Digital Commons Network^™

Reducing Unnecessary Phlebotomy Testing Using A Clinical Decision Support System, Valerie Strockbine Msn, Rn, Cphq

Doctor of Nursing Practice Projects

Background: Overuse of phlebotomy testing offers little to improve patient outcomes. Reducing unnecessary phlebotomy tests can cut costs without compromising quality.

Purpose: To determine the effectiveness of a clinical decision support system (CDSS) on reducing unnecessary type and screen tests, estimate the cost saved by the CDSS implementation, and describe the unnecessary ordering practices by provider type.

Methods: Our study used a separate-sample pretest posttest design at a mid-Atlantic academic medical center to examine the number of unnecessary type and screen tests three months before and after CDSS implementation. A CDSS was embedded in our electronic health record. The CDSS …

Analysis Of Parental Attitudes Of Adolescent Vaccinations In The Retail Health Care Setting, Patrick William Denning Mph, Msn

Doctor of Nursing Practice Projects

Background: The tetanus-diphtheria-acellular pertussis, meningococcal, and human papillomavirus vaccines have been recommended for adolescents since 2005. Retail health clinics can increase the delivery of vaccinations by reaching patients outside the traditional healthcare system.

Objectives: To measure parental attitudes of adolescent vaccinations utilizing the Vaccine Confidence Scale (VCS) and assess reasons parents decided to vaccinate or not. Attitudes were compared to previous studies. Our long-term purpose was to develop targeted interventions to increase adolescent vaccinations.

Methodology: A descriptive survey design measured the parental attitudes of adolescent vaccinations from total VCS scores and subscale scores of benefits, harms, and trust. A qualitative …

Final Defense: Sepsis Screening Tool Assessment At A Freestanding Children’S Hospital In The Midwest, Cassandra Cummings

Doctoral Projects

Pediatric sepsis is a major contributor to childhood morbidity and mortality. Tools for predicting sepsis in pediatric patients have had poor predictive ability nor been validated. Risk assessment screening tools are effective at earlier detection of sepsis. The implementation of an evidence-based pediatric sepsis screening tool could reduce time to detect and diagnose severe sepsis so that patient treatment could occur earlier. This was a quality improvement project that evaluated a sepsis screening tool predictive validity at a children’s hospital.

Implementation Of The Vaccines For Children Program In A Midwest, Urban Clinic Dedicated To The Underserved Population, Akmal Saydazamov

Doctoral Projects

Background: Low immunization rates weaken herd immunity and endanger children. The Safety Net Health Clinic (SNHC) study site serves an underprivileged and refugee population with significantly lower than ideal coverage. Series completion disparities persisted after control for demographic, access-to-care, poverty and language effects (Varan et al, 2016).

Objectives: SNHC implemented the Vaccines for Children (VFC) program in order to increase the vaccination rates among the underserved population.

Methods: As an efficacy study, the project focused on three major areas in the VFC implementation – cost, staff preparedness and patient need. Cost was determined by utilizing electronic medical records (EMR) and …

The Effects Of Organic And Inorganic Nanoparticles On Bacterial Deactivation, Lauren Cooper

Mahurin Honors College Capstone Experience/Thesis Projects

Antibacterial resistance is one of the greatest problems in modern medicine, as healthcare professionals are experiencing more and more difficulty in providing effective care. As such, alternative methods of treatment are needed in order to overcome this issue. One recently proposed method of alternative treatment is photodynamic therapy. Photodynamic therapy is a light-based method of treatment that utilizes (1) a photosensitizing agent, (2) light, (3) produced oxygen species. When the photosensitizing agent is injected into an infected region of interest and then irradiated with a certain wavelength of light, the agent is photoactivated and begins to produce harmful forms of …

Medical Inadmissibility, And Physically And Mentally Disabled Would-Be Immigrants: Canada’S Story Continues, Constance Macintosh

Dalhousie Law Journal

In April 2018, Canada’s federal government announced that it had decided “to eliminate” the medical inadmissibility policy from our immigration regime.1 This was to bring our practices in line with contemporary Canadian values, and to engender consistency with the that Canada signed in 2007 and rati�� ed in 2010. The �������� requires equality for persons with disabilities, including taking actions to enable full and effective participation and inclusion in society.3 To achieve these obligations, states must adopt legislative or other measures that implement these rights, and must repeal or revise legislation or policies which are inconsistent with the ��������’s obligations.

