Digital Commons Network^™

Improving Sedation Management In Mechanically Ventilated Patients, Jannette Lord

Walden Dissertations and Doctoral Studies

Abstract

In the intensive care unit (ICU), sedation management of the critically ill, mechanically

ventilated patient is a source of concern. Optimal sedation management is integral to

critical care practice, yet optimal levels of sedation are not consistently applied.

Suboptimal sedation carries significant risks for patients, as inadequate sedation or

oversedation may lead to prolonged ventilator days, ventilator-associated pneumonia

(VAP), extended length of ICU stay, and costs. The purpose of this quality improvement

(QI) project was to improve sedation management of mechanically ventilated patients by

improving staff nurses’ knowledge of and attitudes toward sedation management,

ultimately achieving a zero-ventilated associated …

Competing Forces Of Withdrawal And Disease Avoidance In The Risk Networks Of People Who Inject Drugs, Elspeth Ready, Patrick Habecker, Roberto Abadie, Bilal Khan, K. Dombrowski

Department of Sociology: Faculty Publications

We analyze a network of needle-sharing ties among 117 people who inject drugs (PWID) in rural Puerto Rico, using exponential random graph modeling to examine whether network members engage in partner restriction to lower their risk of contracting HIV or hepatitis C (HCV), or in informed altruism to prevent others from contracting these infections. Although sharing of used syringes is a significant risk factor for transmission of these diseases among PWID, we find limited evidence for partner restriction or informed altruism in the network of reported needle-sharing ties. We find however that sharing of needles is strongly reciprocal, and individuals …

Prospects And Challenges Of Population Health With Online And Other Big Data In Africa; Understanding The Link To Improving Healthcare Service Delivery, Rowland Edet, Bolarinwa Afolabi

Department of Sociology: Faculty Publications

Big data analytics offers promises to many health care service challenges and can provide answers to many population health issues. Big data is having a positive impact in almost every sphere of life in more advanced world while developing countries are striving to meet up. Even though healthcare systems in the developed world are recording some breakthroughs due to the application of big data, it is important to research the impact of big data in developing regions of the world, such as Africa and identify its peculiar needs. The purpose of this review was to summarize the challenges faced by …

Are Biological Consequences Of Childhood Exposures Detectable In Telomere Length Decades Later?, Blakelee R. Kemp, Kenneth F. Ferraro

Department of Sociology: Faculty Publications

Negative early-life exposures have been linked to a host of poor adult health outcomes, but are such early exposures associated with cellular senescence decades later? This study uses data from the Health and Retirement Study to examine the association between six childhood exposure domains (e.g., socioeconomic disadvantage, risky parental behavior) and a biomarker of aging, telomere length, among 4,935 respondents. Telomere length is obtained from DNA of cells found in saliva and is measured as the telomere repeat copy number to single gene copy number ratio (T/S). Men who as children were exposed to risky parental …

Plasmapheresis In Sepsis-Induced Thrombotic Microangiopathy: A Case Series, Sushmita Rs Upadhya, Chakrapani Mahabala, Jayesh G. Kamat, Jayakumar Jeganathan

Open Access archive

Introduction: Cytokines and granulocyte elastase produced in sepsis cleave a disintegrin and metalloprotease with thrombospondin type I motif 13 (ADAMTS13) and deplete its levels. By this mechanism, sepsis results in microangiopathic hemolytic anemia (MAHA) with thrombocytopenia. Hence, the hypothesis is that plasmapheresis may help in sepsis-induced thrombotic microangiopathy (sTMA), by removing the factors responsible for low levels of ADAMTS13. In tropical countries like India, the contribution of sepsis to intensive care unit (ICU) mortality is high; and hence, it is essential to look out for newer modalities of sepsis treatment. There is abundant literature on the use of plasmapheresis in …

Comparative Validity Of Microalbuminuria Versus Clinical Mortality Scores To Predict Pediatric Intensive Care Unit Outcomes, Shifa Nismath, Suchetha S. Rao, B. S. Baliga, Vaman Kulkarni

Open Access archive

Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed. Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU. Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the …

Mixed Ancestry From Wild And Domestic Lineages Contributes To The Rapid Expansion Of Invasive Feral Swine, Timothy J. Smyser, Michael A. Tabak, Chris Slootmaker, Michael S. Robeson Ii, Ryan S. Miller, Mirte Bosse, Hendrik-Jan Megens, Martien A.M. Groenen, Samuel Rezende Paiva, Danielle Assis De Faria, Harvey D. Blackburn, Brandon S. Schmit, Antoinette J. Piaggio

