Medicine and Health Sciences Commons^™

Improving Compliance With Clinical Practice Guidelines To Reduce Urinary Tract Infection In Long Term Care, Charman L. Miller

Doctor of Nursing Practice Program Projects

This evidence-based clinical change project addressed the clinical problem trigger of increased rates of urinary tract infections and related unplanned discharges in a rural Ohio nursing center. The clinical change involved the implementation of a nursing-driven protocol for suspected Urinary Tract Infection (sUTI) based on the American Medical Director’s Association Clinical Practice Guideline: Common Infections. An interdisciplinary team approach to evidence-based clinical change was utilized through use of the Iowa Model of Evidence-based Practice to Promote Quality Care. Both the process and the intervention were evaluated through analysis of outcome data including rates of urinary tract infection, compliance with the …

Use Of Change Agent To Facilitate Implementation Of Personalized Health Plans, Colleen Miranda

Doctor of Nursing Practice Program Projects

In 2015, the Centers of Disease Control and Prevention reported that the most common, costly but preventable health problems are heart disease, stroke, cancer, diabetes, obesity, and arthritis. Literature shows preventable chronic diseases have increased in the current healthcare system. Healthcare leaders are calling for a change in the current faulty healthcare delivery system to personalized healthcare. A patient-centered approach focuses on the health gains that can be made in the prevention and treatment of chronic disease with a higher level of patient engagement.

The Veterans Health Administration (VHA) is advocating patient-centered care (PCC) to focus on the health gains …

Characterization Of Calbindin Positive Interneurons Within The Ventral Horn Of The Mouse Spinal Cord, Taylor L. Floyd, David R. Ladle

Celebration of Undergraduate & Graduate Research, Scholarship, and Creative Activities Materials

Sensory-motor circuits in the spinal cord integrate sensory feedback from muscles and modulate locomotor behavior. Although we know how the sensory-motor system generally works, the main issue lies in identifying all neurons involved and understanding their interrelationships. Many interneurons contribute to sensory-motor circuits and have been well studied. For example, Renshaw cells (RC) are inhibitory interneurons that prevent motor neurons from over-activity. A distinguishing feature of RCs is that they are the only interneurons within the ventral-most region of the spinal cord expressing the calcium binding protein calbindin (CB). Recent studies have found other subpopulations of ventral horn interneurons outside …

Appropriate Timing Of Fluoxetine And Statin Delivery Reduces The Risk Of Secondary Bleeding In Ischemic Stroke Rats, Maria Helen Harley Balch, Moner A. Ragas, Danny Wright, Kenny Reynolds, Bryce Kerr, Adrian M. Corbett

Neuroscience, Cell Biology & Physiology Faculty Publications

Background: Ongoing clinical trials are testing the effect of fluoxetine delivered post-stroke where a majority of patients are taking statins. This study determined the influence of the timing of administration of fluoxetine and statin on the final infarct volume and the risk of secondary bleeding in an animal model of ischemic stroke.

Methods and findings: Ischemic strokes were induced by endothelin-1 injection into two cortical sites of 10-12 month old female rats, targeting the forelimb motor cortex. Combined medications (5 mg/kg fluoxetine and 1 mg/kg simvastatin) were orally administered either beginning 6-12 hours or 20-26 hours after stroke induction and …

Healthcare Industry Injuries By Patient Contact Status In Kentucky, 2012-2014, Kristen Ranzenberger

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives

The healthcare industry continues to have a high number of reported injuries. The purpose of this study was to 1) characterize healthcare industry injuries by patient contact status; 2) identify the occupations associated with healthcare injuries by patient contact status; and 3) determine healthcare injury rates by occupation, to gain a better understanding of healthcare industry compensated injuries , and better target healthcare industry safety practices and programs.

Methods

Workers’ Compensation first reports of injuries (FROI) from the healthcare industry in Kentucky were categorized into injuries involving in direct patient contact vs. injuries without direct patient contact using narrative …

Are There Delays In Receipt Of Treatment Among Appalachian Kentucky Women With Breast Cancer, Huong Thi Thanh Luu

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Women living in rural and under-resourced Appalachian Kentucky may experience delays in receiving cancer treatment yet such delays have not been systematically evaluated. In this analysis, we hypothesize that women diagnosed with breast cancer who live in Appalachian Kentucky would be more likely to have a treatment delay compared to those living in other Kentucky regions and adjusting for individual measures of socioeconomic status.

