Digital Commons Network^™

Institutionalizing Resilience In Us Universities: Prospects, Opportunities, And Models, Morris Foster, James O'Donnell, Mark Luckenbach, Elizabeth Andrews, Emily Steinhilber, John Wells, Mark Davis

ODU Articles

[From Introduction]

The United States is taking a largely region-specific approach to addressing challenges posed by climate change, in contrast with national and international approaches in most of the rest of the world. In locations such as Hampton Roads, New Orleans, and coastal Connecticut, the impacts of climate change tend to be addressed as they become locally evident rather than as part of a larger anticipatory national plan. Given that regional focus, universities can play a unique role in how the United States responds to the challenges of a changing climate. Universities can be knowledge brokers positioned outside or across …

The Use Of Rapid Antigen Testing And Matrix-Assisted Laser Desorption/Ionization-Timeof Flight Mass Spectrometry In The Diagnosis Of Group A Beta-Hemolytic Streptococci Inthroat Swab Samples, Ridvan Deni̇z, Eli̇f Aktaş Sepetci̇, Ayşe Bariş, Banu Bayraktar

Turkish Journal of Medical Sciences

Background/aim: We aimed to evaluate the efficacy of a rapid antigen test in detecting group A beta-hemolytic streptococci (GAS) in throat samples in comparison with the culture method and to compare the efficiency of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and traditional methods in identifying GAS in cultures. Materials and methods: A total of 3668 throat samples from patients with a prediagnosis of tonsillopharyngitis were assessed by the QuickVue+Strep A antigen test and culture. For GAS identification from cultures, bacitracin sensitivity, PYR, and latex agglutination tests and MALDI-TOF MS were used. Results: A total of 567 (15.5%) …

Eng 1099g : Stories Matter, Honors 1, 2, 3, 4, 5, English

Approved Course Proposals

No abstract provided.

Identifying Rates, Barriers And Facilitators For Hpv Vaccines In Children Ages 11-14 In A Kentucky Primary Care Clinic, Sarah J. King

DNP Projects

Background: Among all of the pediatric vaccinations recommended by the CDC, the HPV vaccination has consistently had lower adherence rates than the goal set by Healthy People 2020. The CDC recommends that adolescents start receiving the human papillomavirus (HPV) vaccine at the ages 9-11 to provide protection against certain strains of HPV that can cause cancer. The goal is to administer the HPV vaccine before the adolescent would be exposed to the virus. However, there has been much resistance and non-adherence to the HPV vaccination. Purpose: The purpose of this study was to identify the current rates of HPV vaccination …

Choosing Medical Malpractice, Nadia N. Sawicki

Faculty Publications & Other Works

Modern principles of patient autonomy and health care consumerism are at odds with medical malpractice law's traditional skepticism towards the defenses of contractual waiver and assumption of risk. Many American courts follow a patient-protective view, exemplified by the reasoning in the seminal Tunkl case, rejecting any attempts by physicians to relieve themselves of liability on the grounds of a patient's agreement to assume the risk of malpractice. However, where patients pursue unconventional treatments that satisfy their personal preferences but that arguably fall outside the standard of care, courts have good reason to be more receptive to such defenses. This Article …

Would Hamsterdam Work - Drug Depenalization In The Wire And In Real Life, John Bronsteen

Faculty Publications & Other Works

The television show The Wire depicts a plan called “Hamsterdam” in which police let people sell drugs in isolated places, and only those places, without fear of arrest. Based on limited but decent empirical evidence, we can make educated guesses about what would happen if that were tried in real life. Indeed, Swiss police tried something remarkably similar in the 1980s. More generally, the results of various forms of drug legalization, depenalization, and decriminalization in Europe--such as in Portugal, which has transferred the state's method of dealing with drug use (including heroin and cocaine) from the criminal justice system to …

Public Health Preparedness & Response: An Exercise In Administrative Law, John D. Blum, Jordan Paradise

