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First Examination Of Palynolgy Across The K-Pg Boundary In The Jackson Purchase Region Of Kentucky, Maeve Mccarty, Jarred Asselta, Gary Stinchcomb, William Lukens, Ingrid Romero, Matthew Pound, Jen O’Keefe

2023 Celebration of Student Scholarship - Poster Presentations

This study examines the Independence School section of the K-Pg Boundary, which is located in a creek cutbank exposure in Carlisle County, in the Jackson Purchase region of Kentucky. This section has not otherwise been examined since 1980 and has not previously been palynologically studied in detail. Specifically, we are examining the Owl Creek and upper McNairy Formations, deposited as Maastrictian-age sediments and the Clayton Formation, deposited as Danian- age sediments, in a mosaic of onshore, nearshore, and coastal environments (Tschudy, 1970; Olive, 1980). The site was relocated by G. Stinchcomb and students from Murray State University in 2020 and …

2023- The Twenty-Seventh Annual Symposium Of Student Scholars

Symposium of Student Scholars Program Books

The full program book from the Twenty-seventh Annual Symposium of Student Scholars, held on April 18-21, 2023. Includes abstracts from the presentations and posters.

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Addition Of Mental Health To The Lady Health Worker Curriculum In Pakistan: Now Or Never, Fauziah Rabbani, Samina Akhtar, Javeria Nafis, Shahid Khan, Sameen Siddiqi, Zul Merali

Brain and Mind Institute

The technical advisory group of the World Health Organization (Geneva, Switzerland) has suggested person-centered and community-based mental health services in response to the long-term and far-reaching mental health impacts of the COVID-19 pandemic. Task shifting is a pragmatic approach to tackle the mental health treatment gap in low- and middle-income countries. Pakistan is dismally resourced to address the mental health challenges. Pakistan’s government has established a lady health worker’s program (LHW-P) which can be effectively utilized to provide some basic mental health services at community doorsteps. However, lady health workers’ current curriculum does not include mental health as a subject. …

Implementation Of A Daily Central Line Maintenance Audit Form In An Outpatient Infusion Center: A Quality Improvement Project, Sarah E. Christiana

DNP Projects

Significance and Background: Best evidence supports central venous access device (CVAD) dressing changes occur every 7 days or sooner, if indicated. At a community hospital in New England, patients receive outpatient antimicrobial therapy via CVADs. It is vital that nurses adequately maintain CVAD dressings according to evidence-based protocols to reduce the risk of central line-associated bloodstream infection (CLABSI). CLABSIs, associated with increased morbidity, mortality, and health care costs, are largely preventable through proper CVAD maintenance. At the project site, a review identified that dressing changes were frequently changed beyond the 7-day parameter. Documentation and surveillance processes were identified as opportunities …

Healthcare In Honduras, Emmett Miller

Honors Projects

Healthcare does not exist in a vacuum. It is influenced by the geography of the area where it is provided, the infrastructure available, the politics that impact its funding, and many other factors. The Honduran Health System is no different. This paper will review the healthcare in Honduras and the challenges to its effectiveness. The first area that will be addressed is the geography of Honduras and how this geography has affected the ability of its citizens to access the services provided by the Health System. The second area to be covered will be the infrastructure and training that is …

Addressing Verbal Aggression To Reduce Workplace Violence Against Nurses, Rebecca Harris

Doctor of Nursing Practice Projects

Background: Almost three-quarters of non-fatal workplace violence-related injuries requiring time away from the workplace occur in the healthcare and social services sector. More than 90 percent of assaults against nurses are from patients. Verbal aggression was correlated with physical violence and could contribute to nurses’ stress and dissatisfaction and compromise patient care. Policies and guidelines addressing verbal aggression against nurses are often unclear and not well-supported by evidence. This can leave nurses unprepared to recognize and respond to verbal aggression or threats of physical harm without compromising their safety.

