Medicine and Health Sciences Commons^™

Perioperative Nurses’ Attitudes Toward The Electronic Health Record, Laura S. Yontz, Jennifer L. Zinn, Edward J. Schumacher

Health Care Administration Faculty Research

Background: The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. There are limited data; however, regarding the attitudes of perioperative nurses toward the use of the EHR.

Purpose: The purpose of this project was to identify perioperative nurses’ attitudes toward the use of the EHR.

Design: Quantitative descriptive survey was used to determine attitudes toward the electronic health record.

Methods: Perioperative nurses in a southeastern health system completed an online survey to determine their attitudes toward the EHR in providing patient …

The Current State Of Physical Therapy Pain Curricula In The United States: A Faculty Survey, Marie K. Hoeger Bement, Kathleen A. Sluka

Physical Therapy Faculty Research and Publications

Insufficient pain education is problematic across the health care spectrum. Recent educational advancements have been made to combat the deficits in pain education to ensure that health care professionals are proficient in assessing and managing pain. The purpose of this survey was to determine the extent of pain education in current Doctorate of Physical Therapy schools in the United States, including how pain is incorporated into the curriculum, the amount of time spent teaching about pain, and the resources used to teach about pain. The survey consisted of 10 questions in the following subject areas: basic science mechanisms and concepts …

Target Zero: Why States Choose To Eradicate Infectious Diseases And How They Succeed, Gifty Abraham

Dissertations, Theses, and Capstone Projects

Realism has remained the dominant paradigm within international relations for most of the modern era, emphasizing the competitive nature of the international arena and the unlikeliness of states to within it to cooperate. The attempts and further still, successes, by states to eradicate infectious diseases--which remain among the most cooperative enterprises--present a number of challenges to realism's assumptions, particularly with respect to the unlikely world historical-times during which the eradication campaigns took place. As such, a two-part puzzle arises. First, why would states, which are natural competitors, cooperate to eradicate infectious diseases given structural and situational incentives not to do …

Tcr Alpha Lcr And Non-Lcr Cis-Elements Contributing To Tissue Specific Expression Of The Tcr Alpha Gene In Thymic And Peripheral T Cells, Martina Kucerova-Levisohn

Dissertations, Theses, and Capstone Projects

Orchestrated expression of multiple genes residing in the complex TCRα/δ/Dad1 locus requires tight control from multiple cis-acting elements. The TCRα locus control region (LCR), is positioned between TCRα and Dad1 gene, and has been implicated in the differential expression of both genes. In this study, we focus our work on the hypersensitive site (HS)1 prime (HS1'), located 3' of the classical Eα enhancer, within the TCRα LCR. We investigated its non- redundant role in TCRα expression in thymic and peripheral T cells as assayed by in vivo and in vitro studies. Furthermore, formation of HS1' in both lymphoid and …

Risk Factors And Costs Influencing Hospitalizations Due To Heat-Related Illnesses: Patterns Of Hospitalization, Michael T. Schmeltz

Dissertations, Theses, and Capstone Projects

The objective of this dissertation was to identify individual and environmental risk factors, investigate outcomes and hospital resource use, including costs, and document the pattern of heat-related illness hospitalizations in the United States. The main data source for the study population was the 2001-2010 Nationwide Inpatient Sample (NIS). The study population for heat-related illnesses (HRIs) consists of patients in the NIS with at least one diagnosis of a heat-related illness (ICD-9 codes 992.0 - 992.9) from 2001 to 2010. Outcome analysis included a study population of patients who had primary or secondary diagnoses of diabetes, cardiovascular diseases, respiratory illnesses, nephritic …

On Voxel-By-Voxel Accumulated Dose For Prostate Radiation Therapy Using Deformable Image Registration., Jialu Yu, Nicholas Hardcastle, Kyoungkeun Jeong, Edward T. Bender, Mark A. Ritter, Wolfgang A. Tomé

Department of Radiation Oncology Faculty Papers

Since delivered dose is rarely the same with planned, we calculated the delivered total dose to ten prostate radiotherapy patients treated with rectal balloons using deformable dose accumulation (DDA) and compared it with the planned dose. The patients were treated with TomoTherapy using two rectal balloon designs: five patients had the Radiadyne balloon (balloon A), and five patients had the EZ-EM balloon (balloon B). Prostate and rectal wall contours were outlined on each pre-treatment MVCT for all patients. Delivered fractional doses were calculated using the MVCT taken immediately prior to delivery. Dose grids were accumulated to the last MVCT using …

How Joint Torques Affect Hamstring Injury Risk In Sprinting Swing-Stance Transition, Yuliang Sun, Shutao Wei, Yunjian Zhong, Li Li, Yu Liu

Health Sciences & Kinesiology: Faculty Publications

Purpose: The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting.

