Medicine and Health Sciences Commons^™

Neuroimaging Biomarkers Of Mtor Inhibition On Vascular And Metabolic Functions In Aging Brain And Alzheimer’S Disease, Jennifer Lee, Lucille M. Yanckello, David Ma, Jared D. Hoffman, Ishita Parikh, Scott Thalman, Bjoern Bauer, Anika M. S. Hartz, Fahmeed Hyder, Ai-Ling Lin

Pharmacology and Nutritional Sciences Faculty Publications

The mechanistic target of rapamycin (mTOR) is a nutrient sensor of eukaryotic cells. Inhibition of mechanistic mTOR signaling can increase life and health span in various species via interventions that include rapamycin and caloric restriction (CR). In the central nervous system, mTOR inhibition demonstrates neuroprotective patterns in aging and Alzheimer’s disease (AD) by preserving mitochondrial function and reducing amyloid beta retention. However, the effects of mTOR inhibition for in vivo brain physiology remain largely unknown. Here, we review recent findings of in vivo metabolic and vascular measures using non-invasive, multimodal neuroimaging methods in rodent models for brain aging and AD. …

Accurate Documentation Of Smoking History Through A Clinical Workflow Improvement Project, Heidi A. Bender

Nursing Capstones

No abstract provided.

Changing Health Care Policy By Utilizing Kingdon's Policy Stream Theory, Brittney Welch

Graduate Theses, Dissertations, and Capstones

The purpose of this paper is to describe the policy process of changing current regulations regarding rural health clinics (RHCs). Using Kingdon’s Policy Stream Theory for guidance, the change project was designed to amend current regulations regarding the directorship of the RHCs, consequently allowing Nurse Practitioners (NP) to act as medical directors for rural health clinics (RHCs). This change fulfills the Institute of Medicine’s charge to have nurses work to the highest level of their education, as well as a defined need to fill a gap in the health care system by decreasing rural health disparities. The Rural Health Care …

Modeling And Mapping Addiction In The Zebrafish, Danio Rerio, Bradley Serpa

Master of Science in Integrative Biology Theses

Driven by the communication of dopamine, the vertebrate reward system has been evolutionarily conserved to maintain survival and optimize fitness. The neural circuits governing this system integrate sensory stimuli to produce appropriate, self-preserving responses that underlie experience-based learning. In the most primitive vertebrates, dopamine release in neuronal circuits drives homeostatic behaviors, such as seeking nutrients, finding a mate, or avoiding danger. From agnathans to mammals, dopaminergic synthesis and signaling genes and molecules, along with neuronal pathways and reward system-based behaviors, remain highly conserved. Dopamine signaling proteins include two classes of metabotropic G-Protein Receptor Coupled Dopamine Receptors, D1-like (DRD1) and D2-like …

Developing The Evidence Base For Mental Health Policy And Services: Inquiries Into Epidemiology, Cost-Benefits, And Utilization, Joseph L. Smith

USF Tampa Graduate Theses and Dissertations

The overarching aim of this dissertation is to use health services research methods to address three problems in behavioral health services. This dissertation seeks to address the knowledge gaps in behavioral health services through the generation of evidence intended to support evidence-based practices (EBP).

Previous work has examined epidemiology of behavioral health disorders in the ED, but they have not attempted to examine disorders by the cause of injury. Chapter 2 examines the epidemiology of psychiatric disorders among adults who seek care in the emergency department (ED) by cause of injury. Data from a national hospital discharge survey was analyzed …

Call For Submissions - Special Issue July 2019: The Role Of Technology And Innovation In Patient Experience, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2019 special issue on the topic of the role of technology in patient & family experience. A focus on technology and innovation will be essential in healthcare experience, requiring new ways of thinking and doing and the technologies and tools to ensure efficiencies, expand capacities and extend boundaries of care.

