Digital Commons Network^™

Caroll County Highlights 2022, Amy Loader

UNH Cooperative Extension

No abstract provided.

New Hampshire Highlights 2022, Amy Loader

UNH Cooperative Extension

No abstract provided.

Coös County Highlights 2022, Amy Loader

UNH Cooperative Extension

No abstract provided.

Specialized Intensive Inpatient Rehabilitation Is Crucial And Time-Sensitive For Functional Recovery From Disorders Of Consciousness, Bei Zhang, Katherine O'Brien, Jean Woo, Bradley Chi, Colton Reeh, Sheng Li, Sunil Kothari

Faculty, Staff and Students Publications

Background: Disorders of consciousness (DoCs) after severe brain injury are considered to be conditions with dire prognosis. Despite the accumulating evidence, inpatient rehabilitation is often denied by payers referring to the Medicare/Medicaid criteria, under the assumption that such patients will not "actively" participate in therapy or make "measurable improvements."

Objective: This study aimed to report on the effectiveness and efficiency of a specialized inpatient DoC rehabilitation program based on measurable clinical parameters.

Methods: A retrospective cohort study was conducted. The cohort comprised 137 patients with DoC admitted to a specialized acute inpatient rehabilitation program between January …

The Use Of Reframing: Increasing The Importance Of Lifestyle Medicine, Molly R Vega, Saad Nadeem, Elizabeth M Vaughan, Craig A Johnston

Faculty, Staff and Students Publications

Lifestyle behavior modification is an essential component to prevention and treatment of non-communicable diseases worldwide. For the last 40 years, studies have recognized that there is suboptimal training of physicians in lifestyle medicine and its implementation in clinical settings. The lack of nutrition and exercise counseling occurring in the medical office does not reflect the high level of evidence supporting its use. Lifestyle behavior counseling is complex; as are the individualized needs of patients. Therefore, we suspect that the lack of knowledge in nutrition and exercise prescriptions are not the only barriers to providing optimal care. Reframing lifestyle medicine interventions …

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

Improving Financial Resiliency To Provide Accessible Community Services During Emergency Conditions Through Strategic Planning, Maria Elisa Colmenares

Walden Dissertations and Doctoral Studies

The study site organization lacked financial resilience to ensure the provision of social services to populations reliant on these services, including before, during, and after emergency conditions. The purpose of this mixed-methods case study was to provide strategic planning recommendations to increase financial resilience and describe the unique partnership between the client agency and the nonprofit arm. The study addressed strategies to increase the financial resilience needed to sustain the organization’s core mission, and strategies the agency can use to provide community services before, during, and after emergencies such as COVID-19, hurricanes, or severe storms. A strengths, weaknesses, opportunities, and …

The Cultural Diet Behaviors Of African Immigrants In California For Preventing Chronic Health Conditions Including Obesity, Jahswill Ukagumaoha

Walden Dissertations and Doctoral Studies

AbstractAfrican immigrants to the United States face many challenges when diagnosed with obesity and other chronic health conditions. However, research concerning the role of cultural diets in preventing or ameliorating chronic health conditions including obesity has rarely focused on African immigrants. The purpose of this study was to explore the opinions, perceptions, and experiences of African immigrants on cultural diet preferences in the prevention of chronic health conditions, including obesity. Using the theory of assimilation and acculturation theory as a framework for the inquiry, the research questions focused on exploring the experiences, opinions, and perceptions of African immigrants concerning chronic …

Teaching Health Justice And Reimagining Narratives Of Place Through Community-Driven Science Practices, Tammie Visintainer

Faculty Research, Scholarly, and Creative Activity

This study explores how a biology teacher from a summer science program engaged high school students of color in a three-week science unit exploring community health at the intersection of history, race, place, and power. The goal of this study is to better understand what community-driven science looks like in a science classroom when a health equity unit is guided by a biology teacher who engages the socio-historical, political, and relational aspects of community structure and agency. Using student and instructor interviews, program observations, and student artifacts, I examine how the instructor's positioning as a Black woman scientist shaped her …

