Medicine and Health Sciences Commons^™

Life-Threatening Hypercalcemia During Prodrome Of Pneumocystis Jiroveci Pneumonia In An Immunocompetent Infant, Judith Sebestyen Vansickle, Tarak Srivastava, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Severe hypercalcemia in infants is usually attributed to genetic etiologies and less commonly to acquired ones. An 8-week-old girl presented with failure to thrive, mild respiratory distress, and life-threatening hypercalcemia (23.5 mg/dL). Serum 1,25(OH)2-D) level was elevated and parathyroid hormone undetectable. Evaluation for genetic mutations and malignant etiologies of hypercalcemia was negative. Treatment with intravenous hydration, loop diuretic, and calcitonin failed to correct the hypercalcemia, which was subsequently controlled with bisphosphonate therapy. Due to progressive respiratory deterioration, a bronchopulmonary lavage was done on day 17 of her hospitalization disclosing Pneumocystis jiroveci infection. The subsequent immunological investigation showed no abnormalities. She …

Factors Associated With Post-Arrest Withdrawal Of Life-Sustaining Therapy., Anne V. Grossestreuer, David F. Gaieski, Benjamin S. Abella, Douglas J. Wiebe, Ari Moskowitz, Daniel J. Ikeda, Jason S. Haukoos, Sarah M. Perman

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Most successfully resuscitated cardiac arrest patients do not survive to hospital discharge. Many have withdrawal of life sustaining therapy (WLST) as a result of the perception of poor neurologic prognosis. The characteristics of these patients and differences in their post-arrest care are largely unknown.

METHODS: Utilizing the Penn Alliance for Therapeutic Hypothermia Registry, we identified a cohort of 1311 post-arrest patients from 26 hospitals from 2010 to 2014 who remained comatose after return of spontaneous circulation. We stratified patients by whether they had WLST post-arrest and analyzed demographic, arrest, and post-arrest variables.

RESULTS: In our cohort, 565 (43%) patients …

Adiponectin Partially Rescues High Glucose/High Fat-Induced Impairment Of Mitochondrial Biogenesis And Function In A Pgc-1Α Dependent Manner., H. Wang, W.-J. Yan, J.-L. Zhang, F.-Y. Zhang, C. Gao, Y.-J. Wang, W.B. Lau, L. Tao

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Plasma adiponectin (APN) levels are decreased in diabetic patients. Dysfunctional mitochondrial biogenesis is involved in type 2 diabetes (T2DM) pathogenesis, by unclear mechanisms. The present study determined (1) whether myocardial mitochondrial biogenesis was impaired in cardiomyocytes exposed to a high glucose/high fat (HGHF) medium (a T2DM in vitro model), (2) the effects of APN administration upon mitochondrial biogenesis in cardiomyocytes affected by HGHF incubation, and 3) the involved underlying mechanisms.

MATERIALS AND METHODS: Neonatal rat ventricular myocytes (NRVMs) were isolated and incubated in HGHF medium. Mitochondrial function was assessed by ATP content, and fluorescent microscopic analysis of myocardial apoptosis …

Women’S Narratives Of Living In Polygamous Marriages: Rural Malawian Experience Distilled And Preserved In Poetic Constructions, April Yerges, Patricia E. Stevens, Lucy Mkandawire-Valhmu, Wendy S. Bauer, Thokozani Mwenyekonde, Lance Weinhardt, Loren W. Galvao

College of Nursing Faculty Research and Publications

Polygamy in sub-Saharan Africa has been linked to poverty, infant mortality, and HIV; however, it is unknown how interpersonal dynamics within polygamous households may influence population health outcomes. Findings from this postcolonial feminist study derive from interview data in a larger mixed-methods study in rural Malawi. We used thematic narrative analysis to probe 25 women's stories and applied an arts-based research technique, poetic construction, to present the results. Participants' evocative expressions, distilled and preserved in poetic form, illustrate themes of perseverance, grief, agency, and reflection. We discuss how gender relations, childrearing, tradition, economics, and health intersect in polygamous households.