Methods: Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated.

Results: During the initial stance phase, the ground reaction force passed anteriorly to the …

Whole Genome Sequencing Based Characterization Of Extensively Drug-Resistant Mycobacterium Tuberculosis Isolates From Pakistan, Asho Ali, Zahra Hasan, Ruth Mcnerney, Kim Mallard, Grant Hill Cawthorne, Francesc Coll, Mridul Nair, Arnab Pain, Taane G. Clark, Rumina Hasan

Department of Pathology and Laboratory Medicine

Improved molecular diagnostic methods for detection drug resistance in Mycobacterium tuberculosis (MTB) strains are required. Resistance to first- and second- line anti-tuberculous drugs has been associated with single nucleotide polymorphisms (SNPs) in particular genes. However, these SNPs can vary between MTB lineages therefore local data is required to describe different strain populations. We used whole genome sequencing (WGS) to characterize 37 extensively drug-resistant (XDR) MTB isolates from Pakistan and investigated 40 genes associated with drug resistance. Rifampicin resistance was attributable to SNPs in the rpoB hot-spot region. Isoniazid resistance was most commonly associated with the katG codon 315 (92%) mutation …

Comprehensive Assessment Of The Disputed Ret Y791f Variant Shows No Association With Medullary Thyroid Carcinoma Susceptibility, Rodrigo A. Toledo, Roxanne Hatakana, Delmar M. Lourenço, Susan C. Lindsey, Cleber P. Camacho, Marcio A. Almeida, José V. Lima, Tomoko Sekiya, Elena Garralda, John Blangero

School of Medicine Publications

Accurate interpretation of germline mutations of the rearranged during transfection (RET) proto-oncogene is vital for the proper recommendation of preventive thyroidectomy in medullary thyroid carcinoma (MTC)-prone carriers. To gain information regarding the most disputed variant of RET, ATA-A Y791F, we sequenced blood DNA samples from a cohort of 2904 cancer-free elderly individuals (1261 via Sanger sequencing and 1643 via whole-exome/genome sequencing). We also accessed the exome sequences of an additional 8069 individuals from non-cancer-related laboratories and public databanks as well as genetic results from the Catalogue of Somatic Mutations in Cancer (COSMIC) project. The mean allelic frequency observed in the …

An Examination Of The Effect Of Vision-Related Factors And Availability Of Health Care Resources On Depression, Functional Status, And Falls Among New York City Senior Center Attendees, Lauren Evans

Dissertations, Theses, and Capstone Projects

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic …

Abuse Among School Going Adolescents In Three Major Cities Of Pakistan: Is It Associated With School Performances And Mood Disorders?, Saleem Khawaja, Adeel Khoja, Komal Motwani

Department of Medicine

Objective: To assess the proportion of various types of abuses and their association with school performances and psychological stress among adolescents from three major cities of Pakistan.

Methods: The cross-sectional school survey was conducted from March to September 2009, comprising adolescent students at six schools in Karachi, Lahore and Quetta. Data was collected using a self-administered and pre-tested questionnaire by trained medical students. SPSS 16 was used for statistical analysis..

Results: Of the 414 subjects in the study, there were 223(54%) boys and 191(46%) girls with an overall mean age of 14.36 ±1.08 years. In all, 140(33.7%) participants were physically …

Study Protocol: Asymptomatic Intracranial Atherosclerotic Disease In Pakistanis., Ayeesha Kamran Kamal, Farzin Majeed,, Omrana Pasha, Muhammad Islam, Iqbal Azam Syed, Muhammad Saleem Ilyas, Munawar Hussain, Kamran Masood, Bilal Ahmed, Sumaira Nazir,, Zafar Sajjad, Scott E. . Kasner

Department of Medicine

Background : Intracranial atherosclerotic disease (ICAD) is the most frequent subtype of ischemic stroke globally. It is important to describe the determinants of early ICAD as a strategy to prevent strokes from clinically evident and progressive ICAD. Our objective is to report the determinants of asymptomatic ICAD by linking the presence or absence of ICAD on magnetic resonance angiogram (MRA) with detailed risk assessment in asymptomatic adults.

