Medicine and Health Sciences Commons^™

Timelines Of Translational Science: From Technology Initiation To Fda Approval, Laura M. Mcnamee, Michael Jay Walsh, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

While timelines for clinical development have been extensively studied, there is little data on the broader path from initiation of research on novel drug targets, to approval of drugs based on this research. We examined timelines of translational science for 138 drugs and biologicals approved by the FDA from 2010±2014 using an analytical model of technology maturation. Research on targets for 102 products exhibited a characteristic (S-curve) maturation pattern with exponential growth between statistically defined technology initiation and established points. The median initiation was 1974, with a median of 25 years to the established point, 28 years to first clinical …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Peace named Statesboro Herald Humanitarian of the Year

Establishing A Nurse Practitioner Residency Program In A Rural Federally Qualified Health Center: A Feasibility Analysis And Pilot Study, Seson Kahn Dnp, Fnp, Alexa Curtis Phd, Fnp-Bc, Jodie Sandhu Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Projects

Abstract

Rural communities are disproportionately underserved and have been identified as a priority population to improve health outcomes and access to care (Agency for Healthcare Research and Quality [AHRQ], 2015). National organizations have recognized a deficit in primary care providers, recommended nurse practitioners (NPs) as a solution, and supported NP residency programs as a means to prepare and recruit qualified practitioners into communities (Institute of Medicine [IOM], 2010; The Patient Protection and Affordable Care Act [PPACA], 2010). However, there are only three primary care NP residency programs in rural California (National Nurse Practitioner Residency and Fellowship Training Consortium [NNPRFTC], 2015). …

Development Of A Protocol For Implementing A Registered Nurse-Led Annual Wellness Visit In A Primary Care Setting, Jennifer R. Campbell

Doctoral Projects

This project was a quality improvement initiative utilizing a new format to deliver the Medicare Annual Wellness Visit (AWV) to Medicare recipients. The purpose of the project was the development of a protocol for implementing a registered nurse (RN)-led AWV in a primary care setting. The pilot project focused on changing the clinic’s current AWV structure from a provider-led format to a RN-led format. The pilot was geared towards improving care coordination, while enhancing preventive services and early intervention for chronic disease management. The 6-week pilot was used to help identify areas of weaknesses in the registered nurse-led AWV. During …

Preparing For The Merit-Based Incentive Payment Structure: A Value-Based Business Plan, Ali R. Saheb

Doctoral Projects

The notion of delivering value-based care while maintaining corporate vitality in health care is a multifaceted process. Shaping a business model to reflect this process requires the alignment of quality implications, reimbursement initiatives, a framework that takes into account stipulations on reimbursement for different types of clinicians, and an understanding and preparedness for emerging guidelines and nationally recognized structures for quality indicators. When organizations recognize the need for change, but are not yet prepared to implement it, a comprehensive business plan can help the organization visualize a path to success. In this project, the foundation of requirements for a value-based …

A Crosswalk Protocol For Implementation Of The Patient-Centered Medical Home And Meaningful Use At A Midwest Nurse Managed Center, Kaitlyn Rath

Doctoral Projects

Healthcare expenditures in the United States far exceed the spending that occurs in other high-income countries (Squires & Anderson, 2015). However, the healthcare outcomes are poorer in the U.S. on multiple key health care measures including life expectancy and the prevalence of chronic illnesses and comorbid conditions (Squires & Anderson, 2015). New care models not only focus on improvement of key health outcomes, but also on healthcare providers to reduce fragmented care with care coordination. This DNP scholarly project addresses the need for financial stability within a Midwest nurse managed center. This center would benefit from utilization of a new …

Return On Investment Comparison Of Three Payment Models For Chronic Care Management Under Medicare In A Northwestern Physician Hospital Organization, Megan J. Madole

Doctoral Projects

Chronic disease is the most prevalent and costly health condition. The coordination of care provided to those with multiple chronic conditions (MCCs) is suboptimal and fragmented. This population is among the highest utilizers of healthcare, and accounts for the majority of Medicare expenditures annually. Chronic care management (CCM) programs represent evidence-based initiatives shown to improve outcomes, reduce hospital and emergency department utilization, and reduce healthcare costs. Centers for Medicare and Medicaid Services (CMS) have provided various payment models for reimbursement of CCM services. Primary care practices have stated that inadequate reimbursement and confusing payment models are barriers to CCM implementation. …

Zika Virus-Like Particle (Vlp) Based Vaccine, Héléne Boigard, Alexandra Alimova, George R. Martin, Al Katz, Paul Gottlieb, Jose M. Galarza

Publications and Research

The newly emerged mosquito-borne Zika virus poses a major public challenge due to its ability to cause significant birth defects and neurological disorders. The impact of sexual transmission is unclear but raises further concerns about virus dissemination. No specific treatment or vaccine is currently available, thus the development of a safe and effective vaccine is paramount. Here we describe a novel strategy to assemble Zika virus-like particles (VLPs) by co-expressing the structural (CprME) and non-structural (NS2B/NS3) proteins, and demonstrate their effectiveness as vaccines. VLPs are produced in a suspension culture of mammalian cells and self-assembled into particles closely resembling Zika …

The Trilogy Of Health Care: Spirituality And Caring, Bro. Ignatius Perkins, O.P.

