Enhancing Care Through Occupational Therapy: Implementing Services At The Unmc Sharing Clinic, Mackenzie Post, Nancy E. Krusen, Nicole Martino

Innovations in Health Sciences Education Journal

This is an abstract from the Spotlight on Scholarship event in 2025.

Health Literacy: Impact And Interventions, Elizabeth Simpson

Lynchburg Journal of Medical Science

The objectives of this paper are to examine the connection between health literacy level and patient outcome, identify contributing factors of low health literacy, and identify ways in which providers and health literacy programs can promote health literacy on an individual and community level. I conducted a literature search using PubMed and Google Scholar in order to lend evidence to these objectives.

The results demonstrated a clear correlation between low health literacy levels and poor patient outcomes. Low health literacy is also correlated with reduced medication adherence, improper use of medication, more emergency department visits, and unhealthy habits during pregnancy …

Polycystic Ovarian Syndrome: A Clinical Review, Amanda Nettles

Lynchburg Journal of Medical Science

Polycystic ovarian syndrome (PCOS) is a pervasive condition that affects women all over the world. It presents with a wide variety of symptoms like menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. Although generally considered to be solely a reproductive disorder, PCOS impacts metabolic, psychological, and cardiovascular health, and increases the risk for those diagnosed for other complications. Although PCOS is relatively common, it remains greatly misunderstood, which makes diagnosing the condition even more complex. Risk factors taken into consideration include genetics, environment, and lifestyle. The pathophysiology of PCOS focuses on dysfunction of the hypothalamic-pituitary-ovarian axis, insulin resistance, and inflammation. There …

Testosterone: The Forgotten Female Hormone, Katherine A. Horner Pa-C

Lynchburg Journal of Medical Science

ABSTRACT

The purpose of this article is to review the current and past use of testosterone as a replacement hormone for women in peri- and early postmenopause. Healthcare providers are often not educated about testosterone as a sex hormone with profound effects on the female body. Yet, clinicians who treat women in the 4th and 5th decades of life should be familiar with the function of testosterone, clinical symptoms associated with declining levels, women’s perceptions about peri- and postmenopause as well as side effects of testosterone, and the implications of its use as a replacement hormone on other body systems. …

Optimizing Interventions For Major Depressive Disorder And Provider Burnout: Self-Speak Exercise Dosing (Sed), Laureen Maloney-Gepfert

Lynchburg Journal of Medical Science

ABSTRACT

Major Depressive Disorder (MDD) is ranked highest among mental illnesses in the United States (US) and significantly contributes to the mental health care crisis. Patients experience resistance to pharmacologic interventions, side effects, co-morbidities, and mental health provider shortages. Subsequently, 33 % of Serious Mental Illnesses (SMIs) are being redirected to Primary Care Providers (PCPs). Concurrently, prescriber mental health is in crisis. Growing workloads for physicians and Advanced Practice Providers (APPs) have increased provider burnout syndrome (BOS). Major Depressive Disorder and BOS are positively affected by exercise, Cognitive Restructuring (CR), and Behavioral Activation (BA). Sports medicine and psychology research shows …

Spirituality And Ptsd Outcomes Among Service Members And Military Veterans, Jennifer Urbina Dmsc, Pa-C

Lynchburg Journal of Medical Science

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating condition among military service members and veterans, often co-occurring with moral injury (MI) and spiritual distress (SD). While conventional PTSD treatments include cognitive behavioral therapy (CBT), exposure-based therapies, and pharmacological interventions, growing evidence suggests that spirituality may play a vital role in improving PTSD outcomes. This paper explores the integration of spirituality in PTSD treatment, examining its potential to mitigate symptoms, enhance resilience, and facilitate post-traumatic growth. Military chaplaincy, spiritually integrated therapies, and Department of Defense (DoD) holistic health models provide frameworks for addressing the spiritual dimensions of PTSD. Studies indicate …

Obesity Awareness Among Pregnant Hispanic Women In Urban New Jersey, Cloris Bustamante

