Medicine and Health Sciences Commons^™

Strengthening Immigrants' Health Access: Current Opportunities, Leighton C. Ku

Health Policy and Management Issue Briefs

This brief summarizes key opportunities helping the nation’s newcomers in gaining health insurance coverage and health access that are possible under the current law. Provisions of the Affordable Care Act (ACA) will help millions of legal immigrants gain access to affordable health insurance coverage. At the same time, however, immigrants will also face new responsibilities. Like citizens, lawfully present immigrants will be responsible for having health insurance coverage or paying a tax penalty, although some are exempt. Rules about immigrants’ access to health insurance benefits are often complicated because they depend on specific immigration categories, as well as eligibility for …

Molecular Evolution Of Protein-Rna Mimicry As A Mechanism For Translational Control, Assaf Katz, Lindsey Solden, S. Betty Zou, William Wiley Navarre, Michael Ibba

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Elongation factor P (EF-P) is a conserved ribosome-binding protein that structurally mimics tRNA to enable the synthesis of peptides containing motifs that otherwise would induce translational stalling, including polyproline. In many bacteria, EF-P function requires post-translational modification with (R)-β-lysine by the lysyl-tRNA synthetase paralog PoxA. To investigate how recognition of EF-P by PoxA evolved from tRNA recognition by aminoacyl-tRNA synthetases, we compared the roles of EF-P/PoxA polar contacts with analogous interactions in a closely related tRNA/synthetase complex. PoxA was found to recognize EF-P solely via identity elements in the acceptor loop, the domain of the protein that interacts with the …

Implementation Plan For Emr And Beyond, Lori Katterhagen

Doctor of Nursing Practice (DNP) Projects

Change is never easy for anyone, but how we implement change can make the difference in how an innovation is accepted. Over the last two years, a small community hospital in California has introduced a new electronic medical record (EMR) to meet the requirements of meaningful use mandated by the Centers for Medicare and Medicaid (CMS) for all hospitals across the United States. EMRs are expected to improve quality in many areas, especially to improve outcomes, while safely reducing costs (U.S. Department of Health & Human Services, 2012). Adoption of EMR’s is not optional, if facilities want to avoid penalties …

Lean Management Principles To The Creation Of Postpartum Hemorrhage Care Bundles, Bethan Faulkner

Doctor of Nursing Practice (DNP) Projects

Postpartum hemorrhage (PPH) is the number one cause of pregnancy-related death in the US. The Maternity local improvement team (LIT), co-led by an Obstetrician and Board Certified Clinical Nurse Specialist found that each month the maternity unit averages 40 PPHs with 1-2 resulting in an emergency. Over a 6-month period, the LIT decreased response time for emergencies significantly. Supply retrieval time decreased by 99.9%, MD response time decreased by 81%, and Family Centered Care increased by 100%. They recently turned their attention to prevention. Given the lack of literature on preventing PPH in postpartum units, the team developed a PPH …

Improving Value Based Purchasing Through The Implementation Of The Clinical Nurse Leader Role: The Chief Nursing Officer’S Case For Change, Leanne M. Hunstock

Doctor of Nursing Practice (DNP) Projects

The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical …

Innovative Approach To New Nurse Residency, Meaningful Use And Health Care Reform, Pamela V. Stanley

Doctor of Nursing Practice (DNP) Projects

The project’s aim was to examine the financial impact of replacing registered nurse (RN) travelers, RN registry and RN overtime with new graduate RNs. Newly graduated RNs are often viewed by hospital administrators as a more costly staffing resource. This project contributes knowledge regarding the potential cost savings with the utilization of a centralized float pool incorporating new graduates. In addition, it contributes a novel idea for reducing organizational costs of implementing an electronic medical record with the utilization of new graduates as super users.

A new graduate program, which incorporated the use of a formal preceptor and mentoring program, …

The Design, Implementation And Evaluation Of A Technology Solution To Improve Discharge Planning Communication In A Complex Patient Population, Susan M. Manfredi

Doctor of Nursing Practice (DNP) Projects

Unnecessary delays in discharge planning can extend the length of stay (LOS) and add non-reimbursable days for socially and medically complex patients thereby increasing the financial burden to healthcare organizations. The literature supports enhanced discharge communication strategies and the use of checklists to facilitate safe and timely discharges. Following root cause analyses of significant discharge delays, one hospital identified gaps in communication as key precursors associated with discharge planning breakdown when discharging patients to skilled nursing facilities. Review of these events demonstrated the need for concurrent communication strategies between multidisciplinary care team members in planning for complex discharges.

