Medicine and Health Sciences Commons^™

Improving Medication Adherence Among Adult Patients With Coronary Heart Disease: A Pilot Study, Xinxin Tang

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Medication adherence reduces morbidity, premature mortality, and healthcare costs related to CHD treatment. Therefore, a patient-centered intervention for both staff and patients was conducted to improve medication adherence in an outpatient setting. 4 Methodology: A pilot study was conducted utilizing a quasi-experimental, pre-post, one group design. Study participants completed an eight-item modified Medication Adherence Scale (MMAS-8) questionnaire to measure self-reported medication adherence before and after the intervention, which consisted of an interview and six weekly follow-up counseling sessions. The study compared the difference in MMAS-8 scores before and after the intervention. The Statistical Package for the Social Science (SPSS) …

The Influence Of Obstructive Sleep Apnea On Post-Anesthesia Duration Of Monitoring: Informing Policy Recommendations For Best Practice In A Veteran Population, George Chris Bone

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Obstructive sleep apnea (OSA) is a common problem affecting millions of Americans annually. In fact, between nine and fourteen percent of the entire population is affected by OSA (Diffee, Beach & Cuellar, 2012). Its impact on post-operative care unit (PACU) patients can necessitate the need for an extended recovery time. At the Dallas Veterans Affairs North Texas Health Care System (VANTHCS) hospital, there was no minimum PACU stay time policy specified for OSA patients. These patients had an increased risk of complications beyond the thirty minute period of stability (as defined by the general PACU stay-time policy). While there was …

Impact Of Parental Coaching On Childhood Obesity, Lizy Jimmy Johns

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background- Childhood obesity is an epidemic in the United States (US) affecting 12.7 million children (CDC8, 2015), and costing the US $14.1 billion every year (Cawley, 2010). It also costs corporate America about $9 billion in direct costs (Adeagbo, 2015) and $4.3 billion in indirect costs for healthcare expenditures (Cawley, 2010). Studies suggest interventions implemented by employers involving the whole family are twice as effective as interventions with employees alone (Adeagbo, 2015). Methods- This quality improvement pilot study used a quasi-experimental pre and post study design in an outpatient employee health clinic to evaluate a coaching method for empowering parents …

Interventions In The Primary Care Setting Aimed At Improving The Rate Of Completion Of Advance Directives, D. Denise Goddard

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The majority of people never discuss their choice of treatment in end-of-life issues and do not have an advance directive (AD). The cause may be due to the lack of organized efforts to achieve completion of ADs. This project used a quasi-experimental one-group pretest-posttest design to determine if an educational intervention increased the completion of an AD. Project results showed that the combination of repeated written and verbal educational information about ADs provided via a primary care setting is an effective intervention to increase completion of ADs. A convenience sample revealed 14% of 90 primary care clinic patients had a …

Effectiveness Of An Evidence-Based Case Management Intervention On Reducing Diabetesrelated Emotional Distress In A Hispanic Medicare Advantage Population, Mari Nickovich-Finley

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Refer to the document.

Increasing Provider Efficacy On Metabolic Monitoring, Johnes Monyoncho

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Second-generation antipsychotics (SGAs), the mainstay of treatment for persons with serious mental illnesses (SMI), have been linked to obesity and metabolic syndrome. There is an urgent need for providers to adhere to clinically applicable guidelines for screening and monitoring metabolic disturbances in this population. 2 Methods: A randomized retrospective chart review of 60 patient records, one group pre-test data without a comparison group was performed following initiation of SGAs, 6 months before the intervention. This was repeated after a 3-month intervention which involved implementation of a recommended schedule for metabolic monitoring. The intervention included provision of monitoring equipment (weighing …

A Heath Intervention To Improve Medication Adherence In Patients With Epilepsy, Ronnie Tobias

