Medicine and Health Sciences Commons^™

Early Data From The Maine Ombudsman’S Hospital Advocacy Program: A Deeper Look At Difficult To Place Patients, Joseph Zamboni

Muskie School Capstones and Dissertations

There is little data available on the complex cause and effect of delayed hospital discharge; however, some evidence suggests that long-stay patients tend to be complex, older, and sicker. In Maine, a 2014 Maine Health Association report found complex hospital patients were waiting weeks, months and sometimes over a year in Maine Hospitals before accessing long-term services and supports. In response to these concerns around delayed discharge from hospitals, the First Regular Session of the 127th Maine Legislature created the Commission to study Difficult to Place Patients. The Commission ultimately passed Legislation that gave the Maine Long- Term Care Ombudsman …

The Post Clinic Ambulatory Blood Pressure (Pc-Abp) Study Correlates Post Clinic Blood Pressure (Pcbp) With The Gold Standard Ambulatory Blood Pressure, Hunaina Shahab, Hamza Sohail Khan, Aysha Almas, Mayera Tufail, K. Kazmi, Aamir Hameed

Section of Cardiology

Objectives: Our previous study showed that post-clinic blood pressure (BP) taken 15 min after a physician-patient encounter was the lowest reading in a routine clinic. We aimed to validate this reading with 24 h Ambulatory Blood Pressure Monitoring (ABPM) readings. A cross-sectional study was conducted in the cardiology clinics at the Aga Khan University, Pakistan. Hypertensive patients aged ≥ 18 years, or those referred for the diagnosis of hypertension were included.
Results: Of 150 participants, 49% were males. 76% of all participants were hypertensive. Pre-clinic BP reading was measured by a nurse, in-clinic by a physician and 15 min post-clinic …

Nursing News & Views - July 2018, Christine Klucznik Rn

Nursing Newsletters

No abstract provided.

Adults Using Long Term Services And Supports: Population And Service Use Trends In Maine, Sfy 2016, Kimberly I. Snow Mhsa, Ba, Frances Jimenez Ba, Tina Gressani, Louise Olsen

Disability & Aging

All of us have likely either used, will use, or know someone who uses long term services and support (LTSS). They enable us to live with dignity and as much independence as possible and offer us the opportunity to remain involved and productive in our communities. The need for LTSS can arise suddenly after injury or illness or a life-long condition. But how ever the need arises, the impact is the same—services such as personal care, work support, home health care, and residential care provide not just for individual health and comfort, but also for interaction, inclusion, and engagement with …

Pull The Andon Rope On Working Memory Capacity Interventions Until We Know More, Sandra Laing Gillam, Sarai S. Holbrook, Jamie Mecham, Daylene Weller

Communicative Disorders and Deaf Education Faculty Publications

Purpose: The purpose of this article is to discuss the current state of interventions for improving working memory (WM) capacity language, and academic skills and to provide suggestions for speech language pathologists working with students who have WM capacity limitations.

Method: Meta-analyses, systematic reviews, randomized controlled trials and non-randomized comparison studies investigating the role of WM interventions for improving WM capacity language, and academic skills are reviewed. Strategies for improving WM are discussed.

Results: The use of interventions designed to improve WM capacity and other cognitive skills is currently not supported by the research. Direct working memory interventions should be …

Rethinking Bullying Interventions For High School Students, Aida Midgett, Diana M. Doumas, April Johnston, Rhiannon Trull, Raissa Miller

Counselor Education Faculty Publications and Presentations

The purpose of this study was to obtain feedback to inform a modification of a brief, school-based bullying intervention originally developed for elementary and middle school students to be age appropriate for the high school level. We investigated the in-depth, inner experiences of high school students randomly selected to participate in a brief, bystander bullying intervention program. Thorough qualitative analysis, we found students spoke about (a) the complexity of bullying in high school, (b) cyberbullying and increased potential consequences related to social media, (c) the normalization and minimization of bullying, (d) lack of adult support, (e) an appreciation for the …

The Significance Of Mgmt Methylation In Glioblastoma Multiforme Prognosis, Aaida Mumtaz Rao, Ayesha Quddusi, Muhammad Shahzad Shamim

Section of Neurosurgery

Methylation of O6-methylguanine-DNA methyltransferase (MGMT) has been extensively studied as a biomarker in predicting the prognosis of patients with GBM (Glioblastoma multiforme). Its significance has been studied in various subgroups, including age, gender and even race. Correlation between prognosis with MGMT methylation and different treatment regimens has also been studied in detail. There are multiple techniques to analyze MGMT methylation in tumour specimen. We review the current evidence for the importance of MGMT methylation as a biomarker for prognosis in GBM patients, the techniques to analyze it and the effect of epidemiologic factors on its significance.