Walden Dissertations and Doctoral Studies

The rising prevalence of obesity among pregnant women presents significant health risks for mothers and children, beginning as early as intrauterine life throughout adulthood. The purpose of this quantitative cross-sectional study was to investigate whether demographic factors influenced obesity awareness as a personal issue in pregnant Hispanic women. The precaution adoption process model guided the study, a theoretical framework focusing on stages of health behavior change, including awareness, decision making, and action. A purposive sample of 134 pregnant Hispanic women aged 18 years or older receiving prenatal care in urban New Jersey was surveyed using the English (15) and Spanish …

The Feasibility And Safety Of Robot-Assisted Vaginal Natural Orifice Transluminal Endoscopic Surgery (Ra-Vnotes) For Gynecologic Disease: 298-Case Series, Qiannan Yang, Daniel Y Lovell, Yingchun Ma, Chunhua Zhang, Xiaoming Guan

Faculty, Staff and Students Publications

Objectives: To explore the feasibility and surgical outcomes of robot-assisted vaginal natural orifice transluminal endoscopic surgery (RA-vNOTES) for women suffering from gynecologic disease.

Methods: We performed an observational study reporting and analyzing the perioperative outcomes of 298 patients with gynecologic disease who underwent RA-vNOTES in a single institution from June 2019 to August 2024.

Results: A total of 298 patients with a median age of 41 years and median body mass index of 29 kg/m2 underwent RA-vNOTES. The primary indications for surgery were endometriosis (43.62%), chronic pelvic pain (11.07%), abnormal uterine bleeding (20.81%), and uterine leiomyomata (14.77%). A total of …

Primary Care Physicians' Perspectives On Clinical Integration And Performance Metrics In A Medically Underserved Area., Kern Kumar

MUSC Theses and Dissertations

With the national movement toward improving population health and helping combat the rising costs in healthcare, there are still assumed challenges and barriers concerning performance among healthcare organizations that impact costs and health outcomes. The Physician Hospital Organization (PHO) site within this study has been plagued with poor performance with assumed challenges and barriers for years. In this mixed-methods study leveraging the qualitative approach to support existing data, all primary care physicians within the PHO under study were interviewed, and by following the inductive approach and thematic analysis, valuable themes arose. It was found that due to patient education lacking …

Metagenomic Signatures Of Extraintestinal Bacterial Infection In The Febrile Term Infant Gut Microbiome, Anna L Deveaux, Carla Hall-Moore, Nurmohammad Shaikh, Meghan Wallace, Carey-Ann D Burnham, David Schnadower, Nathan Kuppermann, Prashant Mahajan, Octavio Ramilo, Phillip I Tarr, Gautam Dantas, Drew J Schwartz

2020-Current year OA Pubs

BACKGROUND: Extraintestinal bacterial infections (EBIs), e.g., urinary tract infection, bacteremia, and meningitis, occur in approximately 10% of febrile infants younger than 60 days. Although many EBI-causing species commonly reside in the infant gut, proof that the digestive system is a pre-infection habitat remains unestablished.

RESULTS: We studied a cohort of febrile term infants <  60 days old who presented to one of thirteen US emergency departments in the Pediatric Emergency Care Applied Research Network from 2016 to 2019. Forty EBI cases and 74 febrile controls matched for age, sex, and race without documented EBIs were selected for analysis. Shotgun sequencing was performed of the gut microbiome and of strains cultured from the gut and extraintestinal site(s) of EBI cases, including blood, urine, and/or cerebrospinal fluid. Using a combination of EBI isolate genomics and fecal metagenomics, we detected an intestinal strain presumptively isogenic to the EBI pathogen (> 99.999% average nucleotide identity) in 63% of infants with EBIs. Although there was no difference in gut microbiome diversity between cases and controls, we observed significantly increased Escherichia coli relative abundance in the gut microbiome of infants with EBIs caused by E. coli. Infants with E. coli …

Retracted Vs Non-Retracted Obstetrical Randomized Trials: Which Quality Criteria Are Most Associated With Retraction For Untrustworthiness?, Sarah Lawson, Georgios Doulaveris, Kathryn Anderson, Carrie Bennett, Vincenzo Berghella

Student Papers, Posters & Projects

Background

Randomized control trials (RCTs) are an essential pillar of scientific knowledge and medical practice, and their integrity has important implications for reliable systemic reviews and meta-analyses. However, the number of article retractions due to falsified data and scientific misconduct has increased in recent years. In response, the scientific community has pursued the creation of quality criteria that can be utilized to promote trustworthiness.