Methods: In this cohort study, women included in the Kentucky Cancer Registry with a diagnosis of an incident, primary breast cancer in the prior 12 months were interviewed by phone (n=1,245; response rate 26.9%). Cox …

Examining Alcohol Consumption, Psychological Distress, And Current Smoking Status: Results From The Behavioral Risk Factor Surveillance System, 2013, Guangxing Zhan

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Approximately 443,000 people die from smoking or exposure to secondhand smoke, and another 8.6 million people have a serious smoking-related illness, which costs nearly $96 billion in health-care expenditures and $97 billion in productivity losses annually in the United States. This study examined the association between alcohol consumption and smoking status, and how psychological distress can affect this association. Methods: Data come from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). We used binary logistic regression models to compute adjusted odds ratios between alcohol consumption and smoking status, controlling for age, gender, race, education, and income. We used chi-square …

Associations Among Sexual Violence, Risky Sexual Behaviors, And Substance Abuse: Risk And Protective Factors Among Women From The National Survey Of Family Growth, Michelle Kroger

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: Millions of women experience sexual violence which results in a plethora of adverse health consequences. Given the scope of the problem, more attention is needed to examine the complexities in which sexual violence occurs, and possible associations among sexual violence and related health behaviors. The present study analyzes whether a significant association between sexual violence and condom use and/or sexually transmitted diseases (STDs) exists, and whether consuming alcohol and/or drugs increases women’s risk of having unprotected sex and/or an STD.

Methods: Data from the National Survey of Family Growth 2006-2010 and 2011-2013 were analyzed using bivariate and multivariate chi-square …

Rural Healthcare Worker's Willingness To Report To Work During Catastrophic Events, Aaron M. Macdonald

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the events leading up to, during, and following a catastrophic event, healthcare workers play a critical role in the outcome of these events. Therefore it is of the utmost importance that healthcare workers are able and willing to report to work. Prior to September, 2001 there had been three willingness to report studies published in the literature. Post September, 2001 and up until 2011 there was a renewed interest in the topic which led to the publishing of twenty plus papers on the topic. The current literature has examined willingness to report thoroughly and definitively; however, there is a …

A Profession Without Limits: The Changing Role Of Reference Librarians, Elaine Sullo, Laura E. Abate, Thomas Harrod, Gisela Butera, Alexandra Gomes, Paul Levett

Himmelfarb Library Faculty Posters and Presentations

Librarians have taken on new and evolving roles, many of which have come about based on a need that can be uniquely satisfied with a librarian's background and expertise. Some roles have simply been filled due to a librarian's availability and willingness to volunteer for something new. In considering how these roles will continue to evolve and affect our daily work, we've identified and categorized the changing roles and responsibilities of Himmelfarb health science librarians.

Treating Acute Migraines: Triptans Vs. Antiemetics, Samuel Reisman

The Science Journal of the Lander College of Arts and Sciences

Influential American medical organizations and publications have published guidelines for the treatment of acute migraine headaches that omit antiemetics, usually suggesting triptans as the first line of treatment. A review of the few comparative studies directly contrasting clinical outcomes of triptans and antiemetics in the treatment of acute migraines suggest that both treatment options are relatively equal in efficaciousness. The added burden of triptan usage, including an added risk of adverse effects and a high cost per dose, would seem to warrant an antiemetic-first approach to migraine treatment, as recommended by several international health communities. Possible reasons for the prominent …

Vigorous Exercise Effect On Cardiovascular Health, Aryeh Mahana

The Science Journal of the Lander College of Arts and Sciences

Many studies examine the effects of vigorous cardiovascular exercise on the heart. Intense exercise causes frequent muscle contractions in the heart and specific biomarkers that usually signify a myocardial infarction are released into the bloodstream. However, studies indicate that there might not be a correlation between the release of biomarkers and cardiac function. Another study shows that long term vigorous exercise negatively affects the heart by dramatically increasing the mass and volume of the right and left ventricles, thereby resulting in hypertrophy. The cardiac hypertrophy is still evident even after the subjects have stopped exercising. Cardiac hypertrophy results in myocardial …

