Digital Commons Network^™

Electronic Health Record Technology And Its Potential To Increase Costs To Medicare, Geetha Lakshmi Makam

Student Works

No abstract provided.

Epidemiology And Virulence Of Clostridium Difficile : An Evolutionary Perspective., Lindsey E. Hastings

College of Arts & Sciences Senior Theses

The emergence of virulent, antibiotic-resistant Clostridium difficile ribotypes over the past thirty years has greatly concerned both the medical and research communities. As of 2010, C. difficile has surpassed methicillin-resistant Staphylococcus aureus (MRSA) as a cause of nosocomial infections and is now found in both healthcare settings and outside communities in the United States. Attendant-borne transmission in hospitals has been associated with the evolution of increased virulence in other nosocomial pathogens, but evolutionary theory has yet to be applied to the epidemiology and virulence of C. difficile. Differences between nosocomial C. difficile infections (CDI) and community-associated CDI (CA-CDI) mortality and …

Is Chlorhexidine An Effective Antiseptic To Prevent Clabsi For Picc Line Maintenance In The Neonatal Population?, Lauren Blankenship

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Central venous catheters (CVCs) are inserted in order to administer fluids and medications. A peripherally inserted central catheter (PICC) is a type of CVC. While beneficial, central line associated bloodstream infection (CLABSI) is a risk for patients having a CVC inserted. Antiseptics are used for skin preparation when inserting a central line to prevent infection and during maintenance of the central line. Currently, the Center for Disease Control recommends the use of chlorhexidine for central venous catheter insertion in patients two months of age or older. Studies have found reduced CLABSI rates with the use of chlorhexidine for CVC insertion …

Regenokine Therapy: Strict Fda Regulation Has The Rich And Famous Traveling Abroad For Treatment, Alexander Bylinkin

Student Works

No abstract provided.

Gay Men Cannot Anonymously Donate Sperm?: How The Fda's Exclusion Unconstitutionally Restricts And Discriminates Against The Lgbt Community, Taimour Tahir Chaudhri

Student Works

No abstract provided.

Protecting The Rights Of Children As Human Subjects In Developing Countries: Revisiting Informed Consent, Adebola Olufowobi

Student Works

No abstract provided.

Biobanking As A Model For Balancing Patient And Research Interests, Hyosung Julie Shin

Student Works

No abstract provided.

Treatment Practices, Outcomes, And Costs Of Multidrug-Resistant And Extensively Drug-Resistant Tuberculosis, United States, 2005-2007, Suzanne M. Marks, Jennifer Flood, Barbara Seaworth, Yael Hirsch-Moverman, Lori Armstrong, Sundari Mase, Katya Salcedo, Peter Oh, Edward A. Graviss, Paul W. Colson, Lisa Armitige, Manuel Revuelta, Kathryn Sheeran, Tb Epidemiologic Studies Consortium

School of Medicine Faculty Publications and Presentations

To describe factors associated with multidrug-resistant (MDR), including extensively-drug-resistant (XDR), tuberculosis (TB) in the United States, we abstracted inpatient, laboratory, and public health clinic records of a sample of MDR TB patients reported to the Centers for Disease Control and Prevention from California, New York City, and Texas during 2005–2007. At initial diagnosis, MDR TB was detected in 94% of 130 MDR TB patients and XDR TB in 80% of 5 XDR TB patients. Mutually exclusive resistance was 4% XDR, 17% pre-XDR, 24% total first-line resistance, 43% isoniazid/rifampin/rifabutin-plus-other resistance, and 13% isoniazid/rifampin/rifabutin-only resistance. Nearly three-quarters of patients were hospitalized, 78% …

A Survey Of Antimicrobial Stewardship Practices In The Western United States: Successes And Challenges, Gayle Louise Allenback

UNLV Theses, Dissertations, Professional Papers, and Capstones

Antibiotics are one of the most important developments in medicine, and their ability to prevent and control infections has had a major impact in clinical medicine. However, the past three decades have shown an increase in multidrug-resistant organisms (MDROs) in both hospital patients and in the community, decreasing our ability to successfully control infection. Complicating the depletion of effective antimicrobials is the fact that, in the last 10 years, there has also been a decrease in the development of new antibacterial agents. Resistant infections have resulted in increased morbidity and mortality, with a consequential increase in healthcare costs. The utilization …

Water System For Developing Countries / Disaster Relief Made With Local Materials, Florencio Serrano Castillo

