Medicine and Health Sciences Commons^™

Impaired Hcv Clearance In Hiv/Hcv Coinfected Subjects Treated With Pegifn And Rbv Due To Interference Of Ifn Signaling By Ifnαr2a, Yu Jin Lee, Xiaozhen Zhang, Estefania Vazquez, Gayathri Shivasabesan, Howard A. Young, Alison Murphy, Honghui Wang, Anthony F. Suffredini, Ulrich Siebenlist, Shyam Kottilil

United States Public Health Resources

Enhanced endogenous interferon (IFN) stimulated gene (ISG) signature has been associated with nonresponsiveness to hepatitis C treatment using pegylated-IFNα (pegIFNα) and ribavirin (RBV) in human immunodeficiency virus/hepatitis C virus (HIV/HCV) coinfected patients. Using a proteomic approach, we identified high levels of IFNα receptor 2a (IFNαR2a) in the serum of null responders to pegIFNα/RBV. IFNαR2a inhibited antiviral activity of all formulations of IFNα in JFH/Huh7.5 cells. Furthermore, serum from null responders, but not from those who achieved sustained virologic response, suppressed IFN-signaling and ISG expression in IFNα-stimulated PBMCs of healthy donors in an IFNαR2a specific fashion. An IFNαR2a transgenic mice model …

Internet And Telephonic Ivr Mixed-Mode Survey For Longitudinal Studies: Choice, Retention, And Data Equivalency, Santosh K. Verma, Theodore K. Courtney, David A. Lombardi, Wen-Ruey Chang, Yueng-Hsiang Huang, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Purpose

This study examined data equivalency and loss to follow-up rates from Internet and interactive voice response (IVR) system surveys in a prospective-cohort study.

Methods

475 limited-service restaurant workers participating in the 12-week study were given a choice to report their weekly slipping experience by either IVR or Internet. Demographic differences, loss to follow-up, self-reported rates of slipping, and selection of first and last choices were compared.

Results

Loss to follow-up rates were slightly higher for those choosing the IVR mode. Rates of slipping and selection of first and last choices were not significantly different between survey modes. Propensity to …

Developing A Dissemination Model To Improve Intervention Reach Among West Virginia Youth Smokers, Kimberly Horn, Traci Jarrett, Andrew Anesett-Rothermel, Nancy O'Hara Tompkins, Geri Dino

Prevention and Community Health Faculty Publications

The Not-On-Tobacco program is an evidence-based teen smoking cessation program adopted by the American Lung Association (ALA). Although widely disseminated nationally via ALA Master Trainers, in recent years, adoption and implementation of the N-O-T program in West Virginia has slowed. West Virginia, unfortunately, has one of the highest smoking rates in the US. Although it is a goal of public health science, dissemination of evidence-based interventions is woefully understudied. The present manuscript reviews a theoretical model of dissemination of the Not-On-Tobacco program in West Virginia. Based on social marketing, diffusion of innovations, and social cognitive theories, the nine-phase model incorporates …

Medicaid Reimbursement For Naloxone: A Toolkit For Advocates, Naomi Seiler, Katie B. Horton, Mary-Beth Malcarney

Health Policy and Management Faculty Publications

Naloxone is an opioid antagonist drug used to counter the effects of an opiate overdose. It can be administered in medical settings, such as an emergency room, or prescribed as a take‑home medication to be used in case of an emergency. Currently, most types of insurance will cover and reimburse for naloxone administered directly in a medical setting. However, coverage of prescription take‑home naloxone is limited. The Medicaid program provides health insurance for a large and growing number of Americans. Therefore, securing coverage for take‑home naloxone—including costs of counseling/training and for the medicine itself—within Medicaid should be a critical priority …

The Importance Of Early Identification And Treatment Of Childhood Onset Bipolar Disorder: Creating Specialty Care, Robert M. Post

Psychiatry and Behavioral Sciences Faculty Publications

No abstract provided.

