Digital Commons Network^™

Using Servqualto Identify Gaps In Quality Care For Patients With Cystic Fibrosis: A Hospital-Based Quality Improvement Project, Alisha M. Nadeau

Master's Theses and Capstones

Background: Cystic Fibrosis (CF) Care Centers were established to centralize and integrate the knowledge and skills of pulmonary medicine, nutrition, gastroenterology, nursing, respiratory therapy, social work, and genetics to efficiently provide care for people living with CF. The high quality, specialized care that is given at CF Care Centers has led to the improved length and quality of life for people living with CF.

Aim: The aim of this quality improvement project was to identify any gaps in providing effective, high quality care to patients with CF to reduce the variability in nursing practices and improve their quality …

Health Literacy And The Level Of Hypertension In Urban Latinos, Marlene Rosetta Glashen

Walden Dissertations and Doctoral Studies

Health literacy (HL) plays a significant role in health care communication and patient compliance. Low health literacy leads to noncompliance with health instructions, poor health choices, failure to participate in recommended health screenings, frequent hospitalizations, and higher health care costs. Using the health belief model (HBM) as the conceptual framework, this quantitative, cross-sectional study addresses a gap in the literature related to the research questions of this study. The research questions are: (a) Is there a relationship between HL and the level of hypertension (HTN) in hypertensive urban Latinos?, and (b) Will HL predict the level of control of HTN …

The Implications Of Climate Change For Nebraska: Summary Report Of Sector-Based Roundtable Discussions (September-October 2015), Donald A. Wilhite, Kimberly Morrow

National Drought Mitigation Center: Faculty Publications

Introduction ... iv

Roundtable Reports: Overview ... iv

Rural Nebraskans Poll: Summary of Key Outcomes on Climate Change ... vi

Summary of Roundtable Discussions ... 1

Addressing the Impacts of Climate Change on Ecosystems and Wildlife in Nebraska ... 1

Implications of Climate Change on Human Health in Nebraska ... 11

Implications of Climate Change on Nebraska’s Forests and Fire ... 21

Implications of Climate Change on Nebraska’s Agriculture, Food and Water ... 27

Implications of Climate Change on Energy Availability, Use and Management in Nebraska ... 31

Climate Change in Nebraska: What Does it Mean for our Faith Communities? …

An Examination Of Mathematical Models For Infectious Disease, David M. Jenkins

Williams Honors College, Honors Research Projects

Starting with the original 1926 formulation of the SIR (Susceptible-Infected-Removed) model for infectious diseases, mathematical epidemiology continued to grow. Many extensions such as the SEIR, MSIR, and MSEIR models were developed using SIR as a basis to model diseases in a variety of circumstances. By taking the original SIR model, and reducing the system of three first-order equations to a single first-order equation, analysis shows that the model predicts two possible situations. This analysis is followed by discussion of an alternative use of the SIR model which allows for one to track the amount of sustainable genetic variation in a …

Zymosan Activation Of Tlrs: Stimulation Of Innate Immunity And Nitric Oxide Production, Sarah Loeser

Williams Honors College, Honors Research Projects

Chronic inflammation can result in pathophysiological changes to numerous organs of the body such as heart tissue (atherosclerosis) and damage to bone. Sources of inflammation can include autoimmune disease, cancer, and chronic infections such as those triggered by HIV or Mycobacterium tuberculosis. Most of the damage associated with chronic inflammation can be associated with chemical mediators, cytokines, given off by cells of the innate immune system. One measure of an active innate immune system can be assessed by quantifying nitric oxide (NO) production by bone marrow (BM) cells.

The purpose of these experiments is to determine if zymosan, a …

Evaluation Of Vaccination Policies Among Utah Pediatric Clinic Employees, Tia Peterson

Theses and Dissertations

Introduction: Pediatric health care settings are high risk environments for spreading communicable and vaccine preventable diseases from health care workers to susceptible patients. Methods: All managers of pediatric clinics operating in the state of Utah were included. Participants were invited to complete a two-page questionnaire regarding their clinic vaccination policies. Results: Half (n = 23, 50%) of Utah pediatric outpatient clinics recommend employee vaccinations, although employee refusal is allowed without consequence. Of all adult vaccines, influenza was most often included as part of the employee vaccination policy. Some clinics required unvaccinated employees to wear masks in the event of illness, …

An Analysis Of Socioeconomic Influences On Health Care Seeking Behavior In Humla, Nepal, Hannah Kuehl

