Medicine and Health Sciences Commons^™

Global Health Governance And Its Role In Health Equity: The Case Of Covid-19, Wafa Abu El Kheir-Mataria

Theses and Dissertations

In the globalized world, we are living in, health became the joint responsibility of individuals, their governments, and the global health governance system. Moreover, based on the right to health, health equity is increasingly in demand, and adopting it to a global level has become an even more complex task to realize. This thesis is focuses on health equity at a global level. The main research questions addressed are: Is health equity present at an intercountry /global level? how is it related to Global Health Governance (GHG)? Is GHG performing well in achieving health equity? what are the reasons behind …

Let Kids Sleep: The Role Of Interdisciplinary Neuroscience Outreach In Stimulating Brains And Developing Research-Informed Approaches To Community Concerns, Marc Chenard

University Honors Theses

Northwest Noggin (NW Noggin), an all-volunteer neuroscience education outreach non-profit, serves its community by bringing students, artists, scientists and other participants together for artistic collaboration and learning. The outreach takes place in K-12 schools and other institutions (such as museums, coffee shops and correctional facilities) all over the Pacific Northwest. Neuroscience education outreach generates discourse surrounding community concerns through illuminating the brain-centric qualities of issues and by drawing on neuroscience research to create solutions. The neuroscience research-informed perspectives on these concerns stimulate awareness, create momentum towards evidence-based reform, and can result in policy interventions. This thesis details how NW Noggin …

The Association Of Patient-Provider Language Concordance With Healthcare Comprehension Among Latino/As In Oregon, Grace Parra

University Honors Theses

Background: The purpose of this study is to describe the need and preferences among Mexican-origin Latinos in Oregon for language-concordant healthcare providers. We hypothesize that the presence of a language concordant provider is associated with greater health care comprehension.

Methods: This is a cross sectional study in collaboration with the General Consulate of Mexico. We developed a 20-item survey that includes questions about socio-demographics, a validated language-based acculturation scale, and questions regarding language concordant care experience and preferences used in previous studies. We are recruiting at the Mexican Consulate 500 Latino/as ages 18 or older who had a healthcare visit …

The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson

University Honors Theses

Period poverty is an issue that impacts menstruators globally. This creates a significant health disparity for menstruators, including difficulties accessing menstrual products, inadequate menstrual and puberty health education, and shame and stigma that come from societal misunderstandings and misinformation regarding menstruation. This paper examines the effects of period poverty on low-income adolescents in the United States. It looks at the current literature that addresses how the financial and accessibility barriers that cause period poverty, as well as how these causes impact school-aged menstruators. It aims to address the role that schools play in creating safe environments for menstruators, including staff …

Comparative Analyses Of The Clinicopathologic Features Of Short-Term And Long-Term Survivors Of Patients With Pancreatic Ductal Adenocarcinoma Who Received Neoadjuvant Therapy And Pancreatoduodenectomy, Tom Z Liang, Matthew H G Katz, Laura R Prakash, Deyali Chatterjee, Hua Wang, Michael Kim, Ching-Wei D Tzeng, Naruhiko Ikoma, Robert A Wolff, Dan Zhao, Eugene J Koay, Anirban Maitra, Suprateek Kundu, Huamin Wang

Faculty, Staff and Student Publications

Neoadjuvant therapy (NAT) is increasingly used to treat patients with pancreatic ductal adenocarcinoma (PDAC). Patients with PDAC often show heterogenous responses to NAT with variable clinical outcomes, and the clinicopathologic parameters associated with these variable outcomes remain unclear. In this study, we systematically examined the clinicopathologic characteristics of 60 short-term survivors (overall survival < 15 months) and 149 long-term survivors (overall survival > 60 months) and compared them to 352 intermediate-term survivors (overall survival: 15-60 months) of PDAC who received NAT and pancreatoduodenectomy. We found that the short-term survivor group was associated with male gender (p = 0.03), tumor resectability prior to NAT (p = 0.04), poorly differentiated …

Differences In Actn3, Ace, And Adbr3 Polymorphisms Between Croatian National Team And Non-National Team Elite Soccer Players, Lana Ružić, Ivan Radman, Branka R. Matković