Faculty Publications & Other Works

Responses to epidemics, pandemics, and other biological disasters require multiple coordinated initiatives that combine sophisticated planning, sound emergency management, effective stockpiles, solid geographic information systems, well-developed laboratory surveillance and response, and effective management capabilities. Critical to the noted elements of planning and response is the existence of a legal structure, which underpins the operations of necessary programs. While the law may not be the first public health tool considered in a disaster, it is fundamental to the effective functioning of multiple actors and must be harmonized across jurisdictional lines. This article explores the role of law in pandemics and other …

Partnering With Inpatient Situation Awareness Screening To Improve Early Sepsis Recognition, Leslie Hueschen, Stephanie Burrus, Andrea Raymond, Charity Thompson, Lisa Carney, Jay Rilinger

Posters

Background

Early recognition of sepsis and designing a huddle process are key drivers of the Improving Pediatric Sepsis Outcomes (IPSO) collaborative. Our tertiary care, free-standing, pediatric hospital joined the IPSO collaboration in 2016. Our hospital began piloting Situation Awareness (SA) Escalation Huddles in 2016, to improve recognition of patients with clinical deterioration. The tool triggers if a patient has a high PEWS(> 5), requires initiation of hi-flow nasal cannula, or for staff/parental concern. The SA paper tool guides the communication process and steps of the huddle. Huddles include a nurse, provider, and respiratory therapist. One of the goals of the …

Evaluation Of Diagnostic Criteria In The Early Identification And Treatment Of Sepsis, Christopher Anzalone Zirker

Yale Medicine Thesis Digital Library

The recently introduced Sepsis-3 guidelines have yet to be applied to the emergency department (ED) setting. To compare these new definitions clinically with those of Sepsis-2, a retrospective analysis was performed using a dual-center ED registry of patients prospectively identified as having sepsis with organ dysfunction as defined by Sepsis-2. Of 446 registry patients meeting Sepsis-2 criteria, 61.0% (n = 272) had an elevated qSOFA score. 28-day in hospital mortality for patients with an elevated qSOFA was 15.8% compared to 10.9% in patients with non-elevation (p = .162). Rates of mechanical ventilation and vasopressor infusion were 38.6% and 36.4% respectively …

Alternatively Activated Macrophages In Pseudomonas Aeruginosa Pneumonia: Modulation Of The Nf-Κb Signaling Pathway And The Immunomodulatory Role Of Arginase-1, Dalia Haydar

Theses and Dissertations--Pharmacy

Background: Azithromycin polarizes macrophages into an alternative phenotype and promotes a regulated immunity. Arginase is an important effector of these macrophages believed to play an essential role in decreasing injury and promoting repair.

Hypothesis: Decreases in inflammation in response to Pseudomonas aeruginosa (PA) pneumonia achieved by polarizing macrophages to an alternative phenotype is dependent upon the production of arginase.

Methods: Requirement of arginase was examined by pharmacological inhibition using S-(2-boronoethyl)- l-cysteine (BEC) or l-norvaline and by infecting arginase-1 conditional knock-out mice (Arg1^flox/flox;Lyz2-cre (Arg1^Δm)) with PA intratracheally. Arg1^ΔM and control Arg1^flox/flox mice were then …

Discovery Of New Antimicrobial Options And Evaluation Of Aminoglycoside Resistance Enzyme-Associated Resistance Epidemic, Selina Y. L. Holbrook

Theses and Dissertations--Pharmacy

The extensive and sometimes incorrect and noncompliant use of various types of antimicrobial agents has accelerated the development of antimicrobial resistance (AMR). In fact, AMR has become one of the greatest global threat to human health in this era. The broad-spectrum antibiotics aminoglycosides (AGs) display excellent potency against most Gram-negative bacteria, mycobacteria, and some Gram-positive bacteria, such as Staphylococcus aureus. The AG antibiotics amikacin, gentamicin, kanamycin, and tobramycin are still commonly prescribed in the U.S.A. for the treatment of serious infections. Unfortunately, bacteria evolve to acquire resistance to AGs via four different mechanisms: i) changing in membrane permeability to …

Synthesis And Biological Evaluation Of Novel Drug Candidates To Address Drug Resistance In Tuberculosis And Fungal Diseases, Huy Ngo

Theses and Dissertations--Pharmacy

Tuberculosis (TB) and fungal infections are two of the most lethal infectious diseases worldwide due to the emergence of drug-resistant Mycobacterium tuberculosis (Mtb) and fungal strains that can resist the most potent antimicrobial drugs currently employed. Due to the rise of these drug resistant strains, effective treatment options for these two infections are limited. This dissertation aims at exploring novel drug scaffolds to help combat drug resistance in TB and fungal infections.

