Medicine and Health Sciences Commons^™

An Exploration Of Social Capital Among Nurses In The Ambulatory Setting, Anna Lutz, Tamara Mckinnon

Doctoral Projects

Bullying and lateral violence are a sadly, common phenomena among nurses. While this issue has been examined within the inpatient, acute setting, it has not been widely researched in the ambulatory setting. This concept is usually looked at from a negative standpoint, looking at the levels of lateral violence. The purpose of this research study was done to explore the levels of social capital, also known as positive peer support, among nurses in the ambulatory setting. The participants of the study were 39 registered nurses from a public health department and an embedded care management department. The tool used was …

The Effect Of Music Intervention On Cam Scores Of Hospitalized Older Adults Experiencing Delirium, Mae Lavente Dizon

Doctoral Projects

Older adults are vulnerable to developing while hospitalized is delirium. Research has shown that non-pharmacological interventions are effective in managing delirium and should be the first-line of treatment; however despite this, nurses fmd it difficult to address delirium. The purpose of this research study is to examine the effectiveness of classical music intervention in hospitalized older adults experiencing delirium by evaluating their Confusion Assessment Method (CAM) scores. A pre-and-post study design to compare the CAM scores of patients before and after music intervention was implemented. Study participants were patients 65 years and older identified to be experiencing delirium by a …

Assessing Readiness For Interprofessional Learning About Sepsis Among Registered Nurses, Physicians, And Respiratory Therapists In A Community Hospital, Katie Choy

Doctoral Projects

Interprofessional teamwork and education have been advanced as methods to address the complexities of patient care (National Academy of Medicine [NAM], 2011-2013). One area needing further exploration is health care professionals' readiness to learn together in the acute care setting. The application of interprofessionalleaming (IPL) focused on sepsis education and improvement in sepsis outcomes in a community hospital has not been fully assessed. This descriptive, quantitative study explored interprofessional readiness to learn, perceptions of professional identity, and understanding of roles and responsibilities, by examining three subgroups. Registered nurses (n = 52), physicians (n = 29), and respiratory therapists (n = …

Barriers To Preoperative Teaching In A Culturally Diverse Healthcare Environment, Rancelle Ablan

Doctoral Projects

The role of the professional nurse is integral in educating and ensuring that patients understand essential components of their plan of care. This is especially true for patients who are to undergo surgical interventions; evidence has demonstrated that preoperative education provided to patients is linked with positive patient outcomes and a decrease in post-operative complications (Blackstone, Garrett, & Hasselkus, 2011). This qualitative study investigated the barriers that nurses experience in providing preoperative education to diverse patients in a multicultural healthcare environment. Ten registered nurses at a private community hospital in the San Francisco Bay Area participated in an hour long …

Development And Evaluation Of A Chronic Care Management Toolkit, Heidi Hongxin He

Doctoral Projects

Currently, little research is available on the topic of Chronic Care Management (CCM) service and its impact on patient health outcomes, largely because the service was recently introduced by Medicare in January 2015. The purpose of this Doctor in Nursing Practice (DNP) project is to create a Chronic Care Management (CCM) Toolkit specific to an established pulmonology practice based in a Central California community. This quality improvement pilot project also included an evaluation of the newly developed CCM Toolkit designed for this project. The evaluation was accomplished by surveying CCM care team members in this pulmonary practice (an internal group), …

A Comparison Of Educational Approaches To The End-Of-Life-Nursing Education Consortium (Elnec) Course, Jennifer L. Bodine

Doctoral Projects

Purpose: The purpose of this project was to compare the effectiveness of two different educational approaches to teaching the End of Life Nursing Education Consortium course.

Background: Terminally ill patients frequently visit the emergency department for palliative care. However, various references show that staff does not have the knowledge base necessary to provide quality end-of-life care in the emergency setting.