Methods : This is an observational cross-sectional analytical study. We plan to recruit 200 adult participants from the radiology departments of two tertiary care centers of Karachi, Pakistan. The participants will first be …

Study Protocol: Validation And Adaptation Of Community-Worker-Administered Stroke Symptom Questionnaire In A Periurban Pakistani Community To Determine Disease Burden., Maria Khan, Ayeesha Kamran Kamal, Omrana Pasha, Muhammad Islam, Iqbal Azam Syed, Azam Virk, Alia Nasir, Anita Andani, Muhammad Jan, Anjum Akhtar, Junaid Abdul Razzak

Department of Medicine

Background : Stroke is the second leading cause of mortality and the leading cause of disability in the world today. The disease burden is on the rise in developing nations, but there is scarcity of data from these regions to inform policy decisions. Stroke burden can be determined by clinical diagnosis alone in the public health context and is a far more feasible way to assess disease status in low- to middle-income countries like Pakistan. We aim to translate and adapt a validated stroke symptom questionnaire, train community health workers in its administration, and verify it against assessment by two …

The Template Of Events For Applied And Critical Healthcare Simulation (Teach Sim): A Tool For Systematic Simulation Scenario Design, Lauren E. Benishek, Elizabeth H. Lazzara, William L. Gaught, Lygia L. Arcaro, Okuda Yasuharu, Eduardo Salas

Publications

Simulation-based training (SBT) affords practice opportunities for improving the quality of clinicians’ technical and nontechnical skills. However, the development of practice scenarios is a process plagued by a set of challenges that must be addressed for the full learning potential of SBT to be realized. Scenario templates are useful tools for assisting with SBT and navigating its inherent challenges. This article describes existing SBT templates, explores considerations in choosing an appropriate template, and introduces the Template of Events for Applied and Critical Healthcare Simulation (TEACH Sim) as a tool for facilitating the formation of practice scenarios in accordance with an …

Rural Emergency Nurses' End-Of-Life Care Obstacles Experiences: Stories From The Last Frontier, Jonathan Rohwer

Theses and Dissertations

Introduction: Rural emergency nurses face unique obstacles to providing quality end-of-life (EOL) care. Stories provided by emergency nurses embody their most difficult EOL care obstacles. Methods: A questionnaire was sent to 53 rural hospitals. Respondents were asked to share stories that epitomized the obstacles faced while providing EOL care in the rural emergency setting. Results: The lack of an ideal death (nurse personally knows the patient, issues with family members, and unknown patient wishes) was the top obstacle. Other reported obstacles were insufficient ED staff and power struggles between nurses and physicians. Discussion: Rural emergency nurses often provide EOL care …

Disrupting Sumoylation Enhances Transcriptional Function And Ameliorates Polyglutamine Androgen Receptor-Mediated Disease, Jason P. Chua, Satya L. Reddy, Zhigang Yu, Elisa Georgetti, Heather L. Montie, Sarmistha Mukherjee, Jake Higgins, Richard C. Mceachin, Diane M. Robins, Diane E. Merry

PCOM Scholarly Works

Expansion of the polyglutamine (polyQ) tract within the androgen receptor (AR) causes neuromuscular degeneration in individuals with spinobulbar muscular atrophy (SBMA). PolyQ AR has diminished transcriptional function and exhibits ligand-dependent proteotoxicity, features that have both been implicated in SBMA; however, the extent to which altered AR transcriptional function contributes to pathogenesis remains controversial. Here, we sought to dissociate effects of diminished AR function from polyQ-mediated proteotoxicity by enhancing the transcriptional activity of polyQ AR. To accomplish this, we bypassed the inhibitory effect of AR SUMOylation (where SUMO indicates small ubiquitin-like modifier) by mutating conserved lysines in the polyQ AR that …

Overview Of Microrna Biology, Ashley M. Mohr, Justin L. Mott

Journal Articles: Biochemistry & Molecular Biology

In considering an overview of microRNA biology, it is useful to consider microRNAs as a part of cellular communication. At the simplest level, microRNAs act to decrease the expression of mRNAs that contain stretches of sequence complementary to the microRNA. This function can be likened to the function of endogenous or synthetic short interfering RNA (siRNA). However, microRNA function is more complicated and nuanced than this ‘on-off’ model would suggest. Further, many microRNA targets are themselves non-coding RNAs. In this review, we will discuss the role of microRNAs in shaping the proteome of the cell in a way that is …