Graduate Student Theses, Dissertations, & Professional Papers

Mobile medical camps (MMCs) are common in Nepal, as well as other parts of the world. MMCs in Nepal provide health care resources that are not available through the government health system, due to Nepal’s weak health infrastructure. Although MMCs are problematic for a variety of reasons, they continue to play a role in health care delivery in remote settings the world over. Despite the fact that MMCs are increasingly common in many countries around the world, their patient populations and their health outcomes are poorly understood. This thesis is an analysis of socioeconomic influences within a select group of …

Best Practices For Improving Flow And Care Of Pediatric Patients In The Emergency Department., Isabel Barata, Kathleen M. Brown, Laura Fitzmaurice, Elizabeth Stone Griffin, Sally K. Snow, American College Of Emergency Physicians Pediatric Emergency Medicine Committee, Emergency Nurses Association Pediatric Committee, Gregory P. Conners, American Academy Of Pediatrics Committee On Pediatric Emergency Medicine

Manuscripts, Articles, Book Chapters and Other Papers

This report provides a summary of best practices for improving flow, reducing waiting times, and improving the quality of care of pediatric patients in the emergency department.

Towards More Efficient Service For Clients, Using Hmis System: Managerial Audit Of Community Technology Alliance, Mohua Chatterjee

Master's Projects

No abstract provided.

Is Sofosbuvir Safer And More Effective Than Peginterferon For Treatment Of Chronic Hepatitis C Virus Infection In Treatment-Naïve Patients?, Nicole L. Luongo

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Sofosbuvir plus Ribavirin is safer and more effective than Peginterferon plus Ribavirin for treatment of chronic Hepatitis C Virus infection in treatment-naïve patients.

Study Design: Systematic review of three English language primary studies, published in 2013.

Data Sources: Three randomized control trials, two of which are open-label, activecontrolled and one that is double-blind, placebo-controlled, comparing Sofosbuvir and Ribavirin versus other chronic HCV modalities found via PubMed in peer-reviewed journals.

Outcomes Measured: Safety was measured by self-reported adverse events, routine laboratory tests, physical exams, vital signs, and …

Does Balneotherapy Effectively Reduce Non-Specific Chronic Low Back Pain In Adults?, Jenna Srebnik

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not balneotherapy effectively reduces non-specific chronic low back pain in adults.

STUDY DESIGN: Review of three single blind, follow up randomized controlled trials (RCT), published in 2012 and 2005.

DATA SOURCES: Three peer reviewed RCTs were found using PubMed and all compared balneotherapy against various control groups.

OUTCOMES MEASURED: Low back pain of patients was assessed using dose of analgesic consumed, visual analog pain scale (VAS) and Oswestry Low Back Pain Disability Questionnaire (OSWDQ). The tools used to assess significance of outcomes measured were Pvalues, change in …

Nasa Limited Inflight Lab Sensor, Gregory P. Howard, James C. Hanreck

Williams Honors College, Honors Research Projects

The National Aeronautics and Space Administration (NASA) is currently developing the capabilities needed to send humans to Mars in 2030 for a three year mission. Astronaut health must be monitored monthly during such a lengthy mission. The UA Enterprise Senior Design Team worked to design a reusable, novel blood panel cartridge system to monitor astronaut health and to minimize waste production. Most current cartridges are composed of polydimethylsiloxane (PDMS). PDMS microchannels were fabricated to conduct simple proof of concept experiments for the design of a novel cartridge. To determine an ideal blood cleaning solution, bovine blood will be injected into …

The Effects Of Vitamin D Supplementation On Influenza, Jonah M. Spoerndle

Williams Honors College, Honors Research Projects

Recently the role of vitamin D in other non-classical capacities has been evaluated. One of these non-classical vitamin D roles is assisting in maintaining proper immune system health. One disease that has a great effect on the immune system is influenza. Vitamin D helps to prevent and limit influenza by moderating the inflammatory cytokines as well as promoting the production of monocytes that help destroy the invading materials. Through the use of vitamin D supplementation the recommended daily amount of vitamin D can be assured and optimal health could be achieved. The purpose of this project was to design a …

Exploring The Viability Of Establishing A Children’S Grief Camp In South Africa, Joann Borer

Williams Honors College, Honors Research Projects

The death of a loved one is an inevitable and unavoidable phase of life that everyone must experience. A variety of thoughts and feelings follow the death a close friend or relative. It is crucial to address the thoughts and feelings associated with the death so that individuals can grief in a healthy manner. Those living in South Africa are most likely going to experience the death of a loved one since South Africa has such a high mortality rate. Through a qualitative study, this paper explores the death system and culture in South Africa. In addition, the organizations and …

Optimizing Strategies For Population-Based Chlamydia Infection Screening Among Young Women: An Age-Structured System Dynamics Approach Infectious Disease Epidemiology, Yu Teng, Nan Kong, Wanzhu Tu

Weldon School of Biomedical Engineering Faculty Publications

Background

Chlamydia infection (CT) is one of the most commonly reported sexually transmitted diseases. It is often referred to as a “silent” disease with the majority of infected people having no symptoms. Without early detection, it can progress to serious reproductive and other health problems. Economical identification of asymptomatically infected is a key public health challenge. Increasing evidence suggests that CT infection risk varies over the range of adolescence. Hence, age-dependent screening strategies with more frequent testing for certain age groups of higher risk may be cost-saving in controlling the disease.