Method: Participants from the emergency department at a Level I Trauma Center were recruited. A quantitative, cross-sectional pilot study was conducted to investigate whether lecture or lecture with simulation was more effective in increasing the knowledge base of participants regarding …

7-Weeks Of Yoga Training And Its Effects On Flexibility, Rate Of Force Development, And Jump Height In Olympic Weightlifters, Andrew Ernst

All NMU Master's Theses

The purpose of the current study was to determine what effects 7-weeks of yoga training had on Olympic weightlifters flexibility, rate of force development, and jump height. Pre- and post-testing was performed consisting of flexibility and jump performance measurements. The participants performed a sit and reach test followed by a loaded overhead squat test with barbell. The overhead squat test was performed with reflective markers and recorded video to assess joint angles. A countermovement jump and snatch, at 80% of their one repetition maximum, was performed next to measure rate of force development and jump height. The participants then were …

Variability In Clinically Measured Wideband Acoustic Immittance Over Time In Young And Old Adults, Allison G. Mcgrath

Dissertations, 2014-2019

Wideband acoustic immittance (WAI) measures of the middle ear have the potential to increase our ability to detect changes in the middle ear transfer function not seen using traditional tympanometry. In order to use this new tool diagnostically we must first understand its normal clinical variability. The present study aimed to investigate the variability that occurs when wideband acoustic immittance (WAI) is measured clinically within subjects as a function of subject age, as a function of time, and as a function of pressure. A total of thirty-six ears from eighteen subjects were studied (n=18 young adults ears, n=18 older adult …

Case Report: Reducing Polypharmacy In Elderly, Orina Machoka

Nursing Capstones

No abstract provided.

The Effect Of The Expanded Food And Nutrition Education Program On Participants’ Diet Quality: Does Supermarket Access Matter?, Rachel Ann Spencer

Graduate Theses and Dissertations

This project assesses the effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) within the context of supermarket access. EFNEP is a national community nutrition education program that strives to give participants the tools to live healthier lives. Analysis was performed on participants from 16 Arkansas counties that completed EFNEP during 2013 or 2014. The program outcome is measured in terms of the change in Healthy Eating Index (HEI) as calculated from 24-hour diet recalls at program entry and exit. Supermarket locations were obtained from the USDA Food Nutrition Service’s SNAP Retail Locator and represent the food environment near …

Effect Of Body Mass Index On Outcome Of Labour Induction, Farheen Yousuf, Tahira Naru, Sana Sheikh

Department of Obstetrics & Gynaecology

The retrospective study to explore the adverse effect of obesity on pregnancy and labour was conducted at Aga Khan University Hospital, Karachi, Pakistan, and comprised data of all patients booked between 12-14 weeks and required induction of labour from January 1 to December 31, 2012. Women were grouped into two body mass index categories: normal weight (23 kg/m2). Obesity increased the risk of development of gestational hypertension and diabetes. Therefore obese women were more likely to be induced due to medical indication whether primiparous or multiparous adjusted odds ratio =2.89(95% confidence interval 1.29-6.48) and 2.77 (95% confidence interval 1.07-7.19) respectively. …

Microrna-186 And Metastatic Prostate Cancer., Dominique Zilpha Jones

Electronic Theses and Dissertations

MicroRNA (miR) dysregulation alters cancer-associated gene expression, which contributes to cancer pathogenesis. For example, miR-186 over expression lead to enhanced proliferation and migration in pancreatic cancer cell models. However, the role of miR-186 in prostate cancer (PCa) remains controversial. Previously, miR-186-5p was up-regulated in PCa patient serum (stage III/IV) compared to controls. Furthermore, miR-186-5p was up-regulated in metastatic PCa (PC-3, MDA PCa 2b, LNCaP) relative to normal prostate epithelial cells (RWPE1). We hypothesized miR-186 inhibition will reduce aggressive PCa using metastatic cell models. To test this, we evaluated whether miR-186-5p inhibition would reduce aggressive PCa behavior and overexpression induce malignant …

Modulation Of Cardiac Kv Currents By Kvbeta2 And Pyridine Nucleotides., Peter Joseph Kilfoil