Aim: This health policy analysis aimed to explore a range of …

Virtual Patient/Family Communication In The Acute Care Setting, Kathleen Defigueiredo

Translational Projects (Open Access)

Patient and family-centered care strategies see patients and families as valuable healthcare team members. Such strategies thus treat these groups as essential clinical partners in providing safe, high-quality care. Participation, collaboration, and shared decision-making are central to this framework. Historically, hospitals have relied on physical presence at the bedside as a prerequisite to engaging families in the shared decision-making process. Visitor restrictions of the COVID-19 pandemic removed the primary strategy for family participation: physical presence. Healthcare organizations rapidly deployed mobile devices to help minimize the exposure of healthcare providers and provide video visits for family members. This deployment was often …

Migrants Sans Papiers: The Impact Of Cantonal Program And Policy Discrepancies On Undocumented Migrant Healthcare Utilization In Switzerland, Denise Peng

Independent Study Project (ISP) Collection

While Switzerland houses what is generally considered one of the best healthcare systems globally, regional policy discrepancies leave undocumented migrants (UDM) in precarious conditions that threaten the nation’s claim to universal health coverage. Critical analyses of existing UDM-catering structures in different cantons, the Swiss Confederation member states, reveal that local discrepancies in healthcare utilization are functional gradients of cantonal support and public endorsement. Relationships with these authorities are instrumental in steering health outcomes not only with program funding and outreach but also management of studies to better understand UDM health determinants and inform future preventative measures.

UDM services and initiatives …

A Comparative Study Of Access To Fetal Echocardiography In Hospital-Based Versus Ambulatory Sites At A Single Cardiac Center, Elena Tsemberis, Bryanna N. Schwartz, Megan B. Barbosa, Jennifer H. Klein, Mary Donofrio, Anita Krishnan

GW Research Showcase 2021-2026

No abstract provided.

2023 Research Day Program, Lincoln Memorial University

Research Day

This program contains abstracts and presentation summaries from LMU's 2023 Annual Research Day conference.

Far From Home: The Role Of Travel Distance And Care Fragmentation In Surgical Outcomes For Inflammatory Bowel Disease, Alexander Booth, Henry Colorado, Gayenell Magwood Phd, Rn, Faha, Faan, Erin Forster, Robert N. Axon, Thomas Curran

Publications

BACKGROUND: Fragmented care for inflammatory bowel disease (IBD) is known to correlate negatively with outcomes, but it is unclear which aspects of care fragmentation are relevant and potentially modifiable. Furthermore, there is little data on the relationship between travel distance and the benefits of integrated care models. Hypothesizing care coordination in the preoperative period may have a significant impact on surgical outcomes, we explored associations between integrated care, travel distance, and surgical outcomes. METHODS: A single-center retrospective cohort study of patients undergoing index abdominal surgery was done to compare the rate of surgical complications with and without long travel distance …

Can Changing Neighborhoods Influence Mental Health? An Ecological Analysis Of Gentrification And Neighborhood-Level Serious Psychological Distress—New York City, 2002–2015, Karen A. Alroy, Haleigh Cavalier, Aldo Crossa, Shu Meir Wang, Sze Yan Liu, Christina Norman, Michael Sanderson, L. Hannah Gould, Sung Woo Lim

Department of Public Health Scholarship and Creative Works

Neighborhood conditions influence people’s health; sustaining healthy neighborhoods is a New York City (NYC) Health Department priority. Gentrification is characterized by rapid development in historically disinvested neighborhoods. The gentrification burden, including increased living expenses, and disrupted social networks, disproportionally impacts certain residents. To ultimately target health promotion interventions, we examined serious psychological distress time trends in gentrifying NYC neighborhoods to describe the association of gentrification and mental health overall and stratified by race and ethnicity. We categorized NYC neighborhoods as hypergentrifying, gentrifying, and not-gentrifying using a modified New York University Furman Center index. Neighborhoods with ≥100% rent growth were hypergentrifying; …

