Digital Commons Network^™

Implementation Of Ace Inhibitor Regimen In Patients With Type 2 Diabetes Mellitus, Rita Chukwurah

Doctor of Nursing Practice

The incidence of type 2 diabetes has increased dramatically and is associated with many problems, including chronic kidney disease. The purpose of this quality improvement project was to implement two evidence-based guidelines that may detect chronic kidney disease and slow its progression in patients with type 2 diabetes by implementing angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy according to evidence-based guidelines from the American Diabetes Association. Patients with type diabetes were screened for microalbuminuria and eGFR of < 60 mL/min/1.73 m². Based on lab results, the provider recommended either an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to patients with as …

Evidence-Based Foot Care For Persons With Type 2 Diabetes, Nicole Gutierrez

Doctor of Nursing Practice

Unmanaged Type 2 diabetes leads to macrovascular changes that affect the lower extremities, thereby damaging the sensory nerve fibers and leading to diabetic peripheral neuropathy. These patients may not be able to feel pain, heat, or cold in their lower extremities and often describe feelings of numbness and tingling. This sensory deficit may lead to the development of diabetic foot ulcers which often result in amputation. These preventable foot complications may be identified promptly with adequate diabetic foot exams. Comprehensive diabetic foot examinations reduce the occurrences of foot complications associated with uncontrolled glucose management and improves health outcomes for patients …

Quality Improvement Initiative To Increase Comprehensive Eye Exams In Patients With Diabetes, Julia Khoury

Doctor of Nursing Practice

Diabetic retinopathy is the most common microvascular complication associated with poorly controlled diabetes. Yet, only 60% of the diabetic population receives an annual eye examination by an eye specialist. Retinal imaging increases surveillance of retinopathy, however, it does not take the place of a comprehensive eye examination by an ophthalmologist or optometrist. The aim of this quality improvement project was to increase comprehensive eye examinations in patients with diabetes aged 18 to 75 years in a family practice that recently purchased a retinal imager. This quality improvement project occurred over a 10-week period. Project objectives included increasing comprehensive dilated eye …

Implementing A Cognitive Impairment Care Planning Toolkit To Enhance Dementia Care: A Quality Improvement Project, Raquel Garcia-Priestly

Doctor of Nursing Practice

Background: Alzheimer’s is the most expensive disease in the United States with costs reaching $277 billion a year and affecting 5.7 million Americans. By 2050, 14 million Americans will have Alzheimer’s disease and related dementias (ADRD). This burdensome disease not only affects the individual, but also those who are responsible for their care, making it extremely complex to manage. Purpose: To systematically integrate the Alzheimer’s Association’s Cognitive Impairment Care Planning Toolkit in an outpatient mental health clinic to enhance care by effectively addressing the needs of patients with ADRD and of their caregivers. Objectives: Increase the number of patients with …

Managing Childhood Obesity In A Primary Care Clinic, Linda Nnajiofor

Doctor of Nursing Practice

Background: Childhood obesity and overweight have increased health burdens on health care systems, and contribute to chronic diseases such as diabetes, heart disease, asthma, and cancer. Childhood obesity is very complex for healthcare providers to manage in primary care settings.

Purpose: To improve childhood overweight and obesity approach and management in a selected primary care practice (Clinic A) in a large east Texas urban community.

Objectives: 1. Increase the percentage of children and adolescents ages 2 to 19 years seen in Clinic A, who received adequate weight management and obesity counseling, to 75%. 2. Increase the number of referrals to …

Improving Residential Asthma Assessment Strategies Within A Low Socioeconomic Community, Monica Ramirez

Doctor of Nursing Practice

Background: Nationally, there are currently 6 million children under the age of 18 with asthma. There are a variety of social determinants and in-home environmental triggers that can contribute to the development of or exacerbation of asthma in children. Therefore, it is important to recognize and improve the needs of children with asthma in older homes and in households with a lower socioeconomic status.

Aim: The aim of this project was to decrease the number of in-home environmental asthma triggers within at-risk homes in San Antonio, Texas.