Alzheimer’S Disease (Ad) Knowledge In Korean Americans: Identifying Knowledge Gaps And Misconceptions And Examining Predictors Of Ad Knowledge, Sang E. Lee, Michin Hong, Banghwa L. Casado

Faculty Research, Scholarly, and Creative Activity

Objectives: This study examined Alzheimer’s disease (AD) knowledge and its predictors among Korean Americans (KAs). Design: Convenience sampling was used to recruit KAs in the Greater Washington metropolitan area. A total of 268 KAs participated in the study and completed a cross-sectional survey in 2014. Using the Alzheimer’s Disease Knowledge Scale (ADKS), overall and domain knowledge was assessed. Multiple regression analyses were conducted for overall and domain knowledge with predictors including exposure to AD, social engagement, sources and frequency of health-related information, stigmatic beliefs (pity, antipathy, and social distance), English proficiency, and education. Results: KAs reported a 59% accuracy in …

Implementing Prediabetes Screening During Hospitalization In An Internal Medicine Unit, Roxana Bustamante

Yale School of Nursing Digital Theses

About 1 in 3 adults in the United States have prediabetes, yet 8 in 10 of people are unaware of having this condition. The gap in timely diagnosis of prediabetes hinders opportunities for awareness of risk for type 2 diabetes (T2DM), self-management, and referral to preventative interventions. Individuals with undiagnosed prediabetes have 1.3 times higher risk for hospitalization. Extending prediabetes screening to the inpatient hospital setting offers opportunity to identify undiagnosed prediabetes. The purpose of this DNP project was to implement a prediabetes screening algorithm in the hospital setting to identify undiagnosed prediabetes and initiate patient education on preventative lifestyle …

Evaluating The Use Of Reflective Practice Principles To Support Nurse Manager Well-Being During A Period Of Chronic Distress, Amy A. Martone

Yale School of Nursing Digital Theses

The COVID-19 pandemic brought forward a crisis that the current U.S. healthcare system was not prepared for. This increased the risk for burnout of teams and individuals, including the nurse leader. Nurse managers were selected as the target audience for support because they are key clinical leaders at the unit and staff level, yet they report feeling undervalued and are at higher risk for turnover than other leaders. This project developed a program that used reflective practice principles to support nurse manager well-being during periods of chronic distress.

The curriculum was guided by the Dimensions of Leadership as framework for …

Implementing A Prediabetes Screening Algorithm To Improve Identification And Referrals In Primary Care, Katherine Masoud

Yale School of Nursing Digital Theses

Almost half (49%) of the United States population has prediabetes or type 2 diabetes. Type 2 diabetes has many associated comorbidities and is the seventh leading cause of death in the United States. It is also the most expensive chronic condition in the nation. Identifying patients with prediabetes allows for early intervention to prevent or delay the onset of type 2 diabetes. The objective of this quality improvement project was to develop and implement a screening algorithm in the primary care setting using the Prediabetes Risk Test and point of care HemoglobinA1c testing to improve identification of patients with prediabetes …

Gene-Environment Interactions Underlying The Etiology Of Neural Tube Defects, Carlo Donato Caiaffa, Cristiane Sá Roriz Fonteles, Lei Yunping, Richard H Finnell

Faculty, Staff and Students Publications

Neural tube defects (NTDs) consist of severe structural malformations of the brain and spinal cord and are the second most common structural birth defect in humans, accounting for approximately 2700 affected pregnancies every year in the United States. These numbers are highly significant, considering that birth defects remain a leading cause of infant mortality in the United States, affecting approximately 120,000 babies born annually. Survivors of these congenital malformations face long-term disability and lifelong challenges imposed by severe physical burdens compromising the afflicted individual's overall quality of life. Clearly, birth defects, and especially NTDs remain a global public health challenge, …

Toward More Rigorous And Informative Nutritional Epidemiology: The Rational Space Between Dismissal And Defense Of The Status Quo, Andrew W Brown, Stella Aslibekyan, Dennis Bier, Rafael Ferreira Da Silva, Adam Hoover, David M Klurfeld, Eric Loken, Evan Mayo-Wilson, Nir Menachemi, Greg Pavela, Patrick D Quinn, Dale Schoeller, Carmen Tekwe, Danny Valdez, Colby J Vorland, Leah D Whigham, David B Allison