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Epilepsy is a chronic disease and it is estimated that between 30% and 60% patients are non-adherent with their antiepileptic drugs (AEDs) therapy. This project aimed to assess if health education improves medication adherence in patients with epilepsy. Methods: This quality improvement (QI) project used a pre-test and post-test study design, 25 participants were recruited with epilepsy from the Epilepsy Foundation in Houston, Texas using the convenience sampling method. Data were gathered using the Morisky Medication Adherence Scale (MMAS-8). 3 Results: The findings revealed statistically significant differences in the pretest and posttest score distributions. The distribution of MMAS-8 scores …

Sms-Text To Improve Medication Compliance Among Hypertensive African-Americans, Daytral Brown

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension, the second leading cause of end-stage renal disease (ESRD), affects approximately 40% of African-Americans (Mansyur, Pavlik, Hyman, Taylor, & Goodrick, 2009). One well-known barrier to hypertension management among African-Americans is poor medication compliance (Ephraim et al., 2014; Solomon et al., 2015). The purpose of this project was to evaluate the effect of SMS-text messages on antihypertensive medication compliance and hypertension knowledge among hypertensive African-Americans with a known history of antihypertensive medication noncompliance. Methods: African-Americans (n=25), with a known history of hypertension and medication noncompliance, received 12 twice weekly SMS-text messages relating to hypertension knowledge and medication compliance. A …

Improving Adherence To Atypical Antipsychotic Agent Screening Guidelines In Pediatric Patients: A Quality Improvement Project Within An Integrated Community Mental Health Setting, Elishia Riffle

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Approximately 14% - 20% of children and adolescents have a mental health problem (Harrison, Cluxton-Keller, and Gross, 2012). Atypical Antipsychotic Agents (AAA) are used to treat behavioral, emotional, and mental health problems in children and adolescents. A discrepancy between best practices and actual practices exist. Objective: To increase adherence, above baseline, to recommended screening guidelines in children, ages 4-18, prescribed Atypical Antipsychotic Agents over 12 weeks. Results: Aggregate comparison of the mean ranks of scores were tested with the Mann-Whitney U test, U = 1,087.5, n1 = n2 = 70, total N =140, p < .001. All seven variables were observed and tested using the Chi Square with Fisher's Exact tests and are significant at or above 99% confidence (p < 0.01). Conclusion: Educating the Mental Health Provider (MHP) on the recommended screening guidelines and implementing a checklist had a measurable effect on increasing adherence to the recommended screening guidelines.

Human Anatomy And Physiology Preparatory Course: Part 1 Of 4 (Interactive), Carlos Liachovitzky

Open Educational Resources

The overall purpose of these preparatory course set of learning objectives is to help students familiarize with some terms and some basic concepts they will find later in the Human Anatomy and Physiology I course.

These 40+ learning objectives to prepare for Human Anatomy and Physiology can be downloaded and played in a desktop, or laptop (windows exe file).

The entire course has four parts:

• Part 1
• Part 2
• Part 3
• Part 4

Each learning objective is followed by a set of multiple choice question similar to those found later in a Human Anatomy and Physiology course.

The organization and …

Two Related Occupational Cases Of Legionella Longbeachae Infection, Quebec, Canada, Marianne Picard-Masson, Élisabeth Lajoie, Judith Lord, Cindy Lalancette, Geneviève Marchand, Éric Levac, Marc-André Lemieux, Patricia Hudson, Louise Lajoie

Études primaires

Two patients with no exposure to gardening compost had related Legionella longbeachae infections in Quebec, Canada. Epidemiologic investigation and laboratory results from patient and soil samples identified the patients’ workplace, a metal recycling plant, as the likely source of infection, indicating a need to suspect occupational exposure for L. longbeachae infections.