This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either creating or implementing technology focused on positively impacting the patient experience …

Condition Help: 10 Years Of Experience Enhancing Our Culture Of Family Engagement, Andrew Mccormick, Catherine Polak, Michael Fox, Michele Carlson, Charles Guthrie, Michael Decker, Diane Hupp, Gabriella Butler, Andrew Urbach

Patient Experience Journal

“Condition Help” is a family activated rapid response team designed to enhance a partnership between providers and the family. Calling a “Condition Help” results in the rapid arrival of a response team (physician, nurse administrator and patient representative) that assesses the clinical status, listens to families’ concerns and promotes communication to move clinical care forward. “Condition Help” has been an active program for the last 10 years at Children’s Hospital of Pittsburgh of UPMC (University of Pittsburgh Medical Center) and has assisted in the care of 608 patient encounters. This article outlines the experience gained using this vital program, summarizes …

Wait Time Reality Check: The Convergence Of Process, Perception, And Expectation, Marian Hill, Lorianne Classen, Andrea Romay, Erika Diaz

Patient Experience Journal

There are few experiences as ubiquitous to patients as the experience of waiting. It is an occurrence that transcends diagnosis, is common to all demographics, and is shared across the continuum of care. The experience can be frustrating and full of ambiguity for patients and their families. Wait time and delays can lead to patients sensing a loss of control and magnify the feelings of anxiety they may already be suffering. In an effort to improve patient experience, a framework was developed to examine patient satisfaction as a function of expectations, perceptions, and reality. The process domain focused on the …

Family Experience Tracers: Patient Family Advisor Led Interviews Generating Detailed Qualitative Feedback To Influence Performance Improvement, Kathryn Taff, Sheryl Chadwick, Deejo Miller

Patient Experience Journal

Patient Family Advisors (PFAs) are integral partners in quality improvement processes at Children’s Mercy Kansas City. Mimicking Joint Commission patient tracers, the Family Experience Tracer program was created to gather perspectives from end users of care and provide valuable insights regarding the patient experience. The Patient and Family Engagement team collaborates with departmental and organizational leadership to define the scope of the tracer project and determine meaningful topics to elicit feedback from patients and families. Tracers are conducted across the continuum of care and are led by a Patient Family Advisor to establish an immediate peer relationship. Patients and families …

Integrating The Patient And Caregiver Voice In The Context Of Pediatric, Adolescent, And Young Adult Care: A Family-Centered Approach, Sarah K. Featherston, Beatriz N. Rozo, Danielle A. Buzanga, Alexandra M. Garcia, Joanne Greene, Laura K. Salvador, Joan O'Hanlon-Curry

Patient Experience Journal

Family-centered care (FCC) is defined as an approach to care coordination founded in collaborative partnerships between healthcare providers, patients and their family caregivers. Amid the enthusiasm for FCC in the pediatric setting, opportunities have been identified to operationalize the engagement of pediatric, adolescent and young adult patients and their caregivers into decision making that translates not only to their healthcare, but also to the context in which care is provided, as well as the research informing their care. At a National Cancer Institute-designated comprehensive cancer center, the Children’s Cancer Hospital was instrumental in designing and implementing patient and family engagement …

Partnering With Pediatric Patients And Families In High Reliability To Identify And Reduce Preventable Safety Events, Julie Kirby, Courtney Cannon, Lynn Darrah, Yolanda Milliman-Richard

Patient Experience Journal

Frameworks for designing highly reliable behaviors and tools to reduce preventable harm are the result of the continued effort to improve patient safety in healthcare. Evidence shows that there has been limited research on engaging patients and families in the development of safety and reliability efforts to achieve zero harm. Our aim was to develop a tool that engages patients and families in an effort to reduce preventable harm in a pediatric academic medical center.