United States Department of Agriculture Wildlife Services: Staff Publications

Invasive alien species are a significant threat to both economic and ecological systems. Identifying the processes that give rise to invasive populations is essential for implementing effective control strategies. We conducted an ancestry analysis of invasive feral swine (Sus scrofa, Linnaeus, 1758), a highly destructive ungulate that is widely distributed throughout the contiguous United States, to describe introduction pathways, sources of newly emergent populations and processes contributing to an ongoing invasion. Comparisons of high-density single nucleotide polymorphism genotypes for 6,566 invasive feral swine to a comprehensive reference set of S. scrofa revealed that the vast majority of feral swine were …

The Role Of European Starlings (Sturnus Vulgaris) In The Dissemination Of Multidrug- Resistant Escherichia Coli Among Concentrated Animal Feeding Operations, Jeffrey C. Chandler, Jennifer E. Anders, Nicolas A. Blouin, James C. Carlson, Jeffrey T. Lejeune, Lawrence D. Goodridge, Baolin Wang, Leslie A. Day, Anna M. Mangan, Dustin A. Reid, Shannon M. Coleman, Matthew W. Hopken, Bledar Bisha

United States Department of Agriculture Wildlife Services: Staff Publications

Antimicrobial use in livestock production is a driver for the development and proliferation of antimicrobial resistance (AMR). Wildlife interactions with livestock, acquiring associated AMR bacteria and genes, and wildlife’s subsequent dispersal across the landscape are hypothesized to play an important role in the ecology of AMR. Here, we examined priority AMR phenotypes and genotypes of Escherichia coli isolated from the gastrointestinal tracts of european starlings (Sturnus vulgaris) found on concentrated animal feeding operations (CAFOs). European starlings may be present in high numbers on cAfos (>100,000 birds), interact with urban environments, and can migrate distances exceeding 1,500 km in North …

Reporting The Limits Of Detection And Quantification For Environmental Dna Assays, Katy E. Klymus, Christopher M. Merkes, Michael J. Allison, Caren S. Goldberg, Caren C. Helbing, Margaret E. Hunter, Craig A. Jackson, Richard F. Lance, Anna M. Mangan, Emy M. Monroe, Antoinette J. Piaggio, Joel P. Stokdyk, Chris C. Wilson, Catherine A. Richter

United States Department of Agriculture Wildlife Services: Staff Publications

Background: Environmental DNA (eDNA) analysis is increasingly being used to detect the presence and relative abundance of rare species, especially invasive or imperiled aquatic species. The rapid progress in the eDNA field has resulted in numerous studies impacting conservation and management actions. However, standardization of eDNA methods and reporting across the field is yet to be fully established, with one area being the calculation and interpretation of assay limit of detection (LOD) and limit of quantification (LOQ).

Aims: Here, we propose establishing consistent methods for determining and reporting of LOD and LOQ for single‐species quantitative PCR (qPCR) eDNA studies.

Materials …

Safety, Immunogenicity, And Efficacy Of Intramuscular And Oral Delivery Of Era-G333 Recombinant Rabies Virus Vaccine To Big Brown Bats (Eptesicus Fuscus), Amy T. Gilbert, Xianfu Wu, Felix R. Jackson, Richard Franka, Gary F. Mccracken, Charles E. Rupprecht

United States Department of Agriculture Wildlife Services: Staff Publications

Attenuated strains of rabies virus (RABV) have been used for oral vaccination of wild carnivores in Europe and North America. However, some RABV vaccines caused clinical rabies in target animals. To improve the safety of attenuated RABV as an oral vaccine for field use, strategies using selection of escape mutants under monoclonal antibody neutralization pressure and reverse genetics–defined mutations have been used. We tested the safety, immunogenicity, and efficacy of one RABV construct, ERA-g333, developed with reverse genetics by intramuscular (IM) or oral (PO) routes in big brown bats (Eptesicus fuscus). Twenty-five bats received 5×10⁶ mouse intracerebral …

Psychological Drivers Of Risk-Reducing Behaviors To Limit Human–Wildlife Conflict, Stacy A. Lischka, Tara L. Teel, Heather E. Johnson, Courtney Larson, Stewart Breck, Kevin R. Crooks