Factors Affecting Functional Outcome After Decompressive Craniectomy Performed For Traumatic Brain Injury: A Retrospective, Cross-Sectional Study, Farid Khan, Arif Villani, Abdul Rehman, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Factors affecting functional outcome after decompressive craniectomy (DC) performed for traumatic brain injury (TBI) remain poorly understood.
Methods: We conducted a retrospective study of all patients who underwent primary DC for TBI at our hospital between 2010 and 2014. Multivariate regression analyses were used to determine the predictors of functional outcome and overall survival.
Results: A total of 98 patients with severe (n = 81, 82.6%) or moderate (n = 17, 17.4%) TBI underwent primary DC and were included in this study. The 30-day and overall mortality rates were 15.3% and 25.5%, respectively. At a median follow-up …

Digital Health Practices, Social Media Use, And Mental Well-Being Among Teens And Young Adults In The U.S., Victoria Rideout, Susannah Fox, Well Being Trust

Articles, Abstracts, and Reports

A national survey of 14- to 22-year-olds provides new evidence on the growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), finds that large numbers of teens and young adults experiencing moderate to severe symptoms of depression are turning to the internet for help, including researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent).

“This survey suggests that …

Diagnosing Isolated Hepatosplenic Tuberculosis In An Immunocompetent Patient: A Case Report, Om Dawani, Raja Samir Khan, Mujtaba Jamal Syed, Abdul Moid Shehzad, Ahmed Alratoot, Muhammad Faizan Ahmed

Section of Pulmonary & Critical Care

For many years, tuberculosis (TB) has been endemic in Pakistan; many rare and unusual presentations have been reported. There is a myriad of non-specific symptoms which always requires a high index of clinical suspicion for TB. World Health Organization data suggest that Pakistan ranks as the fifth highest country burdened with TB and has the fourth highest prevalence of multi-drug resistant TB globally. With an annual incidence of 277 cases per 100,000, the importance of early diagnosis and treatment is self-evident. We present a case where a strong suspicion of isolated hepatosplenic TB in an immunocompetent patient justified a directed …

A Stress Management App Intervention For Cancer Survivors: Design, Development, And Usability Testing, Elin Børøsund, Jelena Mirkovic, Matthew M. Clark, Shawna L. Ehlers, Michael A. Andrykowski, Anne Bergland, Marianne Westeng, Lise Solberg Nes

Behavioral Science Faculty Publications

Background: Distress is prevalent in cancer survivors. Stress management interventions can reduce distress and improve quality of life for cancer patients, but many people with cancer are unfortunately not offered or able to attend such in-person stress management interventions.

Objective: The objective of this study was to develop an evidence-based stress management intervention for patients living with cancer that can be delivered electronically with wide reach and dissemination. This paper describes the design and development process of a technology-based stress management intervention for cancer survivors, including the exploration phase, intervention content development, iterative software development (including design, development, and formative …

A Dose Falloff Gradient Study In Rapidarc Planning Of Lung Stereotactic Body Radiation Therapy, Ganesh Narayanasamy, Dharmin Desai, Sanjay Maraboyina, Jose Penagaricano, Robert Zwicker, Ellis Lee Johnson

Radiation Medicine Faculty Publications

Introduction: Radiation Therapy Oncology Group (RTOG) report #0813 and 0915 recommends using D_2cm and R_50% as plan quality metrics for evaluation of normal tissue sparing in stereotactic body radiation therapy (SBRT) of lung lesion. This study introduces dose falloff gradient (DFG) as a tool for analyzing the dose beyond the planning target volume (PTV) extending into normal tissue structures. In ascertaining the impact of PTV size and SBRT planning techniques in DFG, this study questions the independence of the RTOG recommended metrics. Materials and Methods: In this retrospective study, 41 RapidArc lung SBRT plans with 2 or 3 …

