Medicine and Health Sciences Commons^™

Examining Employee Knowledge Of The Jennie Edmundson Hospital Active Shooter Policy, Mallory W. Darais

Theses & Dissertations

Nationally, there has been a large increase in the number of active shooter events within healthcare facilities such as hospitals. Due to this increase, government organizations have recently released documents to guide healthcare facilities on implementing active shooter policies and updating emergency operation plans. Currently, recommendations from government entities such as the Federal Bureau of Investigation and the Department of Homeland Security suggest the “Run, Hide, Fight” approach during an active shooter incident. Jennie Edmundson Hospital, located in Council Bluffs, Iowa, and affiliated with the Methodist Health System, currently has an active shooter policy in place. Data was collected from …

Epacs: Epigenetic Regulators That Affect Cell Survival In Cancer., Catherine Murari

Theses & Dissertations

Cyclic adenosine monophosphate (cAMP) is a second messenger responsive to many external stimuli, playing an important role in cellular gene expression, metabolism, migration, differentiation, hypertrophy, apoptosis and secretion. All of these cellular functions are important in many diseases including cancer. Most of its effects were initially attributed to the classical protein kinase A (PKA) protein, but cellular functions such as proliferation and migration were found to be PKA independent and dependent on the newly discovered exchange proteins directly activated by cAMP (EPACs). EPACs are single polypeptides that primarily function as guanine exchange factors (GEFs) for Rap proteins that allow the …

Postural Responses To Perturbations Of The Vestibular System During Walking In Healthy Young And Older Adults, Jung Hung Chien

Theses & Dissertations

It has been shown that approximate one-third of US adults aged 40 years and older (69 million US citizens) have some type of vestibular problems. These declining abilities of the vestibular system affect quality of life. Difficulties in performing daily activities (dressing, bathing, getting in and out of the bed and etc.) have been highly correlated to loss of balance due to vestibular disorders. The exact number of people affected by vestibular disorders is still difficult to quantify. This might be because symptoms are difficult to describe and differences exist in the qualifying criteria within and across studies. Thus, it …

Regulatory Roles Of Mical-L1 And Ehd1 In Cell Signaling And Mitosis, James B. Reinecke

Theses & Dissertations

Membrane trafficking is a basic cell biological process that controls the distribution of proteins and lipids. Our lab is particularly interested in delineating the cellular functions as well as the molecular mechanisms that regulate the C-terminal Eps15 Homology Domain (EHD) protein family of adenosine-5’-triphosphatases in mammalian cells. EHD1-4 are ubiquitously expressed in mammalian tissues and serve partially overlapping but also distinct functions in regulating membrane shaping and fission along the endocytic pathway. Specifically, EHD1 is recruited to tubular recycling endosomes (TREs) by Molecule Interacting with CasL Like-1 (MICAL-L1) and facilitates TRE fission and release of cargo from the perinuclear endocytic …

Impact Of Executive Order 13211 On Environmental Regulation: An Empirical Study, Elizabeth Ann Glass Geltman

Publications and Research

A great deal has been written about the Energy Policy Act of 2005 exempting oil and gas operations using hydraulic fracturing from the purview of certain federal environmental laws. Far less attention has been paid to George W. Bush’s Executive Order 13211 (EO 13211), entitled “Actions Concerning Regulations that Significantly Affect Energy Supply, Distribution or Use.” The executive order requires federal agencies to evaluate the impact of federal regulations on “supply, distribution and use of energy.” This study examined the impact of EO 13211 on United States environmental and conservation regulations proposed and promulgated by federal agencies. The study found …

Knowledge, Attitudes, And Intentions Toward Fertility Awareness And Oocyte Cryopreservation Among Obstetrics And Gynecology Resident Physicians, L. Yu, Brennan Peterson, M. C. Inhorn, Julia K. Boehm, P. Patrizio

Marriage and Family Therapy Faculty Articles and Research

STUDY QUESTION What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients?

SUMMARY ANSWER Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines.

WHAT IS KNOWN ALREADY Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients.

STUDY …

Functional Movement Screen Score By Somatotype Category, Amanda Kelch

Masters Theses

Background: The Functional Movement Screen (FMS) is a tool used by fitness and health professionals to assess the quality of movement patterns in active populations. The literature has established descriptive values for FMS scores in various populations. However there has not yet been a study establishing the descriptive values of FMS score based on the somatotype categories. Establishing these descriptive values may provide a better understanding of how an individual's somatotype affects their ability to move. Purpose: The purpose of this study was to establish FMS scores for the four simplified somatotype categories (normal, endomorph, mesomorph, and ectomorph). Methods: Participants …

Ubu-Unique But United: A Movement-Based Curriculum For An Inclusive Pre-School Classroom Focusing On Social-Emotional Learning, Julie Schadeck

