Medicine and Health Sciences Commons^™

Community Collaboration To Decrease Atypical Emergency Department Utilization, Becky Wilkinson

Articles, Abstracts, and Reports

No abstract provided.

Insights Into Local Tumor Microenvironment Immune Factors Associated With Regression Of Cutaneous Melanoma Metastases By, Junbao Yang, Maris S Jones, Romela Irene Ramos, Alfred A Chan, Agnes F Lee, Leland J Foshag, Peter A Sieling, Mark Faries, Delphine J Lee

Articles, Abstracts, and Reports

No abstract provided.

Visionary Fall 2017, College Of Optometry

Visionary

No abstract provided.

Perspectives Volume 5: Number 1, Winter-Spring 2017, College Of Health Care Sciences

Perspectives

No abstract provided.

Actionable Patient Safety Solution (Apss) #3d: Pediatric Adverse Drug Events, Ron Jordan, Jerika Lam, Nathaniel Sims, Anne Lyren, Coco Yang

Pharmacy Faculty Articles and Research

This report presents a plan of action for introducing a "program to reduce the incidence of pediatric adverse drug events (pADEs) and harm ... [that] combine[s] leadership strategies, software (healthcare IT), hardware (drug compounding systems, drug delivery technology, and physiological monitoring systems), and most importantly people (changes in clinical practice, protocols and education)" to protect pediatric patients.

The Autocrine Role Of Proteoglycan-4 (Prg4) In Modulating Osteoarthritic Synoviocyte Proliferation And Expression Of Matrix Degrading Enzymes, Ali Alquraini, Maha Jamal, Ling Zhang, Tannin Schmidt, Gregory D. Jay, Khaled A. Elsaid

Pharmacy Faculty Articles and Research

Background: Lubricin/proteoglycan 4 (PRG4) is a mucinous glycoprotein secreted by synovial fibroblasts and superficial zone chondrocytes. Recently, we showed that recombinant human PRG4 (rhPRG4) is a putative ligand for CD44 receptor. rhPRG4-CD44 interaction inhibits cytokine-induced rheumatoid arthritis synoviocyte proliferation. The objective of this study is to decipher the autocrine function of PRG4 in regulating osteoarthritic synoviocyte proliferation and expression of catabolic and pro-inflammatory mediators under basal and interleukin-1 beta (IL-1β)- stimulated conditions.

Methods: Cytosolic and nuclear levels of nuclear factor kappa B (NFκB) p50 and p65 subunits in Prg4+/+ and Prg4-/- synoviocytes were studied using western blot. Nuclear …

Actionable Patient Safety Solution (Apss) #3b: Antimicrobial Stewardship: The Role Of A Pharmacy And The Microbiology Lab In Patient Safety, Jerika Lam, Jason Yamaki, Ron Jordan, Celine Peters, Steven Barker, Michael Ramsay, Ariana Longley, Joe Kiani

Pharmacy Faculty Articles and Research

This report presents a plan of action for introducing an Antimicrobial Stewardship Plan (ASP) to combat the inappopriate use of antimicrobial drugs, which are a significant cause of patient morbidity and mortality.

Carney Complex With Prkar1a Gene Mutation: A Case Report And Literature Review, Qiuli Liu, Dali Tong, Gaolei Liu, Yuting Yi, Dianzheng Zhang, Jun Zhang, Yao Zhang, Zaoming Huang, Yaoming Li, Rongrong Chen, Yanfang Guan, Xin Yi, Jun Jiang

PCOM Scholarly Works

Rationale: Carney complex (CNC) is a multiple neoplasia syndrome with autosomal dominant inheritance. CNC is characterized by the presence of myxomas, spotty skin pigmentation, and endocrine overactivity. No direct correlation has been established between disease-causing mutations and phenotype.

Patient concerns: A 16-year-old boy was admitted because of excessive weight gain over 3 years and purple striae for 1 year. Physical examination revealed Cushingoid features and spotty skin pigmentation on his face, lip, and sclera.