Is Information Systems Misuse Always Bad? A New Perspective On Is Misuse In Hospitals Under The Context Of Disasters, Dheyaaldin Alsalman

Masters Theses & Doctoral Dissertations

Although the extant literature has investigated how individuals engage in inappropriate behaviors based on the rational choice theory (RCT) (e.g., computer misconduct), the neutralization theory (e.g., IS security policies violation), and workarounds under normal situations, it has given little consideration to how individuals are involved in misuse of information systems with a good intention under the context of disasters. To fill this research gap, we propose a selfless misuse model, which offers a theoretical explanation for the concept of individuals’ selfless misuse intention under uncertainty caused by disasters. In this study, we show why employees make decisions to misuse the …

Comparative Effectiveness Of Secukinumab And Etanercept In Biologic-Naïve Patients With Psoriatic Arthritis Assessed By Matching-Adjusted Indirect Comparison., Philip Mease, Ernest Choy, Peter Nash, Chrysostomos Kalyvas, Matthias Hunger, Luminita Pricop, Kunal K Gandhi, Steffen M Jugl, Howard Thom

Articles, Abstracts, and Reports

OBJECTIVE: Matching-adjusted indirect comparison (MAIC) can be used to assess the comparative effectiveness of two treatments indirectly using data from randomized placebo-controlled trials. This MAIC assessed the comparative effectiveness of secukinumab (an anti-interleukin-17A) and etanercept (a tumor necrosis factor inhibitor) in a target population of biologic-naïve patients with psoriatic arthritis (PsA).

METHODS: Individual patient data pooled from FUTURE 2 (NCT01752634), FUTURE 3 (NCT01989468), and FUTURE 5 (NCT02404350) (secukinumab: 150 mg, n=458 and 300 mg, n=461) were matched to data from the population in the NCT00317499 trial (etanercept 25 mg, n=101) using MAIC methodology, by adjusting for clinical and demographic baseline …

Cardiac Mri T2* In Liver Transplant Candidates: Application And Performance Of A Novel Imaging Technique To Identify Patients At Risk For Poor Posttransplant Cardiac Outcomes., Sara M Lewin, Kimberly Kallianos, M Ilan Nevah, Susan Zhao, Oren K Fix, Gabriel C Brooks, Teresa De Marco, Atif N Qasim, Karen G Ordovas, Neil Mehta

Articles, Abstracts, and Reports

Background: In end-stage liver disease, alterations in iron metabolism can lead to iron overload and development of iron overload cardiomyopathy. In liver transplant candidates, evaluation for cardiac iron overload and dysfunction can help to identify candidates at increased risk for peritransplant morbidity and mortality, though recommendations for pretransplant evaluation of cardiac iron overload are not standardized. Cardiac Magnetic Resonance Imaging T2* (CMRI-T2*) is a validated method to quantify cardiac iron deposition, with normal T2* value of 20 ms or greater. In this study, we sought to identify the incidence and predictors of iron overload by CMRI-T2* and to evaluate the …

School Of Nursing Newsletter Summer 2018, Southern Adventist University School Of Nursing

Southern Nursing - School of Nursing Newsletter

The Summer 2018 issue of the School of Nursing Newsletter features an article faculty with the lifestyle medicine certification, ties with Oakwood University, the Florence Oliver Anderson Lecture Series, and alumni of the year.

Stability Of Extemporaneously Prepared Sodium Benzoate Oral Suspension, Julia Atkins, Melinda E. Lull, Andrew S. Decker, David Hutchinson

Doctoral External Publications

The stability of extemporaneously prepared sodium benzoate oral suspension in cherry syrup and Ora-Sweet was studied. Oral solutions of 250-mg/mL sodium benzoate were prepared in either cherry syrup or Ora-Sweet. To a beaker, 50 grams of Sodium Benzoate Powder USP was dissolved and filtered, the solution was divided equally into two parts, and each aliquot was added into two separate calibrated 100-mL amber vials. In the first vial, cherry syrup was added to make a final volume of 100 mL. In the second vial, Ora-Sweet was added to give a final volume of 100 mL. This process was repeated to …