Electronic Theses and Dissertations

Myocardial voltage-gated potassium (Kv) channels regulate the resting membrane potential and the repolarization phase of the action potential. Members of the Kv1 and Kv4 family associate with ancillary subunits, such as the Kvβ proteins, that modify channel kinetics, gating and trafficking. Previous investigation into the function of cardiac β subunits demonstrated that Kvβ1 regulates I_to and I_K,slow currents in the heart, but the role of Kvβ2 in the myocardium remains unknown. In heterologous expression systems, Kvβ2 increases surface expression of Kv1 channels, shifts the activation potential of Kv1 channels to more polarized voltages, and increases the inactivation of …

Predicting Nclex-Rn Performance : An Exploration Of Student Demographics, Pre-Program Factors, And Nursing Program Factors., Heather Davis Mitchell

Electronic Theses and Dissertations

Nursing programs are experiencing a decline in National Council Licensure Examination for Registered Nurses (NCLEX-RN) pass rates among graduates. While researchers have attempted to identify predictors of performance on the NCLEX-RN, identification of predictors remains elusive. Although the literature is replete with studies exploring NCLEX-RN predictors, prediction under the new 2013 NCLEX test plan and passing standards is not well established. Considering the ever-evolving diversity in students, combined with recent changes in the NCLEX-RN, further exploration of predictors of performance is warranted. Using a correlational design, the study sought to identify the predictors of NCLEX-RN performance for Bachelors of Science …

Long Term Facial Alveolar Bone Changes Associated With Endosseous Implants In The Anterior Maxilla., Deepika Joshi

Electronic Theses and Dissertations

Aim: To quantify the radiographic presence and thickness of facial alveolar bone (FAB_r) adjacent to implants placed in the anterior maxillary region. Lack of FAB_r may suggest that graft procedures are desirable prior to implant placement. Material and Methods: With IRB approval, a retrospective analysis of cone beam computed tomographic cross-sectional images of sites with at least one implant in the anterior maxillary region was performed. Details regarding type of implant and location were recorded. FAB_r perpendicular to the long axis each implant was measured at seven levels by two observers independently and means and standard …

Role Of Microrna-21 In Atherogenesis., Rihab Hamed-Berair

Electronic Theses and Dissertations

MicroRNA-21 (miR-21) is an evolutionarily conserved microRNA, abundant in most cardiovascular tissues. It has been implicated in the pathogenesis of several cardiovascular diseases including restenosis, myocardial infarction, and heart failure. However, little is known about the contribution of miR-21 in atherosclerosis. My data show that expression of miR-21 is increased by >1.5-fold in murine atherosclerotic lesions and by 1.5-2.0-fold in the macrophages of Western diet (WD)-fed LDLR-KO mice (for 12-20 weeks). In vitro, LDL, oxidized LDL, acetylated LDL and LPS induced miR-21 by 2-4-fold and down-regulated its target protein, PDCD4, in bone marrow-derived macrophages. Basally, macrophages isolated from miR-21-KO …

Influence Of In-Office Oral Hygiene Instructions On The Parental Assessment Of Their Child's Oral Health., Sireesha Kodali

Electronic Theses and Dissertations

Purpose: To identify the relation between oral health education and parental assessment of their child’s dental condition. Methods: Our study population included 33,342 children, from Smile KY! annual screenings from 2002 to 20014. Data collection was through questionnaire forms. Our primary risk factor was “dental health instructions received” (yes/no) and our outcome of interest was “parental assessment of your child’s dental health” (good/fair/poor). We had 13 years of data from 2002 to 2014 and used ‘SAS’ statistical software for data manipulation and recoding. Descriptive statistics, chi-square test of independence, trend analysis and multiple logistic regression modeling were performed on ‘SPSS’ …

Ips Cell Transplantation For Traumatic Spinal Cord Injury., Miguel Goulao, Angelo C Lepore