Mindfulness At Work: Antecedents And Consequences Of Employee Awareness And Absent-Mindedness, Jochen Reb, Jayanth Narayanan, Zhi Wei Ho

Research Collection Lee Kong Chian School Of Business

The present study examines antecedents and consequences of two aspects of mindfulness in a work setting: employee awareness and employee absent-mindedness. Using two samples, the study found these two aspects of mindfulness to be beneficially associated with employee well-being, as measured by emotional exhaustion, job satisfaction, and psychological need satisfaction, and with job performance, as measured by task performance, organizational citizenship behaviors, and deviance. These results suggest a potentially important role of mindfulness at the workplace. The study also found that organizational constraints and organizational support predicted employee mindfulness, pointing to the important role that the organizational environment may play …

Improved Systemic Saturation After Ventricular Assist Device Implantation In A Patient With Decompensated Dextro-Transposition Of The Great Arteries After The Fontan Procedure, Ali Abdul Jabbar, Wayne J Franklin, Leo Simpson, Andrew B Civitello, Reynolds M Delgado, O H Frazier

The Texas Heart Institute Journal

We report the successful implantation of a HeartMate II left ventricular assist device after a failed Fontan procedure in a patient with dextro-transposition of the great arteries. The patient had developed significant intrapulmonary arteriovenous shunting. Despite the theoretical risk of worsening intrapulmonary shunting due to the decrease in systemic vascular resistance after device implantation, our patient did well. He was discharged from the hospital in stable condition and had better oxygen saturation than before the device was implanted. To our knowledge, ours is the 2nd report of the use of a ventricular assist device after the failure of a Fontan …

Impact And Predictors Of Noncircular Left Ventricular Outflow Tract Shapes On Estimating Aortic Stenosis Severity By Means Of Continuity Equations, Nirmanmoh Bhatia, Buddhadeb Dawn, Tariq S Siddiqui, Marcus F Stoddard

The Texas Heart Institute Journal

Determining aortic stenosis (AS) severity is clinically important. Calculating aortic valve (AV) area by means of the continuity equation assumes a circular left ventricular outflow tract (LVOT). The full impact of this assumption in calculating AV area is unknown. Predictors of noncircular LVOT shape in patients with AS are undefined.

In 109 adult patients with AS who underwent multiplanar transesophageal echocardiography, we calculated AV area by means of the standard continuity method and by a modified method involving planimetric LVOT area.

We found 54 circular, 37 horizontal-oval, 8 vertical-oval, and 10 irregular LVOTs. Area derived by direct planimetry correlated better …

Taking The Risk: The Other Side Of The Story, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Echocardiographic Versus Histologic Findings In Marfan Syndrome, Xiaoyan Gu, Yihua He, Zhian Li, Jiancheng Han, Jian Chen, J V Ian Nixon

The Texas Heart Institute Journal

This retrospective study attempted to establish the prevalence of multiple-valve involvement in Marfan syndrome and to compare echocardiographic with histopathologic findings in Marfan patients undergoing valvular or aortic surgery.

We reviewed echocardiograms of 73 Marfan patients who underwent cardiovascular surgery from January 2004 through October 2009. Tissue histology was available for comparison in 29 patients.

Among the 73 patients, 66 underwent aortic valve replacement or the Bentall procedure. Histologic findings were available in 29 patients, all of whom had myxomatous degeneration. Of 63 patients with moderate or severe aortic regurgitation as determined by echocardiography, 4 had thickened aortic valves. The …

Early Detection Of A Cavopulmonary Tumor Embolus With The Use Of Transesophageal Echocardiography, Magdy M El-Sayed Ahmed, Raed M Al-Najjar, Muhammad Aftab, James M Anton, John S Colen, Ross M Reul

The Texas Heart Institute Journal

Pulmonary tumor embolization from renal cell carcinoma is associated with severe cardiopulmonary morbidity and high perioperative mortality rates. We report the case of a 71-year-old woman who presented with right-sided abdominal pain. Magnetic resonance images revealed a mass originating from the upper pole of the right kidney and extending into the infrahepatic portion of the inferior vena cava. Transesophageal echocardiography was continuously used to monitor the mass during intended radical nephrectomy and tumor resection. When the right kidney was mobilized, intracaval thrombus detached and migrated to the patient's right atrium, causing severe hemodynamic instability. After emergent sternotomy and during the …

