Immune System Diseases Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Vitamin C Contributes To Epigenetic Regulation Of Genes Related To Diabetic Retinopathy In Retinal Endothelial Cells, Elizabeth L. Turner, Jonathon Reynolds, Walker Kay, Marianne Becnel, Matthew Conway, Alexander Kim, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

No abstract provided.

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson

Doctor of Nursing Practice (DNP) Projects

Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between …

Routine Immunization Coverage And Immunization Card Retention In Pakistan: Results From A Cross-Sectional National Survey, Imtiaz Hussain, Ahmad Khan, Dale A. Rhoda, Imran Ahmed, Muhammad Umer, Uzair Ansari, Muhammad Akram Shah, Soofia Yunus, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Immunization is one of the most successful public health interventions available, saving millions of lives from death and disability each year. Therefore, improving immunization coverage is a high priority for the Government of Pakistan and essential to progress toward universal health coverage. This survey reports the national and provincial/regional coverage and determinants of fully, partially, and not-vaccinated children aged 12–23 months, antigen-wise coverage, percentage of home-based vaccination records (HBR) retention, and reasons for nonretention; dropout, timeliness, and prevalence of missed opportunities for simultaneous vaccination (MOSV).
Methods: The survey was a descriptive cross-sectional national household survey carried out across Pakistan. …

Myasthenia Gravis, Rebecca Wheeler

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG), a neuromuscular and autoimmune disorder, is not completely understood by clinicians and scientists. The primary cause is thought to be anti-Acetylcholine receptor antibodies that attack the neuromuscular junction, causing destruction of post-synaptic junctional folds and blockade of the receptor. This causes frequent weakness and fatigability of voluntary muscles, making activities of daily living difficult for those living with MG. Although it is not an incredibly prevalent disease, the incidence is increasing in the United States due to better testing and diagnosis. Treatments are available, including cholinesterase inhibitors that raise the concentration of Acetylcholine at the neuromuscular junction …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp

Dissertations

Problem: Life expectancy for people living with HIV significantly increased with widespread use of antiretroviral therapy, resulting in population increases in comorbidity prevalence. The increased burden of living with both HIV and comorbidities lowers health-related quality of life (HRQoL).

Methods: Using a descriptive, correlational, cross-sectional design, a convenience sample of HIV-positive adults was selected from seven supportive housing communities. Comorbidities were assessed using a modified Self-Administered Comorbidity Questionnaire, and HRQoL using the Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health.

Results: A sample of 17 (N = 17) adults reported a mean of 4.2 (SD = …

From Caregiver To Patient And Back Again ... My Covid Experience, Marie B. Thornton

Journal of Interprofessional Practice and Collaboration

As a Registered Nurse and a member of the nursing faculty at a public university, my primary role and instinct is to be a caregiver. Here is my story about becoming a patient with COVID-19 and finally returning to be a caregiver once again.

Combined Effects Of Gender Affirmation And Economic Hardship On Vulnerability To Hiv: A Qualitative Analysis Among U.S. Adult Transgender Women., Larissa Jennings Mayo-Wilson, Eric G. Benotsch, Sheila R. Grigsby, Sarah Wagner, Fatmata Timbo, Tonia Poteat, Lauretta Cathers, Ashlee N. Sawyer, Shelby A. Smout, Rick S. Zimmerman

School of Nursing Faculty Publications

Background: Transgender women ("trans women"), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hardship and sexual risk. This study qualitatively examined how gender-affirming behaviors enhance or diminish vulnerability to HIV in light of structural and economic barriers to gender transition.Methods: We conducted individual interviews with 19 adult trans women in two U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

Hiv Screening In Non-Pregnant Patients Age 13 – 64 Years Old In Primary Care Through The Implementation Of The Cdc Guidelines For Hiv Screening, Ashten M. Martin

Doctor of Nursing Practice

As many as 216,000 people living with HIV are unaware they have the disease. In order to combat the inadvertent spreading of HIV, the CDC recommends screening everyone 13 – 64 years of age. The purpose of this Quality Improvement project was to implement the 2015 Sexually Transmitted Diseases Treatment Guidelines as it pertains to HIV screening within a Southeast Texas rural health clinic. The objectives were 1) educating all staff and patients regarding the CDC recommendations for HIV screening, and 2) increase the number of eligible patients who were offered and received HIV screening. A colored checklist served as …

Hiv Knowledge, Attitudes, And Sexual Risk Behaviors Among Women From Trinidad, Rosemarie Graczkowski

FIU Electronic Theses and Dissertations

Currently, the Caribbean has the second highest new cases of HIV infection, only after Sub-Saharan Africa. Women are becoming disproportionally more at risk for HIV/AIDS, mainly through heterosexual contact. The purpose of this dissertation study was to evaluate HIV knowledge, attitudes, and sexual risk behaviors among Trinidadian women. A sample of 113 participants was recruited for this study. The Theory of Planned Behavior (TPB) and Purnell Model of Cultural Competence were used to guide this study. Data were gathered using the HIV Knowledge Questionnaire (HIV-KQ-18), Condom Attitude Scale (CAS), Safe Sex Behavior Questionnaire (SSBQ), and a demographic questionnaire. Data were …