Methods

After a quality criteria checklist was created by a team of experts, retracted and nonretracted studies were evaluated for adherence to assess the checklist’s usefulness and identify potential pitfalls. Retracted studies published in obstetric literature …

Effect Of Chronic Alcohol Feeding Using The Lieber-Decarli Diet On Alzheimer’S Disease Pathology In Tg2576 Mice, Devaraj V. Chandrashekar, Nataraj Jagadeesan, Tamara Abdullah, Rudy Chang, Ross A. Steinberg, Frankey Sanchez, Elias Khal, Joshua Yang, David H. Cribbs, Derick Han, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Background: Chronic alcohol drinking is a modifiable risk factor for Alzheimer’s disease (AD), but underlying mechanisms remain poorly understood. Most studies of alcohol feeding to AD mice have utilized young mice and delivered alcohol in drinking water without controlling nutritional intake.

Objective: To study the impact of Lieber-DeCarli (LDC) liquid alcohol diet, which balances nutritional intake, on AD pathology of aged Tg2576 and wild-type (WT) mice, which is unexplored.

Methods: 13-month-old male and female Tg2576 or WT mice were fed LDC diet (5% ethanol or control) for six weeks (n = 11-13/group). Exploration (open-field test) and spatial reference memory …

Effect Of Feeding A Saccharomyces Cerevisiae Fermentation Product On Immune Response To Vaccines Against Newcastle Disease Virus, Avian Influenza Virus, And The Prevalence Of Chronic Respiratory Disease And Coccidiosis In Chickens Raised In A Low Biosecurity Production System, Bui Thi Hien, Ho Thi Dung, Pham Hoang Son Hung, Le Duc Thao, Nguyen Van Chao, Tran Quang Vui, Nguyen Thi Hoa, Anjan Mondal, Nsereko Victor, Le Dinh Phung

The Thai Journal of Veterinary Medicine

This study was carried out in a low biosecurity production system to explore the effects of a Saccharomyces cerevisiae fermentation product (SCFP) on immune responses to vaccination against Newcastle disease virus (NDV) and Avian influenza (H5N1) and prevalence of common diseases in chickens including chronic respiratory disease (CRD) and coccidiosis. One hundred and ninety two 1-day-old chickens were randomly assigned into control (a standard basal diet) and treatment (a standard basal diet containing 1.25 kg/MT of Diamond V XPC™ – a Saccharomyces cerevisiae fermentation product). Immunity data on antibody titers to NDV and H5N1 were collected at 3 weeks and …

Operating Room Acquired Pressure Injury Prevention, Audrey E. Dillon, Lexi K. Johnston, Grace L. Johnston, Amy N. Cochran

SPARK Symposium Presentations

Our change project focuses on preventing pressure injuries in OR patients using an alternating pressure overlay and gel pad system during surgery and recovery. Pressure injuries cost the healthcare system upwards of $26 billion annually, and surgery patients are at high risk due to prolonged immobility, constant pressure on one area, hemodynamic changes, and excessive moisture. Nurses can play a critical role in reducing healthcare costs and improving patient outcomes by utilizing proper training and outcome tracking. The estimated cost of implementing this system is $37,000, significantly lower than the long-term cost of pressure injuries. Key
stakeholders include nurse managers, …

Session Iib: Natural Sciences Presentation 1 - Pantry To Plate: Using Local Food Pantries To Improve Diabetes Self-Care Deficits, Rachelle Zielazienski

Life of the Scholar Multidisciplinary Conference

The purpose of this project was to improve diabetes self-management, knowledge of healthier diabetes eating habits, and cultural relevance through diabetes education and meal planning by including pertinent information in food boxes provided by a food pantry over two months of project implementation. The project provided culturally sensitive educational resources on diabetic food education and meal planning to individuals with diabetes, pre-diabetics, or those who prepare meals for diabetic individuals. The assistance of a qualified diabetes specialist was used to provide a collaborative effort offering educational support for participants' diabetes health goals and evidence-based diabetes food education.

