Digital Commons Network^™

Implementation Of Enhanced Recovery After Surgery For Adult Cervical Spine Fusion Patients: A Quality Improvement Project, Ashley Darin-Messmer

Doctor of Nursing Practice Projects

Spinal surgeries can lead to an increase in costs and complications for patients and hospital organizations. Complications following spine surgery have been identified in 16.4% to 80% of cases for spine surgeries. An Enhanced Recovery after Surgery (ERAS) protocol is a set of guidelines with the goal of improving surgical outcomes and improving a patient’s quality of life. The purpose of this quality improvement project was to implement an ERAS protocol for adult cervical spine surgery patients at a tertiary care teaching center with the goal to reduce hospital length of stay and readmissions. Inclusion criteria included adult patients undergoing …

Increasing Hpv Vaccination In Adolescents, Emily Martin, Emily Hartmann

Doctor of Nursing Practice Projects

Human papillomavirus virus (HPV) is a sexually transmitted disease that can negatively affect both males and females by leading to cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancer. Vaccinating against HPV using the Gardasil vaccine is an effective method to prevent HPV, however, vaccination rates are still unacceptably low in adolescents ages 11 to 14. Pediatric providers should encourage and strongly recommend HPV vaccines to all adolescents. Addressing and easing parental hesitancy is a key component to improving vaccine acceptance. The setting for the project was a rural pediatric office in southern Illinois where HPV vaccination rates are lower than …

Implementation Of Written Discharge Instructions For Common Diagnoses In The Urgent Care Setting, Melissa Kulp, Kristin Elmore

Doctor of Nursing Practice Projects

Abstract

Discharge instructions are an important tool providers use to communicate information to patients about their medical diagnosis after they return to their home environments. When patients understand and follow discharge instructions there are improved outcomes, fewer callbacks, and decreased return visits. The purpose of this quality improvement project were (a) to develop and distribute discharge instructions at or below a sixth-grade reading level, (b) on common diagnoses appropriate for a rural community, (c) decreased the need for subsequent office visits, and (d) decreased call volumes at a rural walk-in clinic. A large-scale literature review was conducted to determine the …

Dexmedetomidine As An Adjunct Therapy To Neuraxial Anesthesia In Labor And Delivery, Anthony Nungesser

Doctor of Nursing Practice Projects

In 2011, the Centers for Disease Control (CDC) declared the opioid crisis an epidemic, and in 2017 it was declared a public health emergency. In labor and delivery, neuraxial anesthesia has been used for over a hundred years to provide pain relief for parturients. Although many alternatives have been studied, opioids are the most frequently used local anesthetic adjuvants, and their use in neuraxial blocks has evolved over the last 50 years (Swain et al., 2017). While neuraxial opioids have proven to be an effective adjunct for pain relief, they are associated with undesirable side effects as well as the …

Assessment Of Caregiver Burden In A Memory Loss Clinic, Andrea Perkins

Doctor of Nursing Practice Projects

Background: Over 131,000 people in Illinois identify themselves as caregivers of someone with memory loss. The family caregiver may provide care including, but not limited to, assistance with activities of daily living, financial responsibilities, behavior management, and scheduling, and transportation to medical appointments. The care provided by the caregivers may lead to caregiver burden symptoms of depression, anxiety, and perceived stress. Purpose: Health care providers at a central Illinois memory clinic are not currently completing formal assessments of caregiver burden. This quality improvement project was done to determine if the current memory loss program services provide enough support …

Mitochondrial Autophagy In Ischemic Aged Livers, Jae-Sung Kim, William C Chapman, Yiing Lin

2020-Current year OA Pubs

Mitochondrial autophagy (mitophagy) is a central catabolic event for mitochondrial quality control. Defective or insufficient mitophagy, thus, can result in mitochondrial dysfunction, and ultimately cell death. There is a strong causal relationship between ischemia/reperfusion (I/R) injury and mitochondrial dysfunction following liver resection and transplantation. Compared to young patients, elderly patients poorly tolerate I/R injury. Accumulation of abnormal mitochondria after I/R is more prominent in aged livers than in young counterparts. This review highlights how altered autophagy is mechanistically involved in age-dependent hypersensitivity to reperfusion injury.