Studies Of Amino Acid Mutations In Drug Resistance Of The Smo Protein, Eunice Wintona

UNO Student Research and Creative Activity Fair

Smoothened receptor (SMO) is a protein that in humans, is encoded by the SMO gene. A systemic mutation in its binding pocket helps predict the sensitivity of mutant proteins to different drugs. Known as a GPCR-like receptor, it is a component of the hedgehog signaling pathway; a pathway involved in body patterning and the regulation of adult stem cells. An uncontrolled or inappropriate activation of the Hedgehog pathway drives tumor progression in cancers and a number of birth defects. To achieve these goals, the molecular modeling software MOE was used to build small molecules and drug molecules like Vismodegib and …

The Effect Of Ostomate-To-Ostomate Support On Psychosocial Adaptation To Stoma, Marjorie C. Summers

Doctor of Nursing Practice Projects

Approximately one million people in North America are living with an ostomy, and an additional 100,000 will undergo ostomy surgery annually. Persons living with ostomies, often referred to as ostomates, require specialized care and management to sustain physical health and quality of life. Fecal diversion ostomates, when compared to the general population, are more likely to experience psychological disturbance and higher levels of depression. These ostomates have reported increased loneliness, lowered self-esteem, decreased or absent libido, irritability, suicidal ideation, poor self-image, and symptoms of generalized anxiety disorder and social phobia. Being an ostomate has been associated with a reduction in …

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Tb Screening Guidelines For Transitional Care Unit, Caleb E. Newcomer

Scholars Week

The basis of this research was the formation of new TB screening and risk assessment guidelines on a Transitional Care Unit within a medical center. Current evidence-based research studies helped to guide the recommendations for the policy changes based on their results and findings. The most pertinent policy changes are the treatment offered for patients suspected with HIV, the rigorous use of the Risk Assessment Tool, and BAMT testing for TB.

Myasthenia Gravis, Abbe R. Feaver

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease characterized by ocular, bulbar, facial, and skeletal muscle weakness due to a defect in the transmission of nerve to muscle impulses at the neuromuscular junction (Mestecky, 2013, p. 110). Approximately 14-20 in 100,000 people are diagnosed with myasthenia gravis in the United States (Leis, Moore, Kofler, Beric, De Visser, 2014, p. 112). Typically, diagnosis occurs in middle-aged adults with women generally acquiring the disease at a younger age than men (Mestecky, 2013, p. 110). MG has the potential to greatly affect the quality of life of a patient. Although the disease …

Acute Immune Thrombocytopenia Purpura, Erin Woodworth

Nursing Student Class Projects (Formerly MSN)

Immune thrombocytopenic purpura (ITP), formerly known as idiopathic thrombocytopenic purpura, is a relatively rare, but potentially life threatening autoimmune disorder that involves the destruction of platelets by autoantibodies. The resultant decreased platelet count leaves the patient at risk for excessive bruising and bleeding (Hunt, 2010). ITP can occur in both adults and children, and also occurs as an acute or chronic disorder. It is thought that the cause of acute ITP may differ from that of chronic ITP, however, the underlying disease processes that occur are very similar (Johnsen, 2012). Acute ITP, the most common form of the disease, most …

Sle And Pregnancy, Patricia Graham

Nursing Student Class Projects (Formerly MSN)

Systemic lupus erythematosus (SLE) is a life-long, life-threatening autoimmune disease which can affect any organ in the body (Marks & Tullus, 2011). SLE disproportionately affects women in a ratio of 9:1 compared to men with most women being affected during child-bearing age (15-50 years) (Ferenkeh-Koroma, 2012). Pregnancy represents a challenge for the patient with SLE. Pregnant patients with SLE are considered high-risk for multiple medical and obstetric complications, as flares are related to increased irreversible organ damage (Ateka- Barrutia & Khamashta, 2013). Severe flares are also associated with poor fetal outcomes (Peart & Clowse, 2014). Successful pregnancies happen in 67% …

Implementation Of Motivational Interviewing In A Multidisciplinary Hiv Clinic In An Academic Medical Setting, Lucy Ledesma

Doctoral Dissertations

Purpose: People living with HIV (PLWH) struggle with medication adherence. Antiretroviral therapy (ART) requires greater than 95% adherence to prevent HIV drug resistance and treatment failure. Motivational interviewing (MI) is an effective counseling method designed to enhance health behavior change. This project determined the effectiveness of a two-day introductory MI training course on participant MI knowledge, perception of MI effectiveness, perception of client behavior change, and likelihood of MI use in a Midwest outpatient HIV clinic.

Participants: Seven clinical and non-clinical members of the multidisciplinary care team completed the two-day MI training course. Approximately 82% of the participants had never …

Introduction: A Changing Indonesia, Maribeth Erb, Kathleen M. Adams

Kathleen M. Adams

No abstract provided.

