Medicine and Health Sciences Commons^™

Type 2 Diabetes, Aj Mimlitz

Global Issues in Public Health

The purpose of this two page educational document is to inform not only educators, but also students about the description of type two diabetes and what populations are affected, the epidemiology of type 2 diabetes, including how get diagnosed and how that diagnosis will affect specific outcomes, and the solutions to how we can prevent or begin to cure type 2 diabetes. This brief project shows plenty of statistics revolving around these main points. Research shows that “type 2 diabetes already causes 5 million deaths per year, expecting to become the 7th cause of death globally by 2030” (Alidrisi & …

Food Insecurity: United States, Courtney Handzel

Global Issues in Public Health

Food insecurity is a global issue and has caused struggles to millions of people, specifically in the United States. This environmental issue involves not having the resources to obtain adequate food supply. The economic and social influences that affect food insecurity leave vulnerable populations, such as low-income families and minority races, at a greater disadvantage. This issue causes serious health complications to arise too, the most common being diabetes. The increased risk of diabetes due to food insecurity has been studied on several occasions and the results all show the correlation, lack of food security increases the risk of diabetes. …

Water Scarcity: Sudan, Catherine Priebe

Global Issues in Public Health

Water scarcity is an environmental global problem that will only become more pressing as time goes on. It is a public health issue that affects every continent, although certain areas of the world are facing more serious water scarcity than others such as Sudan. Populations that are more vulnerable to the effects of water scarcity are the poor, women, children, and those living in areas of political unrest. For example, South Sudan’s urban water systems have been damaged during recent warfare. Water scarcity is also an issue that disproportionately affects women who are forced from a young age to travel …

Sr. Lucy: Vocational Conflict, Cynthia Johnson

Ask a Sister: Interview Wisdom from Catholic Women Religious

I interviewed Sr. Lucy in January of 2018 to explore her life experiences as a woman religious. This paper includes a portion of the interview in which she spoke about her vocational conflicts over the years, and how she overcame them.

Association Between Immunological Reactivity With Tetrabromobisphenol-A And Autoimmune Target Sites Of The Nervous System, Datis Kharrazian

Health Sciences Program Student Theses, Dissertations and Capstones

Tetrabromobisphenol-A (TBBPA) is the most widely used flame retardant. Flame retardants are sprayed on furniture, mattress beds, children’s pajamas, car seats, upholstery, carpets, and rugs in the United States. Chemical immune reactivity may play a role in the epidemic of autoimmune disease. The goal of this research is to investigate whether any correlation exists between immunological reactivity to TBBPA, a key chemical used in most flame retardants, and neurological autoimmune target sites that are associated with neurological autoimmune diseases with a diverse and specific list of antibodies that include myelin basic protein, myelin-associated glycoprotein, alpha-synuclein, aquaporin receptors, and S100B antibodies …

Medical Literary Messenger (Vol. 5, No. 2, Spring/Summer 2018)

Medical Literary Messenger

The Essentials / Dave Morrison -- Sometimes I Pretend / Emily Pineau -- Psalm for Anorexia / Elizabeth Gauffreau -- On Harvey Dent / Bryan Walpert -- On the Level / Jane Blanchard -- Cirrhosis / Arthur Ginsberg -- Open Microphone / Stuart M. Terman -- Guest Lavatory, Beaumont Hospital, Day Five / John Jeffire -- Change of Heart / Rosie Sorenson -- Code Blue / Caroline Mosher -- Beautiful Pulses / Paul Hostovsky -- The Hospital and After / Michele Levy -- Mouth to Mouth / Charles H. Halsted -- A Meditation on Memory and Morocco / Janie Breggin …

Rita, Rita, Tsos

TSOS Interview Gallery

Rita Alkhaledy grew up in Sadr City, a poor suburb of Baghdad. Her father is an Iraqi Arab and her mother was Kurdish Iranian. Her mother lived in fear that she would be cast out of Baghdad as being an outsider in Iraq was frowned upon. Her father served in the Iraqi army in the 80s and was gone a great deal, leading to a strained relationship. Their relationship was mended when her mother died from cancer.