Faculty Conference Presentations

Presented at the 2017 Spirituality Forum, Caring for the Human Spirit in the Changing Health Care World, Hospital for Special Surgery, New York, NY, May 8, 2017.

New Mexico Trauma System Funding Strategy, Razvan N. Preda

Doctor of Nursing Practice Scholarly Projects

Trauma is the leading cause of death among individuals 1 to 44 years of age. Nationally, one individual dies of traumatic injuries every three minutes. In the United States, the financial impact of trauma is estimated to be approximately $671 billion annually, spent on direct trauma care and associated costs, such as loss in productive days and rehabilitation. The New Mexico trauma system registered dramatic development over the past 10 years. In 2007, the state had only three designated trauma centers, and today there are 12. However, over the same period, trauma system funding registered an equally dramatic decrease of …

New Outpatient Experience Survey Design: A Quality Improvement Case Study, Nathan Paluso

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate the implementation process for a new survey methodology introduced by Maine Medical Partners (MMP), by following the Plan-Do-Study-Act (PDSA) quality improvement cycle framework. This new survey has been implemented to collect data on patients’ experiences in the MMP outpatient facilities, and is offered to the patients via iPad at check-out after their appointment. Through observation at MMP practices and MMP staff interviews, strengths and weaknesses of the implementation process have been identified. Evidence-based solutions pertaining to the identified weaknesses have been selected through a literature review and are incorporated in recommendations …

2nd Place Research Paper: Patient Activation Among Diverse Populations: A Systematic Review, Megan Kenney

Kevin and Tam Ross Undergraduate Research Prize

The purpose of this article was to review the current research regarding patient activation among diverse populations. Patient activation is defined as an individual’s knowledge, skill, and confidence in managing his or her own health and health care. A total of 62 articles were used in this review (54 primary research articles, six retrospective analyses, and two systematic reviews). Articles were obtained using the EBSCO search engine through the Leatherby Libraries at Chapman University. Preliminary and secondary searches were conducted using the keywords “patient activation.” Only articles published within the last ten years (2007 to 2017) were included to ensure …

Relationship Of Patient Self-Administered Copd Assessment Test (Cat) To Physician Standard Assessment Of Copd In A Family Medicine Residency Training Program, Leigh Johnson, Jessica Burchette, Ivy A. Click, Sandra Alicia Williams

ETSU Faculty Works

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. COPD is of particular concern in certain sectors of the country, including Central Appalachia where our clinic is located. Assessing patients with COPD presents many challenges as symptoms range from those considered "typical" such as shortness of breath and sputum production to those less often identified like anxiety and social isolation. We conducted a pilot study comparing physician standard assessment of COPD to patient self-assessment using the COPD Assessment Test (CAT). The CAT is an eight-item questionnaire that measures the impact COPD has …

The Impact Of Psychological Stress On Neurocognitive Functioning And Decline In Hiv-Positive Adults: A Systematic Review Of The Literature, Katherine Kasper

Honors Scholar Theses

Adults infected with HIV have been living longer and healthier lives with the development of antiretroviral therapies. Aging with HIV, however, leads to a growing number of comorbidities. Evidence strongly supports that older HIV-positive (HIV+) adults are at increased risk for the development of HIV-Associated Neurocognitive Disorders (HAND). Currently, there is limited evidence on the etiological factors and mechanisms of this neurocognitive decline. Recent research suggests the potential interactive effects of psychological stress and HIV on decreased neurocognitive functioning. This systematic literature review seeks to examine existing research with the purpose of analyzing the relationship between psychological stress and neurocognitive …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …

Medical School Watercooler Newsletter - May 7, 2017, Lindsey Lyle

Watercooler Newsletter

This is the May 7, 2017 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

‘The USA Community Helped Me Get Back on My Feet’

May Med School Café- Locating Consumer Health Information

Medical School Graduates Participate in Honors Convocation Ceremony

Sandra Curtis Appointed Manager of Quality Improvement

Mark Your Calendar: OFA Junior Faculty Lunch

Alzheimer’S Disease And The Impact Of Music Therapy A Systematic Literature Review, Hayley Guess