United States Department of Agriculture Wildlife Services: Staff Publications

Conflicts between people and wild animals are increasing globally, often with serious consequences

for both. Local regulations or ordinances are frequently used to promote human behaviors that minimize these conflicts (risk-reducing behaviors), but compliance with ordinances can be highly variable. While efforts to increase compliance could be improved through applications of conservation psychology, little is known about the relative influence of different factors motivating compliance. Using concepts from psychology and risk theory, we conducted a longitudinal study pairing data from mail surveys with direct observations of compliance with a wildlife ordinance requiring residents to secure residential garbage from black bears …

Comparative Evaluation Of The Origin, Evolution, Transmission, Diagnosis, And Vaccine Development Of Three Highly Pathogenic Human Coronaviruses (Sars-Cov, Mers-Cov And Sars-Cov-2), Prabhu Dutta Shaw, Nicky Patel, Shailee Patil, Richard Samuel

Open Access archive

Coronavirus infection in humans is not uncommon. The first coronavirus (HCoV-229E) in humans was isolated in 1965. Subsequently, three more coronaviruses were recognized: HCoV-NL63, HCoV-HKU1, and HCoV-229E. These viruses are endemic in humans and cause common cold and mild respiratory infections throughout the year. The three coronaviruses, SARS-CoV, MERS-CoV, and SARS-CoV-2 are highly pathogenic coronaviruses that cause very severe respiratory diseases in human. SARS-CoV-2 is a newly emerging coronavirus posing pandemic COVID-19 disease that has disrupted the human life in many ways. In this review, the origin, evolution, transmission, vaccine development, and clinical characteristics of these highly pathogenic human coronaviruses …

Comparative Evaluation Of Efficacy Of Chlorhexidine And Herbal Mouthwash As A Preprocedural Rinse In Reducing Dental Aerosols: A Microbiological Study, Sangeeta Umesh Nayak, Anushka Kumari, Valliammai Rajendran, Vijendra Pal Singh

Open Access archive

Objective. The risk to dentists, assistants, and patients of infectious diseases through aerosols has long been recognized. The aim of this study was to evaluate and compare the efficacy of commercially available preprocedural mouth rinses containing 0.2% chlorhexidine (CHX) gluconate, Befresh™ herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. Materials & Methods. This was a single-center, double-masked, placebo-controlled, randomized, three-group parallel design study. 30 patients (10 patients in each group) were recruited in the study. Patient rinsed mouth with 10 ml of CHX, 10 ml Befresh™, or 10 ml water. All the patients underwent supragingival …

Estimating Global Injuries Morbidity And Mortality: Methods And Data Used In The Global Burden Of Disease 2017 Study, Spencer L. James, Chris D. Castle, Zachary V. Dingels, Jack T. Fox

Open Access archive

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality …

Genomic-Based Identification Of Environmental And Clinical Listeria Monocytogenes Strains Associated With An Abortion Outbreak In Beef Heifers, Katherine J. Whitman, James L. Bono, Michael L. Clawson, John D. Loy, Joseph M. Bosilevac, Terrance M. Arthur, Jeff D. Ondrak

School of Veterinary and Biomedical Sciences: Faculty Publications

Background: In a beef cattle facility an outbreak of abortions occurred over a 36-day period and included samples from two aborted (non-viable) fetuses and 21 post-abortion clinical cases. There are numerous etiologies, including clinical listeriosis. At the species level, Listeria monocytogenes is ubiquitous in cattle production environments, including soil, feed, and occasionally water sources, and is a common enteric resident of cattle and other mammals. There are four genetically distinct lineages of L. monocytogenes (I-IV), with most lineage III and IV isolates obtained from ruminants. Definitive diagnosis of L. monocytogenes as a causative agent in disease outbreaks relies upon case …

The World Health Organization In Global Health Law, Benjamin Mason Meier, Allyn Taylor, Mark Eccleston-Turner, Roojin Habibi, Sharifah Sekalala, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The World Health Organization (WHO) has sought to bring the world together to respond to a shared threat. This column seeks to examine the central importance of WHO in developing and implementing global health law. Recognizing that global health law requires global governance, the column begins by situating WHO’s role at the forefront of global health governance. WHO’s leadership in global governance for health is supported by an expansive mandate to serve as a forum for the codification of international law, which WHO has exercised sporadically through the evolving development of the International Health Regulations (IHR). Yet, where the IHR …

Communication Pedagogy: The Coronavirus Pandemic, Ron C. Arnett

Journal of Communication Pedagogy

In this historical moment defined by the coronavirus, the global community struggles with and against a seemingly invisible foe. Students, faculty, and administrators open the blinds on windows in the morning, witnessing the brightness of the sun and seemingly the clarity of a morning welcome. Yet, there lurks, not in the shadows, but in the brightness of the everyday sunshine, the possibility of sickness and death. This responsive essay weaves together my communicative rejoinders to the coronavirus and its implications for this challenging time in human history. I turn to the autoethnographic insights of Art Bochner and Carolyn Ellis (2016) …