Mechanisms, Potential Therapies, And The Role Of Tgf-Β In The Formation Of Scars, Isaac Traube

The Science Journal of the Lander College of Arts and Sciences

Scarring is the inevitable outcome of wound healing. This review looks at some of the underlying mechanisms of this complex process with the aim of identifying targets for therapeutic manipulation that could result in reduced scarring or even scarless wound repair. Fetal wounds are shown to heal without scars primarily due to low levels of TGF-β1 and TGF-β2 and high levels of TGF-β3 as compared to adult wounds which heal with scars. Abnormal excessive scarring in keloid and hypertrophic scars are also attributed to TGF-β. Clinical manipulation of TGF-β ratios showed promise as a therapeutic means of controlling scar formation. …

Short-Term Effects On The Fetus And Long-Term Outcome On Children Exposed To Maternal Chemotherapy, Yocheved Kramer

The Science Journal of the Lander College of Arts and Sciences

Ethical questions with regard to treatment arise when pregnant women are diagnosed with cancer. Does the health of the mother or the health of the fetus take priority? However, research suggests that concern over transplacental transfer should not deter those seeking treatments since avoidance of favorable transfer drugs can allow chemotherapy to be a viable option if properly administered. Doctors highly contraindicate the use of chemotherapeutic drugs in the first trimester due to high risks such as teratogenesis and fetal death. However, they reassure that treatment can be given in the final two trimesters. It presents minimal consequences as long …

Transposon Based Gene Therapy As A Treatment For Cancer, Jacob Stauber

The Science Journal of the Lander College of Arts and Sciences

Gene therapy is the use of genes to treat or prevent diseases. Diseases such as cancer, which are difficult to treat using conventional methods, can be treated using gene therapy. The transport of the therapeutic transgene can be accomplished using viral or non-viral methods. However, widespread use of viral vectors is limited due to its high cost of manufacture and safety concern. Non-viral vectors are limited in their effectiveness. The use of transposons such as the Sleeping Beauty transposon system can effectively deliver the transgene with less concern than viral vectors. This review discusses the various vectors and treatment strategies …

Is Proton Beam Therapy More Effective Than Intensity-Modulated Radiotherapy In Prostate Cancer Treatment?, Daniel Zelefsky

The Science Journal of the Lander College of Arts and Sciences

Prostate cancer is the most common form of cancer found in American males. Breaking technological advances in prostate cancer treatment continue to develop to help fight this disease, one such is proton beam therapy. Proton beam therapy is theorized to spare even more healthy tissue than photon radiotherapy because it delivers a majority of its radiation during the Bragg peak. Since this technology is substantially costlier than any other form of radiation therapy, physicians are assessing its effectiveness and determining if it is worth the cost. Currently, there is no significant difference seen in patient quality of life between recipients …

Is There A Link Between Saturated Fat Intake And Alzheimer’S Disease?, Justin Konig

The Science Journal of the Lander College of Arts and Sciences

Alzheimer’s disease is a neurodegenerative disease that causes dementia and ultimately death. Currently, there is no treatment available for this disease. The aging of the population will only increase the incidence of Alzheimer’s disease, making it ever more important to find an effective method of prevention. Dietary intervention is a practical and affordable method of intervention. The brain is a fat rich organ, and dietary fats are critical for proper development of the brain. A literature review was conducted to determine whether there is a link between saturated fat intake and Alzheimer’s disease. According to the literature reviewed, saturated fat …

Regulation Of Ghrelin: A Possible Treatment Option For Obesity And Diabetes, Sarah Picciotto