Senior Honors Projects, 2010-2019

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease (AD) has become the most prevalent form of dementia, a term commonly associated with memory loss and other progressive cognitive deficits that compromise patients’ lives. What may begin as a mindlessly misplaced object or momentary inability to recall newly learned information will eventually advance to a loss of personal identity, forgotten loved ones, and utter misperception of reality. Although a cure for AD has yet to be discovered, there are several non-pharmacological treatments that can improve patients’ quality of life and provide temporary relief from …

Characterization Of Neuronal Specific Responses To Induced Misfolded Protein Stress In Caenorhabditis Elegans, Claire Gormley

Senior Honors Projects, 2010-2019

Abstract

Misfolded protein stress has been associated with many types of disease,

including neurodegenerative disorders like Alzheimer’s, Parkinson’s and Huntington’s

disease. When a cell accumulates misfolded proteins in the endoplasmic reticulum,

misfolded protein stress occurs and the unfolded protein response (UPR) is triggered to

induce mechanisms that will allow the cell to either survive or undergo cell death. The

nascent polypeptide associated complex (NAC) is a co-translational chaperone and α/β

heterodimer that manages protein folding and localization, and protects against misfolded

protein stress; changes in NAC function have been linked to both neurodegeneration and

cancer. In these studies, I depleted …

Rat Hind Limb Nociceptive Withdrawal Response To Heat And Mechanical Stimuli Depends On Initial Position Of The Paw But Not Stimulus Location, Giavanna Verdi

Senior Honors Projects, 2010-2019

Mammals rapidly withdraw their hind limb in response to noxious stimulation, which is a protective movement known as the nociceptive withdrawal response (NWR). The NWR has been previously studied in spinalized, decerebrated and anesthetized non-human and human mammals; however, there is minimal information on the NWR in intact, unanesthetized non-human mammals.

The first specific aim was to identify the factors that determine the direction and magnitude of the NWR in intact, unanesthetized rats. Based on previous studies, we hypothesized that the location of stimulation and the initial position of the paw preceding the NWR will influence the direction and magnitude …

A Survey-Based Study Of The Changes To Self-Efficacy, Trust In Coaching, Goal Orientation, And State Anxiety That Occur During A Marathon Training Taper, Erica A. Witoslawski

Senior Honors Projects, 2010-2019

Throughout a sport season, athletes’ physiological systems are constantly broken down and strengthened due to repeated practices and competitions. However, not just the physiological benefits of tapering impact performance. The purpose of this study was to extend the current literature that has found connections between self-efficacy, trust in coaching, state anxiety, goal orientation, and sport performance by assessing these variables during a marathon training taper period. The study analyzed included 29 subjects who were enrolled in a general-education health and fitness course focusing on marathon training through a series of surveys electronically administered 3 times (baseline, pre-taper, and post-taper) throughout …

Impacts Of Birth Plans On Maternal Satisfaction A Literature Review And Focus Group Study, Kaylyn Brooks

Senior Honors Projects, 2010-2019

Purpose: The purpose of this research paper is to investigate existing research for the relationship between birth plans and maternal satisfaction of the labor and birth experience.

Design: The research found and utilized in this paper is formulated into a literature review format and includes research obtained from a focus group of midwives.

Population/Sample: The population of the research obtain for this literature review consisted of pregnant women (at various stages of their pregnancy, labor, and birth) and post-partum women whom had prepared written birth plans.

Variables Studied: Maternal satisfaction of expectant mothers with their personal labor and birth experience …

Repeatability Of Impedance Cardiography In The Measurement Of Cardiovascular Hemodynamics During Exercise, Lindsey Marie Rodriguez

Senior Honors Projects, 2010-2019

Repeatability of Impedance Cardiography Hemodynamic Variables During Treadmill Exercise

Purpose To analyze the day to day repeatability of cardiac hemodynamic measurements using a Physio Flow 07 Enduro during treadmill submaximal exercise.

Methods 21 male subject ages 18 and older were studied. Two graded treadmill exercise tests consisting of two 5-minute steady state stages (Moderate and Vigorous intensity) were performed using the PhysioFlow device at least 48 hours apart. Cardiac hemodynamic measurements were compared between stages and trials using repeated measures ANOVA, intraclass correlations, and Bland-Altman plots.