Exploring The Potential Of Artificial Intelligence And Machine Learning To Combat Covid-19 And Existing Opportunities For Lmic: A Scoping Review, Maleeha Naseem, Ramsha Akhund, Hajra Arshad, Muhammad Talal Ibrahim

Community Health Sciences

Background: In the face of the current time-sensitive COVID-19 pandemic, the limited capacity of healthcare systems resulted in an emerging need to develop newer methods to control the spread of the pandemic. Artificial Intelligence (AI), and Machine Learning (ML) have a vast potential to exponentially optimize health care research. The use of AI-driven tools in LMIC can help in eradicating health inequalities and decrease the burden on health systems.
Methods: The literature search for this Scoping review was conducted through the PubMed database using keywords: COVID-19, Artificial Intelligence (AI), Machine Learning (ML), and Low Middle-Income Countries (LMIC). Forty-three articles were …

The Dietary Decision-Making Process Of Women In Nigeria, Gachomo Joanne Mapis

Walden Dissertations and Doctoral Studies

Nigerians have been opting for a more processed Western diet. These changes in dietary choices have aligned with obesity and undernutrition, attributable to micronutrient deficiencies or malnutrition. Many scholars have presented varying intervention strategies ranging from consumption of a variety of foods containing the necessary micronutrients to food fortification. The purpose of this grounded theory study was to explore the perceptions of women in an urban city in Nigeria on indigenous foods and Western dietary influences to determine social interactions, the consequence of the interactions, and the women’s current perceptions of food choices. The social-ecological model was used to explore …

An Autoencoder And Artificial Neural Network-Based Method To Estimate Parity Status Of Wild Mosquitoes From Mear-Infrared Spectra, Masabho Peter Milali, Samson S. Kiware, Nicodem J. Govella, Fredros Okumu, Naveen K. Bansal, Serdar Bozdag, Jacques D. Charlwood, Marta F. Maia, Sheila B. Ogoma, Floyd E. Dowell, George Corliss, Maggy T. Sikulu-Lord, Richard J. Povinelli

Mathematical and Statistical Science Faculty Research and Publications

After mating, female mosquitoes need animal blood to develop their eggs. In the process of acquiring blood, they may acquire pathogens, which may cause different diseases in humans such as malaria, zika, dengue, and chikungunya. Therefore, knowing the parity status of mosquitoes is useful in control and evaluation of infectious diseases transmitted by mosquitoes, where parous mosquitoes are assumed to be potentially infectious. Ovary dissections, which are currently used to determine the parity status of mosquitoes, are very tedious and limited to few experts. An alternative to ovary dissections is near-infrared spectroscopy (NIRS), which can estimate the age in days …

Health Outcomes Associated With Gulf War Illness, Shannon K. Barth

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background:

Nearlythirty years after the 1990-1991 Persian Gulf War a definitive case definition for Gulf War Illness (GWI) is lacking. The objective is to explore health outcomes associated with GWI using currently accepted classifications in order to better understand GWI by examining pre-war medical conditions as predictors of probable GWI, mortality outcomes of veterans with probable GWI, and female-specific medical conditions among women with probable GWI. Additionally, we utilize an alternative GWI case definition.

Methods:

Data come from theDepartment of Veterans Affairs (VA)1995-1997 National Health Survey of Persian Gulf War Era Veterans, a population-based survey of deployed …

Immunity Passports And Moral Hazard, Daniel J. Hemel, Anup Malani

Coase-Sandor Institute for Law & Economics Research Paper Series

The idea of using “immunity passports” to restart the economy before the arrival of a SARS-CoV-2 vaccine has attracted increasing attention as the Covid-19 crisis has escalated. Under an “immunity passport” regime, individuals who test positive for SARS-CoV-2 antibodies would receive certificates allowing them to return to work and potentially to participate in a broader range of activities without social distancing. One concern raised by the “immunity passport” proposal is that not-yet-infected individuals would have an incentive to expose themselves to the virus intentionally so that they can develop antibodies and obtain passports. This paper evaluates the moral-hazard risk that …

