Medicine and Health Sciences Commons^™

A Brief Overview Of The Life And Work Of Lyon Henry Appleby, M.D. (1895-1970)., Jon Harrison, Michael J. Pucci, Scott W. Cowan, Charles Yeo

Department of Surgery Gibbon Society Historical Profiles

The life and work of Dr. Lyon Henry Appleby, M.D., portrays the essence of a devoted clinician committed to scholarly excellence. Born in Deseronto, Ontario, in 1895 and passing in 1970, Dr. Appleby influenced all areas of general surgery, most notably popularizing a procedure that bears his name today. After a tour in World War I, he quickly proved himself to be a dedicated clinician with roots in academia, which translated into excellence within the Department of Surgery at St. Paul's Hospital in Vancouver, Canada. He served in various leadership roles including Chair of the Department of Surgery, President of …

The Potential Roles Of Long Noncoding Rnas (Lncrna) In Glioblastoma Development, Shuang Liu, Ramkrishna Mitra, Ming-Ming Zhao, Wenhong Fan, Christine M. Eischen, Feng Yin, Zhongming Zhao

Department of Cancer Biology Faculty Papers

Long noncoding RNA (lncRNA) may contribute to the initiation and progression of tumor. In this study, we first systematically compared lncRNA and mRNA expression between glioblastoma and paired normal brain tissues using microarray data. We found 27 lncRNA and 82 mRNA significantly upregulated in glioblastoma, as well as 198 lncRNA and 285 mRNA significantly downregulated in glioblastoma. We identified 138 coexpressed lncRNA–mRNA pairs from these differentially expressed lncRNA and genes. Subsequent pathway analysis of the lncRNA-paired genes indicated that EphrinB–EPHB, p75-mediated signaling, TNFα/NF-κB, and ErbB2/ErbB3 signaling pathways might be altered in glioblastoma. Specifically, lncRNA RAMP2-AS1 had significant decrease of expression …

Interventions To Increase Vaccination Rates In Homeless Adults Aged 50 Years And Older In A Shelter-Based Clinic, Rubeena Smith

Doctor of Nursing Practice

Pronounced disparities in adult immunizations exist across the country. In homeless adults over 50 years of age with chronic diseases, coverage rates for influenza and pneumococcal vaccinations falls at 30% as compared to the 60% coverage rate found in the general public. Hepatitis B immunization rates are also significantly lower in the elderly homeless population. Increased prevalence of chronic diseases in the elderly homeless shelter residents’ increase their risk for severe complications following influenza, hepatitis B and meningococcal infections. To prevent disease epidemics and further disability in the homeless population, the need for appropriate and timely vaccinations is critical. Attitudes …

Improved Medication Management For Elderly Patients Through Increased Review And Documentation, Esmeralda Rivera

Doctor of Nursing Practice

The purpose of this quality improvement project was to improve medication management processes for patients in a wellness center. Medication reconciliation is a safe practice shown to reduce the potential for patient harm by preventing prescribing errors and adverse drug effects. Medication reconciliation includes assessment of medications, development of medication lists, education, and medication counseling for patients (Snyderman, Salzman, Mills, Hersh, & Parks, 2014). Assessment of medication reconciliation in a geriatric wellness center revealed poor medication management. Education on medication management was provided to staff (N = 10) and the workflow was altered to improve processes. Electronic medical records of …

A Systems Intervention For The Transition Of Postpartum Women To Primary Care, Charlotte Jeannette Matthews

Doctor of Nursing Practice

The Institute of Medicine (2001) describes the United States’ healthcare system as poorly organized and difficult for patients to navigate. Patients are often lost during the transition between providers, failing to establish subsequent care (Thomas, 2015). Gaps in care lead to worsening conditions that result in billions of dollars in healthcare costs (National Quality Forum, 2016). Following discharge from the care of the obstetrician, postpartum women should establish care with a primary care provider (American College of Obstetrics and Gynecology, 2016). The American College of Obstetrics and Gynecology recommends that postpartum women transition to a primary care provider within the …