Effects Of Bingocize® On Quality Of Life, Fall Risk, And Health Knowledge In Community-Dwelling Older Adults, Alyssa Kathryn Dispennette

Masters Theses & Specialist Projects

Quality of life (QOL) is an important aspects of overall well-being in older adults. QOL is associated with functional, physical, and psychological health; all of which can be improved with increased physical activity. A high fall risk is associated with low physical function and QOL. One in four older adults experiences a fall each year, making it necessary to focus public health interventions towards decreasing fall risk and improving QOL in older adults. Bingocize® is a health promotion program designed to promote health, health knowledge, physical activity, and social engagement among older adults. The purpose of this study was to …

Isometric Hip Strength And Dynamic Stability Of Individuals With Chronic Ankle Instability, Ryan S. Mccann, Brenn A. Bolding, Masafumi Terada, Kyle B. Kosik, Ian D. Crossett, Phillip A. Grobble

Rehabilitation Sciences Faculty Publications

Context: Compared with individuals who have a history of lateral ankle sprain (LAS) without markers of chronic ankle instability (CAI; LAS copers) and healthy people, those with CAI often exhibit neuromuscular impairments and dynamic-stability deficits at the hip. However, the influence of hip-strength deficits on dynamic stability remains unknown.

Objective: To compare isometric hip strength and dynamic stability in individuals with or without CAI and examine the degree of dynamic-stability variance explained by isometric hip strength.

Design: Case-control study.

Setting: Research laboratory.

Patients or Other Participants: Sixty individuals (47 women, 13 men; age = 23.7 +/- 4.6 years, height = …

Where's Dad? The Importance Of Integrating Fatherhood And Parenting Programming Into Substance Use Treatment For Men, Carla Smith Stover, Melissa Carlson, Sarika Patel, Raquel Manalich

Mental Health Law & Policy Faculty Publications

Large numbers of men enter substance use disorder treatment each year, yet very little attention is paid to the fatherhood and parenting status of these men. Substance use treatment programmes for men rarely incorporate a parenting component into their treatment planning, despite the increased success of women's treatment programmes that focus on gender and motherhood. This paper provides: (1) a review of the literature on the fathering of substance‐using men, what has been learned from substance use disorder treatment for mothers, and the implications for children and families; (2) pilot quantitative and qualitative outcomes resulting from the implementation of a …

Holmium Laser For Endoscopic Treatment Of Benign Tracheal Stenosis, D J. Verret, Arneya Jategaonkar, Samuel Helman, Sameep Kadakia, Arash Bahrami, Eli Gordin, Yadranko Ducic

Otolaryngology (ENT) Resident Research

Introduction Laryngotracheal stenosis is a difficult problem with varied etiology and various treatment options. The holmium laser represents another tool for the treatment of benign tracheal stenosis.

Objectives To determine the utility of holmium laser treatment for benign tracheal stenosis with regards to safety and efficacy.

Methods This was a retrospective case study examining patients with benign tracheal stenosis from 1998–2016 who underwent holmium laser treatment. Determining the safety of this procedure was the primary goal, and complications were monitored as a surrogate of safety.

Results A total of 123 patients who underwent holmium laser treatment for benign tracheal stenosis …

Breastfeeding-Associated Neonatal Hyperbilirubinemia, Sara Lord

Nursing Student Class Projects (Formerly MSN)

Neonatal jaundice is one of the most common conditions in neonates, with 60-80% of infants experiencing some degree of increased serum bilirubin levels (Itoh, Okada, Kuboi, & Kusaka, 2017). Physiological jaundice is most commonly noted in the first week of life, with rising and peak levels occur between day of life three to five (Moncrieff, 2018) All infants experience a rise in serum bilirubin following birth due to their immature liver’s inability to clear the byproduct of red blood cell breakdown, bilirubin, from the blood (Gardner, Carter, Hines, & Hernandez, 2016). Hyperbilirubinemia can be caused by a variety of factors …

Post Concussion Syndrome, Maria Blank

Nursing Student Class Projects (Formerly MSN)

Post concussion syndrome (PCS) is the persistence of concussion symptoms for longer than one month after the initial injury. PCS varies in the length and duration of its symptoms ranging from mild and/or short duration to debilitating and/or chronic; therefore, PCS presents differently in every patient. The complex pathophysiology of PCS as well as that of a mild traumatic brain injury will be discussed in this poster. The complexity of the treatment and pathophysiology of this syndrome leads to a need for greater discussion and education for healthcare providers so that they may better identify and treat these patients.