Pleiotropic Locus For Emotion Recognition And Amygdala Volume Identified Using Univariate And Bivariate Linkage, Emma E.M. Knowles, Reese Mckay, Jack W. Kent, Emma Sprooten, Melanie A. Carless, Joanne E. Curran, Marcio A. Almeida, Thomas D. Dyer, Harald H.H. Göring, Ravi Duggirala, John Blangero

School of Medicine Publications

Objective: The role of the amygdala in emotion recognition is well established, and amygdala volume and emotion recognition performance have each been shown separately to be highly heritable traits, but the potential role of common genetic influences on both traits has not been explored. The authors investigated the pleiotropic influences of amygdala volume and emotion recognition performance. Method: In a sample of randomly selected extended pedigrees (N=858), the authors used a combination of univariate and bivariate linkage to investigate pleiotropy between amygdala volume and emotion recognition performance and followed up with association analysis. Results: The authors found a pleiotropic region …

Preconception And Early Pregnancy Air Pollution Exposures And Risk Of Gestational Diabetes Mellitus, Candace Robledo, Pauline Mendola, Edwina H. Yeung, Tuija Männistö, Rajeshwari Sundaram, Danping Liu, Qi Ying, Seth Sherman, Katherine Grantz

School of Medicine Publications

Background: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk.

Methods: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5μm (PM2.5) and PM2.5 constituents, PM ≤ 10μm (PM10), nitrogen oxides (NOx), carbon monoxide, sulfur dioxide (SO2) and ozone (O3) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1-24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. …

Bridging The Vocabulary Gap Between Health Seekers And Healthcare Knowledge, Liqiang Nie, Yiliang Zhao, Akbari Mohammad, Jialie Shen, Tat-Seng Chua

Research Collection School Of Computing and Information Systems

The vocabulary gap between health seekers and providers has hindered the cross-system operability and the interuser reusability. To bridge this gap, this paper presents a novel scheme to code the medical records by jointly utilizing local mining and global learning approaches, which are tightly linked and mutually reinforced. Local mining attempts to code the individual medical record by independently extracting the medical concepts from the medical record itself and then mapping them to authenticated terminologies. A corpus-aware terminology vocabulary is naturally constructed as a byproduct, which is used as the terminology space for global learning. Local mining approach, however, may …

Population Health: Where's The Beef?, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Pediatric Solid Organ Transplant Recipients: Transition To Home And Chronic Illness Care, Stacee M. Lerret, Marianne E. Weiss, Gail Stendahl, Shelley Chapman, Jerome Menendez, Laurel Williams, Michelle L. Nadler, Katie Neighbors, Katie Amsden, Yumei Cao, Melodee Nugent, Estella M. Alonso, Pippa Simpson

College of Nursing Faculty Research and Publications

Pediatric SOT recipients are medically fragile and present with complex care issues requiring high-level management at home. Parents of hospitalized children have reported inadequate preparation for discharge, resulting in problems transitioning from hospital to home and independently self-managing their child's complex care needs. The aim of this study was to investigate factors associated with the transition from hospital to home and chronic illness care for parents of heart, kidney, liver, lung, or multivisceral recipients. Fifty-one parents from five pediatric transplant centers completed questionnaires on the day of hospital discharge and telephone interviews at three wk, three months, and six months …

Retrospective Electronic Health Record Review Of Preoperative Screening Of Candidates For Total Joint Replacement, Jill Ann Rude

Dissertations

Advanced practice nurses (APNs) play an important role in preoperative screening. The purpose of this project was to determine the effectiveness of pre-operative screening criterion established February 2012 for patients greater than 40 years old who underwent total knee or hip replacement surgery. Of the 1850 electronic health records reviewed, 1065 (57.6%) total knee and total hip replacement surgeries took place before and 785 (42.4%) took place after screening criteria were implemented. Before implementation of screening criteria 53 (4.98%) patients experienced critical changes (code blue or critical assessment team call); after the implementation of screening 30 (3.82%) patients experienced critical …

Supporting Football: The Physical Damage Of The Game, Greg Youngblood

Faculty Work Comprehensive List

"How ethical it is to support football since it is a sport that 'wreaks devastation on brains and condemns many players to diminished brain functioning, premature dementia, and the like.' ... Instead of asking if supporting football is moral or not I believe we should be asking ourselves as players, coaches, and fans how can we use the gifts, talents and abilities God has given us to create a culture in sports where we demonstrate the spirit of God and work for his glory."

Posting about the morality of supporting football as well as ethics in football from a Christian …