TB caused by the pathogenic Mtb is, alongside with human immunodeficiency virus acquired immunodeficiency virus (HIV), the deadliest infectious disease worldwide with approximately 2-3 billion people …

Rhodococcus Equi In The Foal – Improving Diagnostic And Prevention Measures, Fernanda Bicudo Cesar

Theses and Dissertations--Veterinary Science

Although Rhodococcus equi (R. equi), previously known as Corynebacterium equi, was first isolated from pneumonic foals almost a century ago, it remains the most common cause of subacute or chronic granulomatous bronchopneumonia in foals. While the majority of foals exposed to R. equi develop a protective immune response (regressors), others exhibit a unique susceptibility to infection (progressors). The determinants for either outcome are not completely understood. Therefore, current diagnostic and preventive measures are suboptimal and require betterment. In light of this current need, we hypothesized that immunoglobulin G subisotype T [IgG(T)] against the virulence-associated protein A (VapA) …

Effects Of Endophyte-Infected Tall Fescue Seed And Bromocriptine On Endocrine And Immune Function In Horses, Jessica Marie Hanneman

Theses and Dissertations--Veterinary Science

Consumption of endophyte-infected (E+) grasses has long been associated with health problems in animals. In cattle E+ tall fescue consumption leads to fescue toxicosis, and in horses it leads reproductive problems. The health-related issues associated with endophyte consumption have been attributed to the effects caused by the ergot alkaloids produced by the fungus. These ergot alkaloids are considered D2-like receptor agonists, and 5-HT2 serotonin and α-adrenergic receptor partial agonists. Many studies in humans, swine, cattle, and horses have identified that ergopeptines cause a decrease in prolactin production due to their dopaminergic activities. Additionally, these molecules have been found to cause …

Initial Assessment And Effects Of Snake Fungal Disease On Populations Of Snakes In Kentucky, Jennifer Mckenzie

Theses and Dissertations--Forestry and Natural Resources

Pathogenic fungi are increasingly associated with epidemics in wildlife populations and represent a significant threat to global biodiversity. Snake fungal disease is an emerging disease caused by the fungus, Ophidiomyces ophiodiicola, and appears to be widespread in the eastern United States. Yet an evaluation of field diagnostics, and an understanding of the population-level consequences of the disease, are lacking. First, I evaluated the use of clinical signs to predict the presence of O. ophiodiicola across season and snake habitat affiliation (aquatic or terrestrial) and I compared two sampling methods to see if collection method impacts PCR result. Overall, snakes with …

Cellular And Molecular Basis Of Equine Arteritis Virus Persistent Infection In The Stallion Reproductive Tract: Characterization Of Local Host-Pathogen Interactions Mediating Long-Term Viral Persistence, Mariano Carossino

Theses and Dissertations--Veterinary Science

Equine arteritis virus (EAV) has a global impact on the equine industry being the causative agent of equine viral arteritis (EVA), a reproductive, respiratory, and systemic disease of equids. A distinctive feature of EAV infection is that it establishes long-term persistent infection in the reproductive tract of stallions and is continuously shed in the semen (carrier state). Recent studies showed that long-term persistence is associated with a specific allele of the CXCL16 gene (CXCL16S). However, the cellular and molecular mechanisms underlying the establishment and maintenance of persistent infection are yet to be determined. The studies were undertaken herein …

Hiv Pre-Exposure Prophylaxis: Are We “Preping” For A New Epidemic?, Christopher Disanto

Student Works

No abstract provided.

Public Health And Sterilization Of The Mentally Disabled: Under What Circumstances Should It Be Scrutinized Versus Granted By Court Order?, Devin Griffin

Student Works

No abstract provided.