Following a …

Transforming The Journey For Newly Licensed Registered Nurses: A Community Based Transition-To-Practice Program In Ambulatory Care Settings, Cathryn A. Halford Dnp

Doctor of Nursing Practice (DNP) Projects

Abstract

In response to the job shortage for newly licensed registered nurses (RNs), transition to practice and residency programs have been established in many areas of the country including the San Francisco Bay Area. The programs were designed as demonstration projects to assist new graduates by increasing their competence, confidence, and skills, and their employability. Evidence from new graduate programs suggests that the programs provide an important bridge that is necessary for the critical transition from classroom to clinical practice and from newly licensed RN to qualified nursing professional. The University of San Francisco (USF)

Transition-To-Practice (nurse residency) program in …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Rural Women's Exercise Self-Efficacy
• Ubiquitous Effects of Quantum Entanglement

Factors Influencing Youth Self-Perceptions Of Overweight And Obesity, Caitlin Helen Sommers

Dissertations and Theses

This study sought to examine whether participation in physical activity affects the ability to correctly classify body size, based on body mass index classifications. Secondarily, this study determined whether adolescents who incorrectly classified their body size overestimated or underestimated their size. Self-report data from the Youth Risk Behavior Surveillance Survey collected by the Centers for Disease Control and Prevention were analyzed. Logistic regression was performed to examine relationships between self-perception of body size and physical activity, television viewing time, computer/video game use, physical education class time, and extracurricular sports activities. Significance was set to p<0.05. Physical activity was the only statistically significant independent variable (p=0.058, OR = 1.060). Although physical activity was shown to be statistically significant, it did not appear to meaningfully increase the ability of youth to correctly classify body size. Secondary analysis showed that adolescents who incorrectly classified their body size were more likely to underestimate their body size. Females more frequently underestimated their body size (females=673; males=384).

Biochemical Assay Optimization And Computational Screening Efforts To Identify Potential Luxs Inhibitors, Keeshia Q. Wang

Master's Theses

Quorum sensing (QS) is a process of coordination of bacterial gene expression in response to cell population. System two QS is regulated by the small signaling molecule autoinducer-2 (AI-2) and is implicated in the infectious behaviors of various bacterial species. AI-2 is biosynthesized from S-ribosylhomocysteine (SRH) by the enzyme LuxS and induces interspecies cell-to-cell communication. Inhibition of LuxS would therefore inhibit interspecies QS. Herein, a search for novel molecular species that will competitively bind with SRH in the LuxS binding site is performed in silico. Computational screening results are then validated in vitro using an optimized LuxS inhibition …

Kinetic And Kinematic Asymmetries During Unloaded And Loaded Static Jumps, Chris A. Bailey, Kimitake Sato, Brian Johnson, William A. Sands, Angus Burnett, Michael H. Stone

ETSU Faculty Works

Abstract available in the Annual coaches and Sport Science College.

Interactions Of Peptide Triazole Thiols With Env Gp120 Induce Irreversible Breakdown And Inactivation Of Hiv-1 Virions, Arangassery Bastian, Mark Contarino, Lauren D. Bailey, Rachna Aneja, Diogo Rodrigo Magalhaes Moreira, Kevin Freedman, Karyn Mcfadden, Caitlin Duffy, Ali Emileh

Dartmouth Scholarship

Background: We examined the underlying mechanism of action of the peptide triazole thiol, KR13 that has been shown previously to specifically bind gp120, block cell receptor site interactions and potently inhibit HIV-1 infectivity.

Results: KR13, the sulfhydryl blocked KR13b and its parent non-sulfhydryl peptide triazole, HNG156, induced gp120 shedding but only KR13 induced p24 capsid protein release. The resulting virion post virolysis had an altered morphology, contained no gp120, but retained gp41 that bound to neutralizing gp41 antibodies. Remarkably, HIV-1 p24 release by KR13 was inhibited by enfuvirtide, which blocks formation of the gp41 6-helix bundle during membrane fusion, while …

Ewing's Sarcoma Arising From The Adrenal Gland In A Young Male: A Case Report, Muhammad Nauman Zahir, Tayyaba Zehra Ansari, Tariq Moatter, Wasim Memon, Shahid Pervez

Section of Haematology/Oncology

Background: Ewing's sarcoma uncommonly arises from extraosseous soft tissue or parenchymal organs. Primary adrenal Ewing's Sarcoma, although very rare, is extremely aggressive and commonly fatal.