Transcranial Direct Current Stimulation Of Frontal/Occipital Cortices Modulates Neural Correlates Of Cognition In Healthy Young Adults, Yasra Arif

Theses & Dissertations

An exponential rise in the use of transcranial direct current stimulation (tDCS) to modify the human brain and behavior has been observed over the last 20 years, with studies often yielding mixed outcomes. Such heterogeneity is partially attributed to the lack of a concise understanding of the underlying mechanisms. Though considered to exert modulatory effects by changing neuronal membrane polarization and synaptic efficacy, the interactive effects of offline tDCS and the neural underpinnings of cognition, both at the regional and network-level, are yet to be fully understood. Using High-Definition tDCS (HD-tDCS), Magnetoencephalography (MEG), a range of well-established cognitive paradigms, and …

Returning To Life Activities After Hematopoietic Cell Transplantation In Older Adults, Thuy T. Koll

Theses & Dissertations

The prevalence of hematopoietic cell transplant (HCT) among older adults with hematological malignancies has doubled over the last decade and continues to grow. HCT is an intense process that can impact functional status and health-related quality of life. The objective of this thesis is to describe the experience of returning to life activities after HCT in patients 60 years of age and older and the resources required to adapt and cope to limitations in physical, psychological, and cognitive function. Twenty English speaking adults 60 years and older with hematological malignancy three to twelve months post-HCT completed semi-structured interviews. Open-ended questions …

Hepatocyte-Hepatic Stellate Cell Axis In Potentiation Of Alcohol And Hiv-Induced Liver Injury, Moses O. New-Aaron

Theses & Dissertations

Human Immunodeficiency Virus (HIV) remains a global threat, with approximately 38.4 million active infections and 33 million HIV-related deaths since the first case. While many may be tempted to think of HIV as a relic of the past, emerging data suggests otherwise. By the end of 2021, approximately 1.5 million HIV incidences and 650 000 mortalities were reported globally. The etiologies of HIV-related mortality are numerous. Liver disease is one of the leading etiologies of HIV-related mortality, especially in recent times of antiretroviral therapy (ART)-induced longevity among people living with HIV (PLWH). While co-infections with hepatotropic viruses notoriously contribute to …

Grip Characterization Of Protective Gloves, Doris Burns

Theses & Dissertations

In 2014, ASTM International (ASTM), one of the world's largest international standards developing organizations, published a new test method on glove grip performance. This method was adopted by the National Fire Protection Association (NFPA) in some of their specification standards. The method utilized hand torque instead of the pull method previously used by the NFPA to determine the Percent Bare Hand Control Value (%BHCV). The %BHCV, compares torque results of a gloved hand versus a bare hand. In developing this new test method, only four males and one female participated; therefore, it is unclear if statistical significance was attained. In …

The Link Between Fat Soluble Vitamin Deficiencies, Decreased Microbiota Diversity And Severity In Children With Sickle Cell Disease Followed In A Clinic In Omaha Nebraska, Chinenye R. Dike

Theses & Dissertations

Fat soluble vitamin (FSV) deficiencies are associated with worse pain in individuals with sickle cell disease (SCD). Data on the dietary and pancreatic function influence on fat soluble vitamin levels are limited. Additionally, individuals with SCD have gut dysbiosis but there are gaps in knowledge on the impact of this on severity. This thesis attempted to evaluate FSV prevalence and gut microbial profile in our cohort of children with SCD and compare this with matched healthy children and to ascertain if diet or pancreatic function affects these levels and see if these affects sickle cell severity.

Formal Caregiver Burden Among Nursing Assistants In Nursing Homes: A Mixed Methods Study, Rachel Kunkle

Theses & Dissertations

Formal caregivers are the direct care workforce in nursing homes that aid residents. Providing care to residents is hazardous and demanding, as highlighted during the pandemic. Caregiver burden affects formal caregivers; however, is interchanged with caregiver stress and caregiver burnout. The overall purpose of this dissertation was to describe formal caregiver burden among nursing assistants who provide direct care to residents in nursing homes. This was first accomplished by conducting a concept analysis of formal caregiver burden in nursing homes. Next, an integrative review of the literature was performed to assess formal caregiver burden in nursing homes and available psychometric …

Characterization Of Metastatic Cutaneous Squamous Cell Carcinoma In The Immunosuppressed Patient, Megan E. Wackel

Theses & Dissertations

Patients who are immunosuppressed, such as solid organ transplant recipients (SOTRs), are known to have a higher risk of developing cutaneous squamous cell carcinoma (cSCC). This population is at a higher risk of metastasis and worse disease-specific survival, with over 1 million cases and an estimated 3,932 to 8,791 deaths each year in the United States. Large cancer genomic databases have reported on genomic drivers for many cancer subtypes, yet cSCC has not been included. The immunosuppressed population is generally ineligible to receive immunotherapy which poses a challenge for treatment options in cases that develop metastasis. After we performed a …

Teaching Children With Autism Spectrum Disorder Self-Protection Skills In Response To Bullying Situations, Maya J. Fallon

Theses & Dissertations

Children diagnosed with autism spectrum disorder (ASD) are at high risk of being bullied but research on teaching children with ASD self-protection skills for bullying situations is scant. We assessed the generality of teaching procedures used in Stannis et al. (2019) to teach adults self-protection skills with autistic children. We taught five children self-protection skills for two types of bullying (threats and unkind remarks) in a one-on-one format. In addition, we taught children a self-protection skill for repeated bullying occurrences. We first evaluated behavioral skills training to teach children to report threats of physical or material harm, provide a disapproving …