Oral Health Considerations For Aging Patients Living With Hiv/Aids, Madeleine Daily Dds, Susan Liu Dds, Yuna Park Dds, Mph, Ms, Emily Byington Msw, Ivette Estrada Ma, Mphil, Sunil Wadhwa Dds, Carol Kunzel Phd

The New York State Dental Journal

People living with HIV/AIDS (PLWH) have an increased life expectancy due to advances in antiretroviral therapy. In 1996, the life expectancy for a 20-year old living with HIV was 39-years old; today, it is >70-years old. As life expectancy increases, PLWH are burdened with age-associated comorbidities. This paper reviews the interaction between aging and HIV and how it affects social, physical, and oral health issues. The shift in demographics presents new challenges for clinicians in how to identify, address, and manage these complex manifestations. This review summarizes how to approach HIV-related changes when providing care as a dental clinician.

Telemedicine Among Adults Living In America During The Covid-19 Pandemic, Man Hung, Monica Ocampo, Benjamin Raymond, Amir Mohajeri, Martin S. Lipsky

Institute on Aging Publications

Background and Objectives Telemedicine can expand healthcare access to populations, but relying on technology risks a digital divide. Therefore, it is important to understand who utilizes telemedicine. This study explores telemedicine usage across socio-demographic groups in the United States during COVID-19. Methods Data came from the Household Pulse Survey (HPS) between 14 April 2021, to 11 April 2022. HPS is a rapid online response survey that assesses household experiences during COVID-19. We calculated descriptive statistics and used cross-correlation to test each pair of the time series curves. Results High school graduates used the least telemedicine (20.58%), while those with some …

The Intersectionality Of Race And Rurality In Polysubstance Use During Pregnancy In The United States: A Study Of National Survey On Drug Use And Health, Sophia Tavakol

Senior Theses

Importance: Though detrimental consequences, many pregnant individuals are still binging alcohol, smoking, and/or using illicit drug. Yet, little is known regarding variations in such behaviors across pregnant people in the United States.

Objective: To examine alcohol, tobacco, and drug use during pregnancy in 2015-2020 and assess their racial, ethnic, and rural disparities.

Design: This cross-sectional descriptive study derived maternal characteristics and self-reported prenatal substance use data from 2015 and 2020 National Survey on Drug Use and Health, considering the complex sampling weight per participant per year produced by NSDUH.

Setting: United States.

Participants: A scientific random sample of non-institutionalized residents …

Wernicke's Encephalopathy: Mapping The Risk Factors Throughout The State Of South Carolina, Shannon M. Rychener

Senior Theses

Wernicke’s Encephalopathy is a consistently underrecognized neurodegenerative brain disorder resulting from prolonged thiamine deficiency. Clinical presentation of the disease results from brain lesions attributable to thiamine deficiency. Because these lesions occur in various locations in the cerebral cortex, symptoms can vary significantly. Varied presentation of symptoms, in addition to the lack of a widely accepted biomarker for the disorder cause challenges to clinicians when identifying and diagnosing the disorder. Due to these challenges, healthcare providers must heavily rely on patient history and risk factor prevalence when multiple symptoms of the disorder are present. By mapping the prevalence of the four …

A Non-Antibiotic-Disrupted Gut Microbiome Is Associated With Clinical Responses To Cd19-Car-T Cell Cancer Immunotherapy, Christoph K Stein-Thoeringer, Neeraj Y Saini, Eli Zamir, Viktoria Blumenberg, Maria-Luisa Schubert, Uria Mor, Matthias A Fante, Sabine Schmidt, Eiko Hayase, Tomo Hayase, Roman Rohrbach, Chia-Chi Chang, Lauren Mcdaniel, Ivonne Flores, Rogier Gaiser, Matthias Edinger, Daniel Wolff, Martin Heidenreich, Paolo Strati, Ranjit Nair, Dai Chihara, Luis E Fayad, Sairah Ahmed, Swaminathan P Iyer, Raphael E Steiner, Preetesh Jain, Loretta J Nastoupil, Jason Westin, Reetakshi Arora, Michael L Wang, Joel Turner, Meghan Menges, Melanie Hidalgo-Vargas, Kayla Reid, Peter Dreger, Anita Schmitt, Carsten Müller-Tidow, Frederick L Locke, Marco L Davila, Richard E Champlin, Christopher R Flowers, Elizabeth J Shpall, Hendrik Poeck, Sattva S Neelapu, Michael Schmitt, Marion Subklewe, Michael D Jain, Robert R Jenq, Eran Elinav