Medical School Watercooler Newsletter - March 21, 2025, Lindsay Hughes

Watercooler Newsletter

This is the Friday, March 21, 2025 edition of the Frederick P. Whiddon College of Medicine's newsletter -- Watercooler.

Contents include:

• Match Day 2025: Senior medical students match in residency programs -- and love
• Integrative Health and Wellness Program gaining state and national recognition
• 14th Gulf Coast Trauma Symposium set for March 26-28
• Children's & Women's Hospital receives grant for neonatal abstinence syndrome
• Cancer researcher awarded $300,000 NSF grant to study mitochondria

Effect Of Prehabilitation On Functional Outcomes And Hospital Length Of Stay Following Total Joint Arthroplasty, Kristin Nicole Kaplewicz

Doctoral Dissertations and Projects

The purpose of this study was to determine how prehabilitation effects functional outcomes and length of stay in patients that have undergone total joint arthroplasties. Patients have continued to report being unhappy with their results of surgery and a large majority of the time is secondary to patients not being appropriately prepared for what to expect during their surgical recovery period. This information is important because occupational therapists and physical therapists continue to strive to improve patient satisfaction and outcomes. One of the ethical principles that healthcare providers commit to achieving is that of beneficence which means the clinicians must …

Connections Between Co-Occurring Symptoms Of Eating Disorders, Gut Dysbiosis, Anxiety, And Depression, Erin L. Thomas

Doctoral Dissertations and Projects

Eating disorders (ED) are a pervasive mental health condition that puts individuals at risk for long-term physical consequences or even death, and current treatment methods typically do not offer long-term efficacy. The current study aims to examine relationships between co-occurring symptoms of EDs, gastrointestinal distress, anxiety, and depression to add to the scientific literature and point towards directions that may increase the benefits of treatment efforts. A total of 72 participants were asked to complete an online survey that consisted of measures from each variable and took about 20 minutes to finish. Participating individuals had to be at least 18 …

Identifying And Defining The Healthcare Needs Of A Rural Missouri Community: A Case-Study, Maggie Maria Finley

Doctoral Dissertations and Projects

The purpose of this case study is to understand and describe the healthcare needs of the citizens of a rural community in Missouri. The study was completed using the case study theory developed by Kathleen Eisenhardt. Eisenhardt follows a “no theory first” approach in which the research is used to both develop a theory and elaborate on the developed theory. This theory used the gaps in research to develop a research question and establish its relevance. Current research on rural healthcare provides evidence that rural citizens face healthcare disparities. While this research establishes that there are healthcare gaps in rural …

Neighborhood Disadvantage And Inequities In Access To Preemptive And Living Kidney Transplantation, Brandon M Fairless, Oluwatunmise A Fawole, Duc T Nguyen, Ankona Banerjee, Kenneth J Nobleza, Abiodun O Oluyomi, Omar Rosales, Jayna M Dave, Elizabeth A Onugha

Children’s Nutrition Research Center Staff Publications

Key Points:

1. Pediatric patients residing in low-resource neighborhoods experienced lower rates of preemptive and living donor kidney transplantation.

2. Household-level factors (single-parent, non-English primary language, and receiving government assistance) may also affect the type of transplant received.

3. Area Deprivation Index scores offer an objective way to quantify neighborhood-level disadvantage and can enhance pretransplant screening.