Baltic Journal of Health and Physical Activity

Introduction: This study investigated the differences in ACTN3, ACE and ADRB3 variants in top-level soccer players who entered the Croatian National Team and the ones who did not but played for two best Croatian teams. Material and Methods: The buccal swabs were collected from 56 soccer players playing for the Croatian National Team (N = 31) and/or for one of the two most prestigious Croatian soccer clubs (N = 25). Each participant’s genotype was determined by analyzing the single-nucleotide polymorphism. The ACTN3 gene (rs1815739) on chromosome 11 and the ACE (rs1799752) gene on chromosome 17 were determined. Results: No significant …

Positioning And Feeding Techniques Effective In Improving Sensorimotor Functions In Infants With Cleft Palate, Skylar Russell Mot/S, Kaitlin Steel Mot/S, Robin Edwards Mot/S, Bri Morgan Mot/S, Danielle Boscaccy Mot/S, Haleigh Black Mot/S, Sydney Young Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Orofacial clefts are the second most common type of birth defect in the United States and are continuing to grow each year (Nasreddine et al., 2021). Based on the National Birth Defects Prevention Network annual report in 2014, 1 in 1,700 babies were born in the United States with a cleft palate (Mai CT et al., 2019). While there are different types of orofacial clefts, for this research the term cleft palate will be used to determine appropriate interventions within the scope of occupational therapy, such as positioning, bottle modifications, and sensorimotor techniques. The impact of this birth defect can …

Occupational Therapy Strategies For Postural Orthostatic Tachycardia Syndrome, Rachel Geissler, Marjorie Jamerson, Hunter Tockey, Mackenzie Dew, Emily Bennett, Summer Weldon, Laura Mendez

Master of Occupational Therapy Student Critically Appraised Topics

Effectiveness of occupational therapy strategies with adults with postural orthostatic tachycardia syndrome.

Association Between Symptoms Of Severe Periodontitis And Post-Bronchodilator Lung Function: Results From The China Pulmonary Health Study., Zhiqiang Liu, Xuan Zhou, Lirong Liang, Xiaozhe Han, Ting Yang, Kewu Huang, Yingxiang Lin, Zuomin Wang, Chen Wang

HPD Articles

BACKGROUND: The association between periodontitis and post-bronchodilator lung function is unclear. We aimed to determine the associations between symptoms of severe periodontitis (SSP) and post-bronchodilator lung function in the Chinese population.

METHODS: A cross-sectional study (China Pulmonary Health study) was conducted from 2012 to 2015 in a large Chinese nationally representative sample of 49,202 participants aged 20-89 years. Data on demographic characteristics and periodontal symptoms of participants were collected by questionnaire. Participants who had at least one of the two severe symptoms (tooth mobility and natural tooth loss) in the past year were defined to have SSP, which was set …

Distinct Gene Expression Profiles Between Human Preterm-Derived And Adult-Derived Intestinal Organoids Exposed To Enterococcus Faecalis: A Pilot Study, Andrea C. Masi, Tatiana Y. Fofanova, Christopher A. Lamb, Jennifer Auchtung, Robert A. Britton, Mary K. Estes, Sasirekha Ramani, Simon J. Cockell, Jonathan Coxhead, Nicholas D. Embleton, Janet E. Berrington, Joseph F. Petrosino, Christopher J. Stewart

Food for Health: Publications

We read with interest the study by Kayisoglu et al¹ comparing the gene expression between embryo-derived and adult-derived intestinal organoids. Some innate immune system genes were differentially expressed between the two organoid types, suggesting a potential role of exposure to the environment, including gut microbiota, in shaping the intestinal gene expression. In extremely preterm infants (<32 weeks gestation), microbial–host interaction at the epithelial surface has been associated with various morbidities including late onset sepsis and necrotising enterocolitis.² Thus, preterm intestinal organoids may provide a specific and robust model for this population.

