Medicine and Health Sciences Commons^™

Working Under Pressure: Evidence-Based Risk Assessment And Pressure Injury Prevention In The Pediatric Intensive Care Unit, James A. Hutcheson Iv, Allyson M. Neal

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: The hospital-acquired pressure injury (HAPI) can have physiologic, psychologic, and financial sequelae. Children are at increased risk secondary to immature physiology, developmental differences, and severity of illness. Evidence suggests presence of medical devices exponentiates HAPI risk.

Local Problem: Upward trends in HAPIs revealed nearly 50% are device related in the project setting, an urban Pediatric Intensive Care Unit. The Braden QD Scale was identified as best evidence for HAPI risk assessment. This initiative aimed to observe the ability of the Braden QD Scale as a predictor of HAPI risk as compared to current practice utilizing the Braden Q …

Major Stressful Life Events And The Risk Of Pancreatic, Head And Neck Cancers: A Case-Control Study, Arthi Sridhar, Vishaldeep Kaur Sekhon, Chandler Nguyen, Kamelah Abushalha, Amirali Tahanan, Mohammad Hossein Rahbar, Syed Hasan Jafri

Journal Articles

BACKGROUND: Major stressful life events have been shown to be associated with an increased risk of lung cancer, breast cancer and the development of various chronic illnesses. The stress response generated by our body results in a variety of physiological and metabolic changes which can affect the immune system and have been shown to be associated with tumor progression. In this study, we aim to determine if major stressful life events are associated with the incidence of head and neck or pancreatic cancer (HNPC).

METHODS: This is a matched case-control study. Cases (CAs) were HNPC patients diagnosed within the previous …

Multifactorial Exercise Intervention Decreases Falls Risk In High-Risk And Low-Risk Older Adults, Amanda Estep, Steven Morrison, Shane V. Caswell, Jatin P. Ambegaonkar, João R. Vaz, Nelson Cortes

Rehabilitation Sciences Faculty Publications

Background: Each year, 1 in 4 people over the age of 65 years of age will experience a fall. It is important to identify and address modifiable risk factors that are associated with falls in adults at high and low risk for falls.

Hypothesis: Falls risk improves in both high-risk and low-risk participants with the implementation of Stay Active and Independent for Life (SAIL).

Study Design: Cohort study.

Level of Evidence: Level 3.

Methods: Seventy-eight older adults (age, 70.9 ± 5.1 years) were included in this study and categorized into high risk and low risk for falling based on the …

Machine Learning As A Tool For Early Detection: A Focus On Late-Stage Colorectal Cancer Across Socioeconomic Spectrums, Hadiza Galadima, Rexford Anson-Dwamena, Ashley Johnson, Ghalib Bello, Georges Adunlin, James Blando

Community & Environmental Health Faculty Publications

Purpose: To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. Methods: An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. Results: Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, …

The Effect Of Calcium Channel Blockers On Digital Ulcers In Systemic Sclerosis: Data From A Prospective Cohort Study, Laura Ross, Dylan Hansen, Nancy Maltez, Kathleen Morrisroe, Kimti Kumar, Jennifer Walker, Wendy Stevens, Joanne Sahhar, Gene-Siew Ngian, Lauren Host, Mandana Nikpour, Susanna Proudman

Journal Articles

Digital ulcers (DU) are a common, severe vascular manifestation of systemic sclerosis (SSc) with few effective treatment options. Using data from the Australian Scleroderma Cohort Study (ASCS), we sought to evaluate the effect of calcium channel blockers (CCB) on the treatment and prevention of DU.Using data from 1953 participants, with a median of 4.34 years of follow-up, we used generalised estimating equations to evaluate the clinical characteristics associated with CCB use and ascertain the risk factors for the presence of DU at subsequent study visits. A time-dependent Cox-proportional hazard model was applied to evaluate the risk of future occurrence of …

Youth Shelter Bed Bugs & Lice Education, Madeline Mary Rettenmier, Elvina S. Kuzubov, Quoc H. Phan, Megan Myra Joseph, Allie Mechtel

Nursing Leadership in Community Engagement Projects

Youth Shelter Bed Bugs & Lice Education
Allie Mechtel, Maddy Rettenmier, Elvina Kuzubov, Megan Joseph, Kevin Phan
School of Health Sciences, Seattle Pacific University
NUR 4153: Nursing Leadership in Community Engagement
Leah Ngoche DNP, MPH, ARNP-BC
8 November 2023