Taurine's Effect On Cocaine Reward And Neurogenesis In The Adolescent Male Rat Brain., Avery E. Villa-Gonzalez

Dissertations and Theses

Adolescence is a developmentally critical transition from childhood to adulthood including both maturation of the body and the brain. Neuroplastic changes result in dynamic organization of the brain during adolescence, leaving them vulnerable to development of mental illness and drug-seeking behavior. According to the United Nations Office on Drugs and Crime, the psychostimulant cocaine is the second most popular illicit drug in the world. Cocaine, amongst having many detrimental effects, has shown to also decrease hippocampal neurogenesis, resulting in decreased neuroplasticity and cognitive dysfunction. Previous students in our laboratory have shown that treatment of adult male rats with the essential …

Automatic Optimum Atlas Selection For Multi-Atlas Image Segmentation Using Joint Label Fusion, Kofi Agyeman

Dissertations and Theses

Multi-atlas image segmentation using label fusion is one of the most accurate state of the art image segmentation techniques available for biomedical imaging applications. Motivated to achieve higher image segmentation accuracy, reduce computational costs and a continuously increasing atlas data size, a robust framework for optimum selection of atlases for label fusion is vital. Although believed not to be critical for weighted label fusion techniques by some works (Sabuncu, M. R. et al., 2010, [1]), others have shown that appropriate atlas selection has several merits and can improve multi-atlas image segmentation accuracy (Aljabar et al., 2009, [2], Van de Velde …

Effectiveness Of A Natural Family Planning Service Program, Richard J. Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

Purpose: The aims of this study were to determine and compare extended use-effectiveness of an online nurse-managed fertility education service program among women (and subgroups of women) seeking to avoid pregnancy.

Study Design and Methods: This was a 24-month prospective study of a university-based online Web site with 663 nonbreastfeeding women using an online charting system to avoid pregnancy. Participants tracked their fertility online with either cervical mucus monitoring, electronic hormonal fertility monitoring, or both fertility indicators. Unintended pregnancies were validated by professional nurses.

Results: Participants had a mean age of 30.4 years (SD = 6.3) and mean 1.7 children …

Preparing Family Caregivers To Recognize Delirium Symptoms In Older Adults After Elective Hip Or Knee Arthroplasty, Margaret J. Bull, Lesley Boaz, Mehdi Maadooliat, Mary E. Hagle, Lynn Gettrust, Maureen T. Greene, Sue Baird Holmes, Jane S. Saczynski

College of Nursing Faculty Research and Publications

Objectives

To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers.

Design

Mixed-method, pre–post quasi-experimental design.

Setting

A Midwest Veterans Affairs Medical Center and a nonprofit health system.

Participants

Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention.

Intervention

Four telephone-based education modules using vignettes were completed during the 3 weeks before the older adult's hospital admission for elective hip or knee replacement. Each module required 20 to 30 minutes.

Measurements

Interviews were conducted before the intervention and 2 weeks and 2 months …

Effect Of Sequence Of Simulated And Clinical Practicum Learning Experiences On Clinical Competency Of Nursing Students, Jamie Hansen, Marilyn Bratt

College of Nursing Faculty Research and Publications

Two different sequences of blocks of simulated and clinical practicum learning experiences compared the clinical competency development of nursing students using a randomized crossover design. Competency was measured 3 times: after each block of simulated and clinical experiences and after a final simulated experience. No significant differences in competency scores between the 2 groups across the 3 time points were found. Using alternative models of clinical and simulation learning may help address barriers to the delivery of clinical education faced by schools of nursing

Rankings Matter: Nurse Graduates From Higher-Ranked Institutions Have Higher Productivity, Olga Yakusheva, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Increasing demand for baccalaureate-prepared nurses has led to rapid growth in the number of baccalaureate-granting programs, and to concerns about educational quality and potential effects on productivity of the graduating nursing workforce. We examined the association of individual productivity of a baccalaureate-prepared nurse with the ranking of the degree-granting institution.

Methods

For a sample of 691 nurses from general medical-surgical units at a large magnet urban hospital between 6/1/2011–12/31/2011, we conducted multivariate regression analysis of nurse productivity on the ranking of the degree-granting institution, adjusted for age, hospital tenure, gender, and unit-specific effects. Nurse productivity was coded as “top”/“average”/“bottom” …

Nursing Students’ Perception Of The Stigma Of Mental Illness, Abir K. Bekhet, Carolyn J. Murrock, Qiyan Mu, Harpreet Singh-Gill

College of Nursing Faculty Research and Publications

Background: Mental health disorders are highly prevalent in the U.S. Nursing students’ perceptions regarding the stigma of mental illness will impact the quality of care delivered and the patients’ outcomes.