Purpose: The purpose of this evidence-based practice project was to improve asthma outcomes …

Implementing A Tracking And Referral Follow-Up Process To Increase Screening Colonoscopy Adherence Within A Primary Care Setting, Stephanie Villanueva

Doctor of Nursing Practice

Within the United States, colorectal cancer is the fourth most common cancer diagnosed in both women and men. The American Cancer Society approximated that 97,220 new colon cancer cases and 43,030 rectal cancer cases would occur within 2018. Overall, it was estimated there were approximately 50,630 colorectal cancer deaths in 2018. Despite recommended guidelines, reported screening rates are only 31% to 55%, well below the goal of 75% set by the American Cancer Society. The purpose of this project was to increase preventative colorectal cancer screening referrals and completion of colonoscopies for qualified individuals age 50–75 years within a family …

A Quality Improvement Initiative To Facilitate Provider Adherence To Type Ii Diabetes Mellitus Guidelines, Yazmin Valencia

Doctor of Nursing Practice

Background:A significant number of individuals with type 2 diabetes mellitus do not receive comprehensive diabetes care management to maintain optimal health.

Purpose:This project was designed to facilitate provider adherence to the type 2 diabetes mellitus evidence-based practice standards of care. A primary care practice needs assessment indicated opportunities to improve care management processes which promote adherence to current clinical practice guidelines.

Methods:This 10-week quality improvement project provided the clinical staff and provider with the necessary tools to implement best practices of diabetes care. Objectives assessed throughout project implementation included the design and use of an electronic health …

The Promise And Peril Of Using Disability Law As A Tool For School Reform, Claire Raj

Faculty Publications

No abstract provided.

Cutr Connections [December 2019], Cutr

CUTR Newsletters

No abstract provided.

Benefits Of School Gardening On Low-Income Elementary School Students, Caitlynn Lange

Capstone Projects and Master's Theses

The increase in obesity rates in America’s youth could be a reflection of undernourished school lunches, a decrease in physical activity, and the lack of knowledge of health and nutrition. Children who come from a low-income family are more likely to be affected by these circumstances. School gardening may be a way of replacing those impacts. This senior capstone research project examines the benefits of school gardening on low-income elementary school students when implementing as part of the curriculum in schools.

Roman Law And Global Constitutionalism, Rafael Domingo

San Diego International Law Journal

The parallel between contemporary issues and Roman history often fascinates and illuminates. In this Article, I argue how Roman law can serve today as an inspiration toward global constitutionalism given it was one of the several sources of inspiration for the American founders. Looking to Roman law helps reduce certain prejudices derived from the current privileging of the sovereign state and the positivist paradigm as the only genuine and possible models for international law. These prejudices constitute an actual hindrance to the right development of global constitutionalism. Global constitutionalism inherently moves beyond sovereignty, nationalism, and positivism. Roman law enables constitutionalists …

Life Cycle Assessment Of Small Modular Reactors Using U.S. Nuclear Fuel Cycle, Kara Michelle Godsey

All Theses

In an ever-evolving energy market, it is vital that nuclear technology adapts to become more economically and environmentally feasible. The promising economics and flexibility of small modular reactors (SMRs) may make them the technology of the future for the nuclear industry, offering a simple solution to many of the problems that have plagued the industry in the last decade. Though the economics of SMRs is often a topic of discussion, it is also important to understand the environmental aspects of this technology when implemented in a U.S. market. A life cycle assessment (LCA) of small modular reactors using a U.S. …

Preformulation, Stress Stability Studies And Hplc-Uv Method Development And Validation For 95 % Ethanol Extract Of Moringa Oleifera Lam. Leaves, Harith J. Alsammarraie, Nurzalina Abdul Karim Khan, Roziahanim Mahmud, Mohd Zaini Bin Asmawi, Vikneswaran A/L Murugaiyah

Bulletin of Faculty of Pharmacy Cairo University

Introduction: There is a continuous expansion in number of botanical medicinal products and increase in consumers who often use it. One of such natural source products with versatile traditional uses as treatment for variety of diseases is Moringa oleifera Lam. Objectives: After the pharmacological activity of a new drug candidate is approved, the subsequent development of this product requires substantial information about its physical and chemical properties before designing its dosage form. Methods: Organoleptic properties, physicochemical characteristics, solubility profile, swelling index, partition coefficient, analyses of thermal behaviour, stress stability, heavy metals and microbial limit tests were performed in preformulation studies …