Youth Shelter Bed Bugs & Lice Education

Introduction

Seattle Pacific University Nursing students were assigned a fifth quarter leadership project in the greater Seattle area. Our group was assigned to a youth shelter located in Belltown, Seattle Washington. It is a thirty-bed, animal friendly shelter for young individuals looking for a safe place to stay. They offer long-term housing for those …

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …

Effect Of A Community Hospital’S Sustainable And Enhanced Fall Prevention Quality Improvement Program On Inpatient Falls And Falls With Injury: A Before And After Study, Anne Catino

DNP Scholarly Projects

The frequency of hospital falls is a significant clinical problem and directly related to patient safety. Failure to identify potential risk factors and to implement individualized measures for fall prevention can threaten patients’ safety and lead to increased hospital length of stay, increased hospital cost, and reduced quality of life for patients. The purpose of this project was to enhance an evidence-based, fall prevention program to effect a reduction in falls and falls injury. The project is supported by a multidisciplinary hospital team and builds on a community hospital’s fall reduction program. Falls and falls with injury frequencies for 6 …

Engaging Sleeplessness In Seattle At Clinical Site 1, Benjamin D. Masters, Luis Moreno Nunez, Ally Jo Veenhuizen, Kiana Rendorio

Nursing Leadership in Community Engagement Projects

Introduction

The National Library of Medicine notes an emerging area of research interest is the relationship between substance abuse and sleep (Mahfoud et al., 2009). According to the same 2007 National Survey on Drug Use and Health, “7.6 percent of Americans older than 12 years met the criteria for alcohol abuse or dependence” and goes on to highlight the mundanity of sleep disorder. Additionally, the 2008 National Sleep Foundation’s “Sleep in American” poll demonstrated “addicts in recovery are 5 to 10 times more likely to experience sleep disorders.” (Moufoud et al., 2009). Clinical Site 1 is an agency in Downtown …

Improving Patient Safety With A Pressure Injury Prevention Bundle In A Urban Intensive Care Unit, Radha Denmark, Cassie Belzer, Christopher Bartlett

Quality Improvement/Patient Safety Symposium

Gap Identification/Background

About 2.5 million Americans in acute care facilities develop a hospital-acquired pressure injury (HAPI) each year, with an incidence up to 45% in intensive care settings (ICUs)¹ costing $75,000-$150,000 per patient². They are painful, reduce quality of life, and increase morbidity and mortality, resulting in 60,000 deaths annually in the United States.²

Guideline recommendations are that HAPI prevention begins with a comprehensive risk assessment that is not dependent on a single risk tool since no single tool is comprehensive. However, a chart audit conducted in a 24-bed trauma-surgical intensive care unit (TSICU) of a …

Knowledge, Attitude, And Behavioral Intention About Oral Cancer Among Public Health Students In Southeast Georgia, Ravneet Kaur, Gulzar H. Shah

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Background: Oral cancer (OC) is a significant public health problem; however, the degree to which the future public health workforce is aware of this issue is not well researched. The purpose of this study is to explore the level of knowledge, attitudes, and behavioral intentions about OC among public health students.
Materials and Methods: A sequential exploratory mixed-method research design was employed for this study. Using quantitative and qualitative measures, a survey was administered to 129 public health students. Subsequently, to understand the quantitative findings, two follow-up focus groups were conducted with survey participants.
Results: We found …

Prevention Of Surgical Site Infection: A Ten-Step Approach, Saad Tarabichi, Javad Parvizi

Rothman Institute Faculty Papers

Surgical site infection (SSI) is a common cause of morbidity and mortality in patients undergoing surgery. Similarly, periprosthetic joint infection (PJI), is a major cause of failure after total joint arthroplasty (TJA). As the annual volume of TJA procedures is projected to rise, so will the rate of subsequent SSI and PJI. Currently, prevention has been identified as the single most important strategy for combating SSI/PJI. Hence, the present article will serve as a summary of an evidence-based ten-step approach for SSI/PJI prevention that may help orthopedic surgeons with their infection prevention strategies.