Method: Data was collected from 64 sophomore students. Five open ended questions were distributed to the students during the first class. All the surveys were collected by a volunteer student and were placed in the instructor’s mailbox in a sealed envelope.

Results: The results revealed three categories: students ‘perceptions of the causes of mental illness stigmatization, their own perception of mental illness, and their perception on how to break the …

Fertility Care Services, Richard J. Fehring

College of Nursing Faculty Research and Publications

The Catholic Church calls married couples to responsible parenthood; this includes both openness to new human life and the avoidance of pregnancy when serious reasons present themselves. Natural methods of family planning respect the dignity of the person and the integrity of the sexual act. They treat fertility as a natural process rather than a disease. Natural family planning (NFP) works with a woman’s menstrual cycle; it uses awareness of fertile and infertile times to achieve or avoid pregnancy and allows married couples, through their awareness, to respect and maintain both the unitive and the procreative aspects of the sexual …

Development And Psychometric Evaluation Of The Nurses Professional Values Scale-3, Darlene Weis, Mary Jane Schank

College of Nursing Faculty Research and Publications

Background and Purpose: The Nurses Professional Values Scale-3 (NPVS-3) is an instrument derived from the American Nurses Association Code designed to measure nurses' professional values. The purpose of this study was to examine its psychometric properties. Methods: A random sample of 1,139 baccalaureate nursing students, graduate nursing students, and practicing nurses participated. The 28-item Likert-scale instrument was subjected to exploratory and confirmatory factor analysis. Principal components analysis with varimax rotation and Kaiser normalization resulted in a 3-factor solution. Results: Findings supported internal consistency reliability of 3 factors with alpha coefficients from .80 to .91 and total scale coefficient of .94. …

Cesarean Deliveries And Maternal Weight Retention, Kandice A. Kapinos, Olga Yakusheva, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Cesarean delivery accounts for nearly one-third of all births in the U.S. and contributes to an additional $38 billion in healthcare costs each year. Although Cesarean delivery has a long record of improving maternal and neonatal mortality and morbidity, increased utilization over time has yielded public health concerns and calls for reductions. Observational evidence suggests Cesarean delivery is associated with increased maternal postpartum weight, which may have significant implications for the obesity epidemic. Previous literature, however, typically does not address selection biases stemming from correlations of pre-pregnancy weight and reproductive health with Cesarean delivery.

Methods

We used fetal malpresentation …

Answering Wicked Questions: Dealing With Opposing Truths As A Nursing Associate Professor, Robert V. Topp, Patricia E. Hershberger, Marilyn Bratt

College of Nursing Faculty Research and Publications

Nursing associate professors frequently are confronted with increasing responsibilities and fewer resources. These challenges commonly contribute to declines in job satisfaction and may result in departing academe. This article addresses these challenges by providing answers to four common “wicked questions” experienced by nursing associate professors: (a) How do I decline a request from a supervisor to take on additional responsibilities while continuing to support the mission of the school and advance my own scholarly productivity? (b) How do I handle the workload of multiple doctoral students with a variety of content areas that are different from my own and maintain …

Addressing Traumatic Stress In The Acute Traumatically Injured Patient, Claire Frank, Kathryn Schroeter, Chris Shaw

College of Nursing Faculty Research and Publications

Psychological injuries after an acute traumatic event are commonly overlooked. Currently within United States, there is no consistently utilized screening process that addresses traumatic stress within the acute trauma population. Roy's Adaptation Model guided this project, focusing on the idea that bedside nurses are at the frontline of providing early identification through nursing assessment. The purpose of this pilot study was to evaluate whether the implementation of the Primary Care-Posttraumatic Stress Disorder (PC-PTSD) screening tool by bedside nurses would result in identifying more patients at risk for traumatic stress after an acute trauma as compared with the use of no …

Current Medical Research: Summer/Fall 2016, Richard J. Fehring, Qiyan Mu

College of Nursing Faculty Research and Publications

No abstract provided.

Examining The Relationship Between Clinical Judgment And Nursing Actions In Prelicensure Students, Andrea Stuedemann Fedko, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Faculty frequently use the Lasater Clinical Judgment Rubric (LCJR) to identify students’ clinical judgment; however, it is unclear whether LCJR scores relate to appropriate nursing action. In a pilot study consisting of senior-level nursing students (N = 22), participants were scored on the LCJR and anticipated nursing actions, and results were analyzed using simple linear regression. There was a statistically significant correlation (r = 0.364) between clinical judgment and nursing action. Results suggest that total LCJR scores may be an indicator of the completion of indicated nursing action.