Phylogenetic Analysis Of Bunyamwera And Ngari Viruses (Family Bunyaviridae, Genus Orthobunyavirus) Isolated In Kenya, C. Odhiambo, M. Venter, O. Lwande, R. Swanepoel, R. Sang

All Peer-Reviewed Publications

Orthobunyaviruses, tri-segmented, negative-sense RNA viruses, have long been associated with mild to severe human disease in Africa, but not haemorrhagic fever. However, during a Rift Valley fever outbreak in East Africa in 1997-1998, Ngari virus was isolated from two patients and antibody detected in several others with haemorrhagic fever. The isolates were used to identify Ngari virus as a natural Orthobunyavirus reassortant. Despite their potential to reassort and cause severe human disease, characterization of orthobunyaviruses is hampered by paucity of genetic sequences. Our objective was to obtain complete gene sequences of two Bunyamwera virus and three Ngari virus isolates from …

Plant Resting Site Preferences And Parity Rates Among The Vectors Of Rift Valley Fever In Northeastern Kenya, Samwel O. Arum, Christopher W. Weldon, Benedict Orindi, Caroline Tigoi, Francis Musili, Tobias Landmann, David P. Tchouassi, Hippolyte D. Affognon, Rosemary Sang

All Peer-Reviewed Publications

Background: Mosquito lifespan can influence the circulation of disease causing pathogens because it affects the time available for infection and transmission. The life-cycle of mosquitoes is determined by intrinsic and environmental factors, which can include the availability of hosts and suitable resting environments that shelter mosquitoes from extreme temperature and desiccating conditions. This study determined the parity rates (an indirect measure of survival) and plant resting preference of vectors of Rift Valley fever (RVF) in northeastern Kenya. Methods: Resting mosquitoes were trapped during the rainy and the dry season using a Prokopack aspirator from vegetation, whereas general adult populations were …

Mosquito Host Choices On Livestock Amplifiers Of Rift Valley Fever Virus In Kenya, David P. Tchouassi, Robinson O.K. Okiro, Rosemary Sang, Lee W. Cohnstaedt, David Scott Mcvey, Baldwyn Torto

All Peer-Reviewed Publications

Background: Animal hosts may vary in their attraction and acceptability as components of the host location process for assessing preference, and biting rates of vectors and risk of exposure to pathogens. However, these parameters remain poorly understood for mosquito vectors of the Rift Valley fever (RVF), an arboviral disease, and for a community of mosquitoes. Methods: Using three known livestock amplifiers of RVF virus including sheep, goat and cattle as bait in enclosure traps, we investigated the host-feeding patterns for a community of mosquitoes in Naivasha, an endemic area of Rift Valley fever (RVF), in a longitudinal study for six …

Eet-Dependent Potentiation Of Pulmonary Arterial Pressure: Sex-Different Regulation Of Soluble Epoxide Hydrolase, Sharath Kandhi, Jun Qin, Ghezal Froogh, Houli Jiang, Meng Luo, Michael S. Wolin, An Huang, Dong Sun

NYMC Faculty Publications

We tested the hypothesis that suppression of epoxyeicosatrienoic acid (EET) metabolism via genetic knockout of the gene for soluble epoxide hydrolase (sEH-KO), or female-specific downregulation of sEH expression, plays a role in the potentiation of pulmonary hypertension. We used male (M) and female (F) wild-type (WT) and sEH-KO mice; the latter have high pulmonary EETs. Right ventricular systolic pressure (RVSP) and mean arterial blood pressure (MABP) in control and in response to in vivo administration of U46619 (thromboxane analog), 14,15-EET, and 14,15-EEZE [14,15-epoxyeicosa-5(z)-enoic acid; antagonist of EETs] were recorded. Basal RVSP was comparable among all groups of mice, whereas MABP …

Comparative Effects Of Intranasal Neuropeptide Y And Hs014 In Preventing Anxiety And Depressive-Like Behavior Elicited By Single Prolonged Stress, Esther L. Sabban, Lidia I. Serova, Lishay G. Alaluf, Marcela Laukova, Chandana Peddu

NYMC Faculty Publications

Stress triggered neuropsychiatric disorders are a serious societal problem. Prophylactic treatment or early intervention has great potential in increasing resilience to traumatic stress and reducing its harmful impact. Previously, we demonstrated proof of concept that intranasal administration of neuropeptide Y (NPY) or the melanocortin receptor four (MC4R) antagonist, HS014, prior to single prolonged stress (SPS) rodent post-traumatic stress disorder (PTSD) model, can prevent or attenuate many PTSD associated impairments. Here, we compare effects of NPY or HS014 given 30 min before or immediately after SPS stressors on development of anxiety, depressive-like behavior and associated biochemical abnormalities. SPS triggered anxiety on …