Can An Interactive Application Be Used To Collect Meaningful Feedback From Paediatric Patients And Their Parents In A Hospital Setting?, Janelle O'Neill, Graham R. Reeks, Lauren Kearney

Patient Experience Journal

The objective of this study was to determine the acceptability of using an interactive application (Fabio the Frog) to understand the experiences and perspectives of children and parents/carers regarding their health care encounter for the purpose of quality improvement and consumer feedback. Children’s perspectives of their healthcare were collected via the interactive application through the use of a validated survey, the Children’s Perceptions of Healthcare Survey (CPHS). The acceptability of eliciting views from children and parents via an interactive application platform was collected using an additional survey designed for this purpose. Data were collected in two phases. Overall, healthcare experiences …

What Constitutes The Patient Experience Of Children? Findings From The Photo Elicitation And The Video Diary Study, Nina Karisalmi, Hanna Stenhammar, Johanna Kaipio

Patient Experience Journal

Patient experience (PX) is getting attention among researchers and healthcare service providers, but little is known about the experiences of child patients and how to explore those. This paper reports findings from a study in which two participatory research methods, photo elicitation and video diary, were applied to investigate the elements of children’s PX in the context of children’s hospital. The aim was to find out what elements constitute the PX of children aged 7–16 years. The research data were gathered in 2016–2017. Twenty-two child patients participated in the study: eight children aged between 7 and 10 in the photo …

The Pediatric Emergency Department Care Experience: A Quality Measure, Terri L. Byczkowski, Kimberly A. Downing, Michael R. Fitzgerald, Stephanie S. Kennebeck, Gordon L. Gillespie, Evaline A. Alessandrini

Patient Experience Journal

To develop and validate a measure of the quality of the pediatric emergency department care experience from the parent perspective. This was a multiphase study conducted at a tertiary-care pediatric health system using qualitative and quantitative methods. A list of candidate questions was developed to measure each of eight dimensions of family-centered pediatric emergency care described in a published framework. This list was evaluated and refined using the Question Appraisal System (QAS-99) followed by cognitive interviewing methods. Remaining questions were field tested using survey methods via telephone interviews with randomly selected parents. Composite scores to measure each of the eight …

Caring Moments Within An Interprofessional Healthcare Team: Children And Adolescent Perspectives, Amélia Didier, David Gachoud, Gabriela Von Niederhäusern, Lazare Benaroyo, Maya Zumstein-Shaha

Patient Experience Journal

Patients are now recognized as key partners to improve healthcare outcomes. Some organisations such as the WHO or the Canadian Interprofessional Health Collaborative (CIHC) encourage considering patients as partners in the interprofessional healthcare team. However, limited knowledge exists on patients’ perspective of interprofessional collaboration (IPC) and of their role in the collaborative process, particularly in pediatric settings. The experiences and perspectives of patients regarding IPC have to be considered in order to fully understand the concept of IPC and integrate it into practice. This qualitative study aimed at gaining a better understanding of the perspective of children of IPC, how …

Tertiary Care Centres Must Do More For Patients With Unknown Conditions: Lessons Learned From A Child, Guido Filler, Lana Rothfels

Patient Experience Journal

Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating disease with a commonly non-uniform and unspecific presentation that makes diagnosis difficult. A twelve-year-old girl, recently diagnosed with Addison’s Disease, was referred to paediatric nephrology for Fludrocortisone-induced nocturnal hypertension. She had fallen off the growth curve for both height and weight from the 50th percentile at birth to below the 5th percentile at presentation. The severity and multitude of her symptoms, including muscle weakness, poor body control, dizziness, light headedness, persistent fatigue, excessive sweating, tachycardia, chronic constipation and recurrent infection hinted at the unusual nature of this case of Addison’s. At the …

Breaking Bad News And The Importance Of Compassionate Palliative Care Of The Infant, William S. Sessions Ii, Sean Y. Kow, Elizabeth Waldrop, Kayle Stevenson, Ayo Olanrewaju, Thu Tran, Mubariz Naqvi

Patient Experience Journal

Bad news to parents regarding their infant is information that negatively impacts the parent’s feelings and view of the present and/or future. It is implemented in situations with feelings of no hope or those that induce a threat to a parent’s mental and physical well-being. The term is difficult to define as it is based on parent’s subjective feelings. However, it is important to be aware of the impact of bad news as it can cause severe anguish and stress on the parent’s emotional stability. The style of delivering bad news has a significant impact on the physician/parent relationship and …