Farber Institute for Neuroscience Faculty Papers

A large body of work has been published on transplantation of a wide range of neural stem and progenitor cell types derived from the developing and adult CNS, as well as from pluripotent embryonic stem cells, in models of traumatic spinal cord injury (SCI). However, many of these cell-based approaches present practical issues for clinical translation such as ethical cell derivation, generation of potentially large numbers of homogenously prepared cells, and immune rejection. With the advent of induced Pluripotent Stem (iPS) cell technology, many of these issues may potentially be overcome. To date, a number of studies have demonstrated integration, …

Science Alive!: Connecting With Elementary Students Through Science Exploration, Aarti Raja, Emily F. Schmitt Lavin, Tamara Gali, Kaitlin Donovan

Biology Faculty Articles

A novel program called Science Alive! was developed by undergraduate faculty members, K–12 school teachers, and undergraduate students to enrich science, technology, engineering, and mathematics (STEM) literacy at community schools located near the university. The ultimate goal of the program is to bolster the scientific knowledge and appreciation of local area students and community members and serve as a model for similar programs. Through the program, we observed that elementary school students made gains toward learning their grade-level science curricula after a hands-on learning experience and had fun doing these hands-on activities. Through the program, undergraduate students, working with graduate …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Biomolecular Signatures Of Severe Malarial Anemia, Zachary Shamin Karim

Biomedical Sciences ETDs

Plasmodium falciparum-associated severe malarial anemia [SMA, hemoglobin (Hb)< 5.0g/dL] is a leading cause of morbidity and mortality in African children. Examination of the host immune response and underlying genotypic traits that condition SMA can offer an improved understanding of malaria pathogenesis. Previous investigations have suggested that SMA in high transmission regions is due to impaired erythropoiesis hemolysis and erythrocyte destruction. In the holoendemic transmission region of western Kenya our studies have shown that dyserythropoiesis drives and conditions SMA through poorly understood molecular pathways. Pediatric studies have shown that early erythroid cell populations as well as reticulocyte production is greatly reduced in children with SMA. The driving force of malaria pathogenesis is multifaceted and the mechanisms that promote erythropoietic dysfunction are still being understood. We hypothesize that SMA is conditioned by the immune response through underlying genetic factors that influence erythropoiesis resulting in a exacerbated disease state. To that end the studies described in this manuscript focus on the inflammatory chemokines, monokine induced by gamma (MIG) and interferon gamma-induced protein (IP10) as well as the hemoglobin-coding gene, hemoglobin alpha 2 (HBA2) in the context of SMA and dyserythropoiesis. The first study described herein, identified MIG and IP10 as important mediators associated with SMA. In this study we examined circulating MIG and I10 profiles in non-SMA and SMA children and then genotyped and constructed haplotypes between 5 individual polymorphic variants within the promoter regions for the MIG and IP10 for the entire study cohort (n=1,600). The second study described in this manuscript, utilized a global approach where genome wide association studies as well as whole-genome transcriptomics identified novel molecular pathways between non-SMA and SMA children. These analyses revealed that the expression of the hemoglobin-coding gene, HBA2 is significantly modulated between populations. We then examined these findings closer and genotyped a larger population for 2 promoter variants with the same approach described in the first study. Regression analysis of genotype and haplotype data for both studies revealed significant findings where several variant haplotypes correlated with SMA outcomes and erythropoietic response. Lastly, we used an in vitro model of erythropoiesis to determine if recombinant human MIG and IP10 as well as pediatric study serum (non-SMA and SMA) influence erythroid function. Our results from these studies revealed that pediatric serum from children with SMA influenced cell viability as well as erythroid lineage when we examined cell surface erythroid markers. A similar result was also seen in cell populations that were treated with the inflammatory mediators, MIG, and IP10 which reflected our proposal that serum from children with SMA and inflammatory mediators (MIG and IP10) infringe upon erythroid cell maturation and viability in vivo. Together the results from these studies independently verify the influence of biomolecular markers and mediators on SMA outcomes.