Caring For Cardiovascular Disease In Patients With Sle, Diondra Penland

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Knee Osteoarthritis, Maureen A. Stevens

Nursing Student Class Projects (Formerly MSN)

Knee osteoarthritis (OA) is a common age-related disorder of synovial joints that is classified as a noninflammatory joint disease that affects over 45% of Americans. In order to diagnose and treat the disease, the understanding of the pathophysiology behind the disease is necessary. Knee OA is a disease of cartilage and when that begins to breakdown collagens and proteoglycans are lost causing fibrillation, erosion, and cracking to the joint. This initially appears in the superficial layer of cartilage and progress over time to deeper layers, resulting eventually in large clinically observable erosions causing the disease. Treatments can range from over …

Disseminated Intravascular Coagulation (Dic), Nicholas A. Brown

Nursing Student Class Projects (Formerly MSN)

Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by intravascular activation of coagulation. There is a wide variety of etiologies that can lead to DIC, with sepsis at the forefront. DIC presents in just under 20% of ICU admissions, with mortality rates up to 78%. The following poster will provide a comprehensive review behind this complex disease process, highlighting the underlying pathophysiology, significance, and implications for nursing practice.

Nonalcoholic Fatty Liver Disease, Whitney Smith

Nursing Student Class Projects (Formerly MSN)

Nonalcoholic fatty liver disease (NAFLD) is a common, chronic disease process that has historically affected adults but is becoming more common among children and adolescents due to rising rates of childhood obesity. While the primary risk factor for NAFLD is obesity, other metabolic conditions including dyslipidemias and insulin-resistance may also contribute to increased risk of NAFLD also. NAFLD occurs when excess triglycerides and free fatty acids (FFA) infiltrate the liver and are stored as lipids inside hepatocytes. In addition to the effects of decreased liver function from damaged cells, NAFLD also contributes to increased levels of inflammatory cytokines that further …

Congential Heart Disease (Chd) Adult Survivors And Type 2 Diabetes Mellitus, Olivia Sutter

Nursing Student Class Projects (Formerly MSN)

Congenital heart disease (CHD) includes a wide array of disorders and varying degrees of severity and is the most common birth defect, comprising of 1% of all birth defects (CDC, 2018). Heart defects can be acyanotic (non-critical) or cyanotic (critical) (Deen & Krieger, 2016). Birth defects are determined to be cyanotic or acyanotic based on pulse oximetry and anatomy through echocardiogram technology (Mayo clinic, 2018). Due to the advances of interventions in this field, children with heart defects are living to adulthood and therefore are acquiring diseases of aging, such as atherosclerosis and type 2 diabetes, in addition to the …

Pulmonary Embolism, Kira Robison

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Mortality Among Very Low Birth Weight Infants After Hospital Discharge In A Low Resource Setting, Yaser Abdallah, Flavia Namiiro, Jolly Nankunda, Jamiru Mugalu, Yvonne Vaucher

Faculty of Health Sciences, East Africa

Background Early discharge of very low birth weight infant (VLBW) in low resource settings is inevitable but to minimize mortality of these infants after discharge we need to identify the death attributes.

Method A prospective cohort was conducted among 190 VLBW infants discharged from Mulago Special Care Baby Unit (SCBU) with discharge weight of < 1500 g over an 8 months period. These infants were followed up with the aims of determining the proportion dead 3 months after discharge, identifying factors associated and possible causes of death.

Relevant data were captured, transferred in to STATA and imported to SPSS 12.0.1 for analysis. To determine factors associated with mortality bi-variable and multivariable regressions were conducted. A p-value of < 0.05 was considered significant and 95% confidence interval was used.

Results Of the enrolled infants 164 (86.3%) completed follow up. The median gestational age of study …