Whole Transcriptome Gene Expression And How It Relates To Muscle Performance In Anolis Lizards, Luke Smith

Honors Thesis

Animal muscles are exceptionally diverse in structure and function as they meet a variety of demands for an individual to survive. Muscles coordinate with each other so that individuals can survive in their environments. However, muscles vary in performance to best suit their role in promoting organism survival; differences in gene expression among muscles likely accounts for much of this variation. Anolis lizards, a genus that has undergone considerable adaptive radiation, live in a wide range of habitats and ecotypes to which each species has had to evolve appropriately to survive. These habitats require different muscles of the anole to …

Nsu Sharks Rx_Spring 2019, Nova Southeastern University

NSU Sharks Rx

Volume 5, Number 1

Surveillance Of Ranavirus And Bacterial Microbiome Characterization Of False Map Turtles (Graptemys Pseudogeographica) Along The Lower Missouri River, Usa, Madeline Mcclaine Butterfield

Honors Thesis

Graptemys pseudographica, or the False Map Turtle, is a state-threatened species in South Dakota. The False Map Turtle, a river-dwelling species, is susceptible to the viral pathogen Ranavirus, leading to the deadly ranavirosis, which is a systemic infection transmitted through the water that can cause severe epizootics in turtles (Johnson et al. 2008). We trapped for False Map Turtles in July of 2017 at three different spots along the Missouri River between Yankton, SD and Vermillion, SD and describe the Ranavirus infection status of all 79 False Map Turtles trapped in this area. Additionally, being a river-dwelling species, the bacterial …

Yale Medicine Magazine, Spring 2019, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the Spring 2019 issue of Yale Medicine Magazine, v. 53, no. 2. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965) and Yale Medicine: alumni bulletin of the School of Medicine, v.1 (1965) through v. 52, no.1. (Autumn, 2017).

“The Contempt Of The Poor:” A Closer Look Into New York City Almshouses In The Nineteenth-Century And The Treatment Of The Lower Class, Kelli Jenney

History & Classics Undergraduate Theses

George Beverstock’s poem, “The Silver-Key: or A fancy of TRUTH, and a Warning to YOUTH: Showing the Benefit of MONEY, and the Contempt of the Poor, under the term of a Silver-Key,” emphasizes both the importance of wealth and power and the embarrassment and shame associated with poverty.During the American Revolutionary era and the New Republic, happiness and prosperity, according to Beverstock, were rooted in wealth and power, as symbolized by the silver key. Without wealth, life was meaningless, and families were subject to a lifetime of poverty and hardship. The word “contempt” insinuates that those living in poverty were …

Google Trends Data As A Proxy For Interest In Leadership, Finley W. Walker

Doctor of Education (Ed.D)

The purpose of this quantitative study was to investigate the observable patterns of online search behavior in the topic of leadership using Google Trends data. Institutions have had a historically difficult time predicting good leadership candidates. Better predictions can be made by using the big data offered by groups such as Google to learn who, where, and when people are interested in leadership. The study utilized descriptive, comparative, and correlative methodologies to study Google users’ interest in leadership from 2004 to 2017. Society has placed great value into leadership throughout history, and though overall interest remains strong, it appears that …

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2017, Daniel B. Chastain, David B. Cluck, Kayla R. Stover, Katherine T. Lusardi, Ashley Marx, Sarah Green, Carmen Faulkner-Fennell, Michelle Turner, Elias B. Chahine, P. Brandon Bookstaver, Christopher M. Bland

ETSU Faculty Works

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an "actionable" intervention for 2017. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the "actionable" intervention used by antimicrobial stewardship programs to provide key stewardship literature for training and teaching and identify potential intervention opportunities within their institutions.

Regulation Of Immune Cell Activation And Functionby The Nbmpp2 Protein Andthe Cd5 Co-Receptor, Claudia Mercedes Freitas

Theses and Dissertations

According to the centers for disease control and prevention (CDC) and the world healthorganization (WHO), heart disease and immune related diseases such as diabetes and cancer areamong the leading causes of death around the world. Thus, the regulation of the function ofimmune cell plays a key role in health and disease. Calcium (Ca2+) ions play a critical role inimmune cell activation, function and in a robust immune response. Defects in Ca2+ signalinginfluences the development of cardiac disease, Alzheimer disease, immune cell metabolism,muscle dysfunction, and cancer. Each immune cell is unique in its activation and function,making it relevant to understand how …

Is Breastfeeding Truly Best? Evolutionary, Physiological, & Cultural Factors That Shape Breastfeeding Practices, Emily J. Green 19

Honor Scholar Theses

No abstract provided.