Effect Of Food/Beverage And Selected Drugs On The Oral Absorption Of Artemether-Lumefantrine Tablet: An In Situ And In Vivo Study, Sunday Olajide Awofisayo, Matthew I. Arhewoh, Augustine O. Okhamafe

Bulletin of Faculty of Pharmacy Cairo University

Aim: This study aims at assessing the effect of some meals/beverage and selected drugs on oral absorption of artemether (ATM) and lumefantrine (LMF). Methods: In the in situ model, artemether-lumefantrine (AL) tablets were crushed and administered to anesthetized rabbits (n=2) via oral cannula either alone (CTR1) or with food components/beverage [i.e., starch (STC), albumin (ALB), sunflower oil (SFO) or carbonated drinks (CBS)] or drugs [i.e., lamivudine (LMV) or metronidazole (MTN)]. Blood samples were taken from cannulated carotid artery post dose administration. In the in vivo model, forty two healthy human subjects (28 male and 14 female) in groups of six …

Winning The Battle And The War Against C. Difficile, Emily Villegas

Articles, Abstracts, and Reports

In 2016 Providence St. Patrick Hospital Serious Infection Rate (SIR) for Hospital Acquired C. difficile Infections (HACDI) was well above the acceptable standard. Several departments were working independently of each other to develop and implement interventions. However, these efforts did not result in sustained improvement and in some cases there where downstream consequences that made the problem worse.

Optimizing Care Teams From The Start, Vanessa Casillas, Ryan Dix

Articles, Abstracts, and Reports

Traditionally, the onboarding plan for a new provider is focused on the new employee. But what happens when the success of your role is largely impacted by the relationships you have with others on the interdisciplinary care team? Interprofessional relationships are a key element of Behavioral Health Consultant (BHC) success in their role and the earlier they can start being developed the better. This presentation will identify strategies to help management teams create effective onboarding plans for the BHC that facilitate smooth adoption of integrated principles and launch successful interdisciplinary collaboration across the care team.

Pedia: Prioritization Of Exome Data By Image Analysis., Tzung-Chien Hsieh, Martin A Mensah, Jean T Pantel, Dione Aguilar, Omri Bar, Allan Bayat, Luis Becerra-Solano, Heidi B Bentzen, Saskia Biskup, Oleg Borisov, Oivind Braaten, Claudia Ciaccio, Marie Coutelier, Kirsten Cremer, Magdalena Danyel, Svenja Daschkey, Hilda David Eden, Koenraad Devriendt, Sandra Wilson, Sofia Douzgou, Dejan Đukić, Nadja Ehmke, Christine Fauth, Björn Fischer-Zirnsak, Nicole Fleischer, Heinz Gabriel, Luitgard Graul-Neumann, Karen W Gripp, Yaron Gurovich, Asya Gusina, Nechama Haddad, Nurulhuda Hajjir, Yair Hanani, Jakob Hertzberg, Konstanze Hoertnagel, Janelle Howell, Ivan Ivanovski, Angela Kaindl, Tom Kamphans, Susanne Kamphausen, Catherine Karimov, Hadil Kathom, Anna Keryan, Alexej Knaus, Sebastian Köhler, Uwe Kornak, Alexander Lavrov, Maximilian Leitheiser, Gholson J Lyon, Elisabeth Mangold, Purificación Marín Reina, Antonio Martinez Carrascal, Diana Mitter, Laura Morlan Herrador, Guy Nadav, Markus Nöthen, Alfredo Orrico, Claus-Eric Ott, Kristen Park, Borut Peterlin, Laura Pölsler, Annick Raas-Rothschild, Linda Randolph, Nicole Revencu, Christina Ringmann Fagerberg, Peter N Robinson, Stanislav Rosnev, Sabine Rudnik, Gorazd Rudolf, Ulrich Schatz, Anna Schossig, Max Schubach, Or Shanoon, Eamonn Sheridan, Pola Smirin-Yosef, Malte Spielmann, Eun-Kyung Suk, Yves Sznajer, Christian T Thiel, Gundula Thiel, Alain Verloes, Irena Vrecar, Dagmar Wahl, Ingrid Weber, Korina Winter, Marzena Wiśniewska, Bernd Wollnik, Ming W Yeung, Max Zhao, Na Zhu, Johannes Zschocke, Stefan Mundlos, Denise Horn, Peter M Krawitz

Faculty Research 2019

PURPOSE: Phenotype information is crucial for the interpretation of genomic variants. So far it has only been accessible for bioinformatics workflows after encoding into clinical terms by expert dysmorphologists.