An Intersectional Perspective On Stigma As A Barrier To Effective Hiv Self-Management And Treatment For Hiv-Infected African American Women, Kimberly Adams Tufts

Nursing Faculty Publications

Among those who are HIV-infected and striving to live well with HIV, African American women have poorer health outcomes and represent a higher portion of those women who die from HIV-related causes. Those health inequalities have been associated with the presence of social determinants of health such as stigma. This analytical review asserts that stigmas precipitated by gender, race, and class in the context of HIV-related stigma constitute substantial barriers to active engagement in HIV self-management, care, and treatment for HIV-infected African American women. The utility of the intersectionality framework for analyzing how these various stigmas interact to create unique …

Global Burden Of Tuberculosis, Diana Moses

Nursing Student Class Projects (Formerly MSN)

Tuberculosis (TB) is a major health concern not only in the United States, but in the entire world. TB is an airborne communicable infection which has affected human beings from immemorial times, evidenced by TB being found in the skeletal remains of ancient mummies (Gough & Kaufman, 2011). There are many patho physiological events in TB that concern the entire body, especially the respiratory and immunological systems. According to Knechel, TB prevalence is rising due to the increased number of patients infected with HIV, bacterial resistance to medications, increased international travel and immigration from countries with high prevalence of TB, …

Myasthenia Gravis: A Closer Look, Erin L. Ricker

Nursing Student Class Projects (Formerly MSN)

Myasthenia gravis (MG) is a rare, chronic autoimmune disease that affects the neurotransmitter acetylcholine and the acetylcholine receptors at the neuromuscular junction (Mestecky, 2013). MG causes fluctuating skeletal muscle weakness and fatigue. According to the Myasthenia Gravis Foundation of America (MGFA) (2010), 20 per 100,000 patients are diagnosed with MG, although researchers believe several more patients are misdiagnosed or missed entirely. Several neurological disorders have similar clinical presentations to MG making it difficult for inexperienced practitioners to identify and properly diagnose patients. Patients are often misdiagnosed and delayed proper treatment for one to two years after initial presentation of symptoms …

Steven-Johnson’S Syndrome/Toxic Epidermal Necrolysis, Lindsey Grant

Nursing Student Class Projects (Formerly MSN)

Steven-Johnson’s Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are both diseases mediated by hypersensitive immune reactions resulting in “full thickness epidermal necrosis” characterized by skin detachment. However, in SJS, there is only 10% skin surface area involvement whereas in TEN, over 30% of the skin becomes detached. TENS has a 50% mortality rate. (East-Innis & Thompson, 2013, p. 590) Why Chosen: SJS/TEN is a rare but extremely fatal disease. Initially, it is often mistaken as a simple allergic reaction to a new medication or environmental exposure because both cause truncal rashes and fevers. However, simple allergic reactions occur within days …

Isolation Of Lesbian, Gay, Bisexual, And Transgender Youth: A Dimensional Concept Analysis, Michael Johnson, Elaine Amella

Interdisciplinary Research Scholarship Day

Present the findings of a dimensional concept analysis of isolation within the context of LGBT youth. LGBT youth are at greater risk for negative health outcomes as compared to heterosexual youth, including depression, anxiety, suicide, substance abuse, and HIV/AIDS. Some studies suggest LGBT feeling and being isolated is related to some negative health outcomes. Other research reveals a relationship between isolation and negative health

Methodological Quality Of Quantitative Nursing Lesbian, Gay, Bisexual, And Transgender Research From 2000 To 2010, Michael Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lesbian, gay, bisexual, and transgender (LGBT) people constitute one of the largest underserved populations in any nursing setting. Despite the large LGBT populations, very little nursing research has been conducted on these populations. Nurse researchers have recommended that nursing researchers end the silence on LGBT research. To accomplish this, the methodological rigor of LGBT nursing research must be evaluated and improved upon. Currently, no literature examines the methodological quality of quantitative nursing LGBT research. Using a cross-sectional design, it was the purpose of this study to evaluate the methodological quality of quantitative nursing LGBT research from 2000 to 2010 using …

Identifying And Co-Managing The Hiv-Infected Adult: A Guidebook For Primary Care Clinicians, Jason Leider, Susan F. Lelacheur, Julie G. Stewart Dnp, Mph

Nursing Faculty Publications

This guidebook was designed to help primary care clinicians improve their performance in terms of HIV identification and co-management. Surmounting barriers to opt-out screening, making an HIV diagnosis, and preventing transmission and opportunistic infections will be discussed, as will selection of initial therapy and considerations for patients receiving antiretroviral therapy (ART).

Successful Aging And The Epidemiology Of Hiv, David E. Vance, Teena Mcguinness, Karen Musgrove, Nancy Ann Orel, Pariya L. Fazeli

Gerontology Faculty Publications

By 2015, it is estimated that nearly half of those living with HIV in the US will be 50 years of age and older. This dramatic change in the demographics of this clinical population represents unique challenges for patients, health care providers, and society-at-large. Fortunately, because of highly active antiretroviral therapy (HAART) and healthy lifestyle choices, it is now possible for many infected with HIV to age successfully with this disease; however, this depends upon one’s definition of successful aging. It is proposed that successful aging is composed of eight factors: length of life, biological health, cognitive efficiency, mental health, …