Antimicrobial Susceptibility Patterns Of Salmonella Species In Southern Pakistan, Ghulam Shabbir Laghari, Zahid Hussain, Syed Zohaib Maroof Hussain, Haresh Kumar, Syed Mohammad Mazhar Uddin,, Aatera Haq

Section of Internal Medicine

Introduction Typhoid fever is a major infectious disease among the pediatric population of Pakistan. With inappropriate use of antibiotics and rising trends of multidrug-resistant (MDR) and extended drug-resistant (XDR) typhoid, it is becoming a public health emergency. This study evaluated the current trends in antibiotic susceptibilities to Salmonella (S) typhi and paratyphi A, B, and C in southern Pakistan. Materials and methods This cross-sectional study, conducted in the Pediatrics Department, Civil Hospital, Jamshoro from July to December 2018, included children with S. typhi and S. paratyphi A and B strains isolated from the laboratory-based culture of blood samples. Results There …

Character And Water Quality Of Sandpiper Pond: A Coastal Pond Assessment, Fifteen Years After Restoration, Nicholas E. Workman

Honors Theses

Sandpiper Pond is a coastal pond at Huntington Beach State Park, South Carolina. Originally a tidal inlet surrounded by marshland, it was isolated in 1989 and rechanneled in 2004-2005 under a community-based wetland restoration project. The project was designed to restore the pond to a tidal inlet to improve water quality and biodiversity. Since then, the tidal connection with the ocean has been severed once more and the main influx of seawater occurs from the marsh during spring high tides. In this three-month study, the current state of Sandpiper Pond is evaluated using fundamental biogeochemical indicators that are indicative of …

Providing Preventive Health Education And Developing A Referral Policy And Toolkit To Increase Access To Primary Care For Individuals With Mental Illness, Phaedra Mclin, Stephanie Myers

Doctoral Projects

Treatment rates in primary care for the mental health population is traditionally low. Individuals with mental illnesses were at a higher risk for the development of chronic health problems (Ross et al., 2015). Substance Abuse and Mental Health Services Administration (SAMHSA) indicated that many people with serious mental illness die from preventable diseases. People with serious mental illness also have a higher mortality rate than those in the general population (SAMHSA, 2017b).

The purpose of this Doctor of Nursing Practice (DNP) project was to determine if educational training regarding specific chronic disease conditions influenced the attitude and knowledge of the …

Pathogenic Differences In Listeria Monocytogenes 10403s And Cardiotropic Strains Grown Under Aerobic And Anaerobic Conditions, Alexander Hayes

Honors Theses

Listeria monocytogenes is a gram-positive bacillus that is commonly associated with foodborne illness. It is a facultative intracellular pathogen responsible for causing the listeriosis infection in humans which is particularly dangerous to immunocompromised individuals. L. monocytogenes pathogenesis occurs through a series of complex interactions between host and bacterial cellular machinery. The wild-type strain as well as a cardiotropic strain with high affinity for infecting cardiac tissue were used to investigate pathogenesis in L. monocytogenes. Specifically, the Listeriolysin O protein that is critical for virulence was investigated. Aerobic and anaerobic growth environments as well as short-chain fatty acid supplementation were utilized …

Analysis And Review Of The Effects Of Bacterial Competition On Efflux Pump Inhibition, Robert Leszcynski

Honors Theses

Multidrug resistant antibacterial strains are a dangerous problem for modern medical professionals. When cells of two different strains are grown together, they must compete with each other for nutrients. This competition can lead to the production of harmful compounds that are toxic to the competing strain. One such compound may be a compound that inhibits the efflux of antibiotics from the cell. When the cells compete with one another, one or both of the cells will produce compounds that are harmful to the competing strain.