Chemical Engineering Undergraduate Honors Theses

The objective of this project was to design a water purification system that can be constructed from easily available materials, common to the particular country, and is capable of the complete water purification process. The designed system consisted of a treadle pump (built from wood or bamboo) to pull the water from its source, a filter (made of readily available materials such as sand) to remove contaminants and improve palatability of water, an electrolysis system to allow chlorination from salt water (using locally sourced salt), and a car battery (which could be sourced from a scrapped car) that could be …

Patient-Provider Interaction: Person Centered Approaches To Patient Diversity And Evidence For Training, Hannah O. Allison

Graduate Theses and Dissertations

This study investigates the role of culture in patient-provider interactions. Physicians in Northwest Arkansas were interviewed on their experiences with cultural differences in interactions with patients. Analysis using Grounded Theory methodology indicated that physicians define culture in various ways and the majority view culture as negatively impacting their interactions. The results from this study also reveal that physicians received minimal training in their medical education on how to handle these cultural differences and instead have learned on-the-job through trial and error methods. Finally, the research concludes that many of the physicians interviewed perceived deficits in training and offered suggestions on …

Self-Reported Neurogenic Bowel And Bladder Management In Acute Hospitalized Chronic Spinal Cord Injured Patients: Its Role In Clinical Practice, Mary Lupe Jimenez

Doctoral Projects

Patients with spinal cord injuries and disorders (SCI/D) are at risk for mismanaged bowel care during acute hospitalization, which can lead to numerous medical complications ranging from loss of personal dignity and privacy to many serious medical conditions, some of which are life threatening. Additionally, mismanagement of bowel care during acute hospitalization may lead to costly extended hospital stays. The project was to describe bowel and bladder care for SCI/D patients during acute hospitalization using a self-reported questionnaire submitted by approximately 46.6% of SCI/D patients from the Veterans' Affairs Central California Health Care System. The self-report questionnaire was designed by …

Effect Of Preanalytical Processing Of Thinprep Specimens On Detection Of High-Risk Human Papillomavirus By The Aptima Hpv Assay, Erik Munson, Elizabeth R. Schroeder, Kevin C. Ross, Connie Yauck, Theresa Bieganski, Robert D. Amrhein, Maureen Napierala, April L. Harkins

Clinical Lab Sciences Faculty Research and Publications

Two important preanalytical protocols performed on liquid-based cytological specimens, namely, automated cytology processing and glacial acetic acid (GAA) treatment, may occur prior to the arrival of specimens in a molecular diagnostics laboratory. Ninety-two ThinPrep vials previously positive for high-risk human papillomavirus (HPV) via the Cervista HPV HR test were preselected and alternated with 92 previously negative ThinPrep vials. The specimen set was processed in a consecutive fashion by an automated cytology processor without fastidious decontamination precautions. Carryover potential was subsequently assessed by performance of the Aptima HPV assay on aliquots from reprocessed ThinPrep vials. All previously negative ThinPrep vials yielded …

Childhood Influenza Vaccination Mandates: The Importance Of Research-Based Evidence In Public Health Policy Decision-Making, Helen Becz

Student Works

No abstract provided.

An Assessment Of The Health Needs Of Maine Veterans And Their Access To Veterans Administration Health Care Services, Kristin Brawn

Muskie School Capstones and Dissertations

On a state level, only a few assessments have been conducted, which indicate that Maine veterans are also experiencing similar mental and physical health issues; however, it does not appear that the adequacy of Maine’s VHA services to meet the needs of Maine’s veterans has been comprehensively evaluated. It is unknown whether the physical and mental health needs of Maine’s veterans are currently being met. Therefore, this project proposes to determine if there is a similar problem among Maine’s veterans in regard to health issues and lack of access to VHA health services, as has been reported at the national …

Development Of Hpv Next-Generation Virus-Like Particle Vaccines That Are Cross-Protective, Mitchell Ryan Tyler

Biomedical Sciences ETDs

Virus-like particles (VLPs) comprised of viral structural proteins that self-assemble into particles resembling the native virion represent a relatively novel vaccine development strategy. Both safe and immunogenic, VLPs can be used as vaccines against the virus from which they are derived, but can also be used to present heterologous epitopes from other pathogens to the immune system. Both techniques result in high-titer antibody responses against the target epitope. Indeed, vaccines of VLPs are already available, including the two vaccines targeting Human Papillomavirus (HPV). These vaccines are very effective at preventing infection by the HPV types included in their formulation; high-risk …

Natural And Exogenous Genome Editing In Wiskott-Aldrich Syndrome Patient Cells, Tamara J. Laskowski