Borrelia Burgdorferi Pathogenesis And The Immune Response, Mary Petzke, Ira Schwartz

NYMC Faculty Publications

Borrelia burgdorferi is the tick-borne etiologic agent of Lyme disease. The spirochete must negotiate numerous barriers in order to establish a disseminated infection in a mammalian host. These barriers include migration from the feeding tick midgut to the salivary glands, deposition in skin, manipulation or evasion of the localized host immune response, adhesion to and extravasation through an endothelial barrier, hematogenous dissemination, and establishment of infection in distal tissue sites. Borrelia burgdorferi proteins that mediate many of these processes and the nature of the host response to infection are described.

Sexually Dimorphic Phenotype Of Arteriolar Responsiveness To Shear Stress In Soluble Epoxide Hydrolase-Knockout Mice, Jun Qin, Sharath Kandhi, Ghezal Froogh, Houli Jiang, Meng Luo, Dong Sun, An Huang

NYMC Faculty Publications

We hypothesized that potentiating the bioavailability of endothelial epoxyeicosatrienoic acids (EETs) via deletion of the gene for soluble epoxide hydrolase (sEH), or downregulation of sEH expression, enhances flow/shear stress-induced dilator responses (FID) of arterioles. With the use of male (M) and female (F) wild-type (WT) and sEH-knockout (KO) mice, isolated gracilis muscle arterioles were cannulated and pressurized at 80 mmHg. Basal tone and increases in diameter of arterioles as a function of perfusate flow (5, 10, 15, 20, and 25 μl/min) were recorded. The magnitude of FID was significantly smaller and associated with a greater arteriolar tone in M-WT than …

Genetic Divergence Of Chikungunya Virus Plaque Variants From The Comoros Island (2005), Caroline Wasonga, Shingo Inoue, Cecilia Rumberia, George Michuki, James Kimotho, Juliette R. Ongus, Rosemary Sang, Lillian Musila

All Peer-Reviewed Publications

Chikungunya virus (CHIKV) from a human sample collected during the 2005 Chikungunya outbreak in the Comoros Island, showed distinct and reproducible large (L2) and small (S7) plaques which were characterized in this study. The parent strain and plaque variants were analysed by in vitro growth kinetics in different cell lines and their genetic similarity assessed by whole genome sequencing, comparative sequence alignment and phylogenetic analysis. In vitro growth kinetic assays showed similar growth patterns of both plaque variants in Vero cells but higher viral titres of S7 compared to L2 in C6/36 cells. Amino acids (AA) alignments of the CHIKV …

Abt-199 (Venetoclax) And Bcl-2 Inhibitors In Clinical Development, Shundong Cang, Chaitanya Iragavarapu, John Savooji, Yongping Song, Delong Liu

NYMC Faculty Publications

With the advent of new agents targeting CD20, Bruton's tyrosine kinase, and phosphoinositol-3 kinase for chronic lymphoid leukemia (CLL), more treatment options exist than ever before. B-cell lymphoma-2 (BCL-2) plays a major role in cellular apoptosis and is a druggable target. Small molecule inhibitors of BCL-2 are in active clinical studies. ABT-199 (venetoclax, RG7601, GDC-0199) has been granted breakthrough designation by FDA for relapsed or refractory CLL with 17p deletion. In this review, we summarized the latest clinical development of ABT-199/venetoclax and other novel agents targeting the BCL-2 proteins.