CASE PRESENTATION: A 17 year old Pakistani male was referred to the outpatient oncology clinic at our center with a three month history of concomitant pain, swelling and dragging sensation in the right hypochondrium. Abdominal examination revealed a large, firm mass in the right hypochondrium extending into the right lumbar region and epigastrium. His genital exam was unremarkable and there were no stigmata of hepatic or adrenal disease.Computed tomography scans revealed a large peripherally …

Tetanus, Diphtheria, And Pertussis Screening And Pertussis Prevention Throughout The Age Span, Cara Harris, Thu Tran

MSN Research Projects

The purpose of this study was to determine if preteens and adults are screened and given the diphtheria toxoid and acelluar pertussis vaccine.

Three Dimensional Nutrition: Exploring Nourishment Of Spirit, Mind, And Body During A 28-Day Daniel Fast At Southern Adventist University, Caitlin S. Hobbs

Capstone Research Projects

A person who is living well can be said to be “making lifestyle choices with God’s help to support optimum physical, mental, emotional, and spiritual health and experiencing His gift of abundant life” (Tryon, 2009). All of these “dimensions” of health are interrelated, and in order for a person to truly flourish, each area must be nourished. Dietary choices can have an especially interesting impact on these dimensions. Eating healthfully is not always viewed as a joyous endeavor, but when viewed from a multi-dimensional perspective, it can become a more rewarding and intriguing pursuit.

One way to promote a nutritional …

Tetanus, Diphtheria, And Pertussis Screening And Pertussis Prevention Throughout The Age Span, Lacey Gullick, Kevin Miller

MSN Research Projects

The purpose of this study was to determine the number (percentage) of boys, ages 9-21, who were educated on or who received the HPV vaccine at their local community clinic.

Healthcare Provider Adherence To Asthma Education Guidelines, Kelly Massey, Rebekah Overstreet, Franklin Golden

MSN Research Projects

The purpose of this study was to determine if health care providers are educating adult asthma patients according to the NHLBI guidelines.

Are Health Care Providers Following Evidence-Based Practice Guidelines For The Screening, Diagnosis And Treatment Of Childhood Obesity?, Cara Harris, Thu Tran

MSN Research Projects

The purpose of this study was to determine if preteens and adults are screened and given the diphtheria toxoid and acelluar pertussis vaccine.

Adherence To Guidelines For The Screening And Treatment Of Vitamin D Deficiency In Elderly Patients, Kelly Massey, Rebekah Overstreet, Franklin Golden

MSN Research Projects

The purpose of this study was to determine if health care providers are educating adult asthma patients according to the NHLBI guidelines.

Healthcare Provider's Adherence To The Centers For Disease Control And Prevention's Guidelines Regarding The Human Papillomavirus Vaccine In Males, Lacey Gullick, Kevin Miller

MSN Research Projects

The purpose of this study was to determine the number (percentage) of boys, ages 9-21, who were educated on or who received the HPV vaccine at their local community clinic.

Managing Congestive Heart Failure : A Study Comparing The Management Provided By A Cardiologist, Family Physician And Nurse Practitioner, Jill Lyle, Misti Garnett, Lisa Hayes

MSN Research Projects

The purpose of this project was to compare the care provided to congestive heart failure patients by three different provider types. The providers chosen were a cardiologist, a family physician and a nurse practitioner. The researchers used guidelines set forth by the American Heart Association and the American College of Cardiology.

Primary Care Management Of Type 2 Diabetic Patients With Dyslipidemia According To Ncep Atp Iii Guidelines, Alyssa Simmons, Mary Williams

MSN Research Projects

The purpose of this study was to evaluate healthcare providers compliance with the guidelines established by The Endocrine Society regarding Vitamin D.

