Medicine and Health Sciences Commons^™

The Influences Of The Public Health Care System And Education System On The Economic Growth Of Swaziland, Grace Greer

International and Global Studies Undergraduate Honors Theses

The Kingdom of Eswatini, also known as Swaziland, has one of the youngest populations in the world with over 70% of citizens being under the age of 18 years old. This creates a substantial opportunity for economic, social, and educational growth in a country previously plagued with diseases such as HIV/AIDS, poor health care infrastructure cutting off thousands from basic care, and an educational system with a very low attendance rate and an even lower graduation rate. By evaluating the root causes of such issues dating back to the colonial era there is an opportunity to reprioritize health care ...

Standardized Handoffs For Anesthesia Students, Shawn Barkalow, Noah Prebish

Doctor of Nursing Practice Scholarly Projects

Communication between healthcare providers is an essential aspect of caring for patients. Effective communication is vital during the patient handoff process. The patient handoff process involves exchanging patient’s medical information between a provider currently caring for the patient and the provider assuming care of the patient. If the information exchanged during the handoff process is inaccurate or essential information is omitted, that could potentially lead to harmful consequences for the patient. Currently, no standardized handoff tool exists for student registered nurse anesthesia students (SRNAs) in clinical practicum at the local level one trauma center. The lack of a standardized ...

Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens

Doctor of Nursing Practice Scholarly Projects

Postoperative breastfeeding recommendations for lactating mothers by anesthesia providers are inconsistent and often inaccurate. Inappropriate recommendations have led to withholding of breastmilk to the infant, unnecessary disposal of breastmilk, surgical delay, exposure of an infant to high levels of drugs in breastmilk, and early cessation of breastfeeding. The purpose of the scholarly project was to develop a set of evidenced-based practice guideline recommendations and a proposed implementation plan for anesthesia providers to use in support of breastfeeding mothers who recover from surgery. Many studies in the literature indicate that there are inconsistencies in postoperative breastfeeding recommendations by anesthesia providers. When ...

Creating A Culturally Adaptable Comprehensive Sexuality Education Teacher's Manual, Stephanie Carteciano

Student Works

Purpose: The purpose of this project was to create a culturally adaptable comprehensive sexual education teacher’s manual by (a) standardizing content using The United Nations Educational, Scientific and Cultural Organization’s (UNESCO) 2018 International Technical Guidance on Sexuality Education (CSE), (b) providing evidence-based CSE pedagogy in the form of classroom activities, and (c) including adaptable teaching methods to fit diverse cultural contexts.

Development: The manual lessons were derived from UNESCO’s 2018 International Technical Guidance on Sexuality Education, and the pedagogy followed Anderson and Krathwohl’s revision of Bloom’s Taxonomy. Health information was obtained from various medical and ...

Pharmacokinetics Of Single Feeding Of Cannabidiol In Cattle: A Pilot Study, Haley Cornette

Honors College Theses

Cannabidiol (CBD) is a substance that has been used in complementary medicine for many years. However, modern medicine has little knowledge of how this substance is utilized and metabolized in ruminant animals. Regulations on quality assurance and use in animals are lacking, and CBD supplementation in livestock is not approved. If CBD supplements can be shown to be safe and effective, detection in the animal will be important for determining regulation of use. A withdrawal period can then be established to allow time for deterioration of product to safe levels before livestock products enter human markets. This study sought to ...

Targeting The Cerebrovasculature In Sepsis: A Focus On The Brain Microvascular Endothelium, Divine C. Nwafor

Graduate Theses, Dissertations, and Problem Reports

The blood-brain barrier (BBB) is a critical interface between the systemic circulation and the brain. It is a specialized multicellular unit composed of brain microvascular endothelial cells (BMECs), pericytes, a basement membrane, and astrocytic end foot processes. BMECs are a principal component of the BBB that provide the structural framework needed for the stringent transport of molecules into the brain. BMEC dysfunction permits the trafficking of neurotoxins from systemic circulation into the brain, which ultimately exacerbates BBB dysfunction and neuroinflammation. Studies have shown that BBB dysfunction is a key determinant of cognitive decline in sepsis. However, there are critical knowledge ...

Small Extracellular Vesicle-Mediated Itgb6 Sirna Delivery Downregulates The Αvβ6 Integrin And Inhibits Adhesion And Migration Of Recipient Prostate Cancer Cells, Shiv Ram Krishn, Vaughn Garcia, Nicole M Naranjo, Fabio Quaglia, Christopher D Shields, Maisha A Harris, Andrew V Kossenkov, Qin Liu, Eva Corey, Dario C Altieri, Lucia R Languino

Department of Cancer Biology Faculty Papers

The αVβ6 integrin, an epithelial-specific cell surface receptor absent in normal prostate and expressed during prostate cancer (PrCa) progression, is a therapeutic target in many cancers. Here, we report that transcript levels of ITGB6 (encoding the β6 integrin subunit) are significantly increased in metastatic castrate-resistant androgen receptor-negative prostate tumors compared to androgen receptor-positive prostate tumors. In addition, the αVβ6 integrin protein levels are significantly elevated in androgen receptor-negative PrCa patient derived xenografts (PDXs) compared to androgen receptor-positive PDXs. In vitro, the androgen receptor-negative PrCa cells express high levels of the αVβ6 integrin compared to androgen receptor-positive PrCa cells. Additionally, expression ...