Complete Genome Sequence Of Staphylococcus Aureus, Strain Ilri_Eymole1/1, Isolated From A Kenyan Dromedary Camel, Saima Zubair, Anne Fischer, Anne Liljander, Jochen Meens, Jan Hegerman, Hadrien Gourlé, Richard P. Bishop, Ina Roebbelen, Mario Younan, Mudassir Imran Mustafa, Mamoona Mushtaq, Erik Bongcam-Rudloff, Joerg Jores

All Peer-Reviewed Publications

We report the genome of a Staphylococcus aureus strain (ILRI_Eymole1/1) isolated from a nasal swab of a dromedary camel (Camelus dromedarius) in North Kenya. The complete genome sequence of this strain consists of a circular chromosome of 2,874,302 bp with a GC-content of 32.88 %. In silico annotation predicted 2755 protein-encoding genes and 76 non-coding genes. This isolate belongs to MLST sequence type 30 (ST30). Phylogenetic analysis based on a subset of 283 core genes revealed that it falls within the human clonal complex 30 (CC30) S. aureus isolate cluster but is genetically distinct. About 79 % of the protein …

Knowledge, Attitudes And Practices (Kap) On Rift Valley Fever Among Pastoralist Communities Of Ijara District, North Eastern Kenya, Ismail H. Abdi, Hippolyte D. Affognon, Anthony K. Wanjoya, Washington Onyango-Ouma, Rosemary Sang

All Peer-Reviewed Publications

Outbreaks of Rift Valley fever (RVF), a mosquito-borne viral zoonosis, have previously been associated with unusually heavy rainfall and extensive flooding. The disease is a serious public health problem in Africa and the Middle East, and is a potential global health threat. In Kenya, outbreaks of the disease have disproportionately affected impoverished pastoralist communities. This study sought to assess the knowledge, attitudes and practices (KAP) regarding RVF among the pastoralists of North Eastern Kenya, and to establish the determinants of KAP on RVF. A cross-sectional study involving 392 pastoralists living in Ijara district (Masalani and Ijara wards) was carried out …

Linalool Oxide: Generalist Plant Based Lure For Mosquito Disease Vectors, Vincent O. Nyasembe, David P. Tchouassi, Charles M. Mbogo, Catherine L. Sole, Christian Pirk, Baldwyn Torto

All Peer-Reviewed Publications

Background: Lack of effective vaccines and therapeutics for important arboviral diseases such as Rift Valley fever (RVF) and dengue, necessitates continuous monitoring of vector populations for infections in them. Plant-based lures as surveillance tools has the potential of targeting mosquitoes of both sexes and females of varied physiological states; yet such lures are lacking for vectors of these diseases. Here, we present evidence of the effectiveness of linalool oxide (LO), a single plant-based lure previously developed for malaria vectors in trapping RVF vectors, Aedes mcintoshi and Aedes ochraceus, and dengue vector, Aedes aegypti. Methods: For RVF vectors, we used CDC …

The Responsibility Of Academic Medicine For Reducing Football Injuries, Edward C. Halperin

NYMC Faculty Publications

No abstract provided.

Β-Hydroxybutyrate Attenuates Nmda-Induced Spasms In Rats With Evidence Of Neuronal Stabilization On Mr Spectroscopy, Mi-Sun Yum, Minyoung Lee, Dong-Cheol Woo, Dong Wook Kim, Tae-Sung Ko, Libor Velíšek

NYMC Faculty Publications

BACKGROUND: Infantile spasms (IS) is a devastating epileptic encephalopathy. The ketogenic diet (KD) has been successfully used as a treatment for IS. This study was designed to test whether beta-hydroxybutyrate (BHB), a major metabolite of the KD, is effective in an animal model of IS. METHODS: Pregnant rats received betamethasone on gestational day 15. The offspring received either single [30min prior to NMDA-triggered spasms on postnatal day (P) 15] or prolonged (three per day from P12 to P15) i.p. BHB. An additional experiment used repeated bouts of spasms on P12, P13, and P15 with randomized prolonged BHB treatment initiated after …

Caveolin-1 Deficiency Inhibits The Basolateral K+ Channels In The Distal Convoluted Tubule And Impairs Renal K+ And Mg2+ Transport, Lijun Wang, Chengbiao Zhang, Xiaotong Su, Dao-Hong Lin, Wenhui Wang