Faculty, Staff and Student Publications

Increasing evidence suggests that the gut microbiome may modulate the efficacy of cancer immunotherapy. In a B cell lymphoma patient cohort from five centers in Germany and the United States (Germany, n = 66; United States, n = 106; total, n = 172), we demonstrate that wide-spectrum antibiotics treatment ('high-risk antibiotics') prior to CD19-targeted chimeric antigen receptor (CAR)-T cell therapy is associated with adverse outcomes, but this effect is likely to be confounded by an increased pretreatment tumor burden and systemic inflammation in patients pretreated with high-risk antibiotics. To resolve this confounding effect and gain insights into antibiotics-masked microbiome signals …

Home-Based Cardiac Rehab Vs. Center-Based Cardiac Rehab In Rural Areas, Timothy Fresonke

Physician Assistant Scholarly Project Papers

Cardiac rehabilitation in rural areas can present unique challenges. The main challenge is the locations patients must travel to receive such care. Some patients are expected to travel more then an hour away, on multiple occasions during the week, to undergo therapy. This can be an issue for many patients and something that has been studied and is starting to be addressed in various countries. A literature review was done to see if there was a safe and effective alternative to the traditional center-based cardiac rehabilitation. The electronic search databases PubMed, Embase and CINAHL Complete were utilized to search for …

Shock Mobilities During Moments Of Acute Uncertainty, Biao Xiang, William L. Allen, Shahram Khosravi, Helene Neveu Kringelbach, Yasmin Y. Ortiga, Karen Anne S. Liao, Cuellar Jorge E., Lamea Momen, Priya Deshingkar, Mukta And Naik

Research Collection School of Social Sciences

The COVID-19 pandemic and interventions addressing it raise important questions about human mobility that have geopolitical implications. This forum uses mobility and immobility during the pandemic as lenses onto the ways that routinised state power reacts to acute uncertainties, as well as how these reactions impact politics and societies. Specifically, we propose the concept of "shock mobility" as migratory routines radically reconfigured: emergency flights from epicentres, mass repatriations, lockdowns, quarantines. Patterns of shock mobility and immobility are not new categories of movement, but rather are significant alterations to the timing, duration, intensity, and relations among existing movements. Many of these …

Prehospital Shock Index Predicts Outcomes After Prolonged Transport: A Multicenter Rural Study., James M Bardes, Bradley S Price, Hannah Bailey, Alexander Quinn, Zachary D Warriner, Andrew C Bernard, Aimee Lariccia, M Chance Spalding, Melissa B Linskey Dougherty, Scott B Armen, Alison Wilson

Trauma and Acute Care Articles

BACKGROUND: Shock index (SI) predicts outcomes after trauma. Prior single-center work demonstrated that emergency medical services (EMSs) initial SI was the most accurate predictor of hospital outcomes in a rural environment. This study aimed to evaluate the predictive ability of SI in multiple rural trauma systems with prolonged transport times to a definitive care facility.

