Medicine and Health Sciences Commons^™

The Experience Of Adult Children Cargiving For Aging Parents, Kimberly Conway

Seton Hall University Dissertations and Theses (ETDs)

Background: An estimated 35 million Americans are age 65 or older, and this population is expected to double within 25 years. When the normal progression of life for an aging person is interrupted, adult children are often suddenly faced with assuming care of their parent(s). Currently adult child caregivers of aging parents, work up to 100 hours per month at caregiving. Problem Statement: A limited body of empirical studies exists on the caregiving of aging parents exclusively by their adult children. Despite the amount of time dedicated to parental caregiving little is known about the experience of this exclusive caregiver …

Multiple Quality Control Pathways Limit Non-Protein Amino Acid Use By Yeast Cytoplasmic Phenylalanyl-Trna Synthetase, Adil Moghal, Lin Hwang, Kym F. Faull, Michael Ibba

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Non-protein amino acids, particularly isomers of the proteinogenic amino acids, present a threat to proteome integrity if they are mistakenly inserted into proteins. Quality control during aminoacyl-tRNA synthesis reduces non-protein amino acid incorporation by both substrate discrimination and proofreading. For example phenylalanyl-tRNA synthetase (PheRS) proofreads the non-protein hydroxylated phenylalanine derivative m-Tyr after its attachment to tRNA^Phe. We now show in Saccharomyces cerevisiae that PheRS misacylation of tRNA^Phe with the more abundant Phe oxidation product o-Tyr is limited by kinetic discrimination against o-Tyr-AMP in the transfer step followed by o-Tyr-AMP release from the synthetic …

Sonographic Estimation Of The Prevalence Of Hepatic Steatosis In Hiv Monoinfected Patients At Aga Khan University Nairobi., Bernadette Wambui Muthee

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Human immunodeficiency virus disease (HIV) is a worldwide health problem. It is estimated that 38.6 million people are infected with HIV globally. It has remained endemic in the African continent for close to 20 years and is a long term developmental challenge in Africa which bears 69 % of the HIV/AIDS global burden. The introduction of highly active antiretroviral therapy (HAART) has caused dramatic improvement in prognosis of HIV disease. Consequently, this has resulted in substantial reduction in Acquired Immune Deficiency Syndrome (AIDS) related morbidity and mortality. In contrast, this has been accompanied by an upsurge in liver- related …

Intraoperative Neurophysiological Monitoring For Endoscopic Endonasal Approaches To The Skull Base: A Technical Guide., Harminder Singh, Richard W. Vogel, Robert M. Lober, Adam T. Doan, Craig I. Matsumoto, Tyler J. Kenning, James J. Evans

Department of Neurosurgery Faculty Papers

Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory …

Preventing Hapus In High-Risk Cardiac Cath Patients Using Foam Dressing Protocol, Charles Jasper

Master's Projects and Capstones

The purpose of this project is to implement an evidence-based change in practice resulting safer procedures as evidenced by zero hospital acquired pressure ulcers (HAPUs). It is relevant to nursing as it provides an ethical perspective regarding patient safety and contributes to our present understanding of HAPU prevention. In spite of having already decreased the total number of HAPUs by 50% in 2015, the cardiac catheterization lab (CCL) was implicated in 30% of those reported. My objective is to improve patient safety by reducing the number of HAPUs acquired in the CCL to 0% by three months using a prophylactic …

Missing Links: Challenges In Engaging The Underserved With Health Information And Communication Technology, Maria D. Wright, Mindy Flanagan, Kislaya Kunjan, Bradley N. Doebbeling, Tammy Toscos Phd

Health Services and Informatics Research

PervasiveHealth '16: Proceedings of the 10th EAI International Conference on Pervasive Computing Technologies for Healthcare

We sought to understand underserved patients' preferences for health information technology (HIT) and examine the current use of personal health records (PHRs) in Community Health Centers (CHCs) serving low-income, uninsured, and underinsured patients. Forty-three patients and 49 clinic staff, administrators, and providers from these CHC systems were interviewed using open-ended questions assessing patient experience, perceptions of the CHC, access barriers, strategies used to overcome access barriers, technology access and use, and clinic operations and workflow. All seven CHC systems were at some stage of implementing …

Quality Improvement: An Update For Outpatient Oncology Education, Nicole R. Gee

Master's Projects and Capstones

This project is focused on quality improvement in patient satisfaction with regard to side effect management after oncology patient education. The global aim of this project is to improve oncology-specific patient education through the development of an evidenced-based educational binder to be given to patients in a hospital outpatient infusion center and used as an educational guide for nursing staff. Effective standardized patient education has been seen to improve: satisfaction, quality of life, adherence, self-management, outcomes, and reduce unnecessary emergency room visits (Dalby, 2013; Mann, 2011; Smith et al., 2013). A rise in patient confidence for nausea and vomiting self-care, …