The Science Journal of the Lander College of Arts and Sciences

Obesity is a mounting problem in America today. One major concern about obesity is that it is a risk factor for type 2 diabetes, a disease that impairs insulin sensitivity and secretion. This interferes with blood glucose levels and can cause hyperglycemia, which is when there is too much circulating glucose in the blood. Ghrelin, an amino acid peptide responsible for appetite stimulation and energy balance, plays a direct role in insulin secretion and glucose metabolism. In many experiments, elevated ghrelin levels are associated with decreased insulin secretion from pancreatic islet cells. Although ghrelin concentration is decreased in obese individuals …

Nanotechnology, Zisi Hursarsky

The Science Journal of the Lander College of Arts and Sciences

Nanoparticles are gaining immense popularity in the medical world, specifically in its use in drug delivery systems. The objective of this paper is to study, based on available published literature, how nanoparticles are utilized in drug delivery and more importantly to identify the potential toxic effects of nanoparticles. Based on textual research, it is clear that there are benefits to nanoparticle use, but new studies are showing that there are many potential hazards of nanoparticle-like particles. In order to fully determine the toxicity of the hundreds of types of nanoparticles, a clear method to categorize these particles is needed and …

Viability Of Sirna As A Clinical Treatment, Zev Blumenkranz

The Science Journal of the Lander College of Arts and Sciences

The purpose of this paper is to better understand the methods problems and some solutions for siRNA treatments. The benefits of this novel medical treatment are explored and its benefits are expounded on by comparing it to other more complex and futuristic treatments. The exact process of siRNA silencing and down regulation is unknown. Some hypotheses of how it may work are discussed giving precedence to the most widely accepted hypothesis. Although siRNA treatments are not yet used on a major scale for many diseases, different possible treatment options are compared and explained. Particular care was taken to give a …

Understanding The Hygiene Hypothesis And Its Mechanisms, Yaakov Tropper

The Science Journal of the Lander College of Arts and Sciences

The hygiene hypothesis provides an explanation for the sharp increase in atopy over the past several decades by proposing that it is inversely related to the lack of infectious diseases in our society. Although atopy, as well as other hypersensitivity reactions, do have a genetic basis; studies clearly show that environmental and socioeconomic factors play a large role in determining which people will develop allergies. Proposed mechanisms leading to this disorder include an imbalance in the Th1/Th2 complex in the immune system, and a deficiency in Regulatory T cells which controls excessive T cell activity.

Project Spraoi: A Strategy To Improve Nutrition And Increase Physical Activity In Primary School Children, Lisa Delaney

Masters

Introduction: Paediatric obesity has become a global epidemic with many countries developing strategies to help tackle its prevalence. School based physical activity (PA) and nutrition interventions have proven to play a promising role in tackling childhood obesity.

Background: Project Spraoi is an Irish primary school based intervention. The intervention was delivered to an intervention school to help enhance PA and nutritional behaviour amongst pupils. The intervention school was assigned an ‘Energizer’; a trained PA and nutrition change agent who worked with the school to achieve the objectives. For evaluation purposes a control school was recruited.

Methodology: Pupils from the intervention …

Gender Difference When Processing Death By Suicide: Attitudes Amongst Third Level Students Aged 18-25 Attending Cork Institute Of Technology And College Support Professionals, Sandra Conroy

Masters

Rationale behind research: Survivors of suicide/ suicide bereaved face unique challenges in their grief, resulting in a greater risk of conditions such as complicated grief, PTSD and suicidal ideation developing (Young, Iglewicz, Glorioso, Lanouette, Seay, llapakurti & Zisook, 2012). In dealing with or 'processing' the loss of a loved one by suicide, Wertheimer details that, "suicidal thoughts are not uncommon during the early months of bereavement" (1991: 178). The incidence of young men dying by suicide is notably higher than that of women in this country; a stubborn gender difference persists in Ireland with males representing on average 80% of …

Student Health Benefits Plan Market Research And Analysis, Zachary William Doucette

Honors Theses and Capstones

The University of New Hampshire (UNH) in Durham, New Hampshire requires all full-time students to have health insurance meeting set requirements as a condition of enrollment. UNH offers its own health plan, entitled the Student Health Benefits Plan (SHBP) through its Health Services Center to students as a way to procure this insurance if they lack insurance, or if their current insurance is insufficient or does not meet the insurance requirements. Health Services at UNH is looking for market research on current attitudes, perceptions, and beliefs of both students at UNH, and the parents of students who currently have a …