METHODS: Here, we introduce an approach driven by artificial intelligence that uses portrait photographs for the interpretation of clinical exome data. We measured the value added by computer-assisted image analysis to the diagnostic yield on a cohort consisting of 679 individuals with 105 different monogenic disorders. For each case in the cohort we compiled frontal photos, clinical features, and the disease-causing variants, and simulated multiple exomes of different ethnic backgrounds.

RESULTS: …

The Alliance Of Genome Resources: Building A Modern Data Ecosystem For Model Organism Databases., Alliance Of Genome Resources Consortium, Carol J Bult, Judith A. Blake, Brian R Calvi, J. Michael Cherry, Valentina Difrancesco, Robert Fullem, Kevin L Howe, Thom Kaufman, Chris Mungall, Norbert Perrimon, Mary Shimoyama, Paul W Sternberg, Paul Thomas, Monte Westerfield

Faculty Research 2019

Model organisms are essential experimental platforms for discovering gene functions, defining protein and genetic networks, uncovering functional consequences of human genome variation, and for modeling human disease. For decades, researchers who use model organisms have relied on Model Organism Databases (MODs) and the Gene Ontology Consortium (GOC) for expertly curated annotations, and for access to integrated genomic and biological information obtained from the scientific literature and public data archives. Through the development and enforcement of data and semantic standards, these genome resources provide rapid access to the collected knowledge of model organisms in human readable and computation-ready formats that would …

Editorial Perspective For Systematic Review On C5 Palsies., Jens R Chapman

Articles, Abstracts, and Reports

No abstract provided.

The Impact Of Social And Cultural Factors On Minority Students’ Participation In An International Baccalaureate Diploma Program, Elizabeth Scott-Janda

Dissertations

Although concern about mathematical achievement inequities has become widespread, even in well-funded, high-performing high schools, unequal outcomes for minority and disadvantaged students can seem persistent and difficult to change despite strong efforts. This project reports on an ethnographic study that examined how social environments within schools can affect students’ choices of whether or not to attempt advanced coursework in mathematics, especially among marginalized groups like Hispanic minorities, low socio-economic status (SES) and rural populations. It considered how social and peer environments affect students’ approaches to schooling, and decisions they make that will have long-term implications for their futures. In particular, …

An Examination Of Oregon Department Of Education's Implementation Processes And Practices, Beth Maruka Wigham

Doctor of Education (EdD)

The purpose of this study was to examine state-level implementation practices and processes of current initiatives or programs through personal interviews with implementation managers at the Oregon Department of Education. This study used a qualitative research design for gathering individual perspectives on their effective and ineffective processes and practices for implementation and identified commonalities across implementation managers and departments. This study answered three research questions: (1) What are the practices and processes described by implementation managers in this study as effective for the implementation of their initiative or program?; (2) How are implementation elements conceptualized, enacted, and measured by implementation …

Effects Of A Chronic 0.1 Μm Arsenic Exposure On P19 Mouse Embryonic Stem Cell Differentiation And Pluripotency, Benjamin Mcmichael

All Theses

Globally, at least 140 million people are exposed to levels of arsenic greater than the World Health Organization recommended standard of 10 ug/L (10 ppb) through their drinking water and food. Epidemiological studies have correlated arsenic exposure during embryonic and fetal development with reduced birth weight, as well as muscular and neurodevelopmental deficits. The goal of the current study was to determine the mechanisms by which a chronic, low-level arsenic exposure impairs cellular development and differentiation. This was achieved by exposing P19 mouse embryonic stem cells (mESC’s) to 0.1 μM arsenic (7.5 ppb), a concentration lower than the current drinking …

Solitary Endobronchial Papilloma: A Rare Entity, Muhammad Soban Arif Maan, Muhammad Waleed, Amir Humza Sohail, Asna Sulaiman, Javaid Ahmed Khan

Section of Pulmonary & Critical Care

No abstract provided.