Improving Provider Adherence To Guidelines In Addressing Childhood Overweight And Obesity In A Primary Care Setting, David Hernandez

Doctor of Nursing Practice

The purpose of the quality improvement project was to improve BMI measurement, screening, identification, documentation, and assessment of childhood overweight and obesity among children ages 3 to 18 years old in a primary care setting. Primary care providers continue to fail to address childhood overweight and obesity and have a positive impact on this issue. Delay in early identification and assessment of childhood obesity and overweight may affect patients’ qualify of life and the efficiency of health care. Over the last 30 years, the rates of childhood overweight and obesity have consistently escalated despite the existence of recommended guidelines and …

Improving Foot Care And Kidney Disease Screening Through Implementation Of American Diabetes Association Standards–2016 In The Primary Care Setting, Maricela Hernandez

Doctor of Nursing Practice

The purpose of this quality improvement project was to increase adherence to the American Diabetes Association Standards of Medical Care in Diabetes—2016 recommendations for foot care and kidney disease screening for patients with diabetes mellitus type II in a primary care setting. Diabetes mellitus type II affects approximately 18.9-19.9 million, or 90-95%, of all diagnosed cases in the United States. Early detection and management decrease the risk of developing microvascular complications that may lead to neuropathy and nephropathy. Adults with diabetes mellitus type II, 20 years of age and older, accounted for approximately 73,000 non-traumatic lower-extremity amputations in 2011. Diabetes …

An Initiative To Improve Primary Prevention Of Heart Disease In Adults With Type Ii Diabetes Based On The Acc/Aha (2013) And Ada (2016) Guidelines, Litzie Garza

Doctor of Nursing Practice

Heart disease is the leading cause of death in the United States and in Texas. Hyperlipidemia is a precursor to cardiovascular disease and is a highly manageable and treatable acute and chronic disease in the outpatient primary care setting. This project is designed to increase clinicians’ adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (2016) clinical practice guidelines for the prevention of heart disease in 40 to 75 year old adults with type II diabetes through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a …

Implementation Of Quality Improvement Interventions To Increase Provider Adherence To Standards Of Medical Care In Diabetes, Elizabeth A. Betz

Doctor of Nursing Practice

Purpose: To improve a South Texas primary care clinic’s diabetes management system by implementation of a quality improvement intervention to help staff and medical providers increase adherence to the American Diabetes Association standards of care related to screening referrals and orders for urine microalbumin, in order to improve self-care and health outcomes for adult patients with diabetes. Background and Problem: Diabetes is the 7th leading cause of death in the United States and the cause of vision loss, amputations, and end-stage renal disease. The patients at the Wellness Center do not consistently receive routine screenings for neuropathy, retinopathy, nephropathy, microalbumin, …

Improving The Assessment And Care Management Of Patients With Diabetes At Risk For Foot Ulcers And Amputations, Karen Architect

Doctor of Nursing Practice

Purpose: To implement guidelines set in 2016, by the American Diabetes Association (ADA), which recommend annual and periodic foot exams for patients with type II diabetes mellitus (T2DM). Background: Uncontrolled diabetes and foot complications can lead to permanent disability, loss of employment often leading to depression and increased morbidities (Szpunar, Minnick, Dako, & Saravolatz, 2014). Significance of Problem: Individuals who are diagnosed with diabetes are at risk for foot ulcers and amputations if not properly managed. Implementation of a foot screening program has been shown to reduce foot ulcers and amputations (Peterson & Virden, 2013). Methods: Annual and periodic foot …

2016 Study Of Current Conditions Of Kentucky County Animal Shelters And Degree Of Compliance With Kentucky Animal Shelter Laws, Cynthia L. Gaskill, Rachel Cullman-Clark, Liane Lachiewicz, Matt Lamarre, Brad Rohleder, Kristin Sadler, Rachel Sparling, Craig N. Carter