Estimation And Uncertainty Analysis Of Impacts Of Future Heat Waves On Mortality In The Eastern United States, Jianyong Wu, Ying Zhou, Yang Gao, Joshua S. Fu, Brent A. Johnson, Cheng Huang, Young-Min Kim, Yang Liu

Global Health Faculty Publications

Background: Climate change is anticipated to influence heat-related mortality in the future. However, estimates of excess mortality attributable to future heat waves are subject to large uncertainties and have not been projected under the latest greenhouse gas emission scenarios.

Objectives: We estimated future heat wave mortality in the eastern United States (approximately 1,700 counties) under two Representative Concentration Pathways (RCPs) and investigated sources of uncertainty.

Methods: Using dynamically downscaled hourly temperature projections for 2057–2059, we projected heat wave days that were defined using four heat wave metrics and estimated the excess mortality attributable to them. We apportioned the sources of …

Synthesizing Data And Models For The Spread Of Mers-Cov, 2013: Key Role Of Index Cases And Hospital Transmission, Gerardo Chowell, Seth Blumberg, Lone Simonsen, Mark A. Miller, Cecile Viboud

Global Health Faculty Publications

The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) has caused 209 deaths and 699 laboratory-confirmed cases in the Arabian Peninsula as of June 11, 2014. Preparedness efforts are hampered by considerable uncertainty about the nature and intensity of human-to-human transmission, with previous reproduction number estimates ranging from 0.4 to 1.5. Here we synthesize epidemiological data and transmission models for the MERS-CoV outbreak during April–October 2013 to resolve uncertainties in epidemic risk, while considering the impact of observation bias. We match the progression of MERS-CoV cases in 2013 to a dynamic transmission model that incorporates community and hospital compartments, and …

Competency-Based Medical Education In Two Sub-Saharan African Medical Schools., Elsie Kiguli-Malwadde, E Oluwabunmi Olapade-Olaopa, Sarah Kiguli, Candice Chen, Nelson K. Sewankambo, Adesola O. Ogunniyi, Solome Mukwaya, Francis Omaswa

Health Services Management and Leadership Faculty Publications

Background

Relatively little has been written on Medical Education in Sub-Saharan Africa, although there are over 170 medical schools in the region. A number of initiatives have been started to support medical education in the region to improve quality and quantity of medical graduates. These initiatives have led to curricular changes in the region, one of which is the introduction of Competency-Based Medical Education (CBME).

Institutional reviews

This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME. The processes of curriculum revision are described and common themes …

Safe And Effective Use Of Aromatherapy For Postoperative Nausea, Kristen M. Haack

Theses and Graduate Projects

No abstract provided.

A Support Group Proposal For Women Seeking Fertility Treatment, Emily Jazdzewski

Theses and Graduate Projects

lnfertility is the inability to conceive a pregnancy. Not being able to conceive or carry a child is a devastating reality for many women. Infertility causes both physical and emotional stress that can make it difficult to cope. A literature search revealed the need for a support group for fertility patients to share their journey to decrease the incidence of depression and anxiety. A proposal to develop a support group supported by a Reproductive Endocrinology Department will be explored. The proposal will describe benefits of a support group, integrating cognitive behavioral therapy and relaxation and Mindfulness techniques to promote self-soothing …

Empowering Home Care Nurses To Begin End-Of-Life Conversations, Angela Oujiri

Theses and Graduate Projects

In the United States, some people find the discussion of death and dying a difficult topic to discuss. This difficulty has often delayed conversations about goals and wishes until very late in the healthcare journey. Delays come with a significant cost to both patients and the entire healthcare system. Palliative care is a special type of care meant to provide an extra layer of support to patients and families who are living with serious illness; however, the practice of such care encounters has many challenges for patients, families, physicians, and nurses. Home care nurses are instrumental in the delivery of …