After the Iraq war, Rita and her brothers realized that their lives were in danger. They had to move from house to house …

The Effect Of Ostomate-To-Ostomate Support On Psychosocial Adaptation To Stoma, Marjorie C. Summers

Doctor of Nursing Practice Projects

Approximately one million people in North America are living with an ostomy, and an additional 100,000 will undergo ostomy surgery annually. Persons living with ostomies, often referred to as ostomates, require specialized care and management to sustain physical health and quality of life. Fecal diversion ostomates, when compared to the general population, are more likely to experience psychological disturbance and higher levels of depression. These ostomates have reported increased loneliness, lowered self-esteem, decreased or absent libido, irritability, suicidal ideation, poor self-image, and symptoms of generalized anxiety disorder and social phobia. Being an ostomate has been associated with a reduction in …

The Effect Of Fall Prevention Education That Includes A Fall Safety Agreement On Fall Incident Rates, Rebecca Dotson

Doctor of Nursing Practice Projects

Patients experiencing falls while in the acute care setting is a challenge that plagues healthcare. In 2014, 29 million hospitalized patients fell causing 7 million injuries. Eighty-five percent or greater of unfavorable hospital occurrences are linked to falls. Falls occur regularly and can have detrimental effects both physically and psychologically. Literature reviews revealed encouraging results in relation to a reduction in falls with fall prevention education and the use of a fall safety agreement. The purpose of this project was to explore the effect of fall prevention education including a fall safety agreement on falls and falls with injury during …

Use Of The Coleman Transition Model To Reduce Copd Readmissions, Sara Briggs

Doctor of Nursing Practice Projects

This paper explores the use of the Coleman Transition Model as an evidenced based intervention to reduce 30-day readmissions of Chronic Obstructive Pulmonary Disease (COPD) patients on a pulmonary unit. Nearly 20% of Medicare beneficiaries are re-hospitalized within 30 days after discharge, resulting in an annual cost of approximately $17 billion. Hospitals can engage in activities to lower their rate of readmissions. The evidenced based intervention includes robust case management using The Coleman Transition Model in hospitalized COPD patients to reduce readmissions. COPD is a prevalent, complex, and costly condition to manage. COPD is now the third leading cause of …

Patient Deterioration Simulation Education And New Graduate Nurses' Self-Confidence And Competence, Heather B. Norris

Doctor of Nursing Practice Projects

Inconsistent identification and intervention for patient deteriorations has been identified as a global healthcare issue that has a profound effect on patient outcomes. Failure to rescue (FTR) rates are influenced by the quality of care a hospital provides in the event of patient deterioration. Rapid Response Teams (RRTs) are summoned to the bedside in the event of a patient deterioration to assess the patient and intervene quickly. Efficient use of RRTs prevents cardiopulmonary arrests and decreases hospital mortality, thirty-day morality, and length of stay. Patient deterioration simulation education can improve the use of RRTs and positively influence patient outcomes. New …

A Process Improvement For Depression Screening And Management In A University Health Clinic, Margaret H. Zoellers

Doctor of Nursing Practice Projects

Research indicates that among college students, there is a high prevalence of depression that is frequently undiagnosed and untreated, placing students at risk of impaired academic performance and suicidal behavior. The purpose of the evidence-based process improvement was: a) establish a depression screening and management protocol in the university health clinic, and b) increase university health clinic providers’ knowledge of evidence-based depression screening and management. Family nurse practitioner providers in the university health clinic (n=6) participated in a depression screening and management education program. Knowledge of evidence-based depression screening and management was measured prior to and after the program. A …

Care Coordination: Using A Nurse Navigator In An Endoscopy Unit, Judith L. Poe

Doctor of Nursing Practice Projects

Compliance with colorectal cancer (CRC) screening in Kentucky is low. This is substantiated by Kentucky having the highest rate of new CRC cases in the nation and being the fourth highest in CRC-related mortality. Kentucky’s colorectal screening rate in 2012 was 62.9%. The incidence rate for colorectal cancer in Kentucky is 49.2 per 100,000 which is the highest rate in the United States. Patient navigation has shown promise in increasing compliance with CRC screening and reducing health disparities. The adoption of a patient navigation model in an endoscopy unit can increase efficiency, reduce patient cancellations and same day no show …

Best Practices For Screening, Identification, And Referral Of Female Collegiate Athletes With Disordered Eating, Brenda Caudill