Veterinary Science Reports

Kentucky’s county animal shelter conditions have not been studied for over 20 years. Major goals of this study were to assess current conditions in Kentucky’s county shelters and determine the degree of compliance with Kentucky shelter laws. Additional information was gathered to determine the major problems and needs identified by shelter personnel and researchers. Data was used to determine if additional state funds or refinements and additions to current laws are warranted to ensure humane care of animals in Kentucky’s county shelters. Researchers consisted of a group of 6 veterinary students who traveled to all Kentucky county animal shelters. Ninety …

Does Empowerment Matter? Perceptions Of Nursing Leaders In Pakistan Through Qualitative Approach, Saleema A. Gulzar, Rozina Karmaliani Professor, Kausar S. Khan Ms, Rubina Barolia, Shirin Rahim, Aneeta Pasha

School of Nursing & Midwifery

Background: In a patriarchal society like Pakistan, where women are oppressed, women dominating professions like nursing is mostly seen as disempowered and requires considerable struggle to achieve its due recognition and respect.
Aim: This study aims to explore the experiences of empowerment among the nursing leaders of Pakistan. Methods: This study uses a qualitative descriptive design. Total of twelve Pakistani Nursing leaders were interviewed using semi-structured interview guideline to explore their experiences of empowerment.
Results: The study findings revealed five major categories which include: status of a nurse, nursing profession, power relationships, value-belief system, and leadership and management.
Conclusions: Nurses’ …

Shining A Light On Nursing Art In Pakistan, Shirin Rahim, Rafat Jan Ruknuddin, Kathryn L. Gramling

School of Nursing & Midwifery

Nursing is considered both science and art. Artful nursing has been essential for holistic nursing practice since the time of Nightingale, but it is getting neglected and has been lately limited to nursing literature (Gramling, 2004). This qualitative study seeks to gain an understanding of the perceptions of active nurses in Pakistan about nursing art and yields four major themes: artful nursing is embedded in humane responsiveness, artful nursing has healing power, artful nursing is a satisfying experience, and artful nursing is invisible in nursing practice. Study participants valued nursing art, and their perceptions illuminate Watson's Theory of Human Caring …

Ogilvie's Syndrome, Muhammad Waqas Khan, Sanniya Khan Ghauri, Sara Shamim

Department of Emergency Medicine

Ogilvie's syndrome, also known as 'paralytic ileus of the colon', is characterised by pseudo-obstruction of the large intestine in the absence of any mechanical obstructing component; and presents as a massively distended abdomen. If left untreated, it may lead to bowel perforation or ischemia. Ogilvie's syndrome usually presents as a postsurgical complication, mainly due to the lack and/or restriction of movement coupled with a possible electrolyte imbalance. Here, we present a case of a pre-surgical 63-year lady, having a right hip fracture, who came with complaints of severe abdominal pain and distension for 4 days. Abdominal X-rays showed massively dilated …

Narrative Review Of Vitamin D And Its Specific Impact On Balance Capacity In Older Adults, Ray Marks

Publications and Research

Introduction and Aims: Falls injuries among older adults, a widespread well-established contributor to high disability levels, excess morbidity and mortality rates, have many causes. This review examines the association between vitamin D levels and postural stability or balance control—a fairly consistent predictor of falls among older adults.

Materials and Method: All relevant English language peer reviewed research publications detailing the relationship between vitamin D levels and balance control among the elderly were sought. Key words included “Vitamin D and Balance or Postural Control.” Databases used were Academic Search Complete, PubMed, Scopus, and Web of Science.

Results: Analysis showed no consistent …

Message From The Vice President Of Research, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Scholarships, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.

Genomics And Csf Analyses Implicate Thyroid Hormone In Hippocampal Sclerosis Of Aging, Peter T. Nelson, Yuriko Katsumata, Kwangsik Nho, Sergey C. Artiushin, Gregory A. Jicha, Wang-Xia Wang, Erin L. Abner, Andrew J. Saykin, Walter A. Kukull, Alzheimer’S Disease Neuroimaging Initiative (Adni), David W. Fardo

