Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

A Novel Model Of “Remedy And Elimination Of Tuberculosis”, Akanksha Mishra

Master's Theses

Tuberculosis (TB), is one of the top ten causes of death worldwide. TB is commonly linked to poverty and creates poverty as it is the single largest cause of death in the 15-49-year-old age group in South-East Asia (WHO, 2017). It is also linked to the HIV population, and its leading cause of death. TB is effected by socio-economic factors, cultural factors, and health policy. My goal of this dissertation is to identify systematic approaches that shall support the mission set by World Health Organization (WHO): to eliminate TB globally by the year 2050. Measures might include addressing social barriers …

The Development Of A Wayfinding Smart Phone Application As A Large Healthcare Facility Investment Opportunity, Jessie Fortson Marshall

Doctoral Projects

Health care is a continually growing field. New hospitals are constantly being built, while older facilities are experiencing renovation and expansion. With this growth comes a set of difficulties for patients as they try to navigate through large, multi-building facilities. Most large facilities have multiple parking garages, numerous buildings, and medical towers with an unending number of floors. Patients are forced to rely on directional signage to find their destination that is often insufficient. Attempting to navigate through large facilities is often overwhelming for visitors leading to frustration and stress.

New technology has allowed a convenient solution to this problem …

A Human-Centered Platform For Hiv Infection Reduction In New York: Development And Usage Analysis Of The Ending The Epidemic (Ete) Dashboard, Ashish Joshi, Chioma Amadi, Benjamin Katz, Sarah Kulkarni, Denis Nash

Publications and Research

Background: Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment.

Objective: We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York’s progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020.

Methods: The ETE dashboard was adapted from an existing human-centered geovisualization …

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Sensitivity Of Current Methods For Diagnosing And Documenting Metabolic Syndrome Within A Large Community-Based Health Care System, Tiffany A. Mullen, Danielle M. Greer, Jennifer T. Fink, Renee E. Walker

Journal of Patient-Centered Research and Reviews

Background: Metabolic syndrome (MetS) is a constellation of metabolic conditions, including abdominal obesity, high blood pressure, high triglyceride level, low high-density-lipoprotein level and high fasting blood glucose level, that increase the risk of developing chronic health conditions. Various combinations of diagnostic criteria have been proposed, including those by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), World Health Organization (WHO) and International Diabetes Foundation (IDF), among others. However, inconsistent use of diagnostic criteria and inadequate scientific evidence supporting use of specific criteria are current problems in health care.

Purpose: Quantify the prevalence of MetS diagnosis within the …

Decreasing Time To Broad Spectrum Antibiotics For Septic Patients In The Emergency Department, Joseph J. Zieminski, Emily E. Bryant

Journal of Patient-Centered Research and Reviews

Background: Timely administration of broad spectrum antibiotics has been shown to be directly correlated with decreased mortality for patients with severe sepsis and septic shock. As such, both the Surviving Sepsis Campaign and the SEP-1 CMS measure recognize timely antibiotic administration as a cornerstone of therapy for patients with severe sepsis or septic shock.

Purpose: Decrease time to broad spectrum antibiotic administration for septic patients in the emergency department (ED) of Aurora St. Luke’s Medical Center.

Methods: An alert within the electronic medical record was created to more rapidly identify potentially septic patients in the ED. After receiving the alert, …

Relative Associations Of Age, Height, And Weight On Sinus Of Valsalva And Mid-Ascending Aorta: An Imaging And Epidemiology Study, Mirza Nubair Ahmad, Syed Haris Pir, Mirza Mujadil Ahmad, Sharmeen Hussaini, Bijoy K. Khandheria, A. Jamil Tajik, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Background: Prior studies show ascending aorta diameter varies with age, height and weight, but they did not evaluate relative influence of these variables on aortic diameter. Since height is genetically determined, and genetic disorders like Marfan syndrome are predominantly associated with sinus of Valsalva (SOV) dilation, we hypothesized height may have stronger association with SOV.

Purpose: Based on anecdotal observation, since age, weight and obesity are acquired attributes, we hypothesized age, weight and body mass index may have greater association with mid-ascending aorta (MAA) diameter, even in normal patients.