Mirnas Signature As Potential Biomarkers For Cervical Precancerous Lesions In Human Papillomavirus Positive Women, Martha I. González-Ramírez, Yurley T. Cardona, María C. Agudelo, Carolina López, Juan J. Florez-Acosta, Samuel Agudelo-Gamboa, Jone Garai, Li Li, Carlos A. Orozco-Castaño, Jovanny Zabaleta, Gloria I. Sánchez

School of Medicine Faculty Publications

Biomarkers to identify women at risk of cervical cancer among those with high-risk HPV infection (hrHPV+) are needed. Deregulated expression of microRNAs (miRNAs) contributes to hrHPV-induced cervical carcinogenesis. We aimed at identifying miRNAs with the capacity to distinguish high (CIN2+) and low (≤ CIN1) grade cervical lesions. We sequenced miRNA libraries from Formalin-Fixed Paraffin-Embedded (FFPE) tissues from women with CIN2+ (n = 10) and age-matched women with ≤ CIN1 (n = 10), randomly and retrospectively selected from a trial that followed women for 24 months after a hrHPV+ test at the screening visit. Five miRNAs differentially expressed were validated by …

Early Manual Lymphatic Drainage With Secondary Edema, Tiana Bridges Mot/S, Carly Fallin Mot/S, Emma Hilliard Mot/S, Olivia Holmes Mot/S, Kathryn Mullins Mot/S, Jonathan Richardson Mot/S, Cassie Warlick Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Implementation of an early manual lymphatic drainage program on post-op head/neck patients to decrease secondary edema.

Modified Vs. Standard Sternal Precautions, Alex Rome Mot/S, Katie Morris Mot/S, Payton Johnston Mot/S, Cheyenne Franklin Mot/S, Rachel Jeneff Mot/S, Hannah Tackett Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The poster examines standard and modified sternal precautions in pediatrics following a median sternotomy and the impact on developmental outcomes. The question our poster aims to answer includes, do modified sternal precautions improve developmental outcomes in children who underwent (median) sternotomy in a hospital setting compared to those with traditional sternal precautions? Through searching databases, the authors were able to gather articles providing evidence and information regarding modified vs. standard sternal precautions. Through the research, the authors concluded that there is further research needed on this topic in pediatric populations with the recommendation to proceed using caution due to no …

The Efficacy Of Constraint-Induced Movement Therapy Or Modified Constraint-Induced Movement Therapy In Improving Upper Extremity Motor Function In Adults With Hemiplegia After A Traumatic Brain Injury, Ryan Bizette, Adaire Deblanc, Rachel Ridenour, Lindsey Satterlee, Allyson Smith, Katya Vanausdall

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains 11 research articles from both national and international journals. Study designs include two randomized control trials, one systematic review, four quasi-experimental studies, one case study, two case series, and one pilot case study. All studies relate directly to components of the evidence-based practice question and will be used to draft new practice guidelines for using constraint-induced movement therapy (CIMT) or modified constraint-induced movement therapy (mCIMT) in occupational therapy practice.

Seven articles specifically describe the effectiveness of CIMT or mCIMT for adults with hemiplegia following a traumatic brain injury. The other four articles describe the effectiveness of …

Evidence-Based Guide To Using Artificial Introns For Tissue-Specific Knockout In Mice, Elena Mcbeath, Keigi Fujiwara, Marie-Claude Hofmann

Faculty, Staff and Student Publications

Up until recently, methods for generating floxed mice either conventionally or by CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-Cas9 (CRISPR-associated protein 9) editing have been technically challenging, expensive and error-prone, or time-consuming. To circumvent these issues, several labs have started successfully using a small artificial intron to conditionally knockout (KO) a gene of interest in mice. However, many other labs are having difficulty getting the technique to work. The key problem appears to be either a failure in achieving correct splicing after the introduction of the artificial intron into the gene or, just as crucial, insufficient functional KO of the …

7-Ketocholesterol Promotes Retinal Pigment Epithelium Senescence And Fibrosis Of Choroidal Neovascularization Via Iqgap1 Phosphorylation-Dependent Signaling, Haibo Wang, Aniket Ramshekar, Thaonhi Cung, Chris Wallace-Carrete, Chandler Zaugg, Jasmine Nguyen, Gregory J. Stoddard, M. Elizabeth Hartnett

