospective cross-sectional study was conducted from January 2011 to March 2014 at the Clinical Microbiology Laboratory of Aga Khan University, Karachi, and comprised all invasive strains of streptococcus pneumoniae. Penicillin and ceftriaxone susceptibilities were performed and interpreted based on minimum inhibitory concentration breakpoints recommended by Clinical and Laboratory Standards Institute guidelines. Data was analysed using Stata 12.
Result: There were 163 strains isolated from sterile body fluids of 109 patients. Of the total, 46(28%) samples were meningitic while 117(72%) …

Spectrum Of Neurological Disorders In Neurology Outpatients Clinics In Urban And Rural Sindh, Pakistan: A Cross Sectional Study, Safia Awan, Alam Ibrahim Siddiqi, Ahmed Asif, Naveeduddin Ahmed, Hazim Brohi, Sajad Jalban, Mohammad Wasay

Section of Neurology

Background: Neurological disorders are the most common cause of morbidity and mortality in developing countries. Available evidence on urban–rural differences on neurological diseases is scare in such countries. Our study objective was to determine the prevalence of neurological diseases in urban and rural tertiary care hospitals of Sindh, Pakistan.

Methods: This was a cross sectional study conducted in selected urban and rural region of tertiary care hospitals of Sindh, Pakistan. The outpatients medical records of adults (18 years and above) was obtained from January 1st, 2014 to December 31st, 2014.

Results: A total of 10,786 outpatients visit were recorded in …

Patient-Centered Design Grounded In User And Clinical Realities Towards Valid Digital Health, Victor P. Cornet, Carly Daley, Davide Bolchini, Tammy Toscos Phd, Michael Mirro Md, Richard J. Holden

Health Services and Informatics Research

Valid design of patient-centered digital health or health information technology (IT) systems is based on a thorough and accurate understanding of both “user reality” and “clinical reality.” Type 1 Design Error (User-Reality Error) occurs when designers do not accommodate user characteristics, tasks, context of use, needs, or preferences. Type 2 Design Error (Clinical-Reality Error) occurs when designers do not accommodate the clinical reality, including biomedical knowledge, clinical workflows, and organizational requirements. Both types of errors can invalidate the design, leading to products being rejected by patient end-users or their healthcare delivery systems, product non-use or inappropriate use, and risk of …

Visualization Of Cardiac Implantable Electronic Device Data For Older Adults Using Participatory Design., Ryan Ahmed, Tammy Toscos Phd, Romisa Rohani Ghahari, Richard J Holden, Elizabeth Martin, Shauna Wagner, Carly Daley, Amanda Coupe, Michael Mirro Md

Health Services and Informatics Research

Patients with heart failure (HF) are commonly implanted with cardiac resynchronization therapy (CRT) devices as part of their treatment. Presently, they cannot directly access the remote monitoring (RM) data generated from these devices, representing a missed opportunity for increased knowledge and engagement in care. However, electronic health data sharing can create information overload issues for both clinicians and patients, and some older patients may not be comfortable using the technology (i.e., computers and smartphones) necessary to access this data. To mitigate these problems, patients can be directly involved in the creation of data visualization tailored to their preferences and needs, …

Selection Biases In Technology-Based Intervention Research: Patients' Technology Use Relates To Both Demographic And Health-Related Inequities., Tammy Toscos Phd, Michelle Drouin, Jessica Pater, Mindy Flanagan, Rachel Pfafman, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

OBJECTIVE: Researchers conduct studies with selection biases, which may limit generalizability and outcomes of intervention research. In this methodological reflection, we examined demographic and health characteristics of implantable cardioverter defibrillator patients who were excluded from an informatics intervention due to lack of access to a computer and/or the internet.

MATERIALS AND METHODS: Using information gathered from surveys and electronic health records, we compared the intervention group to excluded patients on demographic factors, computer skills, patient activation, and medical history.

RESULTS: Excluded patients were older, less educated, less engaged and activated in their health, and had worse health (ie, more medical …

Health Coaching To Encourage Obese Adults To Enroll In Commercially-Available Weight Management Programs: The Path To Health Study, Natalia I Heredia, Minjae Lee, Kevin O Hwang, Belinda M Reininger, Maria E Fernandez, Lorna H Mcneill

Faculty, Staff and Student Publications

Physicians are recommended to screen and refer obese patients to weight management programs (WMPs). There are often limited referral options for physicians, though commercially-available WMPs could be a potential solution. The purpose of this study (Path to Health) was to evaluate the efficacy of health coaching to promote enrollment in commercially-available WMPs through a two-arm, RCT with obese patients (n = 168) randomly assigned to intervention (n = 84) or control groups (n = 84). Intervention participants received phone health coaching to help them select and enroll in WMPs. We collected data on program enrollment, weight, self-reported physical activity (PA), …