Methods

We study the optimization of age-dependent screening strategies …

Mass Media And The Contagion Of Fear: The Case Of Ebola In America, Sherry M J Towers, Shehzad Afzal, Gilbert Bernal, Nadya T. Bliss, Baltazar Espinoza, Jasmine Jackson, Julia Judson-Garcia, Maryam Khan, Michael Lin, Robert Mamada, Victor M. Moreno, Fereshteh Nazari, Kamaldeen Okumeye, Mary L. Ross, Claudia Rodriguez, Jan Medlock, David S. Ebert, Carlos Castillo-Chavez,

Department of Electrical and Computer Engineering Faculty Publications

Background: In the weeks following the first imported case of Ebola in the U. S. on September 29, 2014, coverage of the very limited outbreak dominated the news media, in a manner quite disproportionate to the actual threat to national public health; by the end of October, 2014, there were only four laboratory confirmed cases of Ebola in the entire nation. Public interest in these events was high, as reflected in the millions of Ebola-related Internet searches and tweets performed in the month following the first confirmed case. Use of trending Internet searches and tweets has been proposed in the …

Antibacterial Evaluation Of Synthetic Thiazole Compounds In Vitro And In Vivo In A Methicillin-Resistant Staphylococcus Aureus (Mrsa) Skin Infection Mouse Model, Haroon Mohammad, Mark A. Cushman, Mohamed Naguieb Seleem

Department of Comparative Pathobiology Faculty Publications

The emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA), including strains resistant to current antibiotics, has contributed to an increase in the number of skin infections reported in humans in recent years. New therapeutic options are needed to counter this public health challenge. The aim of the present study was to examine the potential of thiazole compounds synthesized by our research group to be used topically to treat MRSA skin and wound infections. The broth microdilution method confirmed that the lead thiazole compound and four analogues are capable of inhibiting MRSA growth at concentrations as low as 1.3 μg/mL. Additionally, three …

Repurposing Clinical Molecule Ebselen To Combat Drug Resistant Pathogens, Shankar Thangamani, Waleed Younis, Mohamed N. Seleem

Department of Comparative Pathobiology Faculty Publications

Without a doubt, our current antimicrobials are losing the battle in the fight against newly-emerged multidrug-resistant pathogens. There is a pressing, unmet need for novel antimicrobials and novel approaches to develop them; however, it is becoming increasingly difficult and costly to develop new antimicrobials. One strategy to reduce the time and cost associated with antimicrobial innovation is drug repurposing, which is to find new applications outside the scope of the original medical indication of the drug. Ebselen, an organoselenium clinical molecule, possesses potent antimicrobial activity against clinical multidrug-resistant Gram-positive pathogens, including Staphylococcus, Streptococcus, and Enterococcus, but not against Gram-negative pathogens. …

Hrd1 Partners In Endoplasmic Reticulum-Associated Degradation, Aaron Alexander Burr

Wayne State University Dissertations

Protein Quality Control (PQC) comprises cellular pathways that regulate the turnover of short-lived, misfolded proteins. A main component of PQC is Endoplasmic Reticulum (ER)-Associated Degradation (ERAD), which controls the degradation of proteins synthesized in the ER. Aberrations in ERAD have been linked to malignancies such as sarcomas, breast, and pancreatic carcinomas, as well as neurodegenerative disease. The machinery in this system is complex and while significant progress has been made to understand ERAD, it is not clear how the different components come together, or how they are regulated. HRD1 is a resident ubiquitin ligase that has been proposed as a …

Role Of Crebh In Endotoxin Mediated Modulation Of Hepatic Metabolism, Aditya Prakash Dandekar

Wayne State University Dissertations

Bacterial endotoxins can induce a variety of physiological changes in the host. This effect is not only restricted to inflammatory changes but also comprises metabolic changes in the host body. Lipopolysaccharide (LPS), one of the key components of the bacterial cell walls, is capable of triggering host metabolic changes. Hyperlipidemia usually accompanies with high endotoxin levels as well as inflammation. Lipid metabolism disorders are one of the common hallmarks of a patient with sepsis or high levels of endotoxin through diet. Previously, we have identified an endoplasmic reticulum (ER) anchored liver-specific transcription factor CREBH (cAMP-responsive element-binding protein, hepatocyte-specific), which is …