School of Medicine Faculty Publications

Accumulation of 7-ketocholesterol (7KC) occurs in age-related macular degeneration (AMD) and was found previously to promote fibrosis, an untreatable cause of vision loss, partly through induction of endothelial-mesenchymal transition. To address the hypothesis that 7KC causes mesenchymal transition of retinal pigment epithelial cells (RPE), we exposed human primary RPE (hRPE) to 7KC or a control. 7KC-treated hRPE did not manifest increased mesenchymal markers, but instead maintained RPE-specific proteins and exhibited signs of senescence with increased serine phosphorylation of histone H3, serine/threonine phosphorylation of mammalian target of rapamycin (p-mTOR), p16 and p21, β-galactosidase labeling, and reduced LaminB1, suggesting senescence. The cells …

Resistance Training And Running Performance And Economy: A Literature Review, James Bottrill

University Honors Theses

Running performance is largely determined by maximal oxygen uptake (VO₂ max), velocity at VO₂ max, fractional utilisation of VO₂ max and running economy. Running economy is relatively under-researched and could be improved by resistance training because of its neuromuscular underpinnings. However, existing research on this topic is quite unorganised and inconclusive and is yet to prove a direct linkage between resistance training, running economy and performance. This literature review aimed to provide an organised overview of the existing literature, identify and address confounding variables and provide recommendations for future research. A search for studies was conducted via …

Social Determinants Of Health And Us Cancer Screening Interventions: A Systematic Review, Ariella R Korn, Callie Walsh-Bailey, Margarita Correa-Mendez, Peter Delnero, Meagan Pilar, Brittney Sandler, Ross C Brownson, Karen M Emmons, April Y Oh

2020-Current year OA Pubs

There remains a need to synthesize linkages between social determinants of health (SDOH) and cancer screening to reduce persistent inequities contributing to the US cancer burden. The authors conducted a systematic review of US-based breast, cervical, colorectal, and lung cancer screening intervention studies to summarize how SDOH have been considered in interventions and relationships between SDOH and screening. Five databases were searched for peer-reviewed research articles published in English between 2010 and 2021. The Covidence software platform was used to screen articles and extract data using a standardized template. Data items included study and intervention characteristics, SDOH intervention components and …

Action Distance As A Predictor Of Winning And Losing Matches At Fivb Volleyball Men’S World Championship, Dariusz Mroczek, Damian Pawlik

Baltic Journal of Health and Physical Activity

Introduction: Technology determines the emergence of functional tools to monitor and control motor activity during the game. One of the solutions for monitoring the player in indoor sports are computer video analyses, which determine basic kinematic parameters. The study aims to compare team and player activity with the outcome of a given set and the effect of the game status on player activity during a championship-level match. Materials and Methods: The study analysed 140 volleyball players aged 19 to 40 years (27.05 ± 4.33 years, height: 197.15 ± 9.63 cm, body mass: 88.51 ± 9.23 kg) participating in the FIVB …

The Prevalence Of Electronic Cigarette Use Among College Students Of Taibah University And Symptoms Of Cardiovascular Disease, Talal Alzahrani, Marwan Fahad Alhazmi, Ahmed Naji Alharbi, Feras Talal Alahmadi, Amer Nasser Alhubayshi, Bader Ahmed Alzahrani

Journal of the Saudi Heart Association

Background: Electronic cigarettes (e-cigarettes) have been increasing in popularity among young adults due to the misconception about the safety of e-cigarettes. Our study aims to identify the prevalence rate of e-cigarette use among college students, the reason behind their use, and the relationship between the use of electronic cigarettes and cardiovascular symptoms among college students. Methods: An online questionnaire was sent to students of Taibah University between 2021 and 2022. Data from this survey were analyzed to obtain the prevalence of e-cigarette use among Taibah University students and to compare the demographic and health characteristics differences between e-cigarette users and …

Linkage To Outpatient Treatment In Inpatients With Alcohol Use Disorder Started On Naltrexone, Stephanie Stamatis