Faculty, Staff and Students Publications

To date, nutritional epidemiology has relied heavily on relatively weak methods including simple observational designs and substandard measurements. Despite low internal validity and other sources of bias, claims of causality are made commonly in this literature. Nutritional epidemiology investigations can be improved through greater scientific rigor and adherence to scientific reporting commensurate with research methods used. Some commentators advocate jettisoning nutritional epidemiology entirely, perhaps believing improvements are impossible. Still others support only normative refinements. But neither abolition nor minor tweaks are appropriate. Nutritional epidemiology, in its present state, offers utility, yet also needs marked, reformational renovation. Changing the status quo …

Editorial: Health Effects And Pathophysiological Mechanisms Of One-Carbon Metabolism Nutrients Intake Throughout The Life Cycle, Jufen Liu, Yunping Lei, Lei Wang, Chao Guo

Faculty, Staff and Students Publications

No abstract provided.

Shifting Mediates Gendered Racial Microaggressions And Perceived Racism Among Asian American Women, Glenn Gamst, Christine Ma-Kellams, Lawrence S. Meyers, Leticia Arellano-Morales

Faculty Research, Scholarly, and Creative Activity

Introduction: Microaggressive attacks on Asian American women increased during the COVID-19 pandemic. The present study tested whether Asian American women's shifting, a coping strategy employed by some women of color to alter their self-presentation in response to perceived racism, mediated the association between gendered racial microaggressions and self-perceived subtle and blatant racism. Methods: A convenience sample of 253 Asian American adult women completed the gendered racial microaggressions scale for Asian American women (GRMSAAW), the Asian American women's shifting scale (AsAWSS), and the subtle and blatant racism scale for Asian American college students (SABR-A2). Results: Results from a structural equation model …

Protocol Of Detection Of West Nile Virus In Clinical Samples, Hephzibah Nwanosike, Freedom M Green, Kristy O Murray, Jill E Weatherhead, Shannon E Ronca

Faculty, Staff and Students Publications

West Nile virus (WNV) is one of the leading causes of arboviral encephalitis in the United States but is often underdiagnosed. Despite the wide breadth of WNV-induced clinical disease syndromes, many of the symptoms associated with WNV are nonspecific at the time of presentation; thus, choosing the right diagnostic tool is essential to not only understand the true burden of disease but also provide pathogen-directed interventions for WNV-infected patients. In this chapter, we briefly discuss the three most common types of diagnostic methods for WNV in human clinical samples: nucleic acid detection, enzyme-linked immunoassay (ELISA), and plaque reduction neutralization test …

Dietary Patterns And Practices And Leucocyte Telomere Length: Findings From The Uk Biobank, Vasiliki Bountziouka, Christopher P. Nelson, Qingning Wang, Crispin Musicha, Veryan Codd, Nilesh J. Samani

Peninsula Medical School

BACKGROUND: Shorter telomere length (TL) is associated with risk of several age-related diseases and decreased life span, but the extent to which dietary patterns and practices associate with TL is uncertain. OBJECTIVE: This study aimed to investigate the association of dietary patterns and practices and leucocyte TL (LTL). DESIGN: This was a cross-sectional study. PARTICIPANTS AND SETTING: Data collected voluntarily from up to 422,797 UK Biobank participants, during 2006-2010. MAIN OUTCOME MEASURES: LTL was measured as a ratio of the telomere repeat number to a single-copy gene and was loge-transformed and standardized (z-LTL). STATISTICAL ANALYSES PERFORMED: Adherence a priori to …

Deciphering The Role Of Qpctl In Glioma Progression And Cancer Immunotherapy, Yu'e Liu, Shaojuan Lu, Yihong Sun, Fei Wang, Shibo Yu, Xi Chen, Lei-Lei Wu, Hui Yang, Yufeng Shi, Kaijun Zhao