Underlying Mechanism Of Ovarian Reserve Preservation From Gonadotoxicity, Yi Luan

Theses & Dissertations

Cancer therapies often lead to premature ovarian insufficiency by ovarian damage and follicle depletion. However, the oocyte death pathway induced by chemotherapies has been debated. Here we clarified the precise mechanism of ovarian depletion induced by cyclophosphamide and doxorubicin. Cyclophosphamide induced direct apoptosis in oocytes rather than overactivation of primordial follicles. Dormant oocytes instead of activated oocytes with high PI3K activity were more sensitive to cyclophosphamide. Although the ABL inhibitor, GNF2, has been proposed to ameliorate the apoptosis of primordial follicles against cyclophosphamide, GNF2 did not prevent the loss of primordial follicles induced by cyclophosphamide in the systems tested. Oocyte-specific …

Structural And Biochemical Studies Of Three Enzymes Involved In Amino Acid Metabolism To Develop Novel Drugs, Yahani Pankaja Jayasinghe Arachchige

Theses & Dissertations

Intrinsic drug resistance in bacteria predates the clinical use of antibiotics. Additionally, heterogeneous metabolic states and the ability of many bacteria to form biofilms further enhances bacterial survival during infection and exacerbates treatment challenges. This necessitates the identification of novel drugs against new drug targets. These studies focus on the development of compounds targeting enzymes in Mycobacterium tuberculosis (Mtb) and Staphylococcus aureus that avoid intrinsic antibiotic defenses. The Mtb-encoded homoserine transacetylase enzyme (HTA) catalyzes the first step of the methionine biosynthesis pathway that produces methionine and S-adenosyl methionine. These compounds are shown to be essential for both dormant …

The Effects Of Active Shootings On 4-H Youth And Families, Melinda Garcia, Elizabeth Gangwer

Journal of Extension

The effects of active shootings should be a priority to provide needed assistance to 4-H youth and families in coping with their social-emotional well-being. Exposure to such violence can lead to lasting impacts on youth that can affect behavior. Addressing this sensitive topic is crucial in ensuring that Extension professionals are prepared to meet the needs of youth and families. Higher rates of depression, aggression, to name a few, are a result of having witnessed such events as a shooting. Providing training for Extension personnel can aid in reducing the amount of PTSD and other social-emotional trauma.

Developing A Healthy Masculinities Program On A University Campus, David A. Scott, Freeman Woolnough, Tony W. Cawthon

New York Journal of Student Affairs

Amid increased concerns about mental health, sexual violence, and substance use among college students, college campuses are looking toward developing targeted programming to help counteract these concerning trends. This practitioner paper highlights the development and impacts of a program at a Canadian institution, which focuses on healthy masculinity and identity development. Although still in the early stages, the feedback and observations are indicative of the powerful potential of this type of programming to improve healthy masculinity on college campuses.

Interdisciplinary Integrative Oncology, Naomi L. Valles

InterProfessional Education Research and Scholarship

No abstract provided.

Mitigation Impact Of Statewide Non-Pharmaceutical Policies On Covid-19: An Application Of Infectious Disease Transmission Model And Partially Observed Markov Process To New Mexico, Xingya Ma

Mathematics & Statistics ETDs

This thesis is an application of epidemiological models for infectious disease transmission and the use of partially observed Markov process (POMP) for model fitting. It focuses on COVID-19 pandemic in the state of New Mexico. The analysis covered March 2020 to June 2021. Daily data of COVID19 cases and deaths and a daily index of eleven statewide government non-pharmaceutical intervention (NPI) policies were collected from six public sources and were validated. These data were integrated through the Susceptible-Exposed-Infected-Removed (SEIR) model. Estimated daily transmission rates between the model compartments quantify the impact of the mitigation policies, and show that transmission rates …

Differential Role Of Type 2 Diabetes As A Risk Factor For Tuberculosis In The Elderly Versus Younger Adults, Blanca I. Restrepo, Julia M. Scordo, Genesis P. Aguillón-Durán, Doris Ayala, Ana P. Quirino-Cerrillo, Raúl Loera-Salazar, America Cruz-González, Jose A. Caso, Mateo Joya-Ayala, Esperanza M. García-Oropesa, Alejandra B. Salinas

School of Medicine Publications

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age …

Sovereign Lands, Brent D. Chicken, Amanda J. Dick

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Wyoming, John R. Chadd

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

West Virginia, Andrew S. Graham

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Virginia, Zachary H. Barrett

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Utah, Alan M. White

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Texas, Melissa Munson

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Tennessee, Westley A. Ketron

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Pennsylvania, Nathaniel I. Holland, Jon C. Beckman, Benedict J. Kirchner

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Oklahoma, Matt Schlensker, Sandra Fraley

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.