Dissertations and Theses (Open Access)

Wiskott-Aldrich syndrome (WAS) is an X-linked primary immunodeficiency disease characterized by thrombocytopenia, recurrent infections and increased autoimmunity. This disease is caused by mutations in the WAS gene (WAS) which encodes for the WAS protein (WASp), exclusively expressed in hematopoietic cells and required for proper platelet production and lymphoid cell function. Approximately 11% of patients with WAS exhibit a phenomenon called Somatic Revertant Mosaicism which is characterized by the presence of lymphocytes which naturally revert back to normal phenotype by restoring WASp expression. To date, the mechanisms of this naturally-occurring gene therapy remains poorly understood, and the full extent …

Identification Of Hcmv Ul97 In Gbm Cell Lines And A Possible Role For Ganciclovir, Thomas Mcfall

All NMU Master's Theses

Glioblastoma multiforme (GBM) is the most common form of malignant glioma, comprising 80% of all malignant gliomas. Recently, active Human Cytomegalovirus (HCMV) was identified in GBM cells, and has been a topic of debate concerning its role with tumor progression. This study used three established GBM cell lines; T98, LN229, and U87 in order to identify and examine the presence of HCMV phosphotransferase protein UL97. Reverse transcriptase polymerase chain reaction identified UL97 within two of the three cell lines, T98 and LN229. Western blotting confirmed that UL97 protein was being expressed and was present in both T98, and LN229 cell …

Influenza A Subtype H3 Viruses In Feral Swine, United States, 2011–2012, Zhixin Feng, John A. Baroch, Li-Ping Long, Yifei Xu, Frederick L. Cunningham, Kerri Pedersen, Mark W. Lutman, Brandon S. Schmidt, Andrew S. Bowman, Thomas J. Deliberto, Xiu-Feng Wan

United States Department of Agriculture Wildlife Services: Staff Publications

To determine whether, and to what extent, influenza A subtype H3 viruses were present in feral swine in the United States, we conducted serologic and virologic surveillance during October 2011–September 2012. These animals were periodically exposed to and infected with A(H3N2) viruses, suggesting they may threaten human and animal health.

The Lived Experience Of Black African Nurses Educated Within The United States, Amy Elizabeth Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the unprecedented growth of minority populations in the United States, the nursing profession has remained relatively homogenous. Nursing education has increased the number of minority students entering nursing programs; however, attrition rates for minority nursing students are as high as 85% (Gilchrist & Rector, 2007). As the population grows in diversity, the need for nurses who are fluent in foreign languages and who understand minority values, traditions, and cultural practice will be essential in delivering culturally competent care. Improving the retention of minority nursing students is an important step in increasing the diversity within the nursing workforce.

Although several …

Health Hazards In Rental Housing: An Overview Of Clark County, Nevada, Amanda Nicole Sokolowsky

UNLV Theses, Dissertations, Professional Papers, and Capstones

A wide range of health conditions are associated with housing conditions, including asthma, respiratory infections, injuries, mental health issues, and lead poisoning. People in modern societies spend more than 90% of their time indoors, the vast majority of which is spent at home. Therefore, any new information on housing related health hazards in a population provides an opportunity for a new prevention program. Reports have shown that rental properties have more health related hazards than owner occupied housing, and rental properties are frequently occupied by low-income and minority individuals. This descriptive study intended to provide an overview of housing related …

Modeling The Adaptive Immune Response To Mutation-Generated Antigens, Rory J. Geyer

Honors Scholar Theses

Somatic mutations may drive tumorigenesis or lead to new, immunogenic epitopes (neoantigens). The immune system is thought to represses neoplastic growths through the recognition of neoantigens presented only by tumor cells. To study mutations as well as the immune response to mutation-generated antigens, we have created a conditional knockin mouse line with a gene encoding, 5’ to 3’, yellow fluorescent protein (YFP), ovalbumin (which is processed to the immunologically recognizable peptide, SIINFEKL), and cyan fluorescent protein (CFP), or, YFP-ovalbumin-CFP. A frame shift mutation has been created at the 5’ end of the ovalbumin gene, hence YFP should always be expressed, …

Fall Risk Evaluation Tool For Acquired Brain Injury: A Validation Of A Multifactorial Assessment: A Pilot Study, Tanya Elesia Orgill, Amanda Marie Woods, Josue Julian Zamora

Dissertations, Masters Theses, Capstones, and Culminating Projects

Objective: The purpose of this study examined the reliability and validity of FRET to predict falls in community-dwelling individuals with acquired brain injuries (ABI).