Tattoo Narratives And Counseling, Danny Lane Mccarty

Graduate Theses and Dissertations

Much research has been done on tattoos and on those who acquire them, but most of the research has focused on negative correlations that might exist with people who have tattoos. This current research, however, showed that people’s tattoo narratives can relate to how they view self, others, and the world, and to how they approach life. A narrative approach to qualitative research was used, and ten people participated in the study. Participants’ views of self, others, and the world were discussed as these views emerged from the narratives. Their possible approaches to life were also addressed. Themes that emerged …

Preliminary Outcomes, Acceptability, And Feasibility Of A Brief Crisis Response Planning Intervention For Reducing Suicide Risk In Primary Care Behavioral Health Patients, Aubrey R. Dueweke

Graduate Theses and Dissertations

Primary care is an important setting for improving identification and treatment of people at risk for suicide. However, there are few developed protocols for management of suicide risk in this setting. This study aimed to evaluate the preliminary outcomes, acceptability, and feasibility of a brief crisis response planning intervention for patients at a moderate risk for suicide in a primary care behavioral health (PCBH) setting. The outcomes examined included change in suicidal cognitions, suicidal intent, hope, and coping efficacy. Twenty-two adult primary care patients at moderate risk for suicide participated in this study, which involved filling out self-report measures before …

How Does Alcohol Intoxication Impair Risk Detection Of Sexual Assault? Testing An Integration Of Alcohol Myopia And Social Information Processing Theories, Alexander James Melkonian

Graduate Theses and Dissertations

Sexual assault among young adults is a highly prevalent public health concern. Alcohol is often implicated as a risk factor for sexual assault through its impairing effects on an individual’s ability to process and respond to social cues in the environment. The effect of alcohol myopia can result in greater focus of attention on salient environmental cues. The relationship between alcohol intoxication and resulting behavior may depend on what type of information is most salient. The current study examined the effects of alcohol on social information processing as it relates to sexual assault risk detection. Method: Participants were 48 young …

Prediction And Evaluation Of Breast Myopathy, Barbara De Almeida Mallmann

Graduate Theses and Dissertations

Broiler breast myopathies, including woody breast, white striping, and spaghetti breast, negatively impact the industry. Therefore, evaluation, prediction, and frequency of these muscle abnormalities on modern birds are important for decision making. Modern broilers are not highly active and often sit with the breast of the bird resting on the floor. Therefore, the first experiment was to promote bird movement and explore the impact on the breast myopathies. The movement was stimulated by human interaction (walking through pen) and higher light intensity so that birds walked around the pen more often throughout the day. The control group had normal low …

Dynamics Of Momentary Perceived Self-Regulation Abilities As Novel Predictors Of Overeating In Daily Life, Kayla Dawn Skinner

Graduate Theses and Dissertations

Despite an increase of research in the realm of overeating - a well-known contributor to obesity - the psychological mechanisms that maintain overeating behaviors across time and context are still poorly understood. It may be that people’s perceptions of their self-regulation abilities fluctuate over time, and overeating results from momentary increases in negative mood eliciting negative perceptions of their self-efficacy and current willpower, stronger beliefs that cravings can be controlled and a greater ability to tolerate distress. The current study examined the dynamics of and momentary predictors of overeating using a 7-day EMA protocol to study unsuccessful restrained eaters (n …

Implicit Bias And The Boundaries Of Belief: A Single-Representational Dual-Attitude Account Of Implicit Attitudes, Austin Dakota Synoground

Graduate Theses and Dissertations

Since their inception, implicit attitudes have been defined as associative mental states, separate from beliefs, which are considered to be propositional in nature. Recently, several philosophers have challenged this distinction, arguing that implicit attitudes are actually unconscious beliefs. In turn, I argue that the attitudes detected by current experimental paradigms are blind to distinctions between implicit attitudes, which I define as the products of an associative learning mechanism, and unconscious beliefs, which are the products of a propositional learning mechanism. Specifically, I argue for a single-representational dual-attitude account of implicit bias.