NYMC Faculty Publications

Kcnj10 encodes the inwardly rectifying K(+) channel Kir4.1 in the basolateral membrane of the distal convoluted tubule (DCT) and is activated by c-Src. However, the regulation and function of this K(+) channel are incompletely characterized. Here, patch-clamp experiments in Kcnj10-transfected HEK293 cells demonstrated that c-Src-induced stimulation of Kcnj10 requires coexpression of caveolin-1 (cav-1), and immunostaining showed expression of cav-1 in the basolateral membrane of parvalbumin-positive DCT. Patch-clamp experiments detected a 40-pS inwardly rectifying K(+) channel, a heterotetramer of Kir4.1/Kir5.1, in the basolateral membrane of the early DCT (DCT1) in both wild-type (WT) and cav-1-knockout (KO) mice. However, the activity of …

Vasopressin-Induced Stimulation Of The Na(+)-Activated K(+) Channels Is Responsible For Maintaining The Basolateral K(+) Conductance Of The Thick Ascending Limb (Tal) In East/Sesame Syndrome, Lili Fan, Xiaoyan Wang, Dandan Zhang, Xinpeng Duan, Chunlei Zhao, Mingxue Zu, Xinxin Meng, Chengbiao Zhang, Xiao-Tong Su, Ming-Xiao Wang, Wen-Hui Wang, Ruimin Gu

NYMC Faculty Publications

The renal phenotype of EAST syndrome, a disease caused by the loss-of-function-mutations of Kcnj10 (Kir4.1), is a reminiscence of Gitelman's syndrome characterized by the defective function in the distal convoluted tubule (DCT). The aim of the present study is to test whether antidiuretic hormone (vasopressin)-induced stimulation of the Na(+)-activated 80-150pS K(+) channel is responsible for compensating the lost function of Kcnj10 in the thick ascending limb (TAL) of subjects with EAST syndrome. Immunostaining and western blot showed that the expression of aquaporin 2 (AQP2) was significantly higher in Kcnj10(-/-) mice than those of WT littermates, suggesting that the disruption of …

Can Clinicians Improve On The Effectiveness Of Statins With Additional Lipid-Lowering Therapies?, William H. Frishman

NYMC Faculty Publications

No abstract provided.

Suppression Of Spreading Depolarization And Stabilization Of Dendritic Spines By Glyx-13, An Nmda Receptor Glycine-Site Functional Partial Agonist, Xiao-Lei Zhang, C William Shuttleworth, Joseph R. Moskal, Patric K. Stanton

NYMC Faculty Publications

Cortical spreading depolarization (SD) is a slow self-propagating wave of mass cellular depolarization in brain tissue, thought to be the underlying cause of migraine scintillating scotoma and aura, and associated with stroke, traumatic brain injury, and termination of status epilepticus. The N-methyl-d-aspartate subtype of glutamate receptor (NMDAR), which gates influx of calcium and is an important trigger of long-term synaptic plasticity, is also a contributor to the initiation and propagation of SD. The current study tested the potential of pharmacological modulation of NMDAR activity through the obligatory co-agonist binding site, to suppress the initiation of SD, and modulate the effects …

Public Health Impact Of Strain Specific Immunity To Borrelia Burgdorferi, Camilo E. Khatchikian, Robert B. Nadelman, John Nowakowski, Ira Schwartz, Michael Z. Levy, Dustin Brisson, Gary P. Wormser

NYMC Faculty Publications

BACKGROUND: Lyme disease, caused by Borrelia burgdorferi, is the most common tick-borne infection in the United States. Although humans can be infected by at least 16 different strains of B. burgdorferi, the overwhelming majority of infections are due to only four strains. It was recently demonstrated that patients who are treated for early Lyme disease develop immunity to the specific strain of B. burgdorferi that caused their infection. The aim of this study is to estimate the reduction in cases of Lyme disease in the United States that may occur as a result of type specific immunity. METHODS: The analysis …