Method: The target population was English speaking, community-dwelling individuals 18 years or older who have sustained an ABI. Individuals were excluded if they had neurodegenerative diseases, used a wheelchair for more than 25% of the day, or were classified as globally confused. Global confusion was assessed using the first three-questions on the Saint Louis University Mental Examination (SLUMS). A total of 12 participants were recruited for the study, two were excluded and there was one attrition. …

Characterization Of T-Bet And Eomes In Peripheral Human Immune Cells., James J. Knox, Gabriela L. Cosma, Michael R. Betts, Laura M. Mclane

Department of Microbiology and Immunology Faculty Papers

The T-box transcription factors T-bet and Eomesodermin (Eomes) have been well defined as key drivers of immune cell development and cytolytic function. While the majority of studies have defined the roles of these factors in the context of murine T-cells, recent results have revealed that T-bet, and possibly Eomes, are expressed in other immune cell subsets. To date, the expression patterns of these factors in subsets of human peripheral blood mononuclear cells beyond T-cells remain relatively uncharacterized. In this study, we used multiparametric flow cytometry to characterize T-bet and Eomes expression in major human blood cell subsets, including total CD4(+) …

Sa-4-1bbl As A Platform To Develop Adjuvant Systems For Prophylactic And Therapeutic Vaccines., Gunes Dinc 1984-

Electronic Theses and Dissertations

Vaccines against infectious diseases are one of the most critical accomplishments in modern medicine. Despite significant progress in vaccinology, there is still a dire need for developing vaccines against various acute and chronic infections and cancer. In general, vaccines are categorized as prophylactic, given to healthy individuals to prevent disease, and therapeutic, administered to people who already have disease. As such, the nature, quality, and quantity of immune responses required for the efficacy of these two types vaccines are different. Prophylactic vaccines against infectious diseases primarily rely on the generation of neutralizing high titers of antibody for their efficacy. These …

Neutrophil/Lymphocyte And C-Reactive Protein/Mean Platelet Volume Ratios In Differentiating Between Viral And Bacterial Pneumonias And Diagnosing Early Complications In Children, Mervan Bekdas, Sevil B. Goksugur, Esma G. Sarac, Mustafa Erkocoglu, Fatih Demircioglu

Saudi Medical Journal

OBJECTIVE: To test the usability of neutrophil/lymphocyte (N/L) and C-reactive protein/mean platelet volume (CRP/MPV) ratios for the differential diagnosis of bacterial versus viral pneumonia, and the early diagnosis of complications related to pneumonia. METHODS: This retrospective study was conducted on 31 patients diagnosed with bacterial pneumonia and 21 patients diagnosed with viral pneumonia from January 2011 to December 2012 in the Department of Pediatrics, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey. We investigated the clinical characteristics, radiological, and laboratory findings of patients from their medical records. RESULTS: The female/male ratio of patients with bacterial was 1.0/1.8, and with …

Disaster Preparedness Scholarly Project, Catherine A. Marcum

DNP Research Projects

No abstract provided.

A Paleopathological Analysis Of The Moran French Colonial Cemetery, Jennifer Lynn Funkhouser

Master's Theses

This research examines the health experiences of early eighteenth-century European immigrants to the Mississippi Gulf Coast. Most were low-status individuals forcibly expulsed from France and brought to Biloxi to colonize Louisiana. Historical records report the immigration effort was poorly provisioned and that large numbers died from malnutrition and disease soon after arrival. The remains of 30 adults, presumably colonists from this period based on collagen dating and grave goods, have been recovered at the Moran site (22HR511). DNA analysis (n = 8) suggests all are European. Most are males, and only one lived past age 40. Estimated mean height is …

Abstracts 2014: Highlights Of Student Research And Creative Endeavors, Columbus State University

Abstracts: Highlights of Student Research and Creative Endeavors

No abstract provided.

Re-Inscribing History, Yoonkyung Kim

Masters Theses

Most images and informational data from historical records and databases remain unseen because there is a massive over-saturation of visual material. This material has not been thoroughly investigated or understood. Historical archives offer opportunities to discover stories that reposition history in more intimate terms. I explore what remains unseen by revealing new routes that these "facts" can take.

Exploring the boundaries between the public and the personal, I visit archival documents, public databases, and historical collections. Fascinated by their stories' multifaceted nature, I critically examine these primary sources that nourish generations of new histories.

My intention is to redefine our …