Results Oxygen consumption (VO₂) and respiratory exchange ratio (RER), were not different …

The Quadriciser’S Effect On Range Of Motion And Upper Body Motor Control In Children With Mixed Quadriplegia Due To Chromosomal Disorders, Jillian P. Serigano

Senior Honors Projects, 2010-2019

PURPOSE: The purpose of this experiment is to determine the effects that the quadriciser has on range of motion and upper body motor control in children with mixed quadriplegia due to chromosomal deletion disorders. METHODS: Two subjects with different chromosomal deletion disorders participated in this study. They completed a 10-week passive exercise intervention using the quadriciser. Range of motion of the elbow and shoulder were taken pre and post quadriciser use for both subjects. For one subject, hip and knee measurements were also taken. Both subjects also completed a timed reach task pre and post quadriciser use to test motor …

Effect Of Biofeedback And Exercise Type On Neural Swallowing Control, Rachel J. Rinehart

Senior Honors Projects, 2010-2019

The clinical efficacy of swallowing exercises is well established in swallowing literature, and biofeedback has been shown to augment cortical hemodynamic response (HDR) during normal swallowing. This study compared HDR during swallowing exercises with and without biofeedback to HDR during normal swallows with and without biofeedback. Healthy adult participants (n=6, mean age=50.83 male=2) were recruited and trained on the following conditions: normal swallowing, swallowing exercise in which a specific physiological target was given (skilled), and swallowing exercises in which no specific physiological target had to be achieved (non-skilled). Biofeedback consisted of submental surface electromyography (sEMG) signals displayed visually. HDR were …

Effects Of Age, Timbre, Pitch Contour, And Background Noise On Melodic Contour Identification And Sentence Recognition By Children, Lindsey M. Seyfried, Sarah A. Troy

Senior Honors Projects, 2010-2019

The researchers collaborated together with the help of Dr. Yingjiu Nie in the Lab of Auditory Perception in Children and Adults on the four research studies completed there. Through these projects, they were involved in all areas of the research process. While they cannot claim the research project as their own, by assisting the graduate students and Dr. Nie, they exposed themselves to how research is conducted in this field and gained valuable knowledge in the process. To conclude the project, they each wrote individual personals reflection to summarize and review the experience.

Interdisciplinary Skill Development During Summer Autism Clinic, Rachel F. Kagle

Senior Honors Projects, 2010-2019

The present paper focuses on the interdisciplinary skill development of speech-language pathology graduate student clinicians and occupational therapy graduate student clinicians in the treatment of children with Autism Spectrum Disorder. This paper explains the significance of these disciplines in the treatment of Autism before giving the results of the study. For the present study, data was collected at James Madison University’s Summer Autism Camp over a four-week period. There were ten speech-language pathology (SLP) clinicians that received the survey and eleven children with Autism that were enrolled in the program. It was hypothesized that the SLP clinicians would display skill …

Maladaptive Behavior And Communication Disorders Following Tbi: Survivor, Caregiver And Speech-Language Pathologists' Perspectives, Marena S. Jones

Senior Honors Projects, 2010-2019

Following traumatic brain injury (TBI), individuals often face neurobehavioral challenges (e.g., aggression) that hinder treatment. Research on the relationship between communication disorders and maladaptive behaviors is limited. Participants from a convenience sample of two survivors of TBI, a caregiver, and a speech-language pathologist were interviewed about their experiences and perspectives. The interviews reflected focused questions that were congruent across participants. Interviews were recorded, transcribed, and coded. Each coder coded the transcriptions individually, they were then compared using consensus coding for reliability, and finally analyzed for emergent themes. The two most referenced themes were “Communication challenges” and “Changes through rehab”. “Communication …

Mother’S Perceptions Of Their Personal Impact On Infant Language Development, Miranda Steinbeck

Senior Honors Projects, 2010-2019

During the early months of a child’s language development, their ability to perceive and process language is very fluid and the language input they receive can have a large impact on their language later in life. From the beginning, children need to be able to differentiate the sounds of speech from the rest of the sounds that occur in their environment (Golinkoff, Can, Soderstrom, Hirsh-Pasek, 2015). In other words, children are exposed to the different sounds in their environment and they begin to pick up on the speech sounds, such as conversation-like interactions, with their parents (Golinkoff et al., 2015). …

The Relationship Between Fundamental Frequency Variation And Articulation In Healthy Speech Production, Casey Behre

Senior Honors Projects, 2010-2019

Fundamental Frequency (F0) and articulation are two factors of speech production that impact speech perception, and yet the potential interactions of these two factors are not well understood. Their relationship has potential theoretical as well as clinical implications. This Honors Project aims to better understand this relationship by examining changes in fundamental frequency (F0) and the acoustic vowel space as an index of articulatory behaviors with a within-speaker approach. Specifically, F0 variations were examined in relation to the acoustic vowel space for 10 male native speakers of American English. Two sets of acoustic measures were made to evaluate F0 and …