Influence Of Heating And Biological Sex On Vascular Dysfunction Associated With Long-Duration Sitting And Standing, Aaron Richard Caldwell

Graduate Theses and Dissertations

Purpose: The purpose of these studies was to determine if arterial angulations (through sitting or standing), shear stress (through local heating), or a combination of these factors affected vascular function. Moreover, this studied estimated the magnitude of the effect that biological sex has on these vascular responses. Methods: Twenty-six healthy, young (18-40 years old) males (n=13) and females (n=13) completed two experimental trials (2-h sitting and 2-h standing). In a randomized fashion, one leg was passively heated in order to increase shear rate. Following a 48-h washout, participants returned to the laboratory to complete the other trial. Flow-mediated dilation (FMD) …

Por Ahí Dicen: Sexual Health Promotion Campaign In A Puerto Rican Community, Isabella M. Antenucci, Yessica Guzman, Phillip Granberry, Maria Idali Torres

Gastón Institute Publications

The purpose of this study was to assess Puerto Rican mother’s levels of exposure to the Spanish media campaign launched by Por Ahi Dicen, and to assess the identification mothers had with these stories. The methodology consisted of in-person survey interviews of 210 Puerto Rican mothers residing in the city of Springfield, Massachusetts. The study used a sub-set of data taken from these interviews and analyzed using Microsoft Excel and Stata15. The major finding of this study showed that the mothers who regularly watched television in the 90-day campaign time frame were more exposed to the campaign than they were …

Individual Eeg Asymmetry As A Predictor Of Hydration Status During Exercise In The Heat, Ayano Katayama

Electronic Theses and Dissertations

Hydration behavior varies among individuals; continuous and correct fluid consumption behavior prevents decreased physical performance and severe dehydration, especially during extended exercise and hot environments. Therefore, the purpose of the present study was to examine individual frontal alpha electroencephalographic asymmetry index (FAI) score in eu-hydrated, hypo-hydrated, and exercise in well-trained men and assess if there is a correlation between FAI score and individual ad libitum fluid consumption behavior. Subjects were kinesiology major college students ranging from 21 to 29 years of age. Subjects were categorized either approach group (n = 8) with resting FAI score more than 0 or avoidance …

The Good, The Bad, And The Ugly Behavior, Michal Lavi

Cardozo Law Review

Shaming is usually referred to as the publication of perceived anti-social or illegal behavior of an individual in order to condemn or humiliate him. It has some virtues: it makes it harder for people to get away with wrongful behavior, and it promotes justice. It also promotes freedom of expression and enables efficient deterrence. By spreading information on the behavior of individuals, shaming encourages one to maintain his reputation and facilitates beneficial transactions. Finally, it helps the public to avoid inefficient services.

Yet shaming raises many problems. Anyone can shame another based on individual, as opposed to universal, values, thus …

Newly Defined Atp-Binding Cassette Subfamily B Member 5 Positive Dermal Mesenchymal Stem Cells Promote Healing Of Chronic Iron-Overload Wounds Via Secretion Of Interleukin-1 Receptor Antagonist, Seppe Vander Beken, Juliane C. De Vries, Barbara Meier-Schiesser, Patrick Meyer, Dongsheng Jiang, Anca Sindrilaru, Filipa F. Ferreira, Adelheid Hainzl, Susanne Schatz, Jana Muschhammer, Natalie J. Scheurmann, Panagiotis Kampilafkos, Andreas M. Seitz, Lutz Dürselen, Anita Ignatius, Mark A. Kluth, Christoph Ganss, Meinhard Wlaschek, Karmveer Singh, Pallab Maity, Natasha Y. Frank, Markus H. Frank, Karin Scharffetter-Kochanek

Research outputs 2014 to 2021

In this study, we report the beneficial effects of a newly identified dermal cell subpopulation expressing the ATP‐binding cassette subfamily B member 5 (ABCB5) for the therapy of nonhealing wounds. Local administration of dermal ABCB5⁺‐derived mesenchymal stem cells (MSCs) attenuated macrophage‐dominated inflammation and thereby accelerated healing of full‐thickness excisional wounds in the iron‐overload mouse model mimicking the nonhealing state of human venous leg ulcers. The observed beneficial effects were due to interleukin‐1 receptor antagonist (IL‐1RA) secreted by ABCB5⁺‐derived MSCs, which dampened inflammation and shifted the prevalence of unrestrained proinflammatory M1 macrophages toward repair promoting anti‐inflammatory M2 …

Millennial Midwifery: Online Connectivity In Midwifery Education, Sadie Geraghty, Angela Bromley, Angela Bull, Mpho Dube, Cindy Turner

Research outputs 2014 to 2021

Aim: The aim of this study was to explore graduate midwives’ experiences of completing a Bachelor of Midwifery online theory course and how that experience led to preparation for practice and future employment as a midwife. Methods: This study used a questionnaire, with the core research design having a quantitative component using open-ended questions, via the use of an electronic platform. Results: The main themes emerging from the data that the graduates considered important issues were flexibility, isolation and lack of support. Conclusion: Course completion, experience of online learning/preparation for practice, and recommendations for improvement were identified as areas of …

Minimally Invasive Technique Of Placing A Dual Chamber Permanent Pacemaker In Children, Muneer Amanullah, Somia Razaq, Asif Hasan Siddiqui, Fazal Wahab Khan