METHODS: This retrospective review was performed at four American College of Surgeons-verified level 1 trauma centers with large rural catchment basins. Adult trauma patients who were transferred and arrived >60 minutes from scene during 2018 were included. Patients who sustained blunt chest or abdominal trauma …

Necrotizing Enterocolitis In Premature Infants-A Defect In The Brakes? Evidence From Clinical And Animal Studies., Venkatesh Sampath, Maribel Martinez, Michael Caplan, Mark A. Underwood, Alain Cuna

Manuscripts, Articles, Book Chapters and Other Papers

A key aspect of postnatal intestinal adaptation is the establishment of symbiotic relationships with co-evolved gut microbiota. Necrotizing enterocolitis (NEC) is the most severe disease arising from failure in postnatal gut adaptation in premature infants. Although pathological activation of intestinal Toll-like receptors (TLRs) is believed to underpin NEC pathogenesis, the mechanisms are incompletely understood. We postulate that unregulated aberrant TLR activation in NEC arises from a failure in intestinal-specific mechanisms that tamponade TLR signaling (the brakes). In this review, we discussed the human and animal studies that elucidate the developmental mechanisms inhibiting TLR signaling in the postnatal intestine (establishing the …

Development And Pilot Testing Of Internet-Delivered, Family-Based Cognitive Behavioral Therapy For Anxiety And Obsessive-Compulsive Disorders In Autistic Youth, Andrew G Guzick, Sophie C Schneider, Amanda B Perozo Garcia, Minjee Kook, Rebecca L Greenberg, David Riddle, Morgan Mcneel, Servando Rodriguez-Barajas, Michelle Yang, Blake Upshaw, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Cognitive behavioral therapy adapted for autistic youth with anxiety and/or OCD has a strong evidence base, but few have access. A 12-week family-based, Internet-delivered cognitive behavioral therapy (iCBT) program for 7-15 year-old autistic youth with anxiety and/or OCD was developed as a potential method to address this problem. Quantitative and qualitative feedback from stakeholders (parents, youth, clinicians) was gathered on an initial draft of content before conducting a pilot trial. This feedback suggested high quality, engagement, usability, and informativeness of the material. Suggestions were incorporated into the treatment program that was tested in a pilot trial. Eight families were randomized …

Telemental Health In Emergency Care Settings: A Qualitative Analysis Of Considerations For Sustainability And Spread, Mckenzie K Roddy, Patricia Chen, Alvin D Jeffery, Jeydith Gutierrez, Melissa Rubenstein, Corey Campbell, Eric Blake, Michael J Ward

Faculty, Staff and Students Publications

Objectives: Following rapid uptake of telehealth during the COVID-19 pandemic, we examined barriers and facilitators for sustainability and spread of telemental health video (TMH-V) as policies regarding precautions from the pandemic waned.

Methods: We conducted a qualitative study using semistructured interviews and observations guided by RE-AIM. We asked four groups, local clinicians, facility leadership, Veterans, and external partners, about barriers and facilitators impacting patient willingness to engage in TMH-V (reach), quality of care (effectiveness), barriers and facilitators impacting provider uptake (adoption), possible adaptations to TMH-V (implementation), and possibilities for long-term use of TMH-V (maintenance). Interviews were recorded, transcribed, and analyzed …

Advancing Diagnostic Equity Through Clinician Engagement, Community Partnerships, And Connected Care, Traber D Giardina, Lechauncy D Woodard, Hardeep Singh

Faculty, Staff and Students Publications

No abstract provided.

Interpersonal Primary Care Continuity For Chronic Conditions Is Associated With Fewer Hospitalizations And Emergency Department Visits Among Medicaid Enrollees, A. Gaglioti, C. Li, P. Baltrus, Zhaowei She, M. Douglas, M. Moore, A. Rao, L. Immergluck, T. Ayer, A. Bazemore, G. Rust, D. Mack

Research Collection Lee Kong Chian School Of Business

Background: Interpersonal primary care continuity or chronic condition continuity (CCC) is associated with improved health outcomes. Ambulatory care-sensitive conditions (ACSC) are best managed in a primary care setting, and chronic ACSC (CACSC) require management over time. However, current measures do not measure continuity for specific conditions or the impact of continuity for chronic conditions on health outcomes. The purpose of this study was to design a novel measure of CCC for CACSC in primary care and determine its association with health care utilization. Methods: We conducted a cross-sectional analysis of continuously enrolled, nondual eligible adult Medicaid enrollees with a diagnosis …