Alcoholism: A Mathematical Model With Media Awareness Campaigns, Erik H. Ander, Zeynep Teymuroglu

Undergraduate Mathematics Day: Past Content

In this paper, we study how media awareness campaigns influence the spread and persistence of drinking behavior in a community. Here, we present a compartmental population model with an additional differential equation to describe the dynamics of media awareness campaigns in combating problem drinking ([10], [12], [21]). Our model indicates a basic reproductive number, R0, where there exists an asymptotically stable drinking-free equilibrium if R0 < 1, and a unique endemic state, which appears to be stable when R0 > 1. We found that the following two components affect the basic reproductive number: the strength of peer influence of problem drinkers on susceptibles and the average overall time spent in the problem drinking environment. Furthermore, …

Comparing A General And Transitional Registered Nurse Orientation To Facilitate Quality Improvement, Kathryn R. Cortes

Walden Dissertations and Doctoral Studies

Most hospitals orient new graduate nurses and experienced nurses in the same generalized orientation programs. To address the cost of orientation to specialty units, a pediatric hospital developed a tailored transitional residency orientation program for experienced nurses. The purpose of this project was to describe, compare, and evaluate the existing generalized orientation program and the transitional orientation program to determine how the orientations differed in structure, process, and outcomes. Donabedian's model assessing quality of care services and Benner's novice-to-expert theoretical framework served as guides in evaluating the orientation outcomes. Qualitative data about residency classroom time, preceptor selection and time, mentor …

Evaluating Parents' Decisions Regarding Recommended Childhood Vaccinations, Jennifer Kline

Walden Dissertations and Doctoral Studies

Vaccinations are among the greatest accomplishments of public health. However, many parents are choosing not to vaccinate. The purpose of this study was to explore the association between social media influence and parents' decisions to vaccinate their children. The health belief model indicates that individuals' likelihood of engaging in a health-related behavior is determined by their perceptions of susceptibility, severity, benefits, and barriers. The research questions addressed whether there is an association between parents' perception of their children's disease susceptibility and their decisions about vaccination, and whether there is an association between exposure to messaging from social media and parents' …

Statistical Analysis Of Rabies Submissions In Kentucky And Weather As A Potential Predictor Of Positive Cases, Hannah Free

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

The rabies virus is a zoonotic pathogen that is nearly 100 percent fatal once symptoms occur. Because it is still active in wildlife populations in Kentucky, the need for preventive measures and surveillance is critical. Temperature and precipitation have been shown to affect rabies. This study examined rabies submissions in Kentucky, weather and geographical distribution to both describe and predict cases.

Methods

Data from the University of Kentucky Veterinary Diagnostics laboratory were used to assess rabies submissions from 2005 through 2015. These submissions were anonymously submitted by the public and the Florescent Antibody Test was used to determine infection …

Cross Contamination In Levered Endoscopes, Ernest Lowell Thomason Jr.

Walden Dissertations and Doctoral Studies

Contamination is a prevalent issue with reprocessed levered endoscopes. The number of infections caused by resistant enterobacteriaceae in patients due to contaminated endoscopes increased to the point that the United States Food and Drug Administration released a safety alert to health care facilities that perform endoscopic retrograde cholangiopancreatography (ERCP). The purpose of this descriptive project was to evaluate if levered endoscopes used in ERCP procedures met high level disinfection criteria, were properly processed, and were germ free after reprocessing. The project was supported by 2 theories: the middle range theory of patient advocacy and the germ theory. Data (counts and …

The Ecosystem Of Women's Health Social Enterprises Based In The United States, Marquita Kilgore-Nolan

Yale Medicine Thesis Digital Library

The overall objective of this thesis research was to elucidate the ecosystem of women's health social enterprises (WHSEs) based in the United States (U.S.). Aim I was to conduct a secondary data analysis of a random national sample of nonprofit WHSEs based in the U.S. regarding their characteristics and areas of intervention. Aim II was to conduct a qualitative assessment of a sample of women's health social entrepreneurs based in the U.S. regarding their perspectives on the ecosystem of WHSEs. Aim I utilized the GuideStar database and assessed enterprise size, geographic location, financial distress, health intervention area, and health activity …