Multimodal Mobile Sensing Systems For Physiological And Psychological Assessment, Nguyen Phan Sinh Huynh

Dissertations and Theses Collection (Open Access)

Sensing systems for monitoring physiological and psychological states have been studied extensively in both academic and industry research for different applications across various domains. However, most of the studies have been done in the lab environment with controlled and complicated sensor setup, which is only suitable for serious healthcare applications in which the obtrusiveness and immobility can be compromised in a trade-off for accurate clinical screening or diagnosing. The recent substantial development of mobile devices with embedded miniaturized sensors are now allowing new opportunities to adapt and develop such sensing systems in the mobile context. The ability to sense physiological …

How Courts In Criminal Cases Respond To Childhood Trauma, Deborah W. Denno

Marquette Law Review

Neurobiological and epidemiological research suggests that abuse and adverse events experienced as a child can increase an adult’s risk of brain dysfunction associated with disorders related to criminality and violence. Much of this research is predictive, based on psychological evaluations of children; few studies have focused on whether or how criminal proceedings against adult defendants consider indicators of childhood trauma. This Article analyzes a subset of criminal cases pulled from an 800-case database created as part of an original, large-scale, empirical research project known as the Neuroscience Study. The 266 relevant cases are assessed to determine the extent to which, …

On The Edge: The Ada's Direct Threat Defense And The Objective Reasonableness Standard, Jarod S. Gonzalez

Marquette Law Review

One of the most important issues under the Americans with Disabilities Act (ADA) is the appropriate standard for evaluating Title I employment disability discrimination cases where the employer argues that the employee has a medical condition that poses too much of a safety risk for the employee to work in a particular position. This is called the “direct threat” concept. In general, this permits an employer to discriminate against an employee on the basis of disability if the employee poses a “significant risk of substantial harm to the health or safety of the individual or others that cannot be eliminated …

Reconceptualizing Access To Justice, Katherine S. Wallat

Marquette Law Review

This Article argues that the assumptions that underlie how we currently conceptualize equal access to justice ensure that we will never achieve it. Much scholarly attention has been paid to the problem of access to justice for lowincome people, which is typically defined as unmet legal need. Most of this attention focuses on the crisis in civil courts of unrepresented parties. These scholars suggest court-focused solutions centered on providing more lawyers and legal advice to help deal with this pro se crisis. But the vast majority of justiciable civil problems are resolved (or not) without any contact with the legal …

Cholesterol Efflux Capacity And Its Association With Metabolic Syndrome In A Multi-Ethnic Population (Dallas Heart Study): A Cross-Sectional Study, Oludamilola Akinmolayemi

Dissertations and Theses (Open Access)

Metabolic syndrome (MetS) is a multi-component risk factor for cardiovascular disease (CVD) and type 2 diabetes. MetS has been found to be associated with increased risk of incident CVD, cardiovascular morbidity and mortality, and prevalence atherosclerosis. Cholesterol efflux capacity (CEC) is a measure of the functional property of high-density lipoprotein cholesterol (HDL-C). In addition, it characterizes the ability of HDL-C to accept cholesterol from extra-hepatic cells in the periphery to the liver and has been shown in clinical studies to be inversely associated with atherosclerosis cardiovascular disease (ASCVD) and incident cardiovascular disease (CVD) . Low HDL-C is one of the …

Examining The Relation Between Social Capital And Physical Activity Across Life Stages, Leigh Ann Ganzar

Dissertations and Theses (Open Access)

Physical inactivity in adults increases the risk for adverse health outcomes, including non-communicable diseases and premature death. Children who are not sufficiently physically active face increased risk for non-communicable disease risk factors, mental health issues, and poor academic performance. Despite these risks, the majority of people do not achieve sufficient physical activity levels. Social capital is an aspect of the social environment that can shape physical activity behavior throughout different life stages. The three studies of this dissertation sought to assess the association between social capital, from both the cohesion and network perspectives, and physical activity behavior in different life …