Establishing The Effect Of Ethanol On Listeria Infection, Ryan Evan Restrepo

Honors Theses

Excessive alcohol consumption is common in the United States, particularly among college campuses. Previous studies have shown that excessive drinking increases the risk of drug dependency, sexual assault and liver damage. Heavy drinking has also proven to impact immune capabilities. Immune cell function and numbers have been shown to be negatively impacted by alcohol treatment. This research project used different cell cultures to model human cells and investigated how exposure to alcohol affects susceptibility to bacterial infection. Listeria monocytogenes, a common foodborne bacterium, was used as a model pathogen. A high alcohol preferring mouse model was also used to examine …

Effect Of Aging And Predonation Comorbidities On The Related Peripheral Blood Stem Cell Donor Experience: Report From The Related Donor Safety Study., Michael A. Pulsipher, Brent R. Logan, Pintip Chitphakdithai, Deidre M. Kiefer, Marcie L. Riches, J Douglas Rizzo, Paolo Anderlini, Susan F. Leitman, James W. Varni, Hati Kobusingye, Raeanne M. Besser, John P. Miller, Rebecca J. Drexler, Aly Abdel-Mageed, Ibrahim A. Ahmed, Luke P. Akard, Andrew S. Artz, Edward D. Ball, Ruthee-Lu Bayer, Carolyn Bigelow, Brian J. Bolwell, E Randolph Broun, Nancy J. Bunin, David C. Delgado, Katharine Duckworth, Christopher C. Dvorak, Theresa E. Hahn, Ann E. Haight, Parameswaran N. Hari, Brandon M. Hayes-Lattin, David A. Jacobsohn, Ann A. Jakubowski, Kimberly A. Kasow, Hillard M. Lazarus, Jane L. Liesveld, Michael Linenberger, Mark R. Litzow, Walter Longo, Margarida Magalhaes-Silverman, John M. Mccarty, Joseph P. Mcguirk, Shahram Mori, Vinod K. Prasad, Scott D. Rowley, Witold B. Rybka, Indira Sahdev, Jeffrey R. Schriber, George B. Selby, Paul J. Shaughnessy, Shalini Shenoy, Thomas Spitzer, William T. Tse, Joseph P. Uberti, Madhuri Vusirikala, Edmund K. Waller, Daniel J. Weisdorf, Gregory A. Yanik, Willis H. Navarro, Mary M. Horowitz, Galen E. Switzer, Bronwen E. Shaw, Dennis L. Confer

Manuscripts, Articles, Book Chapters and Other Papers

The development of reduced-intensity approaches for allogeneic hematopoietic cell transplantation has resulted in growing numbers of older related donors (RDs) of peripheral blood stem cells (PBSCs). The effects of age on donation efficacy, toxicity, and long-term recovery in RDs are poorly understood. To address this we analyzed hematologic variables, pain, donation-related symptoms, and recovery in 1211 PBSC RDs aged 18 to 79 enrolled in the Related Donor Safety Study. RDs aged > 60 had a lower median CD34+ level before apheresis compared with younger RDs (age > 60, 59 × 106/L; age 41 to 60, 81 × 106/L; age 18 to 40, …

Streptococcus Agalactiae Strains With Chromosomal Deletions Evade Detection With Molecular Methods, Isabella A. Tickler, Fred C. Tenover, Scott Dewell, Victoria M. Le, Rachel N. Blackman, Richard V. Goering, Amy E. Rogers, Heather Piwonka, Brittney D. Jung-Hynes, Derrick J. Chen, Michael J. Loeffelholz, Devasena Gnanashanmugam, Ellen Jo Baron

Biology Faculty Publications

Surveillance of circulating microbial populations is critical for monitoring the performance of a molecular diagnostic test. In this study, we characterized 31 isolates of Streptococcus agalactiae (group B Streptococcus [GBS]) from several geographic locations in the United States and Ireland that contain deletions in or adjacent to the region of the chromosome that encodes the hemolysin gene cfb, the region targeted by the Xpert GBS and GBS LB assays. PCR-negative, culture-positive isolates were recognized during verification studies of the Xpert GBS assay in 12 laboratories between 2012 and 2018. Whole-genome sequencing of 15 GBS isolates from 11 laboratories revealed …

Week Of April 1, 2019, New York Medical College

InTouch

• New York Medical College's Days of Giving Raises More Than $420,000 to Support the Next Generation of Healthcare Leaders
• School of Medicine Welcomes Pamela A. Lucchesi, Ph.D., FAHA, as New Associate Dean of Faculty Development
• Maribel Giraldo, M.S., Joins the Purchasing Team as Assistant Director of Procurement Services

Data Re-Use And The Problem Of Group Identity, Leslie Francis, John G. Francis

Utah Law Faculty Scholarship

Reusing existing data sets of health information for public health or medical research has much to recommend it. Much data repurposing in medical or public health research or practice involves information that has been stripped of individual identifiers but some does not. In some cases, there may have been consent to the reuse but in other cases consent may be absent and people may be entirely unaware of how the data about them are being used. Data sets are also being combined and may contain information with very different sources, consent histories, and individual identifiers. Much of the ethical and …