Occupational Safety And Health Practices Among Physical Therapists In Metro Manila During The Covid-19 Pandemic: A Qualitative Study Protocol, Zyra Mae V. Sicat, Paulin Grace M. Espino, Kristina B. Devora, Richard Lemuel Q. Budomo, Jewel Jace M. Abella, Barbara Nicole Y. Angeles, Giancarlo Philip H. Benzonan, Coby Jaleeyah Y. Chan, Erika L. Ignacio, Peter Oliver G. Palacio Jr., Julia Erin G. Tan

Philippine Journal of Physical Therapy

Introduction: The purpose of Occupational Safety and Health (OSH) is to protect and prevent workers from being exposed to risks and hazards that are detrimental to their health and safety. For the past two years, the coronavirus disease 2019 (COVID-19) is one of the most significant occupational health outcomes to physical therapists (PTs) due to the nature of their work. However, minimal studies have been conducted about the experiences and OSH practices of PTs during the pandemic. This study aims to understand the experiences of clinical PTs in Metro Manila, Philippines during the pandemic. The study also seeks to explore …

Understanding Implementation Completion Of Tailored Motivational Interviewing In Multidisciplinary Adolescent Hiv Clinics., Sylvie Naar, M Isabel Fernandez, Lisa Todd, Sara K. Shaw Green, Henna Budhwani, April Carcone, Karin Coyle, Gregory A. Aarons, Karen Macdonell, Gary W. Harper

HPD Articles

BACKGROUND: Understanding the barriers and facilitators of implementation completion is critical to determining why some implementation efforts fail and some succeed. Such studies provide the foundation for developing further strategies to support implementation completion when scaling up evidence-based practices (EBPs) such as Motivational Interviewing.

METHOD: This mixed-methods study utilized the Exploration, Preparation, Implementation, and Sustainment framework in an iterative analytic design to compare adolescent HIV clinics that demonstrated either high or low implementation completion in the context of a hybrid Type III trial of tailored motivational interviewing. Ten clinics were assigned to one of three completion categories (high, medium, and …

Geographic Variations And The Associated Factors In Adherence To And Persistence With Adjuvant Hormonal Therapy For The Privately Insured Women Aged 18-64 With Breast Cancer In Texas, Junghyun Kim, Man S Kim, Suja S Rajan, Xianglin L Du, Luisa Franzini, Tae Gi Kim, Sharon H Giordano, Robert O Morgan

Faculty, Staff and Student Publications

The purpose of this study is to examine the geographical patterns of adjuvant hormonal therapy adherence and persistence and the associated factors in insured Texan women aged 18-64 with early breast cancer. A retrospective cohort study was conducted using 5-year claims data for the population insured by the Blue Cross Blue Shield of Texas (BCBSTX). Women diagnosed with early breast cancer who were taking tamoxifen or aromatase inhibitors (AIs) for adjuvant hormonal therapy with at least one prescription claim were identified. Adherence to adjuvant hormonal therapy and persistence with adjuvant hormonal therapy were calculated as outcome measures. Women without a …

Language: Its Origin And Ongoing Evolution, Ilia Markov, Kseniia Kharitonova, Elena L Grigorenko

Faculty, Staff and Students Publications

With the present paper, we sought to use research findings to illustrate the following thesis: the evolution of language follows the principles of human evolution. We argued that language does not exist for its own sake, it is one of a multitude of skills that developed to achieve a shared communicative goal, and all its features are reflective of this. Ongoing emerging language adaptations strive to better fit the present state of the human species. Theories of language have evolved from a single-modality to multimodal, from human-specific to usage-based and goal-driven. We proposed that language should be viewed as a …