Diagnoses: The patient was diagnosed as Carney complex.

Interventions: the patient underwent right adrenalectomy and partial adrenalectomy of the left adrenal gland. …

Synaptic Up-Scaling Preserves Motor Circuit Output After Chronic, Natural Inactivity, Joseph Michael Santin, Mauricio Vallejo, Lynn K. Hartzler

Biological Sciences Faculty Publications

Neural systems use homeostatic plasticity to maintain normal brain functions and to prevent abnormal activity. Surprisingly, homeostatic mechanisms that regulate circuit output have mainly been demonstrated during artificial and/or pathological perturbations. Natural, physiological scenarios that activate these stabilizing mechanisms in neural networks of mature animals remain elusive. To establish the extent to which a naturally inactive circuit engages mechanisms of homeostatic plasticity, we utilized the respiratory motor circuit in bullfrogs that normally remains inactive for several months during the winter. We found that inactive respiratory motoneurons exhibit a classic form of homeostatic plasticity, up-scaling of AMPA-glutamate receptors. Up-scaling increased the …

Mandarin-English Bilinguals Process Lexical Tones In Newly Learned Words In Accordance With The Language Context, Carolyn Quam, Sarah C. Creel

Speech and Hearing Sciences Faculty Publications and Presentations

Previous research has mainly considered the impact of tone-language experience on ability to discriminate linguistic pitch, but proficient bilingual listening requires differential processing of sound variation in each language context. Here, we ask whether Mandarin-English bilinguals, for whom pitch indicates word distinctions in one language but not the other, can process pitch differently in a Mandarin context vs. an English context. Across three eye-tracked word-learning experiments, results indicated that tone-intonation bilinguals process tone in accordance with the language context. In Experiment 1, 51 Mandarin-English bilinguals and 26 English speakers without tone experience were taught Mandarin-compatible novel words with tones. Mandarin-English …

A Comparative Study Of Cde Utilization Rates And Hospital Admissions For Foot Ulcerations Between Two Hospitals, Amber Toombs

Doctor of Nursing Practice Projects

One of the nine standards of diabetes self-management education declares that education should be performed by an instructor with expertise in diabetes education and management or a certified diabetes educator (CDE). The purpose of the study is to measure the prevalence of referrals to CDEs upon discharge for patients admitted with diabetic foot ulcers compared between two hospital populations, Baptist Hospital in Memphis, TN and NEA Baptist in Jonesboro, AR. Data was collected and reviewed to identify the number of patients who received a referral upon discharge and readmissions rates for these patients. Eighty-six patients were included in the study. …

Improving Syntactic Parsing Of Clinical Text Using Domain Knowledge, Min Jiang

Dissertations and Theses (Open Access)

Syntactic parsing is one of the fundamental tasks of Natural Language Processing (NLP). However, few studies have explored syntactic parsing in the medical domain. This dissertation systematically investigated different methods to improve the performance of syntactic parsing of clinical text, including (1) Constructing two clinical treebanks of discharge summaries and progress notes by developing annotation guidelines that handle missing elements in clinical sentences; (2) Retraining four state-of-the-art parsers, including the Stanford parser, Berkeley parser, Charniak parser, and Bikel parser, using clinical treebanks, and comparing their performance to identify better parsing approaches; and (3) Developing new methods to reduce syntactic ambiguity …

Patient Friendly Formulations Utilizing Hot Melt Extrusion Technology, Manjeet Bhagwan Pimparade

Electronic Theses and Dissertations

This research work exhibited the new outlook of hot melt extrusion technology for orally disintegrating tablet, fast disintegration films and fixed dose combinations. Previous research demonstrated these applications by conventional formulation techniques which has inherent shortcoming of use of large amount of solvent and batch size manufacturing. This present work addressed some of the unique challenges which could provide patients ease of administration and reduce dosing frequencies, and moreover, mitigate the manufacturing challenges. For orally disintegrating tablet study, ethylcellulose, along with a suitable plasticizer, was used as a polymeric carrier. Pore forming agents were incorporated into the extruded matrix to …

Differential Modulation Of Oxycodone Reward And Analgesia By A Cannabinoid Derivative, Hannah Marie Harris

Electronic Theses and Dissertations

No abstract provided.