A Pilot Intervention Combining Assessment And Feedback With Communication Training And Behavioral Nudges To Increase Hpv Vaccine Uptake., Andrea Bradley-Ewing, Brian R. Lee, Jason N. Doctor, Georgann Meredith, Kathy Goggin, Angela Myers

Manuscripts, Articles, Book Chapters and Other Papers

Human papillomavirus (HPV) causes >40,000 cancer diagnoses each year, yet vaccination rates remain low because widespread implementation of strategies to increase vaccinations has not occurred. Behavioral nudges have demonstrated efficacy in improving uptake of desired behaviors in health care settings but have not been tested for increasing HPV vaccinations. We assessed the impact of an intervention combining behavioral nudges with other proven strategies (i.e., assessment and feedback, provider communication training) on HPV vaccination rates and parental satisfaction in four Midwestern pediatric, outpatient practices. Practices were randomly assigned to receive either assessment and feedback or assessment and feedback combined ...

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs

Capstone

Medical prescribing is a common occurrence in daily clinical practice. According to the Centers for Disease Control and Prevention, in 2015-2016 45.8% of the U.S. population used prescription drugs in the past 30 days. (CDC, 2019) Although drug therapy can be effective in treating disease, full benefits are often not realized because many patients do not take their medications as prescribed. There is quite a bit of research out there about non-adherence to medication. Some studies focus on the financial impacts of non-adherence, but most of the studies examine the reasons for medication non-adherence. A gap exists in ...

The Mentored Experience To Enhance Opportunities In Research (Meteor) Program., Lisa Schwartz, Naomi Luban, Alison Hall, Diane Mcquail, Yolanda Haywood

Health Sciences Education Research

PROBLEM: Medical students from groups that are underrepresented in medicine are less likely to pursue careers that incorporate research as compared to their white peers. Clinical and Translational Science Award (CTSA)-funded institutions encouraged centers to establish short-term, mentored summer research opportunities to motivate students underrepresented in medicine to enroll in medical school and ideally choose a career that incorporates research into their clinical practice.

APPROACH: The Mentored Experience To Enhance Opportunities in Research (METEOR) Program was established in 2012 in partnership with the Clinical and Translational Science Institute at Children's National (CTSI-CN) and The George Washington University (GW ...

Associations Of The Covid-19 Pandemic With Older Individuals' Healthcare Utilization And Self-Reported Health Status: A Longitudinal Analysis From Singapore, Sangnam Ahn, Seonghoon Kim, Kanghyock Koh

Research Collection School Of Economics

Background: The COVID–19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID–19 patients. Objectives: To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. Method: Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. Subjects ...

Developing A Lifestyle Intervention Program For Overweight Or Obese Preconception, Pregnant And Postpartum Women Using Qualitative Methods, Chee Wai Ku, Shu Hui Leow, Lay See Ong, Christina Erwin, Isabella Ong, Xiang Wen Ng, Jacinth Jia Xin Tan, Fabian Yap, Jerry K. Y. Chan, See Ling Loy

Research Collection School of Social Sciences

The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. However, the success of a lifestyle intervention is dependent on uptake and continued compliance. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention ...

Equine Kinesiology Tape Application To Equine Hock Joints: Impact On Lameness And Movement Evaluation, Kiara Jones

Honors College Theses

Discomfort in the hocks of horses can cause lameness, resulting in poor performance. Diagnosis by veterinarians typically includes evaluating movement or use of ultrasound or radiography to evaluate tendons, ligaments, or bones. Treatment methods and times vary depending on diagnosis, but often include joint injections, medications, and stall rest. Treatments can be costly both financially and regarding time off from practice or competition. Alternative practices such as using equine kinesiology tape to support joints may improve comfort and movement for lower cost. The objective of this project was to evaluate the ease of use and effects of equine kinesiology tape ...

Association Of Visceral Adiposity Index With Incident Nephropathy And Retinopathy: A Cohort Study In The Diabetic Population, Zhiyuan Wu, Siqi Yu, Xiaoping Kang, Yue Liu, Zongkai Xu, Zhiwei Li, Jinqi Wang, Xinlei Miao, Xiangtong Liu, Xia Li, Jingbo Zhang, Wei Wang, Lixin Tao, Xiuhua Guo

Research outputs 2022 to 2026

Background: The association between visceral adiposity index (VAI) and diabetic complications has been reported in cross-sectional studies, while the effect of VAI on complication development remains unclear. This study aims to evaluate the longitudinal association of VAI and Chinese VAI (CVAI) with the incidence of diabetic nephropathy and retinopathy using a Chinese cohort. Methods: A total of 8 948 participants with type 2 diabetes from Beijing Health Management Cohort were enrolled during 2013–2014, and followed until December 31, 2019. Nephropathy was confirmed by urine albumin/creatinine ratio and estimated glomerular filtration rate; retinopathy was diagnosed using fundus photograph. Results ...