Section of Paediatric Surgery

Objective: To share the experience of a minimally invasive technique in the implantation of a dual chamber permanent pacemaker in paediatric population.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients aged up to1 6 years who underwent epicardial dual chamber permanent pacemaker insertion via xiphisternal incision between April 2011 and August 2016. Demographic data included age, weight and gender of the patient. Indications for pacemaker insertion, electrocardiography findings, concomitant cardiac procedures and procedural complications were reviewed. Pacemaker thresholds and impedance at the time of implantation and throughout the course of follow-up …

Periodontal Pathogens Are A Risk Factor Of Oral Cavity Squamous Cell Carcinoma, Independent Of Tobacco And Alcohol And Human Papillomavirus, Ian Ganly, Liying Yang, Rachel Giese, Yuhan Hao, Carlos W. Nossa, Luc G. T. Morris, Matthew Rosenthal, Jocelyn Migliacci, Dervla Kelly, Wenzhi Tseng

School of Medicine Publications

Over the past decade, there has been a change in the epidemiology of oral cavity squamous cell cancer (OC-SCC). Many new cases of OC-SCC lack the recognized risk factors of smoking, alcohol and human papilloma virus. The aim of this study was to determine if the oral microbiome may be associated with OC-SCC in nonsmoking HPV negative patients. We compared the oral microbiome of HPV-negative nonsmoker OC-SCC(n = 18), premalignant lesions(PML) (n = 8) and normal control patients (n = 12). Their oral microbiome was sampled by oral wash and defined by 16S rRNA gene sequencing. We report that the …

Plasmid Mediated Colistin Resistance In Enterobacteriaceae Isolated From Feces Of Broiler Chicken In The United Arab Emirates, Sara Abdelkafi Mahmoud Ali

Theses

Although human infections with colistin-resistant Mcr-producing Enterobacteriaceae have been reported from the Arabian Peninsula, the presence of mcr gene in strains of animal origin has not been studied.

Ten composite faecal samples were collected in each of four geographically distant poultry farms in Abu Dhabi Emirate. Ten colonies from McConkey agar containing 1 mg/L colistin from each sample were PCR-screened for mcr-1, mcr-2, MCR-3, mcr-4, mcr-5. Of the positive ones, one isolate representing each distinct plasmid profile was selected for susceptibility testing and for whole-genome sequencing (WGS). Transfer of the MCR-1 gene into Escherichia coli …

Data-Driven Surgical Duration Prediction Model For Surgery Scheduling: A Case-Study For A Practice-Feasible Model In A Public Hospital, Kar Way Tan, Francis Ngoc Hoang Long Nguyen, Boon Yew Ang, Jerald Gan, Sean Shao Wei Lam

Research Collection School Of Computing and Information Systems

Hospitals have been trying to improve the utilization of operating rooms as it affects patient satisfaction, surgery throughput, revenues and costs. Surgical prediction model which uses post-surgery data often requires high-dimensional data and contains key predictors such as surgical team factors which may not be available during the surgical listing process. Our study considers a two-step data-mining model which provides a practical, feasible and parsimonious surgical duration prediction. Our model first leverages on domain knowledge to provide estimate of the first surgeon rank (a key predicting attribute) which is unavailable during the listing process, then uses this predicted attribute and …

An Analysis Of The Evolving Intellectual Structure Of Health Information Systems Research In The Information Systems Discipline, Langtao Chen, Aaron Baird, Detmar W. Straub

Business and Information Technology Faculty Research & Creative Works

The rapid evolution of health information systems (Health IS) research has led to many significant contributions. However, while the Health IS subset of information systems (IS) scholarship has considerably grown over the past two decades, this growth has led to questions regarding the current intellectual structure of this area of inquiry. In an effort to more fully understand how Health IS research has contributed to the IS discipline, and what this may mean for future Health IS research in the IS domain, we conduct an in-depth evaluation of Health IS research published in mainstream IS journals. We apply citation analysis, …

The Influence Of Chronic Branched-Chain Amino Acid Supplementation On Measures Of Central And Peripheral Fatigue In Training Athletes, Tara K. Whiton

Electronic Theses and Dissertations

Branched-chain amino acid (BCAA) supplementation may improve recovery from competitive endurance training by reducing symptoms of central and peripheral fatigue. The purpose of this dissertation was to provide evidence for the use of BCAAs as a training nutrition strategy in order to improve recovery from training and further drive adaptive processes to training by increasing readiness to train. Collegiate distance runners undergoing intense competitive endurance training were monitored for symptoms of muscular soreness and psychological stress through a rated soreness chart and the Daily Analysis of Life Demands for Athletes Survey (DALDA) while taking either a BCAA supplement or a …