Pulmonary Bcg Vaccination For Uniform Protection Against Tuberculosis In Environmental Mycobacteria Endemic Regions, Dominique Nicole Price

Biomedical Sciences ETDs

Currently, over one-third of the global population is infected with tuberculosis (TB), one of the world's most deadly infectious diseases. The current vaccine against TB, Bacille Calmette-Guérin (BCG), is a live attenuated vaccine that is intradermally administered in over 150 countries around the world. Despite its widespread use, the vaccine has a variable protective efficacy of 0-80%, with the lowest efficacy rates in regions of the world where TB is most prevalent. This variability is partially due to environmental mycobacteria (EM) found in soil and water sources in areas of the world where BCG efficacy is poor. The research hypothesis …

Regulation Of The Escrt Function Of Alix, Sheng Sun

Dissertations and Theses (Open Access)

The ESCRT (endosomal sorting complex required for transport) is an evolutionary conserved membrane remodeling machinery that performs membrane invagination and abscission. ALIX is a widely expressed adaptor protein that is critically involved in three classical ESCRT-mediated processes, including MVB (multivesicular body) sorting, cytokinetic abscission and retroviral budding. Previous studies have demonstrated that ALIX involvement in these ESCRT-mediated processes requires ALIX interaction with the ESCRT-III component CHMP4 as well as a cargo protein. However, the native form of ALIX contains a default intramolecular interaction between N-terminal Bro1 domain and C-terminal PRD (proline-rich domain), leading to a closed conformation of ALIX that …

Ethnic Identity And Teratogenic Risk Perceptions, Katie M. Chan

Dissertations and Theses (Open Access)

Elevated perceptions of teratogenic risk can cause anxiety and confusion among pregnant women. To assess whether ethnic identity and demographic factors can influence teratogenic risk perceptions, 194 pregnant women in Houston were surveyed using the Multigroup Ethnic Identity Measure (MEIM) and visual analog scales to quantify perceptions of teratogenic risk for common exposures during pregnancy. Overall, participants estimated an elevated baseline risk of 25% for birth defects among the general population. In addition, participants overestimated birth defect risks for specific exposures, such as alcohol and marijuana. Based on the MEIM scores, ethnic identity was not significantly associated with teratogenic risk …

Protein Phosphatase 1 Abrogates Irf7-Mediated Type I Ifn Response In Antiviral Immunity, Ling Wang, Juan Zhao, Junping Ren, Kenton H. Hall, Jonathan P. Moorman, Zhi Q. Yao, Shunbin Ning

ETSU Faculty Works

Interferon (IFN) regulatory factor 7 (IRF7) plays a key role in the production of IFN‐α in response to viral infection, and phosphorylation at IRF7 C‐terminal serine sites is prelude to its function. However, phosphatases that negatively regulate IRF7 phosphorylation and activity have not been reported. In this study, we have identified a conserved protein phosphatase 1 (PP1)‐binding motif in human and mouse IRF7 proteins, and shown that PP1 physically interacts with IRF7. Exogenous expression of PP1 subunits (PP1α, β, or γ) ablates IKKε‐stimulated IRF7 phosphorylation and dramatically attenuates IRF7 transcriptional activity. Inhibition of PP1 activity significantly increases IRF7 phosphorylation and …

The Impact Of Vascular Complications On Survival Of Patients On Venoarterial Extracorporeal Membrane Oxygenation., Daizo Tanaka, Hitoshi Hirose, Nicholas C. Cavarocchi, John W.C. Entwistle

Department of Surgery Faculty Papers

BACKGROUND: There are various factors that can influence the survival of patients receiving venoarterial extracorporeal membrane oxygenation (VA ECMO). Vascular complications from femoral cannulation are common and are potentially serious. We analyzed the impact of vascular complications on survival of patients receiving VA ECMO.