Amyotrophic Lateral Sclerosis (Als) And Spinal Muscular Atrophy (Sma): A Genetic Linkage?, Michael Groden

The Science Journal of the Lander College of Arts and Sciences

Neurodegenerative motor neuron disorders (MNDs) have devastating effects. Spinal Muscular Atrophy (SMA), for example, is a debilitating and sometimes lethal disease in children. SMA is monogenic, autosomal recessively inherited disorder caused by a loss-of-function mutation of surviving motor neuron 1 (SMN1). SMN2 is an identical copy of this gene and produces abbreviated transcripts without exon 7 though some full transcripts are produced that ameliorate the disease. Previous clinical trials for this disease have not produced consistent results. However, in a recent cross-sectional study, biomarkers for SMA (BforSMA), protein candidates and metabolite markers were identified (Finkel et al., 2012). These markers …

Pitch-Count And Its Effects On Shoulder Injuries: How To Keep A Pitcher Healthy, Alexander Malek

The Science Journal of the Lander College of Arts and Sciences

Baseball is currently the fourth most popular sport in high schools across the country. However, pitchers are at a high risk to develop career ending injuries. Overuse can result in SLAP tears as well as torn rotator cuff muscles that can end a dream of pitching professionally. Major League Baseball has teamed up with leading sports medicine researchers to determine safe pitch-count guidelines for pitchers of all ages. Articles were found using Touro’s e-Journal database as well as Pubmed.gov to find pertinent research on this topic. Studies on ball velocity and scapular kinematics were done on three different levels of …

Is The Neuraminidase Inhibitor Tamiflu Effective In The Treatment Of Influenza?, Eliyakim Hershkop

The Science Journal of the Lander College of Arts and Sciences

Influenza is a disease that has caused the deaths of tens of millions people in the last century alone. The influenza neuraminidase protein is essential in the mechanism infection. It enables the virus to leave the infected cell and proliferate. Antiviral neuraminidase inhibitor drugs can be used for treatment. The drug Tamiflu is the standard of care for both treatment and prophylaxis of influenza. The Cochrane reports of 2009 and 2014 conclude that evidence is lacking to support this. Numerous bodies disagree. Cochrane also question the accuracy and credibility of many studies and agencies in support of Tamiflu. This paper …

Do Probiotics Effectively Promote Wellbeing?, Tzvi H. Adams

The Science Journal of the Lander College of Arts and Sciences

Probiotics have been commonly ascribed many therapeutic powers. The aim of this review is to investigate these claims. While some of the claims are well supported by research, the effects of probiotics are very specific and depend on the strains used as well as the disease or condition targeted. Age and racial ethnicity may also be factors impacting the efficacy of probiotic strains.

Epigenetics As A Cure For Cancer, Sara Rivka Margolis

The Science Journal of the Lander College of Arts and Sciences

Epigenetics is an emerging research topic that is being tested as a potential cure for cancer. Epigenetics is a non-genetic influence that shapes the phenotype. Epigenetics effects gene expression, but does not cause any changes in the DNA. DNA methylation patterns is one such epigenetic change in the cell that has huge potential for cancer treatment. Scientists have observed that many cancerous genes express signs of either hypermethylation or hypomethylation. The key for the treatment is that epigenetic changes are reversible, which opens the door to potential drugs to cure cancer and other diseases.

Biological Therapy In The Treatment Of Ulcerative Colitis, Tzipora Glanzman

The Science Journal of the Lander College of Arts and Sciences

Ulcerative colitis (UC), a subdivision of inflammatory bowel disease, is a chronic disease of the large intestines. Ulcerative colitis is normally a lifelong chronic illness with times of intense flairs and remission. During a flare, the lining of the colon becomes inflamed, and develops small ulcers causing patients to experience rectal bleeding, vomiting, anemia and diarrhea. The treatment options available to treat colitis are very small, causing many patients to need a total colectomy with in the first five years of their diagnosis. However, recent advancement in bio-technology has led to the development of a large array of new therapeutic …