Quality Of Life And Depression Among Patients With Type I Diabetes: A Study Of Gender Differences, Eisha Gohil, Ruby Charak, Haroon Rashid, Priyanka Sharma

Psychological Science Faculty Publications

Diabetes is a progressive chronic condition which places a significant burden of self management on the individual, such as daily monitoring and medications management, worry about the future and distress about the impact of diabetes on various aspects of life. It is a group of metabolic diseases characterized by elevated blood glucose levels (hyperglycemia) resulting from defects in insulin secretion, insulin action or both. The present study aimed to assess gender differences in quality of life and depression in patients suffering from type I diabetes. A sample of 70 participants (44 male and 26 female) in the age range of …

What Is The Purpose Of The Orphan Drug Act?, Matthew Herder

Articles, Book Chapters, & Popular Press

The Orphan Drug Act (ODA) [1], first enacted in the United States in 1983, was set up to encourage the development of drugs for rare diseases. At that time, drug therapies for such diseases were rarely developed. Three decades later, a growing proportion of industry research and development (R&D) [2] and regulatory drug approvals [3] target diseases affecting fewer than 200,000 persons in the United States, the prevalence-based threshold of rare disease under the ODA.

In a new article published in PLOS Medicine, Aaron Kesselheim and colleagues document an embedded trend: within the …

The Efficacy Of Biofeedback And Its Use Towards Adhd, Darius Witold Bieganski

CMC Senior Theses

Attention deficit hyperactivity disorder (ADHD) is a psychopathology commonly characterized by general inattentiveness and/or a lack of impulse control resulting in hyperactive tendencies. ADHD is estimated to cost the United States roughly $266 billion every year. ADHD is currently treated via medications, cognitive behavioral therapy, or more recently, neurofeedback. Neurofeedback – and biofeedback in general – is the process of providing a patient with information about autonomic bodily functions so that they may control said autonomic function. In the case of ADHD, neurofeedback focuses on reinforcing the behaviors and sensations associated with attentiveness. Currently however, neurofeedback systems are large and …

Prevention Of Ovarian And Endometrial Cancer By Combined Oral Contraceptives: A Demographics Study, Joanna S. Heywood

CMC Senior Theses

Endometrial cancer is the most common gynecologic cancer with 54,870 cases occurring in the United States in 2015 and causing 10,170 deaths, an 18.5% mortality rate (Elit and Reade, 2015). Ovarian cancer, while less common, is much more fatal. In 2015 in the United States, 21,290 cases occurred and resulted in 14,180 deaths, a 66.6% mortality rate. This mortality rate makes ovarian cancer the fifth most deadly cancer for women in the United States, which is largely explained by ineffective screening strategies and limited treatment possibilities (Cramer, 2012). Thus, developing effective prevention strategies is especially important to saving the lives …

Molecular Modeling Of Novel Tryptamine Analogs With Antibiotic Potential Through Their Inhibition Of Tryptophan Synthase, Jared Schattenkerk

CMC Senior Theses

The growing prevalence of antibiotic-resistant bacteria is a global health crisis that threatens the effectiveness of antibiotics in medical treatment. Increases in the number of antibiotic-resistant bacteria and a drop in the pharmaceutical development of novel antibiotics have combined to form a situation that is rapidly increasing the likelihood of a post-antibiotic era. The development of antibiotics with novel enzymatic targets is critical to stall this growing crisis. In silico methods of molecular modeling and drug design were utilized in the development of novel tryptamine analogs as potential antibiotics through their inhibition of the bacterial enzyme tryptophan synthase. Following the …

Hispanic Use Of Alternative Medicine As Demonstrated In Internet Searches, Elad Yom-Tov, William F. Strong, Lupita Rodriguez Strong

Communication Faculty Publications

Objective: We investigated how cultural shifts occur with respect to the use of traditional medicine for influenza-like illness (ILI) within the Latino population near the US-Mexico border.

Methods: We extracted searches of ILI treatments (modern, traditional western, and traditional Hispanic) to the Bing search engine from 5 US states near the US-Mexico border. The incidence of these searches was correlated with county-level demographic data and ILI incidence.