Doctor of Nursing Practice Projects

Eating disorders have the highest mortality rate of any mental illness, including depression. Female collegiate athletes are at greater risk compared to the non-athlete population. Athletic personnel should be prepared to screen, identify, and refer female athletes for eating disorders. However, most staff are not familiar with common signs and symptoms of disordered eating, which could delay recognition of unhealthy behavior and ultimately long-term health risks. Appropriate screening protocols can assist with early identification. The purpose of this DNP project was improve the knowledge of the athletic staff regarding eating disorder recognition, awareness of university policy for identification and referral …

Designing A Nurse Residency Program For Cultural Fit: A Pilot Project, Melinda Blair

Doctor of Nursing Practice Projects

New graduate registered nurse (NGRN) turnover in an acute care setting is estimated between 35% - 61% nationally and is costly to an organization. Costs are estimated between $60,000 – $90,000 dollars to replace one NGRN. A smooth transition from student nurse to professional nurse is fraught with problems, including increased job stress and pressures imposed on the NGRN from a high-paced, uncertain health care environment. The purpose of this project was to design a customized nurse residency program (NRP) curriculum to increase NGRN retention. NRP curriculum elements were identified using findings from the Casey Fink Graduate Nurse Experience Survey …

A Nurse Mentor Program In A Long Term Acute Care Hospital, Regina Masters

Doctor of Nursing Practice Projects

Nurse turnover is a national problem with the potential to affect quality of care and patient outcomes. A Long Term Acute Care Hospital (LTACH) with nurse turnover rates above the national average as high as 28% sought to address this problem. A review of the literature identified nurse mentor programs increasing registered nurse (RN) satisfaction and decreasing turnover. Therefore, the purpose of this project was to implement a mentor program for newly hired RNs. Mentors were paired with new RNs for a four-week program. Pre and post intervention data were collected via the McCloskey Mueller Nurse Satisfaction Survey (MMSS) and …

Medication Error Reporting To Improve Patient Safety, Dianna Madden

Doctor of Nursing Practice Projects

In 2006, the Institute of Medicine estimated that 1.5 million preventable adverse drug events occur in healthcare facilities annually (Institute of Medicine, 2006). Each ADE adds approximately $8,750 per hospital stay (Institute of Medicine, 2006). In 2017, the Food and Drug Administration (FDA) estimated that 1.3 million people are injured annually from medication errors (Agency for Healthcare Research and Quality, 2017). For the purposes of this project, all Registered Nurse staff on the Medical-Surgical unit were mandated to participate in an education targeted at medication error reporting, the importance of reporting, and a demonstration of inputting an error into the …

A Scoping Review Of Biopsychosocial Risk Factors And Co-Morbidities For Common Spinal Disorders, Bart N Green, Claire D Johnson, Scott Haldeman, Erin Griffith, Michael B Clay, Edward J Kane, Juan M Castellote, Shanmuganathan Rajasekaran, Matthew Smuck, Eric L Hurwitz, Kristi Randhawa, Hainan Yu, Margareta Nordin

Physical Therapy Collection

OBJECTIVE: The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders.

METHODS: A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities.

RESULTS: Of …

Modeling The Expenditure And Recovery Of Anaerobic Work Capacity In Cycling, Phoebe Bickford, Vijay Sarthy M. Sreedhara, Gregory M. Mocko, Ardalan Vahidi, Randolph Hutchison

Health Sciences Publications

The objective of this research is to model the expenditure and recovery of Anaerobic Work Capacity (AWC) as related to Critical Power (CP) during cycling. CP is a theoretical value at which a human can operate indefinitely and AWC is the energy that can be expended above CP. There are several models to predict AWC-depletion, however, only a few to model AWC recovery. A cycling study was conducted with nine recreationally active subjects. CP and AWC were determined by a 3-min all-out test. The subjects performed interval tests at three recovery intervals (15 s, 30 s, …

An Experimental Protocol To Model Recovery Of Anaerobic Work Capacity, Vijay Sarthy M. Sreedhara, Gregory M. Mocko, Randolph Hutchison