Arthropod Organic Anion Transporting Polypeptides In Tick-Borne Bacterial And Viral Infections, Vikas Kumar Taank

Biomedical Sciences Theses & Dissertations

Vector-borne diseases (VBDs) are human illness transmitted by an arthropod vector. World Health Organization (WHO) estimates that VBD has a huge impact worldwide that is responsible for affecting a billion people and causes 700,000 deaths annually. In recent years, there has been a continuous increase in the incidences of tick-borne diseases such as Lyme diseases and human anaplasmosis as reported by Center for Disease Control and Prevention. Very few reliable VBD control strategies have emerged till now. Transmission-blocking vaccines can provide effective management of VBDs but requires identification and characterization of novel vector-pathogen conserved molecules that play a significant role …

Spatio-Temporal Cluster Detection And Local Moran Statistics Of Point Processes, Jennifer L. Matthews

Mathematics & Statistics Theses & Dissertations

Moran's index is a statistic that measures spatial dependence, quantifying the degree of dispersion or clustering of point processes and events in some location/area. Recognizing that a single Moran's index may not give a sufficient summary of the spatial autocorrelation measure, a local indicator of spatial association (LISA) has gained popularity. Accordingly, we propose extending LISAs to time after partitioning the area and computing a Moran-type statistic for each subarea. Patterns between the local neighbors are unveiled that would not otherwise be apparent. We consider the measures of Moran statistics while incorporating a time factor under simulated multilevel Palm distribution, …

Sustainable Polymers And Antimicrobial Biomaterials From Multicyclic Natural Products, Md Anisur Rahman

Theses and Dissertations

In this dissertation, the development of sustainable polymers and antimicrobial biomaterials from multicyclic natural products is illustrated. In Chapter 1, an overall background and recent development of sustainable polymers from natural product-based renewable biomass, antimicrobial biomaterials, and polymerization methods are introduced. Afterward, the primary research objectives of my doctoral research work are illustrated.

In chapter 2, designing block copolymer architectures toward tough bioplastics from renewable natural rosin was described. One of the most abundant natural biomasses is resin acids, however, most of the polymers derived from resin acids are brittle because of their bulky hydrophenanthrene pendant group. To overcome the …

Long-Term Use Of Antibiotics And Risk Of Colorectal Adenoma, Yin Cao, Kana Wu, Raaj Mehta, David A. Drew, Mingyang Song, Paul Lochhead, Long H. Nguyen, Jacques Izard, Charles S. Fuchs, Wendy S. Garrett, Curtis Huttenhower, Shuji Ogino, Edward L. Giovannucci, Andrew T. Chan

Department of Food Science and Technology: Faculty Publications

Objective: Recent evidence suggests that antibiotic use, which alters the gut microbiome, is associated with an increased risk of colorectal cancer. However, the association between antibiotic use and risk of colorectal adenoma, the precursor for the majority of colorectal cancers, has not been investigated.

Design: We prospectively evaluated the association between antibiotic use at age 20–39 and 40–59 (assessed in 2004) and recent antibiotic use (assessed in 2008) with risk of subsequent colorectal adenoma among 16,642 women aged ≥ 60 enrolled in the Nurses’ Health Study who underwent at least one colonoscopy through 2010. We used multivariate logistic …

The Ecological Niche Of Echinococcus Multilocularis In North America: Understanding Biotic And Abiotic Determinants Of Parasite Distribution With New Records In New Mexico And Maryland, United States, Sebastian Botero-Cañola, Altangerel Tsogtsaikhan Dursahinhan, Sara E. Rácz, Parker V. Lowe, John E. Ubelaker, Scott Lyell Gardner

Scott L. Gardner Publications

English abstract: Understanding the factors shaping the niche of parasites and its expression over geographical space and through time continues to be a modern scientific challenge with the results of research in this area directly influencing both theoretical and applied biology. This is especially important for proactive management of zoonotic parasites such as Echinococcus multilocularis, the etiologic agent of alveolar echinococcosis. Echinococcus multilocularis has a Holarctic distribution; with its geographic range and prevalence increasing recently in areas of the western Palearctic, while its distribution dynamics are poorly understood in the Nearctic. In this paper, we use an ecological niche …