Life With My Baby In A Neonatal Intensive Care Unit: Embracing The Family Integrated Care Model, Yasmin Lalani

Patient Experience Journal

This paper is a personal narrative that describes the components of the Family Integrated Care Model in a neonatal intensive care unit in Canada. I begin by introducing the reader with a brief story of how my son came to be admitted into a NICU. Next, I discuss three aspects of the Family Integrated Care Model that I found to be most striking: medical rounds, “do-ups” and skin-to-skin contact. I also discuss how my immersion in this healthcare setting for three months was a form of autoethnographic fieldwork, as I experienced the NICU both as a parent and a health …

What Medicine Can Learn From Pediatrics: A Mother's Perspective, Nancy Michaels

Patient Experience Journal

As a mother of a young adult child with Aspergers syndrome, as well as being a long-term patient myself (liver transplant in 2005), I have extensive experience in both camps. Recently my 20-year old son was admitted to a children’s hospital for a twisted colon that had to be surgically reduced. As the parent of a child with special needs and related physical health-related issues connected to him being on the autism spectrum, I was naturally very concerned about him entering a hospital (perhaps PTSD based on my own experience at moments). Surprising to me, the experience was a very …

Partners For Excellence: Committed To Meaningful Partnerships With Patients And Families In Pediatrics, Rachel Biblow, Msw, Sara Toomey Md, Mphil, Mph, Msc

Patient Experience Journal

Although the landscape in pediatrics continues to shift and change, one of the keys to our continued success remains the same… it’s about partnership. It’s clear the element of partnership is well woven through our organizations as illustrated by many of us having patient and family advisory councils, family consultants, and family partners. While this foundation is strong and essential, we must do more to truly listen, recognize the value of patient and family involvement, act upon the information shared, openly discuss issues, and strive for better together. True partnership with patients and families requires us to shift the paradigm …

Lessons For Patient Experience From The Voices Of Pediatrics And Children’S Hospitals, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

This special issue on patient & family experience in children’s hospitals and pediatric care underlines pediatrics’ position as a leader in the experience journey. In pediatrics and children’s hospitals significant efforts are made to the ensure the environment is welcoming and comfortable, there is a commitment to communicating to patients – the children that are cared for – in a way they can understand, and there is a clear intention of engaging family members as an integral part of the care experience. In acknowledging that this is a special issue on pediatrics, we would miss a significant opportunity if we …

Acute Kidney Injury, Olutola Banjoko

Nursing Student Class Projects (Formerly MSN)

According to Koza, Y. (2016), “acute kidney injury (AKI) is a complex clinical disorder that is associated with severe morbidity and mortality. Despite technological advances in renal replacement therapy, AKI continues to be associated with poor outcomes. AKI is a syndrome of sudden loss of the kidney’s excretory function, often with oliguria, which usually occurs over the course of hours to days. AKI is common in hospitalized patients, especially in critically ill patients.

Multiple Sclerosis, Michelle Summers

Nursing Student Class Projects (Formerly MSN)

Multiple Sclerosis (MS) is a chronic, progressive, inflammatory auto-immune disease hallmarked by demyelination and subsequent plaque formation throughout the central nervous system (CNS)(Balto et al., 2017). MS has no one known cause for development, but genetic, environmental, viral, and lifestyle risk factors have all been found to contribute (Zostawa, Adamczyk, Sowa, & Adamczyk-Sowa, 2017). The disease can present with numbness, tingling, pain, progressive weakness, loss of continence, visual problems, and muscle spasms. Though there is currently no cure, 15 disease management treatments are currently available to preserve function, and to prevent exacerbations (Reich et al., 2018). This poster further delves …

Neutropenic Sepsis In The Intensive Care Unit, Nicole Melchiorre

Nursing Student Class Projects (Formerly MSN)

This poster will review the pathophysiology of neutropenic sepsis, specifically involving patients in the Intensive Care Unit (ICU). Understanding the pathophysiological process of neutropenic sepsis allows the caregiver to comprehend the severity and consequences of the disease process and how imperative early intervention is in treatment of these patients. Early intervention with fluid resuscitation, antibiotics, obtaining cultures, and maintaining adequate perfusion of vital organs by treating hypotension and hypoxia are all a part of improving outcomes and decreasing mortality. It is crucial to recognize the complexity of neutropenic sepsis and responding to it as an oncological emergency.