Background: Living donor kidney transplant (LDKT) generally results in better outcomes than deceased donor kidney transplant (DDKT). Preemptive kidney transplant (KT) allows patients to bypass undergoing maintenance dialysis and is associated with improved patient and graft survival. Studies in the US pediatric population have shown racial-ethnic disparities …

Evaluation Of The Distress Thermometer In Older Patients With Cancer, Charlotte Zuber, Kristine Swartz, Andrew Chapman, Lora Rhodes, Tingting Zhan, Kuang-Yi Wen

Kimmel Cancer Center Faculty Papers

INTRODUCTION: The Geriatric Depression Scale is a useful tool in screening for depression in older adults, a particularly vulnerable population in oncology. The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) has been validated as a fast and effective screening tool for psychological distress in general oncology populations, and it could possibly be used as a surrogate for the longer Geriatric Depression Scale (GDS) test in older adults with cancer.

MATERIALS AND METHODS: In this retrospective cross-sectional study in older adults prior to starting cancer treatment, we evaluated the relationship between the DT and GDS by comparing 242 older adults …

Racial And Ethnic Inequalities In Actual Vs Nearest Delivery Hospitals, Nansi S. Boghossian, Lucy T. Greenberg, Jeffrey S. Buzas, Joshua Radack, Molly Passarella, Jeannette Rogowski, George R. Saade, Ciaran S. Phibbs, Scott A. Lorch

Faculty Publications

IMPORTANCE Minoritized racial and ethnic groups, such as American Indian and Black individuals, often receive lower quality health care compared with White individuals. There is limited understanding of how these disparities extend to obstetric care, particularly when comparing the quality of care at the actual delivery hospital vs the nearest obstetric hospital based on the birthing individual’s residence. OBJECTIVE To examine inequality in care based on the actual delivery hospital and the closest delivery hospital to the birthing individual’s residential zip code centroid. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used data from 5 states (2008 to 2020 …

Improving Management Of Suicidality Within An Outpatient Eating Disorder Treatment Program Through Standardization Of A Suicide Rating Scale Among Clinical Staff Members: An Evidenced-Based Practice Project, Nicole Neale

Doctoral Dissertations and Projects

Standardization of suicide assessment protocols is essential for maintaining standards of care and optimizing patient safety. However, many healthcare organizations lack a universal protocol for suicide assessment, likely due to the absence of a gold-standard method or tool. This evidence- based practice project aims to enhance the accuracy and consistency of suicide assessments for individuals diagnosed with eating disorders as well as other mental health disorders, ultimately improving patient safety measures and outcomes within an eating disorder treatment center. This project includes a thorough literature review of suicide risk factors, assessment methods, and available tools, followed by the education and …

Protocol For Unlocking Alternative Polyadenylation Insights From Bulk Rna-Seq Data With Polyaminer-Bulk, Venkata Jonnakuti, Sriya Jonnakuti, Hari Krishna Yalamanchili

Duncan NRI Faculty and Staff Publications

PolyAMiner-Bulk, a deep-learning-based algorithm to decode alternative polyadenylation (APA) dynamics from bulk RNA sequencing (RNA-seq) data, enables scientists to identify and quantify APA events from processed bulk RNA-seq data. The protocol allows researchers to explore differential APA usage between two conditions and gain a better understanding of post-transcriptional regulatory mechanisms. The major steps involve input data preparation, executing PolyAMiner-Bulk, and interpreting the results. A basic familiarity with pre-processing bulk RNA-seq data and command-line tools is suggested.

For complete details on the use and execution of this protocol, please refer to Jonnakuti et al.¹

Longitudinal Changes In Aerodigestive Responses To Varying Nipple Properties In Infant Pigs, François D H Gould, Christopher Mayerl, Khaled Adjerid, Jessica Reibel, Nichole Charles, Chloe Edmonds, Rebecca Z German

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Coordination of respiration and swallowing is critical for survival in infant mammals and changes throughout infant maturation. Infants show sensorimotor feeding responses to changes in physical properties of nipples. Commercial nipples are promoted as improving aerodigestive coordination. However, it is unknown how nipple properties influence coordination of respiration and swallowing. Furthermore, how infant-nipple interactions change throughout maturation is not well understood. We designed and manufactured four silicone nipples of the same shape that varied in two parameters: nipple opening diameter and nipple stiffness. We used our validated infant pig model to test the impact of nipple parameters on aerodigestive coordination …