Soy Isoflavones Mediate Radioprotection Of Normal Lung Tissue By Modulating The Radiation-Induced Inflammatory Response, Lisa Marie Abernathy

Wayne State University Dissertations

Radiation-induced lung injury (RILI) is caused by an early inflammatory process triggered by damage to lung parenchyma, epithelial cells, vascular endothelial cells and stroma. Initially, oxidative injuries after radiation induce altered expression of pro-inflammatory cytokines. Infiltrating inflammatory cells are stimulated and activated, producing additional mediators, resulting in a cytokine cascade. The expansion and perpetual activation of inflammatory cells, as well as lung parenchyma, lead to clinical pneumonitis. Activated cells produce molecular mediators and growth factors that affect the proliferation and gene expression of lung fibroblasts. This process leads to increased collagen synthesis and deposition, eventually leading to the development of …

Adipocyte-Induced Inflammation In Prostate Tumor Progression In Bone: Role Of Cxcr2 And Osteopontin, Aimalie Lynnette Hardaway

Wayne State University Dissertations

Abstract

Prostate cancer (PCa) is the second leading cause of cancer-related deaths among men. Evidence suggests that age and obesity, conditions associated with adipocyte accumulation in the bone marrow, are linked to increased risk of developing PCa and progressing to metastatic disease. Studies presented in this dissertation were based on the hypothesis that metastatic progression in bone is a result of a cooperative effort between bone marrow adipocytes, macrophages, osteoclasts, and PCa cells. We specifically focused on two adipocyte-supplied chemokines, CXCL1 and CXCL2, and bone marrow macrophage-secreted osteopontin as key drivers of pro-inflammatory environment in the bone marrow and important …

Mitigation Of Prion Infectivity And Conversion Capacity By A Simulated Natural Process—Repeated Cycles Of Drying And Wetting, Qi Yuan, Thomas Eckland, Glenn Telling, Jason C. Bartz, Shannon L. Bartelt-Hunt

Department of Civil and Environmental Engineering: Faculty Publications

Prions enter the environment from infected hosts, bind to a wide range of soil and soil minerals, and remain highly infectious. Environmental sources of prions almost certainly contribute to the transmission of chronic wasting disease in cervids and scrapie in sheep and goats. While much is known about the introduction of prions into the environment and their interaction with soil, relatively little is known about prion degradation and inactivation by natural environmental processes. In this study, we examined the effect of repeated cycles of drying and wetting on prion fitness and determined that 10 cycles of repeated drying and wetting …

Effects Of Barred Owl (Strix Varia) Range Expansion On Haemoproteus Parasite Assemblage Dynamics And Transmission In Barred And Northern Spotted Owls (Strix Occidentalis Caurina), Krista E. Lewicki, Kathryn P. Huyvaert, Antoinette J. Piaggio, Lowell V. Diller, Alan B. Franklin

United States Department of Agriculture Wildlife Services: Staff Publications

The range of the barred owl (Strix varia) has expanded westward over the past century and now entirely overlaps the range of the federally threatened northern spotted owl (S. occidentalis caurina) in the Pacific Northwest. We compared Haemoproteus blood parasite assemblages among northern spotted owls in their native range and barred owls in both their native and invasive ranges to evaluate predictions of five hypotheses about parasites and biological invasions: (1) Enemy Release, where hosts benefit from a loss of parasites in their invasive range, (2) Enemy of My Enemy, where invasive hosts introduce parasites to …

Subtype-Specific Influenza A Virus Antibodies In Canada Geese (Branta Canadensis), Whitney M. Kistler, David E. Stallknecht, Thomas J. Deliberto, Kyle Van Why, Michael J. Yabsley

United States Department of Agriculture Wildlife Services: Staff Publications

Historically, surveillance for influenza A viruses (IAVs) in wild birds has relied on viral detection assays. This was largely due to poor performance of serological assays in wild birds; however, recently developed commercial serological assays have improved the ability to detect IAV antibodies in wild birds. Serological surveillance for IAV antibodies in Canada geese (Branta canadensis) has shown that, despite a low prevalence of virus isolations, Canada geese are frequently exposed to IAVs and that exposure increases with latitude, which follows virus isolation prevalence patterns observed in dabbling ducks. The objectives of this study were to further evaluate IAV antibodies …