Medical School Watercooler Newsletter - May 15, 2016, Lindsey Lyle

Watercooler Newsletter

This is the May 15, 2016 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• Vote Today for USA Medical Student in AMA Healthier Nation Innovation Challenge
• USA Medical Students Coach 'Buddy Ball'
• Mark Your Calendar: Autism Grand Rounds
• Ambulatory Services Division of USA Health Implements New Uniform Policy

Antibiotic Resistance: Use Of Delayed Prescriptions For Viral Syndromes In Urgent Care, Patricia Hansen

Seton Hall University DNP Final Projects

Purpose: Widespread use of antibiotics leads to a development of antimicrobial resistance, an increasing global problem. The rise of antibiotic-resistant bacterial strains represents a serious threat to the public. The Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses and 23,000 deaths are caused by antibiotic resistant bacteriain the United States (CDC, 2014). The strategy of delayed antibiotic prescribing, sometimes called “wait and see” prescriptions, may reduce antibiotic use for viral syndromes in primary care settings. The overall purpose of this scholarly project is to explore delayed prescriptions used by providers in two urgent care settings, …

Developing Therapeutic Communication Skills: Integration Of Standardized Client Simulation In An Associate Degree Nursing Program, Kristine Weber, Timothy Farrell

UNLV Theses, Dissertations, Professional Papers, and Capstones

By the year 2020, it is projected that there will be a shortage of 300,000 to one million registered nurses in the United States (Juraschek, Zhang, Ranganathan & Lin, 2012). Therapeutic communication skills are a fundamental and integral part of any registered nurse’s practice. Despite the importance of therapeutic communication, evidence suggests that the lack of skill development in nursing programs is having an adverse effect on the NCLEX-RN pass rate of graduating registered nurses. Identifying and addressing shortfalls in effective communication offers an opportunity to improve this pass rate. Learning to effectively communicate in a simulated situation will provide …

Auras In Patients With Temporal Lobe Epilepsy And Mesial Temporal Sclerosis., Ali Akbar Asadi-Pooya, Maromi Nei, Ashwini Sharan, Michael R. Sperling

Department of Neurology Faculty Papers

We investigated auras in patients with drug-resistant temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS). We also investigated the clinical differences between patients with MTS and abdominal auras and those with MTS and non-mesial temporal auras. All patients with drug-resistant TLE and unilateral MTS who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center from 1986 through 2014 were evaluated. Patients with good postoperative seizure outcome were investigated. One hundred forty-nine patients (71 males and 78 females) were studied. Thirty-one patients (20.8%) reported no auras, while 29 patients (19.5%) reported abdominal aura, and 30 patients (20.1%) reported non-mesial temporal auras; …

Health Literacy Among Elderly Hispanics And Medication Usage, Wilda Parker

Walden Dissertations and Doctoral Studies

Health literacy among the elderly Hispanics is a problem for 44% who read at the lowest level due to issues with recognition, cognition, or vision. The purpose of this study was to determine the extent that elderly Hispanics have problems with medication adherence due to health literacy. The social cognitive theory was the framework for this study. Inclusion criteria consisted of being 65-75 years of age, and speaking and/or reading English and/or Spanish. Questionnaires from 156 individuals were completed in Cobb County/Atlanta GA and analyzed using multiple regression to determine the relationship between health literacy and medication usage. Medication adherence …

Acute Anteroseptal Myocardial Infarction After A Negative Exercise Stress Test, Abdullah M. Al-Alawi, Jyotsna Janardan, Kah Y. Peck, Alan Soward

Sultan Qaboos University Medical Journal

A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST segment elevation myocardial infarction was observed on electrocardiography. After thrombolysis, he was transferred to a tertiary hospital where coronary angiography subsequently revealed significant left …

Use Of Mobile Phones For Infant And Young Child Feeding Counseling In Sri Lankan Tea Estates: A Formative Study, Manuj C. Weerasinghe, Upul Senerath, Sanjeeva Godakandage, Hiranya Jayawickrama, Aravinda Wickramasinghe, Indika Siriwardena, Srisothinathan Nimalan, Michael J. Dibley, Ashraful Alam

The Qualitative Report

Despite the availability of free health services, children residing in Sri Lanka’s less developed plantation sector are more likely to be undernourished than children in urban and rural sectors. Hence, we need new approaches to improve their nutritional status. One promising approach involves mobile health initiatives, which is used effectively in other countries in primary health care settings. We studied the nature of mobile phone use in this community, and their perceptions on using m-health counseling for infant and young child feeding. Focus group discussions and in-depth interviews were the study methods. We found that mobile phone usage is common …