Workplace Harassment And Attitudes Towards Lgbt People: Differences Across Human Service Occupations In South Florida, Daniel Sheridan, Joseph Zolobczuk, Kiet Huynh, Debbiesiu L. Lee

Florida Public Health Review

Research documents that discrimination and harassment directed toward lesbian, gay, bisexual, and transgender (LGBT) individuals are ongoing and prevalent in the workplaces in the United States. However, no studies have identified the specific occupations wherein LGBT-discrimination and harassment are most severe. Furthermore, no study has examined how prepared and comfortable employees feel in addressing discriminatory situations. Utilizing a dataset comprised of 1,691 participants, in this exploratory study we sought to identify whether differences in workplace environment toward LGBT individuals existed across four human service occupations (mental health, medicine, education, and public and private government-related non-profit community organizations). We found that …

Community Planning For Hiv/Aids Health Services System Transformation, Graham F. Watts, Deidre Kelly, Cindy Watson

Florida Public Health Review

HIV is a public health concern. Duval County schools Youth Risk Behavior Surveillance data on middle and high school students for 2013 reveal high-risk sexual activity; yet, one in five received no formal instructions about HIV/AIDS. Knowing one’s HIV status is pivotal for HIV prevention and treatment. HIV positive youth who seek treatment, and achieve viral suppression have optimal health outcomes and are less infectious. Northeast Florida joins the national initiative to reduce HIV infection. The City of Jacksonville, Ryan White Part-A Program, Florida Department of Health-Duval, and local HIV/AIDS organizations convened a Youth Summit. Conversations focused on how HIV …

A Deliberate Departure: Making Physician-Assisted Suicide Comfortable For Vulnerable Patients, Browne C. Lewis

Law Faculty Articles and Essays

This Article is divided into four parts. Part I discusses the history and evolution of the "right to die movement" in the United States. The current legal landscape in the United States is examined in Part II. In Part III, I analyze some of the relevant ethical concerns caused by the availability of physician-assisted suicide. My analysis primarily focuses on the Oregon statutes because it is the oldest physician-assisted suicide law in the United States and has served as a model for laws in the United States and abroad. For example, Lord Falconer's Bill, which was defeated by the British …

The Effects Of Low-Intensity Therapeutic Ultrasound On Measurable Outcomes: A Critically Appraised Topic, Sarah Daniels, Gabriela Santiago, Jennifer Cuchna, Bonnie Van Lunen

Ellmer School of Nursing Faculty Publications

Therapeutic ultrasound (US) is a popular modality among health care professionals and is used to treat a variety of musculoskeletal conditions. A new technology has been established to allow for the miniaturization of the US unit. Patients receive treatment with the device secured to them, eliminating the portability constraint of traditional US units. Early studies suggest that this portable unit can deliver low-intensity acoustic energy achieving the same temperature increase and pain relief that come from traditional US units, in a more versatile and patient-friendly manner. Clinical Question: What effects does low-intensity therapeutic ultrasound (LITUS) have on measurable outcomes? Summary …

Breed Quality Scores For Post-Cervical Artificial Insemination And The Effects On Farrowing Rate And Total Born At A Commercial Swine Facility In The Southern United States, Kathryn R. Prus

Murray State Theses and Dissertations

The objective of this experiment was to determine the possible relationship between a sow’s ease of breeding on the first service and the farrowing rate and total born. This study was conducted in a commercial farrowing unit in the Southern United States utilizing pen gestation with stock of 6,000 head. Five hundred ninety-seven sows were bred between the months of April and May 2017 were selected for this study. All animals were inseminated using a post-cervical artificial insemination catheter unless insertion of the inner catheter was impossible. The semen dose fell within the following parameters: concentration of 1.5 x 10 …