Demographic And Spatiotemporal Patterns Of Avian Influenza Infection At The Continental Scale, And In Relation To Annual Life Cycle Of A Migratory Host, Rodolfo Nallar, Zsuzsanna Papp, Tasha Epp, Frederick A. Leighton, Seth R. Swafford, Thomas J. Deliberto, Robert J. Dusek, Hon S. Ip, Jeffrey Hall, Yohannes Berhane, Samantha E.J. Gibbs, Catherine Soos

United States Department of Agriculture Wildlife Services: Staff Publications

Since the spread of highly pathogenic avian influenza (HPAI) H5N1 in the eastern hemisphere, numerous surveillance programs and studies have been undertaken to detect the occurrence, distribution, or spread of avian influenza viruses (AIV) in wild bird populations worldwide. To identify demographic determinants and spatiotemporal patterns of AIV infection in long distance migratory waterfowl in North America, we fitted generalized linear models with binominal distribution to analyze results from 13,574 blue-winged teal (Anas discors, BWTE) sampled in 2007 to 2010 year round during AIV surveillance programs in Canada and the United States. Our analyses revealed that during late summer staging …

Contact Heterogeneities In Feral Swine: Implications For Disease Management And Future Research, Kim M. Pepin, Amy J. Davis, James C. Beasley, Raoul Boughton, Tyler A. Campbell, Susan M. Cooper, Wesson D. Gaston, Steve Hartley, John C. Kilgo, Samantha M. Wisely, A. Christy Wyckoff, Kurt C. Vercauteren

United States Department of Agriculture Wildlife Services: Staff Publications

Contact rates vary widely among individuals in socially structured wildlife populations. Understanding the interplay of factors responsible for this variation is essential for planning effective disease management. Feral swine (Sus scrofa) are a socially structured species which pose an increasing threat to livestock and human health, and little is known about contact structure. We analyzed 11 GPS data sets from across the United States to understand the interplay of ecological and demographic factors on variation in co-location rates, a proxy for contact rates. Between-sounder contact rates strongly depended on the distance among home ranges (less contact among sounders …

Antibody Response Of Cattle To Vaccination With Commercialmodified Live Rabies Vaccines In Guatemala, Amy T. Gilbert, Lauren Greenberg, David Moran, Danilo Alvarez, Marlon Alvarado, Daniel L. Garcia, Leonard Peruski

United States Department of Agriculture Wildlife Services: Staff Publications

Vampire bat rabies is a public and animal health concern throughout Latin America. Aspart of an ecological study of vampire bat depredation on cattle in southern Guatemala,we conducted a vaccine seroconversion study among three dairy farms. The main objec-tives of this cross sectional and cohort study were to understand factors associated withbat bites among cattle, to determine whether unvaccinated cattle had evidence of rabiesvirus exposure and evaluate whether exposure was related to bat bite prevalence, and toassess whether cattle demonstrate adequate seroconversion to two commercial vaccinesused in Guatemala. In 2012, baseline blood samples were collected immediately prior tointramuscular inoculation of …

Neuropsychological Rehabilitation Specific To Anorexia Nervosa: A Critical Review Of The Literature On Executive Functioning Symptomatology And Cognitive Remediation Treatment Applications Tailored To This Patient Population, Kayleigh Elizabeth Hale

Theses and Dissertations

Engaging, maintaining, and treating patients with anorexia nervosa (AN) remains a significant challenge for clinicians, hypothesized explanations for which are thought to involve specific executive functioning impairments. The neuropsychological treatment paradigm Cognitive Remediation Therapy (CRT) represents the translation of neurocognitive research into practice, and is thought to remediate neuropsychological symptoms and associated maladaptive cognitive processes. Additionally, the etiological model of AN related to executive functioning provides a conceptual framework for this novel approach to treatment. This study identifies and examines such a model, in addition to CRT protocols. Methodology involved a comprehensive synthesis and critical analysis of the literature pertaining …

Variations In Microbiota Of Culex (Melanoconion) Ocossa And Culex (Culex) Declarator Across Peri-Urban And Rural Environments, M. Nelson Starkey

Honors Theses

Mosquitoes serve as the primary mode of transmission for many tropical infections such as Venezuelan equine encephalitis virus, dengue virus, and malaria. Therefore, mosquitoes are an important area of study for disease control. This study is part of a larger goal to examine the differences in gut microbiota of Culex melanoconion species across two different habitats: periuban and rural. Mosquitoes were collected from locations around Iquitos, Peru and their gut bacterial DNA was extracted and analyzed. Based on previous studies, it is believed that the bacterial flora will differ among mosquitoes reared in different locations.