Results: The fraction of queries related to Hispanic medicines is correlated with the distance from the US-Mexico border (Spearman rho = -0.24), which is a slower decay than that observed in the use …

Structure-Function Investigation Of Proteins Involved In Cellulose Biosynthesis By Escherichia Coli, Thomas Brenner

Theses and Dissertations (Comprehensive)

Bacteria thrive within multicellular communities called biofilms consisting of a self-produced matrix. Biofilm matrices improve bacterial adherence to surfaces while creating a barrier from host immune responses, disinfectants, antibiotics and other environmental factors. Persistent colonization by the widely distributed pathogens, Escherichia coli and Salmonella spp., has been linked to production of biofilms composed of the exopolysaccharide cellulose. Cellulose-containing biofilms are also important to Acetobacter, Sarcina, Rhizobium and Agrobacterium species to form symbiotic and pathogenic interactions. In Enterobacteriaceae, two operons (bcsABZC and bcsEFG) are proposed to encode for proteins that form a cellulose biosynthetic complex that spans the …

Protocol Based Screening Tools To Identify Sepsis Patients Transported By Emergency Medical Services, Isaiah Moser

Honors Undergraduate Theses

Sepsis is a complicated disorder in which an infection has reached the bloodstream and caused a cascade of events that in time will lead to death. Interventions aimed at identifying sepsis early in its progression are imperative to stopping the process. The purpose of this study is to examine the current state of the literature regarding sepsis screening tools utilized by emergency medical services. A literature review exploring the various tools in place was conducted to see their value in predicting sepsis and secondary what the initiation of a sepsis alert has on the patients’ outcome. Results found included that …

Pain Management In Patients With Fibromyalgia, Linsey Fischer

Honors Undergraduate Theses

Fibromyalgia is a chronic widespread pain disorder that can also cause fatigue, depression, sleep disturbances, and cognitive symptoms. Because the etiology of fibromyalgia is unknown, it is difficult to treat. Research shows that medication alone is insufficient to treat the symptoms of fibromyalgia and that complementary therapies are required to fully manage this disorder. The purpose of this research was to determine what complementary therapies patients with fibromyalgia were currently using. The sample for the survey was taken from fibromyalgia support groups throughout the state of Florida. A total of 15 people diagnosed with fibromyalgia participated in the survey. The …

Exploring Barriers And Consequences Related To Nurses Reporting Child Abuse, Asmita Devkota

Honors Undergraduate Theses

Background: Child abuse is a pervasive and serious problem in the United States. Over 3 million children are the victims of some kind of physical assault by adults. Due to their prolonged contact with children and opportunity to report, nurses should be trained to accurately assess, identify, and manage cases of child abuse. The purpose of this study was to examine student’s experiences with Child Protective Services, and explore their confidence and attitudes related to identifying and reporting child abuse. Factors associated with non-reporting were identified.

Methodology: This was an exploratory, descriptive study. Students enrolled in the online …

Associations Between Pre-Pregnancy Weight Status And/Or Gestational Weight Gain And Obesity In Older Children, Marisa P. Hammond

Honors Undergraduate Theses

Childhood obesity is a global health concern that puts children at risk for developing serious health complications. With increasing rates worldwide, it is important to determine how to decrease its prevalence and promote prevention in future generations. Emerging evidence indicating that pre-pregnancy weight status and/or gestational weight gain (GWG) may be linked with overweight/obesity in children. Much of this body of research focused on weight status of offspring at birth and at preschool age. The purpose of this study is to: (1) analyze the research findings regarding obesity in children 5 to 18 years and their mother’s pre-pregnancy weight status …

Canine-Assisted Therapies Among U.S. Veterans With Post Traumatic Stress Disorder: An Integrative Review Of The Literature, Olivia A. Kondos

Honors Undergraduate Theses

A sizeable number of U.S. veterans of all ages experience post-traumatic stress disorder (PTSD) which can impact their quality of life; physically, mentally and socially. Consequences of PTSD are associated with physical and emotional disabilities, including ideation of self-harm and even suicide. Increasingly, animal-assisted therapies (AAT) are used to treat PTSD and other physical and behavioral conditions in veterans. Over the decades, AATs have used dogs, cats, horses, and dolphins among other animals. The purpose of this integrative review is to examine the use of AAT focusing on canine assisted therapy (CAT) among veterans diagnosed with PTSD. The methodology involved …