Health Sciences Publications

Models of fatigue are based on physiological parameters such as Critical Power (CP) and Anaerobic Work Capacity (AWC). CP is a theoretical threshold value that a human can generate for an indefinite amount of time and AWC represents a finite expendable amount of anaerobic energy at intensities above CP. There is an increasing interest in developing mathematical models of energy expenditure and recovery for athletic training and human performance. The objective of this research is to propose and validate a model for recovery of AWC during a post exertion recovery interval of cycling. A cycling …

Suicide Risk By Unit Component Among Veterans Who Served In Iraq Or Afghanistan, Tim Bullman, Aaron Schneiderman, Robert Bossarte

Clinical and Translational Science Institute

This study assessed the risk of suicide by time since separation from the military for US veterans who served in Iraq or Afghanistan. Suicide risk was assessed by comparing the number of suicides among veterans, when stratified by active vs. reserve/National Guard status to the expected number based on rates of suicide in the US general population. Hazard rates were used to assess suicide risk since the time each veteran separated/deactivated from active duty service. Compared to the US general population, active duty veterans had a 56% increased risk of suicide and reserve/National Guard veterans had a 29% increased risk. …

Navigating The "No Man's Land" Of Tki-Failed Egfr-Mutated Non-Small Cell Lung Cancer (Nsclc): A Review, Bryan Oronsky, Patrick Ma, Tony R. Reid, Pedro Cabrales, Michelle Lybeck, Arnold Oronsky, Neil Oronsky, Corey A. Carter

Clinical and Translational Science Institute

As the leading cause of cancer-related mortality, lung cancer is a worldwide health issue that is overwhelmingly caused by smoking. However, a substantial minority (~25%) of patients with non–small cell lung cancer (NSCLC) has never smoked. In these patients, activating mutations of the epidermal growth factor receptor (EGFR) are more likely, which render their tumors susceptible for a finite period to treatment with EGFR tyrosine kinase inhibitors (TKIs) and confer a better prognosis than EGFR wild-type NSCLC. On progression, due to the inevitable insurgence of resistance, TKIs are generally followed by second- or third-line salvage chemotherapy until treatment failure, after …

The Endogenous Cannabinoid System: A Budding Source Of Targets For Treating Inflammatory And Neuropathic Pain, Giulia Donvito, Sara R. Nass, Jenny L. Wilkerson, Zachary A. Curry, Lesley D. Schurman, Steven G. Kinsey, Aron H. Lichtman

Clinical and Translational Science Institute

A great need exists for the development of new medications to treat pain resulting from various disease states and types of injury. Given that the endogenous cannabinoid (that is, endocannabinoid) system modulates neuronal and immune cell function, both of which play key roles in pain, therapeutics targeting this system hold promise as novel analgesics. Potential therapeutic targets include the cannabinoid receptors, type 1 and 2, as well as biosynthetic and catabolic enzymes of the endocannabinoids N-arachidonoylethanolamine and 2-arachidonoylglycerol. Notably, cannabinoid receptor agonists as well as inhibitors of endocannabinoid-regulating enzymes fatty acid amide hydrolase and monoacylglycerol lipase produce reliable antinociceptive effects, …

Difficulty Concentrating In Generalized Anxiety Disorder: An Evaluation Of Incremental Utility And Relationship To Worry, Lauren S. Hallion, Shari A. Steinman, Susan N. Kusmierski

Clinical and Translational Science Institute

Difficulty concentrating is one of the most common diagnostic criteria across DSM-5 categories, especially within the emotional (mood- and anxiety-related) disorders. A substantial literature has characterized cognitive functioning in emotional disorders using objective (behavioral) computerized cognitive tasks. However, diagnoses are typically formed on the basis of subjective (self-reported; clinician-rated) assessments of symptoms, and little is known about difficulty concentrating as a symptom. These questions are particularly important for generalized anxiety disorder (GAD), which has long been the subject of nosological debates, and for which several theoretical models that suggest a central role for cognitive impairments (including difficulty concentrating) in the …

Intravenous Thrombolysis Before Endovascular Therapy For Large Vessel Strokes Can Lead To Significantly Higher Hospital Costs Without Improving Outcomes, Ansaar T. Rai, Sohyun Boo, Chelsea Buseman, Amelia K. Adcock, Abdul R. Tarabishy, Maurice M. Miller, Thomas D. Roberts, Jennifer R. Domico, Jeffrey S. Carpenter