Creative Arts Therapies Theses

The purpose of this program development is to address the problem of true inclusion by focusing on the role of the body and movement in social-emotional learning (SEL) among pre-school children. Every year, millions of 3 to 4 year old children leave the safe cradle of their home and embark on a life-long journey of discovery where they soon find out that not everyone is like them. To teach them that different does not mean necessarily separate, I used the University of Wisconsin Cooperative Extension logic model to develop a movement-based curriculum for an inclusive pre-school classroom focusing on SEL. …

Are Immune Modulating Single Nucleotide Polymorphisms Associated With Necrotizing Enterocolitis?, Ashanti L Franklin, Mariam Said, Clint D Cappiello, Heather Gordish-Dressman, Zohreh Tatari-Calderone, Stanislav Vukmanovic, Khodayar Rais-Bahrami, Naomi L C Luban, Joseph M Devaney, Anthony D Sandler

Genomics and Precision Medicine Faculty Publications

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal emergency. The purpose of this study is to determine if functional single nucleotide polymorphisms (SNPs) in immune-modulating genes pre-dispose infants to NEC. After Institutional Review Board approval and parental consent, buccal swabs were collected for DNA extraction. TaqMan allelic discrimination assays and BglII endonuclease digestion were used to genotype specific inflammatory cytokines and TRIM21. Statistical analysis was completed using logistic regression. 184 neonates were analyzed in the study. Caucasian neonates with IL-6 (rs1800795) were over 6 times more likely to have NEC (p = 0.013; OR = 6.61, 95% CI 1.48-29.39), and over …

Preserving Personhood In Individuals With Cognitive Impairment: A Caregiver's Role, Maren Legg

Honors Projects

This project consists of an educational program for informal caregivers in the Bowling Green community on preserving personhood in individuals with cognitive impairments through caregiving experiences. The program was based on a copious amount of research regarding personhood, how personhood relates to individuals experiencing cognitive impairment, and how care provided by caregivers can be provided in a way that promotes and preserves an individual’s personality, personhood, and selfhood.

The program was developed over the span of four months and incorporates models of personhood, behaviors that threaten and preserve or promote personhood, as well as practical suggestions for strategies in how …

Selective Vip Receptor Agonists Facilitate Immune Transformation For Dopaminergic Neuroprotection In Mptp-Intoxicated Mice., Katherine E. Olson, Lisa M. Kosloski-Bilek, Kristi M. Anderson, Breha J. Diggs, Barbara E. Clark, John M. Gledhill, Scott J. Shandler, R. Lee Mosley, Howard Gendelman

Journal Articles: Pharmacology & Experimental Neuroscience

UNLABELLED: Vasoactive intestinal peptide (VIP) mediates a broad range of biological responses by activating two related receptors, VIP receptor 1 and 2 (VIPR1 and VIPR2). Although the use of native VIP facilitates neuroprotection, clinical application of the hormone is limited due to VIP's rapid metabolism and inability to distinguish between VIPR1 and VIPR2 receptors. In addition, activation of both receptors by therapeutics may increase adverse secondary toxicities. Therefore, we developed metabolically stable and receptor-selective agonists for VIPR1 and VIPR2 to improve pharmacokinetic and pharmacodynamic therapeutic end points. Selective agonists were investigated for their abilities to protect mice against MPTP-induced neurodegeneration …

Triage Training: Improving Access To Care, Leslie D. Simpson-Crawford

Master's Projects and Capstones

Left Without Being Seen (LWBS) rates have been described as “the gold standard of metrics” for high acuity units. In this project, the aim is to increase patient access to care by decreasing both wait times for patients and the LWBS rate for the unit, which approaches 6%. As part of a military hospital, the unit provides for veterans, active duty service members, and their families, with ages ranging from infant to elderly, in a 24 hour acute care hospital setting.

Triage training was identified as a necessary first-step for improving the unit efficiency and increasing patient satisfaction. While the …

From Clinical Center To Academic Institution: An Example Of How To Bring About Educational Change, Hanan M. Al-Kadri, Ibrahim A. Al Alwan, Mohamed S. Al-Moamary, Youssef A. Al Eissa, Bandar A. Al Knawy

Health Professions Education

Background: The usual scenario for change management in the medical education field is an academic institution creating a patient care facility. The opposite change is however rather rare and challenging. There is not much in the medical education literature on experiences of change management that provides sufficient support to readers who are involved in such process of change. Methods: We analyzed the experience of a clinical institution that has changed into an academic one. The methods used were archival analysis and interviews with those involved. The raw data were analyzed using a framework derived from the change management literature. Results: …

Iron-Dependent Gene Expression In Actinomyces Oris, Matthew P. Mulé, David Giacalone, Kayla Lawlor, Alexa Golden, Caroline Cook, Thomas Lott, Elizabeth Aksten, George A. O'Toole, Lori J. Bergeron

Dartmouth Scholarship

Actinomyces oris is a Gram-positive bacterium that has been associated with healthy and diseased sites in the human oral cavity. Most pathogenic bacteria require iron to survive, and in order to acquire iron in the relatively iron-scarce oral cavity A. oris has been shown to produce iron-binding molecules known as siderophores. The genes encoding these siderophores and transporters are thought to be regulated by the amount of iron in the growth medium and by the metal-dependent repressor, AmdR, which we showed previously binds to the promoter of proposed iron-regulated genes.