Sanders-Brown Center on Aging Faculty Publications

We report evidence of a novel pathogenetic mechanism in which thyroid hormone dysregulation contributes to dementia in elderly persons. Two single nucleotide polymorphisms (SNPs) on chromosome 12p12 were the initial foci of our study: rs704180 and rs73069071. These SNPs were identified by separate research groups as risk alleles for non-Alzheimer’s neurodegeneration. We found that the rs73069071 risk genotype was associated with hippocampal sclerosis (HS) pathology among people with the rs704180 risk genotype (National Alzheimer’s Coordinating Center/Alzheimer’s Disease Genetic Consortium data; n = 2113, including 241 autopsy-confirmed HS cases). Furthermore, both rs704180 and rs73069071 risk genotypes were associated with widespread brain …

Development Of Psychometrically Equivalent Speech Recognition Threshold Materials For Native Cebuano Speakers, Melissa Dawn Anderson

Theses and Dissertations

While there is a clear and immediate need for reliable speech audiometry materials to evaluate the speech recognition threshold (SRT), these recorded materials are not available in Cebuano, a language of the Philippines with 15.8 million speakers. The purpose of this study was to develop, digitally record, evaluate, and psychometrically equate a set of Cebuano trisyllabic words for use in measuring the SRT. To create the SRT materials, common Cebuano trisyllabic words were digitally recorded by a male talker of Cebuano and presented for evaluation to 20 native speakers of Cebuano with normal hearing. Based on psychometric performance, a set …

Uchunguzi (Journal Watch/Montre De Journal) December 2016, Benjamin Wachira

Emergency Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent

Medication Adherence In Patients With Myotonic Dystrophy And Facioscapulohumeral Muscular Dystrophy, Bryan Fitzgerald, Kelly Conn, Joanne Smith, Andrew Walker, Amy L. Parkhill, James E. Hilbert, Elizabeth A. Luebbe, Richard T. Moxley Iii

Doctoral External Publications

Myotonic dystrophy (DM) and facioscapulohumeral muscular dystrophy (FSHD) are the two most common adult muscular dystrophies and have progressive and often disabling manifestations. Higher levels of medication adherence lead to better health outcomes, especially important to patients with DM and FSHD because of their multisystem manifestations and complexity of care. However, medication adherence has not previously been studied in a large cohort of DM type 1 (DM1), DM type 2 (DM2), and FSHD patients. The purpose of our study was to survey medication adherence and disease manifestations in patients enrolled in the NIH-supported National DM and FSHD Registry. The study …

Associations Between Weight Status And Post-Tonsillectomy Pain Experiences In Children: A Retrospective Study, Shirley Smith Martin

Nursing Dissertations - Archive

There has been little research on pain outcomes in obese and overweight (OB/OW) children undergoing surgery. Tonsillectomy or adenotonsillectomy (T&A) is one of the most common painful surgeries performed in children. The estimated number of OB/OW children undergoing T&A each year approaches 200,000. Post-tonsillectomy pain (PTP) management after surgery is complicated by potential for airway obstruction or altered drug metabolism in OB/OW children. The purpose of this study was to examine associations between weight status and PTP outcomes in the PACU. A retrospective correlational cohort design was used. Data were obtained from 180 electronic health records of children who had …

A Retrospective Descriptive Study Of Chemically Impaired Nurses In Texas, Mercy Ngosa Mumba

Nursing Dissertations - Archive

There are approximately 3.1 million nurses in the Unites States (US Census Bureau, 2016) and approximately 8% of them suffer from chemical dependency and substance use disorders (Kunyk, 2015). In Texas, nurses with impaired practice are referred to peer assistance programs such as the Texas Peer Assistance Program for nurses (TPAPN), a monitoring program for nurses as they seek rehabilitation and recovery. Nurses are referred for various reasons including diversion of medications from patients and impairment at work. Currently, 348 nurses in TPAPN are actively participating in the program for substance abuse related offenses. Many nurses are also referred to …