Cutaneous Squamous Cell Carcinomas In Solid Organ Transplant Recipients: A Single-Center Experience, Joyce Y. Cheng

Yale Medicine Thesis Digital Library

CUTANEOUS SQUAMOUS CELL CARCINOMA IN SOLID ORGAN TRANSPLANT RECIPIENTS: A SINGLE-CENTER EXPERIENCE

Joyce Y Cheng, Fang-yong Li, Christine J Ko, Oscar R Colegio. Department of Dermatology, Yale School of Medicine, New Haven, CT

Solid organ transplant recipients (SOTR) have an approximately 100-fold increased risk of developing cutaneous squamous cell carcinoma (SCC). These SCCs may behave more aggressively than SCCs developing in non-immunosuppressed individuals. The purpose of this study was to gather more data regarding aggressive behavior of SCCs in immunosuppressed SOTRs compared with SCCs occurring in an immunocompetent control group. An 8-year retrospective observational cohort study was conducted to compare …

Relationship Between Assisted Reproductive Technology And Risk Of Stillbirth, Jeani Chang

Walden Dissertations and Doctoral Studies

Assisted reproductive technology (ART) is an infertility treatment used to assist women to become pregnant. Although the procedure is safe, there are gaps in understanding the association between treatment and adverse pregnancy outcomes (e.g., stillbirth) in the United States. The purpose of this study was to investigate the relationship between stillbirth delivery and ART. The 2 research questions addressed the association between methods of conception (ART versus non-ART) and the delivery of a stillbirth, and the association between multiple gestation pregnancy and risk of stillbirths. Retrospective cohort data from the States Monitoring ART collaborative were analyzed using Pearson's chi squared …

The Association Between Dietary Flavonoid Intake And Chronic Obstructive Pulmonary Disease, Systemic Inflammation, And Comorbidity Burden, Tennador Sanderson

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. Dietary habits may have an impact on COPD through anti-inflammatory mechanisms. For this cross-sectional secondary data analysis study, the advanced model of the epidemiology triangle was used as a guide to assess the association between total daily flavonoid intake and COPD diagnosis, COPD severity, systemic inflammation, and comorbidity burden. Data from over 5,100 male and female participants aged 30 and older were obtained from the 2007-2010 National Health and Nutrition Examination Survey. The prevalence of COPD was 5.2% according to spirometry data. Multiple …

Using Nursing Simulation To Improve Early Recognition Of Emergent Situations, Carlene Blais

Walden Dissertations and Doctoral Studies

Nurses' ability to recognize and respond to postoperative patients who require emergent medical care and need immediate assistance during a code blue in the first 10 minutes is essential to improve patient outcomes. This is particularly important for the project site, a 44-bed inpatient surgical specialty hospital located in the Northeast, providing care for patients with head and neck cancer, as the hospital does not have an internal code blue response team. An adjacent facility responds to all code blue emergencies and takes approximately 10 minutes for the team to respond. The purpose of this DNP project was to develop …

Rural Jail Administrators Perceptions Of Take-Home Naloxone To Control Opioid Overdoses, Jaclyn Woollett

Walden Dissertations and Doctoral Studies

Opioid overdoses and overdose deaths have increased significantly throughout the United States. Naloxone distribution has become a harm reduction strategy that has proven effective in reducing opioid overdoses in urban areas through drug treatment centers and needle exchange programs. However, limited research is available on the efficacy and feasibility of these programs in rural locations and other nontraditional settings. Guided by harm reduction theory, the purpose of this qualitative phenomenological study was to address this gap by exploring the feasibility of implementing a take home naloxone program in rural jails. Semistructured interviews were conducted with 6 jail administrators in rural …