A Healthy Work Schedule: Improving Dynamics For Nurses’ Health, Amy Schei

Theses and Graduate Projects

Rotating shift work is an unavoidable, integral aspect of nursing at a large hospital in the Midwest; however, the fatigue involved in rotating shift work is avoidable. Research has shown how fatigue related to rotating shifts can impact nurses and ultimately affect patients. Fatigue caused by rotating shift work has been proven to decrease nurses’ levels of alertness and vigilance, which directly correlates to higher incidences of errors with patients. In addition, nurses who work rotating shifts have been proven to have problems with psycho-physical health, biological functions, and social relationships. It is through an understanding of the risks related …

Healthy Choice, Healthy Life, Dawn M. Sanderman

Theses and Graduate Projects

According to the U.S. Department of Health and Human Services, unhealthy eating and inactivity cause any where from 310,000 to 580,000 deaths every year. How and what a child eats today will have a significant impact on his/her health throughout adolescence and adulthood. Consuming nutritious foods helps children grow, develop, do well academically and also prevents health issues, such as obesity, Type 2 diabetes, nutrient deficiencies and poor bone health. A project to empower middle school children to make healthy food choices was designed. An after school educational “Health Fair” was created using the theoretical framework of Watson’s Theory of …

Advanced Practice Care Model In A Midwestern Allergy Clinic, Bernie Theobald

Theses and Graduate Projects

Health care organizations are creating innovative patient care models to deal with the rapidly changing healthcare environment. Implementation of the Affordable Care Act has led to reduced revenue for healthcare organizations and placed an impetus on quality. For healthcare providers to continue to practice, they must change their model of care. An allergy clinic in a large Midwestern healthcare organization created a care model which capitalizes on the unique skillset that nurses possess. Nurses in the care model contact the patient before their visit, assess patient needs, and follow-up with the patient in a post- consult nurse visit. The care …

Advanced Practice Care Model In A Midwestern Allergy Clinic, Bernie Theobald

Theses and Graduate Projects

Health care organizations are creating innovative patient care models to deal with the rapidly changing healthcare environment. Implementation of the Affordable Care Act has led to reduced revenue for healthcare organizations and placed an impetus on quality. For healthcare providers to continue to practice, they must change their model of care. An allergy clinic in a large Midwestern healthcare organization created acare model which capitalizes on the unique skillset that nurses possess. Nurses in the care model contact the patient before their visit, assess patient needs, and follow-up with the patient in a post-consult nurse visit. The care model has …

Creation Of Care Coordination Team, Linda Peterson

Theses and Graduate Projects

Healthcare in the United States is fragmented and costly. Care coordination positively impacts healthcare cost and quality in healthcare systems. Case managers, social workers, and community health workers create health care teams in a health care home model. A team approach, formed by relationships built from collaboration, communication, and application of Complexity Theory, produces these outcomes. Relational coordination based on shared goals, shared knowledge, and mutual respect creates the framework from which to establish a team. Watson's Caring Science theory provides the conceptual framework to support the connectedness that occurs within a team approach. Creating a collaborative team of case …

Advance Directives Educational Program For Nurses, Rose R. Pappas

Theses and Graduate Projects

Advance directives (AD) are legal documents outlining a patient's preferences for treatment at the end of life. AD allow people to communicate their end-of-life (EOL) decisions about medical care to family, friends, and health care professionals in the event that they are unable to make those decisions themselves. Many nurses observe patients and their families waiting until the patient is at the end of their life before they initiate an AD. With the current rate of aging baby boomers in the United States, AD would appear to be a phenomeron that should be encouraged. Assisting patients with completion of AD …

Interprofessional Collaboration, Amy L. Brabec

Theses and Graduate Projects

The World Health Organization emphasizes the importance of interprofessional collaboration, which occurs when multiple health workers from different professional backgrounds work together with patients, families, caregivers, and communities to deliver the highest quality of care. As the blood and marrow transplant (BMT) practice continues to grow at a large Midwestern hospital, the need for improved interprofessional collaboration between the hospital-based nurses and the mrse coordinators in the outpatient clinic was apparent. Using Newman's theoretical framework of nurse-patient relationship, person-environment interaction, and rurses being fully present, the BMT partnership group was formed. An interdisciplinary group consisting of the hospital-based nurses and …