Methods: We evaluated echocardiographic studies of patients ≥ 15 years old …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …

Characterization Of Different Molecular Markers For Identification Of Salmonella Enterica Serovar Typhi In Pakistani Population, Faizan Muttiullah, Fida Muhammad Khan, Fakhar-I- Abbas, Sabiha Shamim

Journal of Bioresource Management

Typhoid is caused by Salmonella enterica serovar Typhi that is usually diagnosed by using serologic and immuno-chromatographic techniques in developing counties including Pakistan, which is thought to be an unreliable diagnostic method. For accurate diagnosis we used molecular techniques to amplify 204 bp StyR-36 and 498 bp flagellin gene for the identification of Salmonella enterica serovar Typhi. This study was done on 58 individuals diagnosed positive of typhoid via serologic tests and 50 healthy individuals as a control group. Success rate of amplification for flagellin gene was 77.58% while that for StyR-36 gene was 68.97% showing that flagellin gene primer …

Determining The Detective Quantum Efficiency (Dqe) Of X-Ray Detectors In Clinical Environments, Terenz R. Escartin

Electronic Thesis and Dissertation Repository

According to Health Canada, dental and medical radiography accounts for more than 90% of total man-made radiation dose to the general population. Ensuring patients receive the health benefits of diagnostic x-ray imaging without use of higher radiation exposures requires knowledge and understanding of the detective quantum efficiency (DQE). Currently, the DQE is not measured in clinics because it requires specialized instrumentation and specific DQE-expertise to perform an accurate analysis. In this regard, the goals of this thesis were to: 1) address the limitations of measuring the DQE in clinical environments that affects the accuracy of the measurement; 2) develop and …

Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten Mccaffery

Ray Moynihan

OBJECTIVES: Changing terminology for low-risk, screen-detected conditions has now been recommended by several expert groups in order to prevent overdiagnosis and reduce the associated harms of overtreatment. However, the effect of terminology on patients' preferences for management is not well understood. This review aims to synthesise existing studies on terminology and its impact on management decision making. DESIGN: Systematic review. METHODS: Studies were included that compared two or more terminologies to describe the same condition and measured the effect on treatment or management preferences and/or choices. Studies were identified via database searches from inception to April 2017, and from reference …

The Effect Of Target-Specific Biomolecules In Breast Cancer, Mohannad Garoub

FIU Electronic Theses and Dissertations

Cancer is the second leading cause of mortality in the United States and the World, therefore, early effective prevention, diagnosis, and therapy is needed. Estrogens play a major role in the initiation and progression of breast cancer. Elevated lifetime exposure to estrogens is associated with an increased risk of developing breast cancer. Estrogens through influencing mitochondria contribute to estrogen induced breast carcinogenesis; however, the exact mitochondrial mechanisms underlying the estrogen carcinogenic effect in breast tissue are not clearly understood. For this dissertation, the mitotoxic and cytotoxic effects of triphenylphosphonium cation (TPP) and Origanum majorana organic extract (OME) as well as …

Response To Quality Of Life Surveying: An Analysis Of Patients With Wiskott-Aldrich Syndrome, Tara Bani-Hashemi

Master's Projects and Capstones

Patient-reported outcomes and surveying has increased in clinical settings in order to assess outcomes and patient health status. However, there is a lack of these assessments from a pediatric standpoint, an inpatient standpoint, and family perspective. In addition to health status and overall clinic experience, expanding the self-reported evaluation to include quality of life on physical and psychosocial levels will provide a more comprehensive evaluation of the patients’ health services. The PedsQL ™ scale scores four domains: physical, emotional, social, and school/work functioning. It includes a parent-proxy report as well as self-report for patients ages 5 to 18 years. Infant …

Examination Of Neurocorrelates Of Mild Traumatic Brain Injury In Young Adults, Rachel J. Raucci

Neuroscience Honors Papers

In recent years, there has been an upswing in the number of concussion diagnoses per year in the United States, particularly in young athletes with still-developing brains. Accompanying this recent trend is an increased amount of research on concussions and their long-term impacts. This ongoing research project collects and compares data from concussed and non-concussed individuals using various neuropsychological batteries, self-report surveys and participants’ EEG readings. Data analysis of the results from 51 participants indicates that previously concussed individuals differ from their non-concussed counterparts. Specifically, individuals who have suffered a concussion exhibit specific and occasionally idiosyncratic deficits in executive control …

Needs Assessment Of Pediatric Radiological Equipment And Cross-Cultural Investigation Into Parental Empowerment In Pediatric Radiology Program Development In The Kingdom Of Bhutan, Danielle Canter

GW Research Days 2016 - 2020

Background:

Bhutan is a magnificent mountainous country hugged by India to the east and west and by China to the North and South. This peaceful nestled country faces challenges in combating non-communicable diseases due to the lack of radiological equipment necessary for early diagnosis. Prior to implementation of these medical devices, it is imperative to investigate the cultural attitudes, beliefs, and infrastructure, to ensure successful integration. Bhutan is beginning to implement a pediatric radiology program for the nation with the assistance of ABAH Foundation and RAD-AID International, both of whom partnered with graduate students at George Washington University School of …

Examining Cervical Cancer Screening Utilization Among African Immigrant Women: A Literature Review, Adebola Adegboyega, Mollie Aleshire, Ana Maria Linares

Faculty Scholarship

Background: Globally, 530,000 women per year are diagnosed with cervical cancer, and approximately 275,000 die from the disease. Routine cervical cancer screening may reduce the burden of cervical cancer morbidity and mortality through early detection and improved treatment outcome. Immigrant women in the United States (U.S.) may be disproportionately affected by cervical cancer; however, there is scarce literature addressing cervical cancer screening in African immigrants (AIs) when compared to other immigrant groups. This systematic review evaluates the state of cervical cancer screening research in AIs and identifies current gaps.

Materials and methods: Through a comprehensive literature search, we identified 16 …

Using Quality Improvement Methods To Increase Use Of Pain Prevention Strategies For Childhood Vaccination., Jennifer Verrill Schurman, Amanda D. Deacy, Rebecca J. Johnson, Jolynn Parker, Kristi Williams, Dustin Wallace, Mark Connelly, Lynn Anson, Kevin Mroczka

Manuscripts, Articles, Book Chapters and Other Papers

AIM: To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.

METHODS: Specific intervention strategies (i.e., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit. Additionally, self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention …

Urine Cotinine In Children And Parental Behavior Modification: A Pilot Study, Teresa Lachance

Muskie School Capstones and Dissertations

“Urine Cotinine in Children and Parental Behavior Modification” was designed by Dr. Deirdre Burns, a pediatrician at the Barbara Bush Children’s Hospital (BBCH). It was implemented as a pilot study to determine whether urine cotinine testing in children who are admitted to the hospital for respiratory illness and tracking parental smoking behaviors over time was feasible. Parents were given a brief survey to assess their current smoking behaviors and to understand their readiness to quit smoking. They received smoking cessation materials provided by the Breathe Easy Coalition of Maine. These materials outline information about second-hand and third-hand smoke, and encourage …

Life-Saving Medicines And Equipment In Facilities In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

This research brief is a part of a larger landscaping analysis by Population Council, with support from USAID and the MacArthur Foundation. In Bangladesh, in 12 upazilas in four districts, it assessed the capacity of primary health facilities to manage pre-eclampsia and eclampsia (PE/E). This brief shares findings from 134 facilities on required infrastructure for providing maternal and newborn health (MNH) services, human resources, facility readiness, and MNH commodities and supplies. Facility readiness is vital to providing quality services to antenatal care (ANC) patients, especially to women with PE/E. Without functioning equipment, ANC/PNC registers, essential medicines, electricity, and running water, …

Stress: Effects And Management, Breanna Buscher

Nebraska College Preparatory Academy: Senior Capstone Projects

Stress is how the body reacts to any change in a person's life, as well as how it reacts in life or death situations. It is important everyone knows how to manage stress and what will happen if they do not. While there are an abundance of terrifying things that can happen when stress goes unmanaged, there are also plenty of easy ways everyone can keep their stress in check.

Stress can feel overwhelming and often cause health problems if gone unmanaged but luckily there are a plethora of ways to manage it.

Future Research: I would like to research …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Biomarkers Of Sepsis: A Retrospective Approach, Jose M. Roberts

Williams Honors College, Honors Research Projects

Background: Biomarkers are taking the spotlight in becoming the norm for early diagnoses. Sepsis is an inflammatory disease that increases metabolic rate in children. The first biomarker is hyponatremia. Hyponatremia is a frequent electrolyte imbalance in clinical practice, often observed in children with inflammatory disease and infection. Presence of hyponatremia is associated with electrical signaling imbalances, inflammation and renal dysfunction. The clinical value of hyponatremia in pediatric patients is unknown. The C-reactive protein is a second biomarker. Its presence signifies that necrotic cells and inflammation are present.

Objectives: To evaluate the use of biomarkers in children seen in the Emergency …