Evaluation Of The Tuberculosis Management Program In Ghana, Boampong Akese

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a major health issue estimated to be affecting about 1/3 of the world’s population. TB is a major health problem in Ghana primarily because of weak health infrastructure and poor TB case detection and management practices. Measuring and evaluating the performance of health programs is an important aspect of health care services in any country. The purpose of this quantitative study was to evaluate the TB management program in Ghana. A cross-sectional research design was used to answer the research questions. Secondary data were obtained from the Ghana District Health Information Management System database. The theoretical foundation …

Can Farmers And Bats Co-Exist? Farmer Attitudes, Knowledge, And Experiences With Bats In Belize, Hannah G. Shapiro, Adam S. Willcox, Mallory Tate, Emma V. Willcox

Human–Wildlife Interactions

Bats (Chiroptera) are often viewed negatively by the public. Negative public perceptions of bats may hinder efforts to conserve declining populations. In Belize, the presence of vampire bats (Desmodus rotundus and Diphylla ecaudata) exacerbates the potential for conflicts with humans because of the increased rabies transmission risks. To mitigate these risks, the Belize government provides farmers with assistance to trap and remove vampire bats. In June 2018, we surveyed farmers (n = 44) in and adjacent to the Vaca Forest Reserve in Belize to learn more about their attitudes, knowledge, and experiences with bats. This information may …

Maintaining Effective Infection Control Protocol, Lauren Eusner, Kimberly Lintag

Dental Hygiene Faculty Publications

The safety of clinicians and patients in the dental office rests on adherence to evidence-based infection control standards.

Focused Deterrence Violence Prevention At Community And Individual Levels, Edmund F. Mcgarrell

Marquette Law Review

The focused deterrence violence prevention model emerged as part of Boston Ceasefire in the mid-1990s. Since that time, solid research evidence has emerged indicating focused deterrence can influence community levels of violence, particularly gang- and group-related violence. It is considered an evidence-based violence reduction strategy. The evidence of the impact on individuals, however, is much more limited and mixed. This Article presents the focused deterrence model, reviews the research evidence and considers the implications for reducing violent recidivism. Several lingering research questions as well as considerations for leveraging focused deterrence along with other recidivism reduction strategies are discussed.

Preprint (Medicine & Pharmacology, Preprints.Org): Avoiding Covid-19 Complications With Diabetic Patients Could Be Achieved By Multi-Dose Bcg Vaccine: A Case Study Of Beta Cells Regeneration By Serendipity, Bassam Ayoub, Eman Ramadan, Nermeen Ashoush, Mariam M. Tadros, Moataz S. Hendy, Mohamed M. Elmazar, Shaker Mousa

Pharmacy

No abstract provided.

Virus Purification Framework And Enhancement In Aqueous Two-Phase System, Pratik Umesh Joshi

Dissertations, Master's Theses and Master's Reports

Viral infections regularly pose detrimental health risks to humans. Preventing viral infections through global immunization requires the production of large doses of vaccines. The increasing demand for vaccines, especially during pandemics such as COVID-19, has challenged current manufacturing strategy to develop advanced unit operations with high throughput capability. Over the decade, the upstream processing responsible for synthesizing viral products in cell cultures has shown significant success in yielding high titers of viruses and virus-like particles. The progress in the upstream stage has now shifted the bottleneck to the downstream processing (DSP). Overlooked for decades, the DSP responsible for viral product …

Recovering From Covid-19 Building Closures: Guidance Document, David Krause, Cheri Marcham, John Springston, Alex Lebeau, Robert Rottersman, Timothy Froehlig, Bart Ashley

Publications

While the country comes to terms with the inevitable impact that SARS-CoV-2, the virus that causes COVID-19, will have on our lives and communities, public health authorities remain focused on breaking the chain of transmission. Managing the risk has resulted in widespread closures of businesses, schools, universities, resorts, and other facilities deemed “non-essential.” Practically speaking, this means closing buildings and ceasing operations. For building owners and operators, this poses a significant challenge to protect their assets and to ensure they are ready to reoccupy once the pandemic subsides.

Risk Factors Associated With Infection Of Blood-Borne Virus Among People Who Used Methamphetamine, Yilin Cai, Sijin Wen, Ruchi Bhandari

Faculty & Staff Scholarship

Background

The surge of methamphetamine use has been a complicating factor compounding the steeply increasing number of drug overdose deaths in the U.S. Infection from blood-borne viruses including hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV, related to methamphetamine use continue to grow. This study aims to examine the risk factors associated with HBV, HCV and HIV among people who used methamphetamine.

Methods

People who ever used methamphetamine were identified from five National Health and Nutrition Examination Survey (NHANES) cohorts, 2007 to 2016. The outcome was either positive or negative for blood-borne viruses as identified from laboratory tests. …