Written On By Experience, Akesis Anonymous Author

Akesis

This poem is about a conversation I had with a friend about beginnings, and how any given experience has no intrinsic good or bad qualities, but rather holds whatever we imbibe it with.

What Is My Beginning?, Stephanie Braunthal

Akesis

I find that when we ask about beginnings, we are really asking about the present. How did a person come to be who he or she is today? As I try to answer this question about myself, I am finding it easier to express myself in diagrams (pen on scratch paper) than in words. Perhaps this is a product of being a medical student; or perhaps it is because beginnings are a complex amalgam of static forces and fluid experiences that cannot be expressed linearly through prose...Enjoy!

To Care Is To Treat, Himanshu Malhotra

Akesis

To Care is to Treat is a reflection of a few experiences from my second and third year that have inspired me to become a palliative care physician.

The Narrative Of My Childhood, Nihit N. Mehta

Akesis

I was a weak child from early on, never able to run or play as much as the other kids in my block. Each month I'd visit doctors, trying my best to recover from common colds and coughs. Luckily, all this changed as I matured and in a way I almost began living a "normal life".

However, when it came to deciding what I wanted to be as an adult, I remembered the sick kid I was and how my doctors were always there for me, helping me "find health." This made me realize that I too, could someday be …

The Descent Down The Step One Rabbit Hole, Katelyn A. Hanson

Akesis

At the start of my second year of medical school I was ecstatic to move away from the study of the normal, healthy human body and to begin to immerse myself in the complex mechanisms behind the pathophysiology of disease. I drew this illustration to connect aspects of my personality with the aspects of medicine I was most excited about exploring deeper. This image was drawn with permanent markers on the cover of a binder dedicated solely to preparing for the first part of the medical licensing exam; I looked at this drawing every day as I drove myself closer …

Laurie's Greenhouse, Elizabeth G. Mcandrew, Kelsey Albert

Akesis

Pottery by: Elizabeth McAndrew

Photography by: Kelsey Albert and Elizabeth McAndrew

Modeling: Laurie the Bird

Materials: Wheel thrown pottery - Cone 10 white clay and dipped glaze (cobalt blue and mossy green). Philodendron Heartleaf Plant. Laurie is a parrotlet, which is the second smallest species of parrot. Photo editing was done directly on the iPhone photo application.

This photo represents beginnings because it includes many elements of my life that I drew toward me in the year that I began my medical career. Living alone for the first time, I bought plants so that I wasn't the only living thing …

Beginnings, Nehal J. Shah

Akesis

The beginning of one thing signifies the end of another – for one to start, another must end. With that said, under karmic and Hindu belief, we are constantly in a cycle of beginnings, and endings, until we achieve “moksha” – true oneness with God. Furthermore, within each cycle, there are four stages of life that one hopes to go through, carrying out the ideal goals and progress of each existence. Therefore, this life ultimately is a new beginning to an old soul – a soul that has traveled and journeyed upon eons of time to find happiness, spirituality, completeness …

Beginnings: A Letter From The Editors, Akesis Editors

Akesis

The editors would like to welcome you to the inaugural issue of Akesis.

Latest Jcph Capstones In The Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

A new batch of capstone presentations from the Jefferson College of Population Health have been loaded in the Jefferson Digital Commons.

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 …

2015 December 15 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Aileen Ishuin Macmillan, Aileen Ishuin Macmillan, Kelsey Duinkerken

Jefferson Nursing Oral Histories

Aileen Ishuin MacMillan did not grow up wanting to be a nurse, but after two years of college in Montclair not knowing what she wanted to do, Ms. MacMillan decided by chance to pursue nursing at Jefferson. After graduating in 1976 from the Diploma program she took a job as a nurse in the maternity ward of Thomas Jefferson University Hospital. During her forty year career at Jefferson Ms. MacMillan also completed her BSN at Gwynedd Mercy University. She remains very involved in Jefferson Nursing, serving on both the Jefferson Nursing College Alumni Board and, as president, on the Diploma …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Segmentation And Strain Mapping Of A Beating Heart, Kenna Middleton

McKelvey School of Engineering Graduate Student Theses & Dissertations

Conventional methods of estimating deformation optically often compare image intensities before and after deformation to help estimate the strain fields. However, these current meth ods often introduce undesirable error that propagates through the system, growing larger through each strain calculation. These errors create false, concentrated regions of strain throughout the image. Additionally, gathering and evaluating images in three- and four dimensional space creates even more difficulty for conventional methods. Here, by imple menting new techniques of gathering four-dimensional ultrasound data sets and calculating deformation fields with traditional errors reduced three-fold, four-dimensional images were evaluated to create a novel visualization tool …

Community Emergency Medicine: Benefits And Challenges Of Screening For Elder Abuse In The Emergency Department Of A Developing Country, Muhammad Akbar Baig, Asad Mian, Erfaan Hussain, Shahan Waheed

Department of Emergency Medicine

No abstract provided.