Yale School of Medicine Physician Associate Program Theses

Naltrexone is a full opioid antagonist approved for the treatment of alcohol use disorder that can effectively reduce alcohol consumption. There are few studies that study the impact of starting naltrexone for alcohol use disorder in the inpatient setting. We propose to compare rates of outpatient treatment follow-up for alcohol use disorder in hospitalized patients who are referred to treatment without initiating naltrexone versus those initiated on oral naltrexone or injectable naltrexone. Using an open-label, randomized clinical trial design, we will enroll 75 adults aged 18 to 55 with alcohol use disorder admitted to a general medicine inpatient service and …

Efficacy Of Psychotherapy-Supported Mdma In The Treatment Of Complex Posttraumatic Stress Disorder, Danielle Dubois

Yale School of Medicine Physician Associate Program Theses

Complex Posttraumatic Stress Disorder is a debilitating psychiatric disorder with no approved treatment options despite the high symptom burden and diminished quality of life. Randomized controlled trials have shown robust attenuation of posttraumatic stress disorder symptomatology using treatment with 3,4-Methylenedioxymethamphetamine (MDMA) plus psychotherapy, but individuals with complex traumatization have not been studied explicitly. Prior trials primarily utilized an inactive placebo group, undermining the interpretation of the results due to concern for unblinding of subjects. The proposed study is the first to utilize an active comparator to test a key hypothesis related to MDMA’s mechanism of action and to preserve blinding. …

Comparison Of Oral Carotene Supplementation And Oral Polypodium Leucotomas In Preventing Photodamage, Jazmin Martinez

Yale School of Medicine Physician Associate Program Theses

Skin exposure to ultraviolet (UV) irradiance is the major cause of skin disorders, such as sunburn and nonmelanoma cancer. The current standard of care for photoprotection is the daily use of sunscreen, although patient adherence and adequate application continues to be an issue. Current data show systemic photoprotection can be added to sunscreen use to reduce the risk of cutaneous diseases. This randomized controlled study will investigate whether supplementation with Polypodium leucotomas versus carotenoid supplementation versus the standard of care, provide increased photoprotection in adults with Fitzpatrick skin types II-IV. Outcomes will be measured by comparing the minimal erythema dose …

Periodontal Regeneration Risk Assessment In The Treatment Of Intrabony Defects., Robert A. Levine, Muhammad H A Saleh, Debora R. Dias, Jeffrey Ganeles, Maurício G. Araújo, Franck Renouard, Harold M. Pinsky, Preston D. Miller, Hom-Lay Wang

HPD Articles

BACKGROUND: Regenerative approaches performed in periodontics seems to be efficient in treating intrabony defects. There are, however, many factors that may affect the predictability of the regenerative procedures. The present article aimed to propose a new risk assessment tool for treating periodontal intrabony defects by regenerative therapy.

METHODS: Different variables that could affect the success of a regenerative procedure were considered based on their impact on (i) the wound healing potential, promoting wound stability, cells, and angiogenesis, or (ii) the ability to clean the root surface and maintain an optimal plaque control or (iii) aesthetics (risk for gingival recession).

RESULTS: …

First Line Acne Treatment: Comparison Of Cost And Efficacy, Michael P. Mcneil, Karlen E. Luthy, Christine R. Platt, Michael S. Robinson, Janelle L.B. Macintosh

Student Works

Acne vulgaris is a common skin concern that may cause permanent disfiguration and encumbering effects on self-esteem and mental health. Additionally, it is often associated with expensive treatment costs for patients. When selecting the most appropriate therapeutic approach, nurse practitioners must also consider the price of the medication. For the majority of mild to moderate cases of acne (both comedonal and inflammatory), effective first-line treatment recommendations include a combination of a topical retinoid, benzoyl peroxide, and a topical antibiotic such as clindamycin. Generic and compounded medications are typically more cost-effective for patients than brand name formulations.