Women's Experiences During An Acute Myocardial Infarction, Dena R. Allen

Nursing Dissertations - Archive

Objective: The objective was to describe the lived experience of women having a myocardial infarction and seeking health care, using the framework of the stress and coping theory (Lazarus & Folkman, 1984). Setting: Three acute care hospitals in a major metropolitan area in the North Texas region were the settings for the study. Method: A total of 20 English speaking women were interviewed about their experience when having an acute myocardial infarction from the onset of their symptoms through their hospital stay. The interview questions and findings were aligned with the stress and coping theory concepts. Results: The women realized …

A Novel Codon-Optimized Siv Gag-Pol Immunogen For Gene-Based Vaccination, Catherine M. Crosby, Eric A. Weaver, Reeti Khare, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Simian immunodeficiency virus (SIV) is a robust pathogen used in non-human primates to model HIV vaccines. SIV encodes a number of potential vaccine targets. By far the largest and most conserved protein target in SIV is its gag-pol protein that bears many epitopes to drive multivalent immune T cell responses. While gag-pol is an attractive antigen, it is only translated after a frame shift between gag and pol with the effect that gag and pol are expressed at an approximate 10/1 ratio. The codon bias of native lentiviral genes are also mismatched with the abundance of tRNAs in mammalian cells …

The Dynamics Of Adult Neurogenesis In Human Hippocampus, Amadi O. Ihunwo, Lackson H. Tembo, Charles Dzamalala

Brain and Mind Institute

The phenomenon of adult neurogenesis is now an accepted occurrence in mammals and also in humans. At least two discrete places house stem cells for generation of neurons in adult brain. These are olfactory system and the hippocampus. In animals, newly generated neurons have been directly or indirectly demonstrated to generate a significant amount of new neurons to have a functional role. However, the data in humans on the extent of this process is still scanty and such as difficult to comprehend its functional role in humans. This paper explores the available data on as extent of adult hippocampal neurogenesis …

South Asian Contributions To The International Rehabilitation Literature: An Online Literature Survey Of 10 Years, Sermad Ahmad Mangat, Farooq Azam Rathore, Shahbaz Ali Nasir, Mubasshar Shahid, Hassaan Altaf

Pakistan Journal of Neurological Sciences (PJNS)

Physical medicine and rehabilitation (PM & R) deals with management, rehabilitation and community reintegration persons with disabilities. It is an emerging medical specialty in the South-Asian region (Pakistan, India, Bangladesh, Nepal, Srilanka ,Afghanistan, Bhutan and Maldives,). The region comprises 24% of the world population with a huge burden of disability. The contributions of South Asian authors to the international rehabilitation medicine literature are unknown. The aim of this study was to document the contributions of south Asian authors in the international rehabilitation literature in the last decade.

Stroke As A First Presentation Of Malignancy, Farheen Niazi, Puneet Kakar, Ratneshwari Jha, Reena Dhami, Farook Edoo

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a frequent complication in patients with cancer occurring in nearly 15% of the cases. However cerebrovascular disease as the first presentation of malignancy has rarely been reported. We report two such cases who were admitted with acute stroke but were later on found to be having malignancy. Routine workup was unrewarding in both patients. Both patients developed pulmonary embolism as well during hospital stay suggesting hypercoagulable state as likely etiology. Reaching to the final diagnosis was an arduous journey but can help guide other clinicians facing similar cases. Non Hodgkins B cell lymphoma and Carcinoma Gall bladder were …

Determination Of Secondary Encounter Rates For Urinary Tract Infections In Patients Treated With Cephalexin, Aubrey Goertel Pharmd, Jarrod W. Kile Rphd

Department of Pharmacy

No abstract provided.

Noise: Its Impact In The Operating Room, Brennon Wesley Sloan

Doctoral Projects

Orthopedic and neurologic cases routinely reach noise levels exceeding 120 decibels (Katz, 2014). Modern equipment and monitors used by anesthesia personnel only reach 85 decibels (Katz, 2014). These monitors can go undetected during peak noise levels creating a serious safety concern for patients that could lead to patient injury or death (Gawande, Zinner, Studdert, & Brennan, 2003). A clinical question was developed to determine if the education of noise levels in the operating room affects change in practice. For operating room managers and staff, does education of noise levels in the operating room compared to no education initiate a change …