Bridging The Gaps In Nutritional Development: A Literature Review On Toddler Nutrition Interventions, Stephanie L. Branstine

Master of Nutrition and Dietetics

Optimal nutrition in early childhood is essential for achievement of developmental milestones all of which encompass established benchmarks of physical, emotional, and cognitive growth. The field of early childhood nutrition is dedicated to devising strategies that ensure young children receive the necessary nutrients for their ideal development. Despite advancements in areas such as the availability of diverse food options on the market, educational programs for young parents, and nutrition-focused school initiatives, nutritional deficiencies remain a significant challenge. These deficiencies hinder the ability of toddlers to thrive both physically and mentally, impacting their overall growth and developmental potential.

Recent research has …

Using The 5ms Framework To Advance Aging-Responsive Care For Heart Failure With Reduced Ejection Fraction, Abigail Latimer, Debra K. Moser, Jia-Rong Wu, Kim K. Birtcher, Malachy J. Clancy, Jennifer D. Portz, Joanna Paladino, Daniel D. Matlock, Christopher E. Knoepke

Department of Occupational Therapy Faculty Papers

Complexity of care is the inevitable consequence of an aging population and is particularly true in instances where patients are managing chronic conditions such as heart failure with reduced ejection fraction (HFrEF). HFrEF itself is complex, with an undulating course of illness, increased risk of sudden cardiac death, and myriad accompanying treatment considerations. Generalist management of HFrEF among older patients is further complicated by competing comorbidities, potential for financial toxicity, potential for mental health symptoms, and risk of care with does not align with goals and preferences. The 5Ms (multicomplexity, mind, mobility, medications, and matters most) is a holistic conceptualization …

Exploring The Role Of Physical Health Interventions In The Management Of Mental Health Disorders: A Comparative Study Of Mental Health And Kinesiology Professionals' Perspectives, Vicki Hamill

Doctorate in Kinesiology

The study's purpose was to understand the factors that may influence the use of physical health interventions in the mental health treatment process. The lack of professional guidelines for kinesiology professionals has been linked to an implementation gap of evidenced based exercise prescription in the prevention of the physical health comorbidities associated with mental illness. These comorbidities are linked to a 15-20 year decrease in life expectancy, long-term disability, and increased healthcare costs. The Exercise in Mental Illness Questionnaire-Health Professional (EMIQ-HP) was used in the study to compare the mental health and kinesiology professional perspective in the domains of exercise …

Improving Female Health At Various Life Stages: A Systematic Review Of The Impact Of Date Fruit Products, Elham Shirdel, Farinaz Rahimi, Masoumeh Abdi, Fatemeh, Fatemeh Alsadat Rahnemaei

Sultan Qaboos University Medical Journal

This systematic review examines the effects of date fruit products on female health across different life stages. The quality of the included studies was assessed using the risk of bias tool. A total of 21 eligible studies were reviewed, demonstrating that date fruit consumption benefits puberty, reproductive health, and menopause. During puberty, date fruit intake was associated with improved hemoglobin levels in adolescent girls. In reproductive-age women, date fruits positively influenced fertility parameters and sexual function. Additionally, in menopause, they contributed to alleviating dyspareunia and supporting ovarian reserve maintenance. Providing women with proper nutrition and integrating date fruits into their …

Vitamin D Status And Oxidative Stress In Children With Sickle Cell Anaemia In Sagamu, Nigeria, Ayobola A. Sonuga, Oyebola O. Sonuga, Olatunbosun O. Ogundeji, Sunday P.

Sultan Qaboos University Medical Journal

Objectives: Sickle cell anaemia (SCA) is characterised by nutritional deficiencies and oxidative stress. Vitamin D possesses antioxidant properties; however, its role in SCA within sub-Saharan Africa remains inadequately understood. This study aimed to investigate the relationship between vitamin D status, oxidative stress and antioxidant levels in children with SCA, exploring its possible role in mitigating complications associated with oxidative stress in SCA. Methods: This study was conducted for a period of 9 months from November 2022 until July 2023 at the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria. This case-control study involved 100 HbS genotype and 100 HbA genotype …