Faculty, Staff and Students Publications

BACKGROUND: Glioma is the most lethal and most aggressive brain cancer, and currently there is no effective treatment. Cancer immunotherapy is an advanced therapy by manipulating immune cells to attack cancer cells and it has been studied a lot in glioma treatment. Targeting the immune checkpoint CD47 or blocking the CD47-SIRPα axis can effectively eliminate glioma cancer cells but also brings side effects such as anemia. Glutaminyl-peptide cyclotransferase-like protein (QPCTL) catalyzes the pyroglutamylation of CD47 and is crucial for the binding between CD47 and SIRPα. Further study found that loss of intracellular QPCTL limits chemokine function and reshapes myeloid infiltration …

An Overview: The Diversified Role Of Mitochondria In Cancer Metabolism, Yu'e Liu, Yihong Sun, Yadong Guo, Xiaoyun Shi, Xi Chen, Wenfeng Feng, Lei-Lei Wu, Jin Zhang, Shibo Yu, Yi Wang, Yufeng Shi

Faculty, Staff and Students Publications

Mitochondria are intracellular organelles involved in energy production, cell metabolism and cell signaling. They are essential not only in the process of ATP synthesis, lipid metabolism and nucleic acid metabolism, but also in tumor development and metastasis. Mutations in mtDNA are commonly found in cancer cells to promote the rewiring of bioenergetics and biosynthesis, various metabolites especially oncometabolites in mitochondria regulate tumor metabolism and progression. And mutation of enzymes in the TCA cycle leads to the unusual accumulation of certain metabolites and oncometabolites. Mitochondria have been demonstrated as the target for cancer treatment. Cancer cells rely on two main energy …

Factors Associated With Nonsyndromic Anotia And Microtia, Texas, 1999–2014, Jeremy M Schraw, J P Woodhouse, Renata H Benjamin, Charles J Shumate, Joanne Nguyen, Mark A Canfield, A J Agopian, Philip J Lupo

Faculty, Staff and Students Publications

BACKGROUND: Few risk factors have been identified for nonsyndromic anotia/microtia (A/M).

METHODS: We obtained data on cases and a reference population of all livebirths in Texas for 1999-2014 from the Texas Birth Defects Registry (TBDR) and Texas vital records. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for A/M (any, isolated, nonisolated, unilateral, and bilateral) using Poisson regression. We evaluated trends in prevalence rates using Joinpoint regression.

RESULTS: We identified 1,322 cases, of whom 982 (74.3%) had isolated and 1,175 (88.9%) had unilateral A/M. Prevalence was increased among males (PR: 1.3, 95% CI: 1.2-1.4), offspring of women with …

Weight Strategy In Older Adults With Obesity: Calorie Restriction Or Not?, Georgia Colleluori, Dennis T Villareal

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: Along with the marked increase in the population of older adults with obesity is the need for effective strategies to treat aging- and obesity-related complications. This review highlights recent progress in obesity management in older adults.

RECENT FINDINGS: Although calorie restriction is needed to significantly reduce fat mass, an exercise protocol is crucial to ameliorate functional outcomes. The addition of a resistance exercise protocol improves the response of muscle protein synthesis to anabolic stimuli, preventing the calorie restriction-induced reduction in muscle and bone mass. The addition of an aerobic exercise protocol improves cardiorespiratory fitness and cognitive function. …

Effects Of Aging On Urinary Tract Epithelial Homeostasis And Immunity, Marianne M Ligon, Chetanchandra S Joshi, Bisiayo E Fashemi, Arnold M Salazar, Indira U Mysorekar

Faculty, Staff and Students Publications

A global increase in older individuals creates an increasing demand to understand numerous healthcare challenges related to aging. This population is subject to changes in tissue physiology and the immune response network. Older individuals are particularly susceptible to infectious diseases, with one of the most common being urinary tract infections (UTIs). Postmenopausal and older women have the highest risk of recurrent UTIs (rUTIs); however, why rUTIs become more frequent after menopause and during old age is incompletely understood. This increased susceptibility and severity among older individuals may involve functional changes to the immune system with age. Aging also has substantial …