Clinical and Translational Science Institute

Background Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. Purpose To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). Methods A single-center retrospective analysis was performed. Clinical and demographic data were collected prospectively and relevant cost data were obtained for each patient in the study. Results 90 consecutive patients were divided into EV-Only (n=52) and IV+EV (n=38) groups. There was no difference in demographics, …

Design And Synthesis Of Small Molecule Agonists Of Epha2 Receptor, Aaron Petty, Nethrie Idippily, Viharika Bobba, Werner J. Geldenhuys, Bo Zhong, Bin Su, Bingcheng Wang

Clinical and Translational Science Institute

Ligand-independent activation of EphA2 receptor kinase promotes cancer metastasis and invasion. Activating EphA2 receptor tyrosine kinase with small molecule agonist is a novel strategy to treat EphA2 overexpressing cancer. In this study, we performed a lead optimization of a small molecule Doxazosin that was identified as an EphA2 receptor agonist. 33 new analogs were developed and evaluated; a structure−activity relationship was summarized based on the EphA2 activation of these derivatives. Two new derivative compounds 24 and 27 showed much improved activity compared to Doxazosin. Compound 24 possesses a bulky amide moiety, and compound 27 has a dimeric structure that is …

Bacteria Antibiotic Resistance: New Challenges And Opportunities For Implant-Associated Orthopedic Infections, Bingyun Li, Thomas J. Webster

Clinical and Translational Science Institute

There has been a dramatic increase in the emergence of antibiotic resistant bacterial strains, which has made antibiotic choices for infection control increasingly limited and more expensive. In the U.S. alone, antibiotic resistant bacteria cause at least 2 million infections and 23,000 deaths a year resulting in a $55–70 billion per year economic impact. Antibiotics are critical to the success of surgical procedures including orthopaedic prosthetic surgeries, and antibiotic resistance is occurring in nearly all bacteria that infect people, including the most common bacteria that cause orthopaedic infections, such as Staphylococcus aureus (S. aureus). Most clinical cases of orthopaedic surgeries …

Mind The Hype: A Critical Evaluation And Prescriptive Agenda For Research On Mindfulness And Meditation, Nicholas T. Van Dam, Marieke K. Van Vugt, David R. Vago, Laura Schmalzl, Clifford D. Saron, Andrew Olendzki, Ted Meissner, Sara W. Lazar, Catherine E. Kerr, Jolie Gorchov, Kieran C. R. Fox, Brent A. Field, Willoughby B. Britton, Julie A. Brefczynski-Lewis, David E. Meyer

Clinical and Translational Science Institute

During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and “key to building more resilient soldiers”. Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for …

Dyslipidemia In Children With Arterial Ischemic Stroke: Prevalence And Risk Factors., Sally Sultan, Michael Dowling, Adam Kirton, Gabrielle Deveber, Alexandra Linds, Mitchell S. V. Elkind

Clinical and Translational Science Institute

Background—Risk factors for pediatric stroke are poorly understood and require study to improve prevention. Total cholesterol (TC) and triglyceride (TG) values peak to near-adult levels before puberty, a period of increased stroke incidence. The role of lipids in childhood arterial ischemic stroke (AIS) has been minimally investigated. Subjects/Methods—We performed a cross-sectional analysis of lipid and Lp(a) concentrations in children with AIS in the International Pediatric Stroke Study (IPSS) to compare the prevalence of dyslipidemia and high or low ranking lipid values in our dataset to reported population values. We tested sex, BMI, race, ethnicity, family history and stroke risk factors …

Development Of An Instrument To Measure Faculty's Information And Communication Technology Access (Ficta), Kamal Ahmed Soomro, Ugur Kale, Reagan Curtis, Mete Akcaoglu, Malayna Bernstein

Clinical and Translational Science Institute

The phenomenon of “digital divide” is complex and multidimensional, extending beyond issues of physical access. The purpose of this study was to develop a scale to measure a range of factors related to digital divide among higher education faculty and to evaluate its reliability and validity. Faculty’s Information and Communication Technology Access (FICTA) scale was tested and validated with 322 faculty teaching in public and private sector universities. Principal components analysis with varimax rotation confirmed an 8-factor solution corresponding to various dimensions of ICT access. The 57-item FICTA scale demonstrated good psychometric properties and offers researchers a tool to examine …