METHODS: Patients supported with VA ECMO by means of femoral cannulation from October 2010 to November 2014 were enrolled in this study. Data were gathered retrospectively by reviewing our institutional database. Patients were separated into two groups depending on the presence of major vascular complications, defined as patients who required surgical intervention. We evaluated predisposing factors …

Long-Term Effect Of Antiepileptic Drug Switch On Serum Lipids And C-Reactive Protein., Scott Mintzer, Rachael Miller, Krunal Shah, Inna Chervoneva, Maromi Nei, Christopher T. Skidmore, Michael R. Sperling

Department of Neurology Faculty Papers

BACKGROUND: Prior studies have shown that switching patients from inducing antiepileptic drugs (AEDs) to lamotrigine, levetiracetam, or topiramate reduces serum lipids and C-reactive protein (CRP). These studies were all of short duration, and some drugs, such as zonisamide, have not been investigated.

METHODS: We recruited 41 patients taking phenytoin or carbamazepine who were being switched to zonisamide, lamotrigine, or levetiracetam. We measured serum lipids and CRP before the switch, >6weeks after, and >6months after. An untreated control group (n=14) underwent similar measurement. We combined these data with those of our previous investigation (n=34 patients and 16 controls) of a very …

Gray Matter Abnormalities In Temporal Lobe Epilepsy: Relationships With Resting-State Functional Connectivity And Episodic Memory Performance., Gaelle Eve Doucet, Xiaosong He, Michael R Sperling, Ashwini Sharan Md, Joseph I Tracy

Department of Neurology Faculty Papers

Temporal lobe epilepsy (TLE) affects multiple brain regions through evidence from both structural (gray matter; GM) and functional connectivity (FC) studies. We tested whether these structural abnormalities were associated with FC abnormalities, and assessed the ability of these measures to explain episodic memory impairments in this population. A resting-state and T1 sequences were acquired on 94 (45 with mesial temporal pathology) TLE patients and 50 controls, using magnetic resonance imaging (MRI) technique. A voxel-based morphometry analysis was computed to determine the GM volume differences between groups (right, left TLE, controls). Resting-state FC between the abnormal GM volume regions was computed, …

การจัดการเรียนรู้โดยใช้สถานการณ์จำลองสำหรับนิสิตนักศึกษาพยาบาล, วงเดือน สุวรรณคีรี, อรพิน จุลมุสิ, ฐิติอาภา ตั้งค้าวานิช

Journal of Nursing Research, Innovation, and Health

การจัดการเรียนรู้โดยใช้สถานการณ์จำลองสำหรับนิสิตนักศึกษาพยาบาล เป็นนวัตกรรมทางการศึกษาที่ได้รับการออกแบบเพื่อให้ผู้เรียนมีประสบการณ์ และเกิดการเรียนรู้ตามวัตถุประสงค์ที่กำหนด โดยจำลองความเหมือนจริงของผู้ป่วยผ่านการใช้หุ่นมนุษย์จำลองที่สามารถควบคุมอาการ และอาการแสดงได้โดยใช้โปรแกรมคอมพิวเตอร์ เพื่อใช้ในการฝึกปฏิบัติการพยาบาลในสถานการณ์ต่างๆ ของนิสิตนักศึกษาพยาบาล ภายใต้สิ่งแวดล้อมในคลินิกที่จำลองให้ใกล้เคียงความเป็นจริงมากที่สุด การจัดการเรียนรู้ในลักษณะดังกล่าวทำให้ผู้เรียนมีประสบการณ์ที่เหมือนจริงในสิ่งแวดล้อมที่ปลอดภัยต่อการเรียนรู้ และผู้ป่วย นิสิตนักศึกษาสามารถปฏิบัติการพยาบาลซ้ำได้จนกว่าจะมีทักษะที่ต้องการ และสามารถจัดให้ผู้เรียนมีประสบการณ์ที่เหมือนกันได้ทุกคน การจัดการเรียนรู้โดยใช้สถานการณ์จำลองให้มีประสิทธิภาพเป็นบทบาทสำคัญของผู้สอน ซึ่งต้องมีความรู้ความข้าใจเกี่ยวกับองค์ประกอบของการเรียนรู้โดยใช้สถานการณ์จำลอง และขั้นตอนในการจัดการเรียนรู้โดยใช้สถานการณ์จำลอง