Atrial Fibrillation (Af): Causes, Sequela, Risk Factors, And Management, Jason Govia

Nursing Student Class Projects (Formerly MSN)

This poster gives detailed information covering atrial fibrillation such as its definition, relevance, classifications, symptoms, and risk factors. Also included is a moderately in-depth discussion of the different pathophysiological mechanisms underlying the condition and a section with esoteric terms necessary to understand those mechanisms. The poster features a summary of management strategies for atrial fibrillation and concludes with implications for nursing.

Human Papillomavirus And Cervical Cancer, Sarah J. Colon

Nursing Student Class Projects (Formerly MSN)

The pathophysiology of cervical cancer and human papillomavirus (HPV) is important for practitioners to understand to treat patients accordingly. The correlation between HPV and cervical cancer is a significant concept to learn and teach patients as it is different than other disease processes because HPV is a virus that causes cervical cancer. By using ten references information was gathered to support this presentation. Up to date research from government agencies and scholarly resources was used from the last four years. Research was used to retrieve similar information supporting the pathophysiology, signs and symptoms, and implications of nursing care for patients …

Pathophysiology Of Human Papillomavirus (Hpv), Kara Shroff

Nursing Student Class Projects (Formerly MSN)

Human Papillomavirus (HPV) is the most common sexually transmitted virus and infects millions of men and women yearly. Prevention and screening are crucial to help minimize the spread of this disease. This poster provides an explanation of the disease, how it affects people differently, and the ways in which Advanced Practice Nurses (APNs) are essential in intervening before patients are affected.

Diabetic Ketoacidosis, Brandon L. Mosely

Nursing Student Class Projects (Formerly MSN)

Diabetic ketoacidosis (DKA) is a major complication of diabetes mellitus (DM) and often the initial admitting diagnosis in type I diabetes diagnosis (Sharma, Kumar & Yadav, 2017). The purpose of this poster is to discuss the pathophysiology, risk factors, nursing implications signs and symptoms of DKA. The incidence of DKA has risen by 30% over the past decade, with more than 140,000 hospital admissions every year in the United States (Basam et al., 2017). DKA hospitalizations account for 2.4 billion dollars annually (Basam et al., 2017). DKA can be a life threating complication for any diabetic. As a future family …

Obstructive Sleep Apnea And It's Relationship To Cardiovascular Disease, Cody Steffes

Nursing Student Class Projects (Formerly MSN)

Obstructive sleep apnea and cardiovascular disease have numerous risk factors in common, however, research shows that sleep apnea itself is powerfully linked to the development of cardiovascular disease. The pathophysiology of obstructive sleep apnea illustrates the development of cardiovascular disease and the severe effects that it has on patients over time. By understanding the pathophysiology, recognizing early symptoms, and considering the serious consquences related to obstructive sleep apnea, advanced practice nurses can play a significant role in the treatment and prevention of sleep apnea related cardiovascular disease.

Ischemia Reperfusion Injury And Its Effect On The Myocardium, Anthony Mathenge

Nursing Student Class Projects (Formerly MSN)

Acute myocardial infarction is a leading cause of morbidity and mortality in the world. Reperfusion strategies are the current standard therapy for acute myocardial infarction (Neri, 2017). Most clinicians assume that ischemic injury terminates with return of spontaneous circulation (ROSC). However, according to Ibáñez 2015, damage inflicted on the myocardium during acute myocardial infarction is the result of two processes: ischemia and subsequent reperfusion (Ibáñez, 2015). The purpose of the poster is to inform clinicians regarding the process of ischemic injury, before and after reperfusion. Mitochondrial permeability transition pore (MPTP) is a large mega channel that opens due to increased …