Senescence Disorder Literacy Among Prelingual/Culturally Deaf Individuals Age 50 And Older, J. Delores Hart

Walden Dissertations and Doctoral Studies

The preferred method of communication for most prelingual/culturally Deaf individuals is American Sign Language (ASL), and members of this linguistic/cultural minority community are often not recognized as being bilingual. Many prelingually/culturally Deaf individuals have limitations and deficits in English proficiency; which can lead to deficits in general knowledge of health-related terminology. Current projections are that older adults are expected to live longer, and will also experience the development of, increases in and more extended periods of living with senescence/age-related health disorders, also includes prelingual/culturally Deaf individuals. This quantitative research project, utilizing the theoretical framework of health literacy and a modified …

The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow

Walden Dissertations and Doctoral Studies

Pressure ulcers are a serious health condition that have negative consequences for patients and organizations. The primary cause of pressure ulcers is intense and/or prolonged pressure or pressure in combination with shear that results in damage to the skin and underlying soft tissue. Early identification of patients at risk for pressure ulcers and 2-hour repositioning to off-load pressure are key components in reducing pressure ulcer development. Despite ongoing efforts to prevent pressure ulcers, the incidence and prevalence of hospital-acquired pressure ulcers (HAPUs) at the practicum site exceeded the benchmark for Magnet hospitals and the health system's goal of 1%. Patient …

Effective Communication And Teamwork Improve Patient Safety, Helene M. Anderson

Walden Dissertations and Doctoral Studies

Work environment influences the effectiveness of care for patients in any healthcare setting. It is even more important in settings such as the neonatal ICU (NICU) where this project took place. When the environment is not healthy, communication may suffer and result in poor patient outcomes and, family, patient, and staff dissatisfaction. The purpose of this quality improvement project was to understand how the implementation of the TeamSTEPPS program, for nurses in the NICU, could impact the safety culture as measured by the AACN Healthy Work Environment (HWE) tool. Lewin's professional practice change theory and the AHRQ change model were …

Relationship Between Health Care Costs And Type Of Insurance, Macey Buker

Walden Dissertations and Doctoral Studies

Continued escalation in health care expenditures in the United States has led to an unsustainable model that consumes almost 20% of GDP. Policymakers have recognized the need for industry reform and have taken action through the passage of the Affordable Care Act (ACA). The purpose of this quantitative, longitudinal study was to examine the relationship between the type of health insurance and health care costs. Mechanism theory and game theory provided the theoretical framework. The analysis of secondary data from the Healthcare Cost and Utilization Project included a sample of 1,956,790-inpatient hospital stays from 2007 to 2014. Results of one-way …

Healthcare Executive Leadership Development And Succession Planning, Robin Ford Dillard

Walden Dissertations and Doctoral Studies

Business leaders face leadership crises as executives from the baby boomer generation retire, creating a shortage of experienced and knowledgeable leaders. Some business leaders are unprepared for the replacement of retiring senior-level executives and lack strategies for succession planning. The findings of this study indicate succession planning and leadership development play a significant role in preparing future healthcare leaders in their ability to improve the quality of patient care and improve the strategic and financial health of the organization. Guided by the human capital theory the purpose of this multiple case study was to explore the strategies used by healthcare …

Nonresidential Fathers Parenting Their Children Residing In Shelters: A Phenomenological Study, Karen Denise Hudson

Walden Dissertations and Doctoral Studies

This phenomenological qualitative study explored the parenting role of nonresidential fathers of children living in shelters. Special attention was paid to the perceived contributions of these fathers to the overall health and general well-being of their children residing in shelters. Often separations of nonresidential fathers from their children in shelters decreased their contributions to their children's health and well-being. Increased knowledge of these parental roles and contributions can enhance programs and policies to support these fathers in improving the health and well-being of their children. In-depth semistructured interviews were conducted with 6 demographically diverse nonresidential fathers living in Philadelphia. The …