Adherence To Guidelines For The Screening And Treatment Of Vitamin D Deficiency In Elderly Patients, Alyssa Simmons, Mary Williams

MSN Research Projects

The purpose of this study was to evaluate healthcare providers compliance with the guidelines established by The Endocrine Society regarding Vitamin D.

Healthcare Provider Adherence To Asthma Education Guidelines, Jill Lyle, Misti Garnett, Lisa Hayes

MSN Research Projects

The purpose of this project was to compare the care provided to congestive heart failure patients by three different provider types. The providers chosen were a cardiologist, a family physician and a nurse practitioner. The researchers used guidelines set forth by the American Heart Association and the American College of Cardiology.

Factors Mediating Disruptive Behaviors In A Veterans Affairs Medical Center, Marylois Lacey

Dissertations

. Disruptive behaviors are often related to care giving situations in which the patient wants something that is not possible, refuses to participate in what is required, demands instant gratification, or demands immediate emotional support. In response to the patients’ demands and actions, health care providers use limit setting, activity demand, and denial of request. This study sought to answer the following questions: (a) Are code greens associated with symptoms of a medical and/or psychiatric diagnosis, denial of request, limit setting, and activity demand? (b) Are activity demand, denial of request, and limit setting more likely to be associated with …

The Creation And Implementation Of Interprofessional Simulation Leadership Scenarios, Angeline C. Delucas

Doctor of Nursing Practice (DNP) Projects

Healthcare is in a historical state of change creating an era that requires superior leadership skills. Leaders face burgeoning challenges in a competitive environment ensconced in reform. Today’s dynamic healthcare environment demands that nurse and interprofessional leaders be astute in a variety of areas including: fiscal responsibility and accountability, organizational politics, interpersonal skills, human resources, communication, conflict resolution, and emotional intelligence. Some areas such as fiscal management are considered hard skills, or skills which can be taught, while others such as conflict resolution are referred to as soft skills, or skills that are learned through experience. Though soft …

Cultural Conflict In Medicine: A Moral Debate Between Paternalism And Patient Autonomy, Hannah Webb

Honors Theses

In today’s society filled with globalization and mass movement of people and ideas, there is an ever present question of how each individual society fits into the overall culture of a diversified country such as the United States. The idea of the US as a melting pot has triggered the inability to create a “one size fits all” style of living. In terms of medicine, westernized practices are typically accepted in a majority of the world. However, conflicting traditional practices as well as religious beliefs are still present in some areas of the world as well as in the US …

Age-Related Modifications To The Magnitude And Periodicity Of Neuromuscular Noise, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Background: Evaluation of task related outcomes within geriatric and fall-prone populations is essential not only for identification of neuromuscular deficits, but also for effective implementation of fall prevention strategies. As most tasks and activities of daily living are performed at submaximal force levels, restoration of muscle strength often does not produce the expected benefit in functional capacity. However, it is known that muscular control plays a key role in the performance of functional tasks, but it remains unclear to what degree muscular control and the associated neuromuscular noise (NmN) is age-related, particularly in the lower-extremities.

Objectives: The aim of this …

Sevoflurane Induces Cardioprotection Through Reactive Oxygen Species-Mediated Upregulation Of Autophagy In Isolated Guinea Pig Hearts., Mayumi Shiomi, Masami Miyamae, Genzou Takemura, Kazuhiro Kaneda, Yoshitaka Inamura, Anna Onishi, Shizuka Koshinuma, Yoshihiro Momota, Toshiaki Minami, Vincent M. Figueredo

Division of Cardiology Faculty Papers

PURPOSE: Sevoflurane increases reactive oxygen species (ROS), which mediate cardioprotection against myocardial ischemia-reperfusion injury. Emerging evidence suggests that autophagy is involved in cardioprotection. We examined whether reactive oxygen species mediate sevoflurane preconditioning through autophagy.

METHODS: Isolated guinea pigs hearts were subjected to 30 min ischemia followed by 120 min reperfusion (control). Anesthetic preconditioning was elicited with 2 % sevoflurane for 10 min before ischemia (SEVO). The ROS-scavenger, N-(2-mercaptopropionyl) glycine (MPG, 1 mmol/l), was administered starting 30 min before ischemia to sevoflurane-treated (SEVO + MPG) or non-sevoflurane-treated (MPG) hearts. Infarct size was determined by triphenyltetrazolium chloride stain. Tissue samples were obtained …