Analysis Of A Vector-Borne Diseases Model With A Two-Lag Delay Differential Equation, Y. Qaddura, Nsoki Mavinga

Mathematics & Statistics Faculty Works

We are concerned with the stability analysis of equilibrium solutions for a two-lag delay differential equation which models the spread of vector-borne diseases, where the lags are incubation periods in humans and vectors. We show that there are some values of transmission and recovery rates for which the disease dies out and others for which the disease spreads into an endemic. The proofs of the main stability results are based on the linearization method and the analysis of roots of transcendental equations. We then simulate numerical solutions using MATLAB. We observe that the solution could possess chaotic and sometimes unbounded …

Realizing Restorative Justice: Legal Rules And Standards For School Discipline Reform, Lydia Nussbaum

Scholarly Works

Zero-tolerance school disciplinary policies stunt the future of school children across the United States. These policies, enshrined in state law, prescribe automatic and mandatory suspension, expulsion, and arrest for infractions ranging from minor to serious. Researchers find that zero-tolerance policies disproportionately affect low-income, minority children and correlate with poor academic achievement, high drop-out rates, disaffection and alienation, and greater contact with the criminal justice system, a phenomenon christened the "School-to-Prison Pipeline."

A promising replacement for this punitive disciplinary regime derives from restorative justice theory and, using a variety of different legal interventions, reform advocates and lawmakers have tried to institute …

Reducing T Cell-Mediated Cardiac Injury With Cpg Oligodeoxynucleotides, Erik Alexander Barfod Levinsohn

Yale Medicine Thesis Digital Library

Lymphocytic myocarditis is a common condition associated with both infectious diseases and immunological disorders, and is often associated with severe morbidity and mortality, but few effective treatments. In many cases, the pathophysiology involves a failure of central and/or peripheral immune tolerance leading to a cardiac-specific autoimmune T cell response. Previous studies indicate that the PD-1:PD-L1 axis plays an important role in limiting inflammation in the heart. CpG ODN are TLR9 agonists with known immunoregulatory capacity, in part through their potent induction of type I IFN, a known inducer of PD-L1. In this study, we used human tissue to determine the …

The Role Of Endothelial Nitric Oxide Synthase (Enos) Coupling Status During Acute Hyperglycemia As Determined By Real-Time Measurements Of Blood Nitric Oxide And Hydrogen Peroxide In Rat, Matthew Bertolet

PCOM Biomedical Studies Student Scholarship

Acute hyperglycemia can impair vascular endothelial function in non-diabetic subjects in addition to diabetic patients. Decreased endothelial-derived nitric oxide (NO) bioavailability and increased concentrations of reactive oxygen species (ROS), such as superoxide (SO) and hydrogen peroxide (H202), are the major characteristics of vascular endothelial dysfunction. Normally, vascular endothelial function depends on NO production from coupled endothelial NO synthase (eNOS) in the presence of 5,6,7,8- tetrahydrobiopterin (BH4). By contrast, 7,8-dihydrobiopterin (BH2, Oxidized form of BH4) and/or lack ofL-arginine (coupled eNOS substrate) causes eNOS uncoupling to produce SO, which can be quickly converted to H202. The role of eNOS uncoupling in acute …

Reducing Arsenic Exposure From Private Well Water In The United States: The Use, Effect, And Potential Of Testing Requirements, Sara Flanagan

Dissertations and Theses

Over 45 million Americans drink from unregulated private well water of unknown quality. Arsenic is the most concerning groundwater contaminant for health because of its toxicity and widespread natural occurrence. Most residential wells in arsenic-affected areas have not been tested for arsenic; the success of community programs and efforts to motivate testing is limited by a range of psychological, situational, and socioeconomic barriers. However, testing only acts as screening and does not reduce exposure without effective and consistent actions to follow. Given the limitations in relying on individual well owners to be aware, willing, and capable of testing their water, …

Genetic Information Discrimination In Public Schools: A Common-Sense Exception, Tyler Wood

University of the Pacific Law Review

No abstract provided.