Effectiveness Of Mobile Apps To Improve Urinary Incontinence: A Systematic Review Of Randomised Controlled Trials, Renee Widdison, Amineh Rashidi, Lisa Whitehead

Research outputs 2022 to 2026

Introduction: Pelvic floor exercises are effective in the treatment of urinary incontinence (UI) and are routinely prescribed, along with bladder training, by primary healthcare providers as first line conservative management. Mobile phone applications are increasingly popular within the healthcare setting and can provide opportunities for patients to complete treatments at home. To date, there has not been a systematic review examining outcomes from randomised controlled trials on the effectiveness of mobile applications to improve UI. Methods: A systematic review of randomized controlled trials evaluating the effectiveness of mobile applications to improve UI was carried out according to the PRISMA reporting ...

Geotemporospatial And Causal Inference Epidemiological Analysis Of Us Survey And Overview Of Cannabis, Cannabidiol And Cannabinoid Genotoxicity In Relation To Congenital Anomalies 2001–2015, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Background:

Cannabinoids including cannabidiol have recognized genotoxic activities but their significance has not been studied broadly epidemiologically across the teratological spectrum. We examined these issues including contextual space-time relationships and formal causal inferential analysis in USA.

Methods:

State congenital anomaly (CA) rate (CAR) data was taken from the annual reports of the National Birth Defects Prevention Network 2001–2005 to 2011–2015. Substance abuse rates were from the National Survey of Drug Use and Health a nationally representative longitudinal survey of the non-institutionalized US population with 74.1% response rate. Drugs examined were cigarettes, monthly and binge alcohol, monthly cannabis ...

Physical And Technical Demands Of Australian Football: An Analysis Of Maximum Ball In Play Periods, Christopher Wing, Nicolas H. Hart, Fadi Ma’Ayah, Kazunori Nosaka

Research outputs 2022 to 2026

Background: This study compares ball in play (BiP) analyses and both whole game (WG) and quarter averaged data for physical and technical demands of sub-elite Australian football (AF) players competing in the West Australian Football League across playing positions. Methods: Microsensor data were collected from 33 male AF players in one club over 19 games of the 2019 season. BiP time periods and technical performance data (e.g., kicks) were acquired from the Champion Data timeline of statistics, and time matched to the microsensor data. Linear mixed modelling was utilised to establish differences between maximum BiP periods and averaged data ...

Western Australian Adolescent Emotional Wellbeing During The Covid-19 Pandemic In 2020, H. M. Thomas, K. C. Runions, L. Lester, K. Lombardi, M. Epstein, J. Mandzufas, T. Barrow, S. Ang, A. Leahy, M. Mullane, A. Whelan, J. Coffin, F. Mitrou, S. R. Zubrick, A. C. Bowen, P. W. Gething, D. Cross

Research outputs 2022 to 2026

Background:

The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family’s financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic.

Methods:

We report on data from 32,849 surveys from Year 7–12 students in 40 schools over two 2020 ...

Medicines And Vaccines Supply Chains Challenges In Nigeria: A Scoping Review, Victory O. Olutuase, Chinwe J. Iwu-Jaja, Cynthia P. Akuoko, Emmanuel O. Adewuyi, Vishnu Khanal

Research outputs 2022 to 2026

Background:

Medicines and vaccines supply chains represent critical systems for realising one of the major targets of the United Nations’ third Sustainable Development Goals (SDGs)- access to safe, effective, quality, and affordable essential medicines and vaccines, for all. However, evidence suggests the system is confronted with several challenges in many low-medium income countries, including Nigeria. This scoping review aims to summarize the available evidence on the challenges of medicines and vaccines supply chain system in Nigeria.

Results:

We searched relevant databases including Scopus and Web of Science for studies published between January 2005 and August 2020 on the challenges associated ...

Physical And Technical Demands Of Offence, Defence, And Contested Phases Of Play In Australian Football, Christopher Wing, Nicolas H. Hart, Fadi Ma’Ayah, Kazunori Nosaka

Research outputs 2022 to 2026

Background: This study compared the physical demands and effect of field location for different phases of play (offence, defence and contested), and examined the physical and technical demands of successful and unsuccessful phases of play during Australian Football matches. Methods: Global positioning system (GPS) and technical performance data were collected from 32 male Australian Football players in one club over 19 games in the 2019 season. The GPS data was aligned with phases of play acquired using Champion Data. Linear mixed models were used to detect differences between phases of play and field location which were further contextualized using Cohen ...