Utilizing Watson's Theory Of Caring To Develop A Palliative Care Proposal For Olmsted Medical Center, Tammie Johnson

Theses and Graduate Projects

Palliative care is aimed at alleviating the suffering of patients with serious or chronic illnesses. Literature examined to determine the needs of seriously or chronically ill patients and their farnilies found patients to have physical, psychosocial, and spiritual needs while coping with their illness. In addition, patients' family needed support in physical care of their loved ones, as well as information and psychosocial needs for themselves. The purpose of this project is to develop a proposal for an inpatient palliative care program for Olmsted Medical Center's (OMC's) consideration, Watson's Theory of Caring was utilized in the development of a palliative …

Heart Nursing Care Model, Jennifer M. Harden

Theses and Graduate Projects

The role of the hematology ambulatory registered nurse (HARN) is currently disorganized at a large Midwestern clinic. Cumently the HARN is responsible for telephone care, lab results, prescription refills, patient education, submitting forms, and helping patients with miscellaneous items. The HARN is pulled in several directions throughout the day. With healthcare reimbursement changing, there is a growing need for HARNs to be utilized to one's fullest potential and licensure. The purpose of this project is to create a new model of nursing care, which will further enhance the HARN role. Jean Watson's Philosophy and Science of Caring provides a framework …

Diabetic Assessment In A Wound Care Clinic, Laura Dooley

Theses and Graduate Projects

The number of people with diabetes in the United States is continuing to grow at an alarming rate. Over 23 million people in the United States are affected with the disease and it is estimated that the number of people diagnosed with diabetes in the United States is increasing by 1 million people annually. It is essential that nurses working in all capacities help with the prevention and management of this disease. lssues surrounding adequate patient self-management of the disease are identified as smoking, glycemic control, diabetes education, footcare, and financial concerns. An algorithm for diabetes assessment was developed to …

Maendeleo Ya Wanawake Project: Developing A Nursing Based Support Group For Kenyan Women In Minneapolis, Jackline Ikobe

Theses and Graduate Projects

In recent years, the Kenyan community living in Minneapolis, Minnesota, has had many cases of violence that have resulted in death or injury to the women and their children. Domestic violence is especially difficult because it disrupts every aspect of the victim's well-being. Many women experience repeated victimization because of the difficulty in leaving their abusive relationships. A woman's ability to disclose abuse and receive emotional support is critical to her survival. Implementing a nursing based support group for Kenyan women living in Minneapolis, who are victims of domestic violence, will empower them to understand the effects of living in …

Holistic Understanding, Bridget Burness

Theses and Graduate Projects

In 2007, the Association of American Retired People (AARP) published its Funeral and Burial Planners survey key findings that revealed 12 percent were interested in green burial and that practitioners should provide education on environmentally friendly options to this audience. Nurses are currently knowledgeable about Advance Care Directives (ACD) for cessation of care. To gain a better understanding of nurses' attitudes toward green burial, a plan to create a holistic nurse-learning circle was developed to discuss the Funeral Rule, pre-burial planning for green funerals and flameless cremation, and the importance of collaborating with funeral directors. To facilitate this group, a …

Trauma Resource Nurse: A Leadership Role In A Pediatric Level 1 Trauma Center, Claudia Hines

Theses and Graduate Projects

Nurses in a pediatric emergency department are accustomed to caring for critically ill and injured children. Pediatric trauma requires nurses to have a high level of expertise. However, along with this expertise, nurses need to demonstrate strong leadership skills to be an effective partner in the trauma team. Attaining a pediatric level I trauma designation by the American College of Surgeons generated uncertainty in emergency nurses' perceptions of their ability to care for trauma patients. Emergency departments within trauma centers have recognized the need for specialized nursing programs or nursing roles in the care of trauma. Nursing leadership competencies, interprofessional …