Exploring Modern Trends And Prevention Strategies For Childhood Obesity: A Comprehensive Literature Review, Anya E. Bogen

Honors Theses

This literature review seeks to provide an overview of the current research on childhood obesity. The study examines the prevalence and causes of childhood obesity, including genetic, environmental, and behavioral factors. The review also discusses the health consequences associated with childhood obesity, such as the increased risk for chronic diseases and psychological and social problems. Additionally, the review explores the effectiveness of interventions designed to prevent childhood obesity, including individual lifestyle modifications, education from health practitioners and school programs, and global, national, and state programs to promote wellness. The literature review concludes that childhood obesity is a complex and multifactorial …

Debunking Medical Myths: The Dangers Of Vaginal Douching, Madilyn Mason, Jesse Kato, Samaah Saifullah, Emmanuel Meram, Brandon Brown, Hasti Nema

Patient Education Projects

No abstract provided.

Debunking Medical Myths: Saw Palmetto Helps Prevent Prostate Cancer, Deepa Raghavan, Dipra Debnath, Ranya Krayem, Constance Cleveland, Jay Maixner, Zane Mustafa

Patient Education Projects

No abstract provided.

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani

Office of the Provost

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and …

Exploring Sociodemographic Correlates Of Suicide Stigma In Australia: Baseline Cross-Sectional Survey Findings From The Life-Span Suicide Prevention Trial Studies, Lisa N. Sharwood, Alison L. Calear, Philip J. Batterham, Michelle Torok, Lauren Mcgillivray, Demee Rheinberger, Stephanie Zeritis, Tuguy Esgin, Fiona Shand

Research outputs 2022 to 2026

The risk of suicidal behaviour in Australia varies by age, sex, sexual preference and Indigenous status. Suicide stigma is known to affect suicide rates and help-seeking for suicidal crises. The aim of this study was to investigate the sociodemographic correlates of suicide stigma to assist in prevention efforts. We surveyed community members and individuals who had attended specific emergency departments for suicidal crisis. The respondents were part of a large-scale suicide prevention trial in New South Wales, Australia. The data collected included demographic characteristics, measures of help-seeking and suicide stigma. The linear regression analyses conducted sought to identify the factors …

The Association Of Adolescents' Smoking With The Physical Activity Levels Of Their Friends, R.A. Smit, M.A.G. Kuipers, B. Federico, Luke Clancy, J. Perlman, A.D. Rozema, A.E. Kunst

Articles

Background: Smoking is inversely related to people's Physical Activity Level (PAL). As the behavior of friends may affect the choices and behavior of adolescents, having friends with a high PAL may potentially protect against adolescent smoking. This study aims to assess whether adolescents' smoking is associated with the PAL of their friends. Methods: SILNE-R survey data of 11.918 adolescents from 55 different schools in 7 European cities was used to determine weekly smoking, individual PAL, PAL of friends, school PAL, and smoking of friends. Multilevel, multivariable logistic regression analysis were used to assess the association between the PAL of friends …

Mpox (Formally Known As Monkeypox), Molly O'Neill, Tricia Lepage, Vanessa Bester, Henry Yoon, Frederick Browne, Eric C. Nemec

Physician Assistant Studies Student Publications

Mpox originates from the Mpox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family.1, 2, 3 Other Orthopoxvirus species include the variola virus (the now eradicated smallpox virus), vaccinia virus (a virus used in the creation of the smallpox vaccine), and cowpox virus.1, 2, 3 The identified clades consist of the West African clade and the Congo Basin clade, each with varying fatality rates of 1% and 10%, respectively.1, 2, 3, 4 Since the eradication of smallpox in 1980, the Mpox virus has emerged as the most relevant Orthopoxvirus infection in humans.

A Novel Skin Cancer Prevention Strategy: Preservice Teachers' Perceptions Of A Sun Safety Intervention And Experiences In Schools, Joseph J. Scott, Robyn S. Johnston, Jill Darby, Sally Blane, Mark Strickland, Bronwen M. Mcnoe

Research outputs 2022 to 2026

Issue addressed:

Teachers play a vital role in developing children's sun protection routines however upskilling preservice teachers (PSTs) while at university has not yet been trialled as a targeted skin cancer prevention strategy. Hence, this study investigated PSTs perceptions and experiences of sun safety following a brief pilot intervention and placement in primary schools in Western Australia.