The Feasibility Of Using Metacognitive Strategy Training To Improve Performance, Foster Participation, And Reduce Impairment Following Neurological Injury, Timothy J. Wolf

Arts & Sciences Graduate Student Theses and Dissertations

Executive function is central to our ability to learn and participate in everyday life activities and rehabilitation outcomes for individuals with executive dysfunction after neurological injury are poor. The impairments and performance challenges these individuals experience are typically not identified appropriately so they often do not receive adequate rehabilitation and can have significant challenges returning to complex everyday life activities. The vast majority of rehabilitation efforts to support individuals with neurological injuries with executive dysfunction are based on a restoration model that aims to improve cognitive function with the expectation that these gains will translate to everyday life. The available …

Transancestral Fine-Mapping Of Four Type 2 Diabetes Susceptibility Loci Highlights Potential Causal Regulatory Mechanisms, Momoko Horikoshi, Lorenzo Pasquali, Steven Wiltshire, Jeroen R. Huyghe, Anubha Mahajan, Jennifer L. Asimit, John Blangero

School of Medicine Publications

To gain insight into potential regulatory mechanisms through which the effects of variants at four established type 2 diabetes (T2D) susceptibility loci (CDKAL1, CDKN2A-B, IGF2BP2 and KCNQ1) are mediated, we undertook transancestral fine-mapping in 22 086 cases and 42 539 controls of East Asian, European, South Asian, African American and Mexican American descent. Through high-density imputation and conditional analyses, we identified seven distinct association signals at these four loci, each with allelic effects on T2D susceptibility that were homogenous across ancestry groups. By leveraging differences in the structure of linkage disequilibrium between diverse populations, and increased sample size, we localised …

Effects Of Preoperative Aspirin On Major Outcomes In Graded High-Risk Patients Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Jordan E. Goldhammer, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Among patients with cardiovascular disease, nearly 70% take preventive aspirin.¹
• The benefits of aspirin are greater as a patient’s risk of cardiovascular events increases; patients with a lower risk of cardiovascular events derive less of a benefit from aspirin.²
• The effect of aspirin in surgical patients has not yet been investigated, in particular if there is an optimal effect based on operative risk when undergoing cardiac surgery.

Objective:

To determine the effects of preoperative aspirin on major outcomes after cardiac surgery in patients with low, medium, and high predicted operative mortality as determined by the EuroSCORE risk …

Heart Failure Outcomes With Empagliflozin In Patients With Type 2 Diabetes At High Cardiovascular Risk: Results Of The Empa-Reg Outcome® Trial., David Fitchett, Bernard Zinman, Christoph Wanner, John M. Lachin, Stefan Hantel, Afshin Salsali, Odd Erik Johansen, Hans J Woerle, Uli C Broedl, Silvio E Inzucchi

Epidemiology Faculty Publications

AIMS: We previously reported that in the EMPA-REG OUTCOME(®) trial, empagliflozin added to standard of care reduced the risk of 3-point major adverse cardiovascular events, cardiovascular and all-cause death, and hospitalization for heart failure in patients with type 2 diabetes and high cardiovascular risk. We have now further investigated heart failure outcomes in all patients and in subgroups, including patients with or without baseline heart failure.

METHODS AND RESULTS: Patients were randomized to receive empagliflozin 10 mg, empagliflozin 25 mg, or placebo. Seven thousand and twenty patients were treated; 706 (10.1%) had heart failure at baseline. Heart failure hospitalization or …

Do Rats Consume Ethanol To Regulate A Negative Emotion Induced By A Successive Negative Contrast Procedure?, Andrew Dieterich

Seton Hall University Dissertations and Theses (ETDs)

According to the self-medication hypothesis, individuals may consume drugs or alcohol, or engage in other behaviors in order to reduce a negative emotional state (Khantzian, 1985; Gross, 2013; Crum et al., 2013). Rats experiencing a negative state induced by various stressors (Bertholomey et al., 2010), or a decrease or loss in reward value of a sucrose solution (Manzo et al., 2015; Manzo et al., 2014) demonstrate increased consumption of alcohol. I used successive (SNC) and anticipatory negative contrast (ANC) procedures to further examine this hypothesis and the previous findings (Manzo et al., 2015), that rats increase consumption and preference for …

Effects Of Diabetes Mellitus And Chronic Kidney Disease On Major Outcomes In Patients Undergoing Cardiac Surgery, Mark W. Berguson, Jordan E. Goldhammer, Hong Liu, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). CKD typically manifests in late stages of DM.