Organizational Strategies And Best Practices For Telehealth Delivery During Covid-19, Maria D. Mejia

Walden Dissertations and Doctoral Studies

Organizational Strategies and Best Practices for Telehealth Delivery during COVID-19

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Characteristics Of Type 2 Diabetes In Female And Male Youth, Beatriz Castillo Rodriguez, Marcela Astudillo, Mustafa Tosur, Ahmad Rafaey, Siripoom Mckay, Fida Bacha, Ashok Balasubramanyam, Maria J Redondo

Faculty, Staff and Students Publications

The incidence of type 2 diabetes in children is rising and carries a worse prognosis than in adults. The influence of sex on pediatric type 2 diabetes outcomes has not been well investigated. We studied 715 youth with type 2 diabetes diagnosed at a median age of 13.7 years and compared sex differences in demographic, clinical, and laboratory characteristics within the first year of diagnosis. Females diagnosed with type 2 diabetes were younger and at a higher stage of pubertal development than males, yet presented with lower A1Cs, a lower prevalence of diabetic ketoacidosis, and higher HDL cholesterol levels.

Filipino Americans’ Attitudes And Experiences With Mental Health And Help-Seeking Behaviors, Kelsey Guerrero

Walden Dissertations and Doctoral Studies

Filipino Americans suffer from mental illness at an alarming rate and have a low rate of seeking mental health treatment. Because Filipino Americans are underrepresented in social science research, psychologists do not understand how to resolve this issue within the Filipino American population. The purpose of this generic qualitative study was to describe the experiences with mental health and treatment of Filipino Americans. Bronfenbrenner’s ecological model theory and Latane’s social impact theory served as the theoretical foundation for the study. A sample of 12 Filipino Americans was interviewed using a semistructured interview design. Participants were asked 10 questions addressing their …

Clostridioides Difficile Infection In Hospitalized Pediatric Patients: Comparisons Of Epidemiology, Testing, And Treatment From 2013 To 2019, Price T Edwards, Cary W Thurm, Matthew Hall, Jordan D Busing, Stacy A Kahn, Richard Kellermayer, Larry K Kociolek, Maria M Oliva-Hemker, Julia S Sammons, Madison Weatherly, Kathryn M Edwards, Maribeth R Nicholson

Faculty, Staff and Students Publications

OBJECTIVES: To compare the incidence, epidemiology, testing patterns, treatment, and outcomes of Clostridioides difficile infection (CDI) among hospitalized pediatric patients from 2013 to 2019.

STUDY DESIGN: The Pediatric Health Information System database was queried for patient admissions (age 0-17 years) with International Classification of Diseases, 9th and 10th edition, codes for diagnoses of CDI with a billing code for a CDI-related antibiotic treatment.

RESULTS: We identified 17 142 pediatric patients, representing 23 052 admissions, with CDI. The adjusted annual CDI incidence decreased over the study period from 7.09 cases per 10 000 patient-days (95% CI, 6.15-8.18) in 2013 to 4.89 …

Cholestasis Impairs Gut Microbiota Development And Bile Salt Hydrolase Activity In Preterm Neonates, Lauren E Lynch, Amy B Hair, Krishnakant G Soni, Heeju Yang, Laura A Gollins, Monica Narvaez-Rivas, Kenneth D R Setchell, Geoffrey A Preidis

Faculty, Staff and Students Publications

Cholestasis refers to impaired bile flow from the liver to the intestine. In neonates, cholestasis causes poor growth and may progress to liver failure and death. Normal bile flow requires an intact liver-gut-microbiome axis, whereby liver-derived primary bile acids are transformed into secondary bile acids. Microbial bile salt hydrolase (BSH) enzymes are responsible for the first step, deconjugating glycine- and taurine-conjugated primary bile acids. Cholestatic neonates often are treated with the potent choleretic bile acid ursodeoxycholic acid (UDCA), although interactions between UDCA, gut microbes, and other bile acids are poorly understood. To gain insight into how the liver-gut-microbiome axis develops …