Workers With Suspected Diagnosis Of Silicosis: A Case Study Of Sarcoidosis Versus Siderosis, Diemen Delgado-García, Patricio Miranda-Astorga, Ashley Delgado-Cano, Juan Gómez-Salgado, Carlos Ruiz-Frutos

School of Medicine Publications

Silicosis is one of the most important occupational respiratory diseases worldwide, hence the importance of making a correct diagnosis. Diagnosis is commonly based on radiological findings according to the ILO International Classification of Radiographs of Pneumoconioses and occupational exposure. High-resolution computed tomography is indicated for differential diagnosis. This article presents two cases with an initial diagnosis of silicosis that ended up being diagnosed as sarcoidosis and siderosis, respectively. The first case was a 42-year-old male who worked as a crushing operator in an underground copper and molybdenum mine for 22 years. He had a history of exposure to silicon dioxide …

Current Best Practice In Pelvic And Hip Fracture Management In The Older Adult Population, Anthony P. Joseph

Journal of Geriatric Emergency Medicine

Fractures of the pelvis and hip are a relatively frequent occurrence in the older population. Pelvic fractures in older patients usually occur after a fall from standing height. CT scan is the investigation of choice. There are several classifications available which are useful in risk stratification and predicting surgical treatment. Haemorrhage is a major complication and can usually be treated by interventional radiology. An Orthopedic opinion should be sought promptly, and surgical stabilisation (if indicated) should be completed as early as possible to enable early mobilisation and the avoidance of complications such as deep vein thrombosis or pneumonia.

Hip fractures …

Bibliometric Analysis Of Spinopelvic Alignment In Total Hip Arthroplasty, Samantha Harrer, Justin A. Magnuson, Gregory R. Toci, Andrew M. Star, Arjun Saxena

Rothman Institute Papers

INTRODUCTION: Postoperative dislocation of unclear etiology remains a concern after total hip arthroplasty (THA). Interest is growing in the importance of spinopelvic alignment on stability in THA. The purpose of this study was to analyze publication trends, areas of interest, and future research direction of spinopelvic alignment in THA.

METHODS: Articles on the topic of spinopelvic alignment in THA published between 1990 and 2022 were obtained through Web of Science Core Collection of Clarivate Analytics (WSCCA). Results were screened by title, abstract, and full text. The inclusion criterion was English-language peer-reviewed journal publications on the clinical topic of spinopelvic alignment …

The Upper And Lower Respiratory Tract Microbiome In Severe Aspiration Pneumonia, Georgios D Kitsios, Janet S Lee, Et Al.

2020-Current year OA Pubs

Uncertainty persists whether anaerobic bacteria represent important pathogens in aspiration pneumonia. In a nested case-control study of mechanically ventilated patients classified as macro-aspiration pneumonia (MAsP, n = 56), non-macro-aspiration pneumonia (NonMAsP, n = 91), and uninfected controls (n = 11), we profiled upper (URT) and lower respiratory tract (LRT) microbiota with bacterial 16S rRNA gene sequencing, measured plasma host-response biomarkers, analyzed bacterial communities by diversity and oxygen requirements, and performed unsupervised clustering with Dirichlet Multinomial Models (DMM). MAsP and NonMAsP patients had indistinguishable microbiota profiles by alpha diversity and oxygen requirements with similar host-response profiles and 60-day survival. Unsupervised DMM …

Novel Potential Targets For Function-Promoting Therapies: Orphan Nuclear Receptors, Anti-Inflammatory Drugs, Troponin Activators, Mas Receptor Agonists, And Urolithin A, Waly Dioh, Vihang Narkar, Anurag Singh, Fady Malik, Luigi Ferrucci, Cendrine Tourette, Jean Mariani, Rob Van Maanen, Roger A Fielding

Faculty, Staff and Student Publications

In recent years, several new classes of therapies have been investigated with their potential for restoring or improving physical functioning in older adults. These have included Mas receptor agonists, regulators of mitophagy, skeletal muscle troponin activators, anti-inflammatory compounds, and targets of orphan nuclear receptors. The present article summarizes recent developments of the function-promoting effects of these exciting new compounds and shares relevant preclinical and clinical data related to their safety and efficacy. The development of novel compounds in this area is expanding and likely will need the advent of a new treatment paradigm for age-associated mobility loss and disability.