Methods:

This study used a triangulation mixed methods design. Participants (n = 161) completed a post intervention survey which was analysed quantitatively. A random sub-sample was invited to participate in focus groups (three groups, n = 21) and one-on-one interviews (n = 4). …

Tourism Experiences Reduce The Risk Of Cognitive Impairment In The Chinese Older Adult: A Prospective Cohort Study, Qian Li, Zheng Guo, Fangli Hu, Mengfei Xiao, Qiang Zhang, Jun Wen, Tianyu Ying, Danni Zheng, Youxin Wang, Song Yang, Haifeng Hou

Research outputs 2022 to 2026

Background: Given the etiological complexity of cognitive impairment, no effective cure currently exists for precise treatment of dementia. Although scholars have noted tourism’s potential role in managing cognitive impairment and mild dementia, more robust empirical investigation is needed in this area. This study aimed to examine the associations between tourism and cognitive impairment and dementia in older Chinese adults. Method: From a nationwide community-based cohort, 6,717 individuals aged ≥ 60 were recruited from 2011 to 2014, of whom 669 (9.96%) had had at least one tourism experience in the 2 years prior to enrollment. All the participants were then prospectively …

Women’S Views On Obstetric Fistula Risk Factors And Prevention In North-Central Nigeria: An Interpretive Descriptive Study, Lydia Babatunde Bulndi, Deborah Ireson, Esther Adama, Sara Bayes

Research outputs 2022 to 2026

Objective: Obstetric fistula, also known as vesicovaginal fistula or rectovaginal fistula, is an abnormal opening between the vagina and rectum caused by prolonged obstructed labour that causes substantial long-term harm to women. It is most prevalent in low resource settings and although preventative measures have been proposed, they have not, to date, taken women’s own views into account. The objective of this study was to explore the views of North Nigerian women on obstetric fistula risk factors and prevention.

Design: This study was conducted using Interpretive Description methodology, which is a qualitative approach underpinned by Symbolic Interactionism. A semistructured questionnaire …

Investigating The Effects Of An Occupational Safety Course On Needlestick Injury Prevention And Incident Reporting For Emergency Department Registered Nurses: A Quality Improvement Project, Shadaina Dessalines

Nicole Wertheim College of Nursing Student Projects

Abstract

Background: Needlestick injuries are a well-known hazard in the workplace, especially in healthcare settings. Despite knowledge of the potential consequences after sustaining a needlestick injury, numerous incidents remain unreported by healthcare workers.

Aim: This quality improvement project examined whether an interactive occupational safety course regarding needlestick injury prevention and incident reporting in the workplace would positively influence the knowledge, attitudes, and behaviors of emergency department registered nurses regarding needlestick injury prevention and incident reporting.

Design: Pre and post-test survey design.

Sample and Setting: Five registered nurses staffed in the emergency department of a public 716-bed, pediatric and adult hospital. …

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler

Office of the Provost

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …

Survival Analysis And Prognostic Factors Of The Carcinoma Of Gallbladder, Zainab Feroz, Priyanka Gautam, Sonia Tiwari, Girish C. Shukla, Munish Kuma

Biological, Geological, and Environmental Faculty Publications

Background: The present study aims to evaluate the survival status of patients with gallbladder cancer (GBC) and explore the prognostic factors for the improvement and preventions.
Methods: The study consists of 176 patients with clinically diagnosed gallbladder cancer; the study was conducted between 2019 and 2021 registered at Kamala Nehru Memorial Cancer Hospital, Prayagraj, India. The survival rates were analyzed by the Kaplan-Meier method; survival rate difference was analyzed by log-rank test, prognosis factors; and hazard ratio for mortality outcomes was estimated using Cox regression method.
Results: The overall median survival time of patients was 5 months with the 1-year, …

Drug-Resistant Bacterial Infections: We Need Urgent Action And Investment That Focus On The Weakest Link, Christiane Dolecek, Sadia Shakoor, Buddha Basnyat, Tochi Okwor, Benn Sartorius

Department of Pathology and Laboratory Medicine

Despite high mortality and morbidity, drug-resistant bacterial infections remain the forgotten pandemic. We argue for strengthening of diagnostics, WASH (water, sanitation, and hygiene) and infection prevention and control to reduce drug-resistant infections, as an integral part of sustainable high-quality health services, particularly in low- and middle-income countries.