Preparing Nurses For Medical Emergencies: Developing A Collaborative Mock Code Training Program, Joseph Heaser

Theses and Graduate Projects

Medical emergencies are stresstul and anxiety producing situations that require quick and precise action. As first responders in the hospital setting, nurses are often responsible for initiating resuscitative efforts until additional help arrives. Positive patient outcomes are dependent on the nurses' ability to quickly and accurately utilize basic life support (BLS) and advanced cardiac life support (ACLS) to deliver the care needed during the critical first few minutes following cardiac arrest. It is very difficult for nursing staff to maintain emergency medical response skills and knowledge when they are only required to practice them once a year for their annual …

Transforming The Preoperative Patient Education Experience, Hilary Joachim

Theses and Graduate Projects

In 2009 a large Midwestern healthcare institution introduced preoperative education classes for orthopedic patients undergoing joint replacement surgery to better prepare them for surgery and promote a timely discharge from the hospital. According to literature findings, preoperative patient education decreases patient anxiety, improves pain control, and decreases length of stay in the hospital. While length of stay for joint replacement patients within this healthcare instifution decreased, it was difficult to pinpoint the effect of the educational classes due to other simultaneous changes in postoperative orthopedic care, such as earlier mobilization of patients. Through an analysis of class attendance, it was …

Reiki For Pain Control, Jeffrey L. Burt

Theses and Graduate Projects

Hemodialysis is a procedure used to remove waste products and electrolytes from the bloodstream when the kidneys are no longer working. In addition to removing waste products and unwanted electrolytes, the process also removes some medications as well; 60% of the most commonly used analgesics are removed during dialysis. For renal patients who experience chronic pain as a result of their illness, this is a serious problem. Dialysis patient are held to the same medication regulations regarding frequency and dosing as the general hospital population, leaving them without pain coverage for longer periods of time. The introduction of a complimentary …

Hepatitis B Serology Testing: An Educational Module For Nurses In Outpatient Dialysis, Kristi Hanson

Theses and Graduate Projects

For nurses in outpatient dialysis, an accidental needle stick could result in contracting the Hepatitis B virus. It is recommended that all individuals receive the series of three Hepatitis B vaccinations. To determine if immunity is developed as a result of the vaccinations, Hepatitis B serology testing is performed and a positive antibody and titer level above 10 mIU/mL is indicative of immunity. Without awareness of their personal Hepatitis B serology, nurses working with Hepatitis B positive patients in the outpatient dialysis setting lack knowledge to protect their health. The implementation of an educational module, influenced by Knowles' principles of …

Trauma Informed Nursing Care For Women Who Are Marginalized: An Educational Workshop, Jenna Fadlalla

Theses and Graduate Projects

Traumatic events profoundly affect both the physical and emotional health of a woman who endures the event. Gender, socioeconomic, racial, and ethnic disparities in rates of trauma exist showing that women who are marginalized are at a higher risk for trauma. Nurses are privileged to provide care for these women in their greatest times of need, yet despite the intimate relationship between nurses and their patients, trauma is a topic that remains largely unaddressed by the field of nursing. Because trauma can have such a profound effect on health, it is essential for nurses of all specialties and at all …

Reducing Anxiety In Pediatric Bone Marrow Transplant Patients Using Reiki, Robyn Ait Ali

Theses and Graduate Projects

Reiki, meaning universal life force energy, facilitates the flow of energy that travels naturally in and around the body. Blockages in energy flow create disease and or pain in the body; the Reiki practitioner facilitates the removal of blockages which allows for healing and restoration of balance. Anxiety in children undergoing Bone Marrow Transplant (BMT) manifests itself across all body systems and effects the care they receive during hospitalization. Children are open to the concept of energetic healing therefore, the use of Reiki for children undergoing BMT to reduce anxiety, facilitate relaxation, and ease pain makes sense. The introduction of …