• DM and CKD are prevalent in patients with cardiovascular disease.

• The impact of concurrent DM and CKD on major adverse cardiocerebral events (MACE) in patients undergoing cardiac surgery remains unclear.^1,2

Objective:

To determine the effect of DM and CKD on major outcomes in patients undergoing cardiac surgery.

Preoperative Aspirin And Major Perioperative Outcomes In Patients With Hypertension Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Hypertension is prevalent in patients undergoing cardiac surgery and associated with a higher incidence of cardiovascular complications.
• Aspirin has been shown to prevent cardiovascular events in patients with a high risk of cardiovascular disease.
• Very few studies have investigated aspirin and hypertension, particularly its effects on major outcomes in hypertensive patients undergoing cardiac surgery.^1,2

Objective

To determine the effects of preoperative aspirin on postoperative outcomes for patients with hypertension undergoing cardiac surgery.

To examine the impact of chronic kidney disease and heart failure superimposed with hypertension on outcomes after cardiac surgery.

The Utility Of Remote Hemodynamic Monitoring Devices In Patients With A Ventricular Assist Device, Bennet George, Amanda Hart, Sarah Branam, Maya Guglin

The VAD Journal

Remote intracardiac hemodynamic monitoring is a growing area of interest to help aid in the management of patients with chronic congestive heart failure. The utility of remote hemodynamic monitoring has not previously been investigated with a ventricular assist device population. We present two cases of patients with ventricular assist devices in which we employed remote hemodynamic monitoring data to aid in patient management.

Revealing The Quality Of Movement: A Meta-Analysis Review To Quantify The Thresholds To Pathological Variability During Standing And Walking, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Neuromotor processes are inherently noisy, which results in variability during movement and fluctu-ations in motor control. Although controversial, low levels of variability are traditionally considered healthy, while increased levels are thought to be pathological. This systematic review and meta-analysisof the literature investigates the thresholds between healthy and pathological task variability.

After examining 13,195 publications, 109 studies were included. Results from over 3000 healthy sub-jects and 2775 patients revealed an overall positive effect size of pathology on variability of 0.59 forwalking and 0.80 for sway. For the coefficient of variation of stride time (ST) and sway area (SA), upperthresholds of 2.6% …

Telephone Follow-Up For Heart Failure Patients Discharged To Skilled Nursing Facilities, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Reducing hospital readmissions has become a national priority for health care institutions. Telephone follow-up, a cost-effective intervention, has been used with varying degrees of success in reducing 30-day readmissions for heart failure (HF) patients. However, little is known about interventions directed toward HF patients discharged to skilled nursing facilities (SNFs). The purpose of this project was to test the effect of telephone follow-up with SNF staff by an advanced practice nurse (APN) on 30-day readmission rates. A one-time call to SNF staff was made by the APN to review key components of HF management. Readmission rates for the intervention …

Sentinel Event Management Model: A Performance Improvement Project, Kelly M. Johnson

Graduate Theses, Dissertations, and Capstones

The purpose of this performance improvement project was to implement a standard sentinel event management model in an acute care hospital that is part of a healthcare system based on best practices and principles of high reliability organizations. The project used define, measure, analyze, improve and control (DMAIC) methodology and Lewin’s Theory of Planned Change. High rates of medical harm and preventable deaths have been demonstrated around the world. It is estimated that one in four American families will be affected by preventable harm in healthcare involving further medical care, disability or even death. Despite international awareness and substantial efforts …

Impact Of Nurse-Led Telephone Follow-Up On Heart Failure Readmissions, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Heart failure readmissions are a common and costly issue. Poor transitions of care as patients move from one setting to another are thought to be a major contributor to this growing problem. For those patients discharged to skilled nursing facilities (SNFs), poor transitions can be especially problematic. Telephone follow-up by nurses is a cost effective intervention commonly used to improve communication and coordination of care, thought little is known about interventions directed at patients discharged to SNFs. The purpose of this review is to evaluate the evidence regarding nurse led telephone follow-up in the transition of care process and …

Right Total Knee Arthroscopy In Female Geriatric Patient, Jason Watkins

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

No abstract provided.

Scaphoid Fracture Or Grade One Wrist Sprain On A Division I College Female Athlete, Brittany Talley

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

No abstract provided.

Lumbar Transverse Process Fractures In Collegiate Male Football Player, Trevor Pfister, Samantha Phillips, Trent Stratton

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

No abstract provided.

Knock-Off Fracture In Track & Field Athlete, Justin Isinghood

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

No abstract provided.