Oral N-Acetyl Cysteine Versus Rectal Indomethacin For Prevention Of Post Ercp Pancreatitis: A Multicenter Multinational Randomized Controlled Trial, Pezhman Alavinejad, Nguyen-Phuong Nhu Tran, Omid Eslami, Omar El Shaarawy, Omar El Shaarawy, Ahmad Hormati, Seied Saeed Seiedian, Abazar Parsi, Mohammed Hussien Ahmed, Amna Subhan Butt

Section of Gastroenterology

Background: This multicenter multinational RCT designed to compare the efficacy of suppository indomethacin and NAC for prevention of PEP.
Methods: During a 6-month period, all of the ERCP cases in seven referral centers were randomly assigned to receive either 1200 mg oral NAC, indomethacin suppository 100 mg, 1200 mg oral NAC plus indomethacin suppository 100 mg or placebo 2 hours before ERCP. The primary outcomes were the rate and severity of any PEP.
Results: A total of 432 patients included (41.4% male). They were originally citizens of 6 countries (60.87% Caucasian). They were randomly allocated to receive either NAC (group …

The Importance Of An Early Onset Of Migraine Preventive Disease Control: A Roundtable Discussion, Christopher Gottschalk, Anirban Basu, Andrew Blumenfeld, Bradley Torphy, Michael J. Marmura, Jelena M. Pavlovic, Paula K. Dumas, Nim Lalvani, Dawn C. Buse

Department of Jefferson Headache Center papers and presentations

Background: Newly approved migraine preventive therapies have allowed for rapid control of migraine activity, offering potential to minimize the burden of migraine. This report summarizes a roundtable discussion convened to analyze evidence for early onset of prevention, ascertain its clinical relevance, and provide guidance for healthcare professionals in crafting goals and treatment expectations for patients with migraine initiating preventive therapy.

Methods: A virtual roundtable meeting of migraine clinicians, researchers, and patient advocates convened in October 2020. Participants reviewed and discussed data summarizing patient and healthcare professional perceptions of migraine prevention and evidence from the peer-reviewed and gray literature to develop …

Cardiorespiratory Fitness Is A Risk Factor For Lower-Limb And Back Injury In Law Enforcement Officers Commencing Their Basic Training: A Prospective Cohort Study, Myles C. Murphy, Nicole Merrick, Andrea B. Mosler, Garth Allen, Paola Chivers, Nicolas H. Hart

Research outputs 2022 to 2026

We aimed to report the epidemiology of lower-limb and lumbosacral injuries in Police Force recruits. We performed a cohort study of Police Force recruits undergoing a six-month training program with prospective injury data collected between 2018 and 2021. Cardiorespiratory fitness was quantified by the beep-test and police-specific-functional-capacity was quantified using a specifically designed physical performance evaluation (PPE) tool. Injury frequency and prevalence were reported. Fifteen percent (n = 180) of study Police Force recruits (n = 1,181) sustained a lower-limb or lumbosacral injury. The six-month training program significantly improved cardiorespiratory fitness (p < 0.001) and functional capacity (p < 0.001). Increased cardiorespiratory fitness at baseline decreased injury risk (OR = 0.8, 95%CI: 0.66–0.97, p = 0.019). Injury rates decreased over time and females were injured significantly earlier than males (HR = 0.70, 95%CI: 0.52 to 0.95, p = 0.021). Interventions that can pre-condition Police Force recruits prior to the commencement of their basic physical training may reduce the number of lower-limb and lumbosacral injuries.

Age Related Macular Degeneration, Kathryn J. Hopsicker

Student Publications

This paper is a literature review on the subject Age-Related Macular Degeneration (AMD) with a focus on its etiology, pathophysiology, clinical features, diagnosis, treatment, and prevention. AMD is the leading cause of severe and irreversible central vision loss in in individuals over the age of 55. There are two subtypes of AMD referred to as dry and wet respectively. The etiology of this disease is multifactorial and complex, with no hallmark of disease definitively identified. The distinct pathophysiological features differing in dry and wet AMD are explored in this review as well as its diagnosis and treatment. This disease is …