Medicine and Health Sciences Commons^™

Telehealth-Based Gay-Affirmative Cognitive Behavioral Therapy For Young Gay And Bisexual Men In The Rural South, Andrew Mccormick Cook

Yale School of Medicine Physician Associate Program Theses

Young rural gay and bisexual men suffer a disproportionate burden of psychiatric disorders compared to their urban and heterosexual counterparts because of the increased stigma-related stressors they face. Co-occurring mental and behavioral health problems often affect them, including depression and substance use disorders. In two randomized controlled trials, a gay-affirmative cognitive behavioral therapy called Effective Skills to Empower Effective Men significantly decreased alcohol use, and improved mental health outcomes among urban gay and bisexual men by targeting stigma-related stress responses. However, the intervention’s efficacy has not been studied among rural populations. In a randomized controlled trial, we propose to deliver …

The Comparison Of Spectral Domain Optical Coherence Tomography (Sd-Oct) To Histopathology In A Patient With Diffuse Macular Drusen, Harold Salmons, Ralph Eagle, Md

Department of Pathology Honors Program Student Research Symposium

Background: Spectral Domain Optical Coherence Tomography (SD-OCT) has become a gold standard technique in ophthalmologic practice, and has revolutionized the diagnosis and treatment of retinal disease. As SD-OCT uses low interference interferometry and mathematical algorithms to produce detailed theoretical cross-sectional images of the retina, it is crucial to examine correlations between SD-OCT images and their corresponding histopathologic slides.

Methods: In the present study, careful correlative light microscopy was performed on the eye that was enucleated from an elderly patient who had a uveal melanoma and early agerelated macular degeneration evident clinically as soft drusen. SD-OCT was performed prior to enucleation …

Improving Access To Collegiate Substance Use Prevention Resources, Sarah Danko

Senior Honors Projects

The incidence of substance use has been increasing at an alarming rate and declared a public health epidemic. Certain subpopulations, including the collegiate population, are at an increased risk for developing a substance use disorder. According to The National Center on Addiction and Substance Abuse, 22.9% of college students meet the criteria for a substance use disorder. This rate is markedly high compared to the rate amongst the general public of 8.5%. A number of factors predispose college students to alcohol and substance use disorders. These factors include increased freedom, social pressures, and high-demand academic workload. Despite the scope of …

Establishing A Hybrid Wound And Ostomy Continuing Education Program, Vivian K. Wong

Faculty Publications

Wound and ostomy nurses receive specialty training and certification to provide care in abdominal stomas, ostomies, wounds, fistulas, and pressure injuries. The eight existing nationwide programs in 2011 were inadequate to meet increasing patient population demands. We developed an innovative nondegree, postbaccalaureate continuing wound and ostomy education program using a hybrid design. The program integrated interactive online classes with intensive onsite classes and skills training. The program has been granted seven-year accreditation; student evaluations have been positive.

The Impact Of Quick Response (Qr) Technology On Anxiety With First Semester Nursing Students Related To The Performance Of Psychomotor Skills With Patients In Clinical, Lee-Ann Terri Kenny

Nursing Theses and Capstone Projects

Anxiety seen with first semester nursing students in a clinical setting when performing psychomotor skills can be a root cause of fear, lack of confidence, ill symptoms, and can lead to unsafe practice ultimately causing injury to patients. The learning and practicing of psychomotor skills occur prior to students first clinical experience, and in most cases over a short period of time. Implementation of Quick Response (QR) technology linked to psychomotor skills during didactic, allowed students quick access to review skills prior to performing skills within the clinical setting. In conclusion, a decrease in anxiety was noted by first semester …

Frailty Screening In Cardiac Surgery Patients: Improving Risk Stratification, April P. Hargett

Nursing Theses and Capstone Projects

Frailty has been noted throughout the literature to have a negative effect on patient outcomes especially in patients undergoing major surgical interventions such as cardiothoracic surgery. Preoperative assessments have historically included assessment of all body systems, however fails to evaluate patients for baseline physical functioning or frailty. The American College of Cardiology has recommended frailty screening on all cardiac surgery patients; however, facilities have failed to educate staff providing care to this population on the impact of frailty and use of commonly used frailty screening tools. This project hypothesized that Cardiothoracic Surgery Nurses and providers would have improved knowledge and …

Discharge Risk Screening And Interdisciplinary Communication: A Method To Mitigate Discharge Delays, Tammy Linton

Nursing Theses and Capstone Projects

Identification of discharge barriers early during the hospital stay is essential to coordinate services post-discharge. Timely discharge of patients when medically safe controls costs, promotes positive health outcomes, and increases quality of care. Discharge planning is a multifaceted interaction that relies heavily on effective communication between all disciplines and the patient. Research suggests interdisciplinary collaboration and effective communication as leading strategies to mitigate discharge delays. The purpose of this study was to examine the impact of interdisciplinary collaboration on discharge planning and length of stay for medical surgical patients. A daily discharge team meeting was implemented as a best practice …

Nurse Confidence Levels In Malignant Hyperthermia, Paige Wilson

Nursing Theses and Capstone Projects

Malignant hyperthermia is a life threatening medical emergency. When individuals with a certain genetic predisposition are exposed to certain pharmaceutical triggering agents, a malignant hyperthermia crisis can occur. If the crisis is not recognized early and symptoms are not treated, the ending result will be patient death. The ability to recognize and intervene in a malignant hyperthermia crisis demonstrates knowledge and confidence by the nurse. Simulation training is an educational tool that nurses can use to increase confidence levels in recognizing and intervening in this type of medical emergency in a safe environment. The findings from this research indicate a …

Improving Self-Efficacy In Persons Experiencing Chronic Back Pain, Mechell Smith

Nursing Theses and Capstone Projects

The effects of chronic pain are extensive and negatively impact the health of an individual. Negative impacts of chronic pain include issues with sleep, cognitive processes, mood/mental health, cardiovascular health, relationships, and overall quality of life. Self-efficacy is an important predictor of outcomes associated with persons experiencing chronic pain. The use of technology in healthcare is supported in the literature and is a promising way to enhance self-efficacy of those experiencing chronic pain. An evidenced-based project was conducted at a rehabilitation and pain specialty office in the northeastern part of North Carolina. The project evaluated if text message reminders of …

Healthcare Data Analytics Final Analysis (Hcad7520nc), Nalin Johri

Health and Medical Sciences (OER)

No abstract provided.

Precision Medicine For Crc Patients In The Veteran Population: State-Of-The-Art, Challenges And Research Directions., Shyam S Mohapatra, Surinder K Batra, Srinivas Bharadwaj, Michael Bouvet, Bard Cosman, Ajay Goel, Wilma Jogunoori, Michael J Kelley, Lopa Mishra, Bibhuti Mishra, Subhra Mohapatra, Bhaumik Patel, Joseph R Pisegna, Jean-Pierre Raufman, Shuyun Rao, Hemant Roy, Maren Scheuner, Satish Singh, Gitanjali Vidyarthi, Jon White

Surgery Faculty Publications

Colorectal cancer (CRC) accounts for ~9% of all cancers in the Veteran population, a fact which has focused a great deal of the attention of the VA's research and development efforts. A field-based meeting of CRC experts was convened to discuss both challenges and opportunities in precision medicine for CRC. This group, designated as the VA Colorectal Cancer Cell-genomics Consortium (VA4C), discussed advances in CRC biology, biomarkers, and imaging for early detection and prevention. There was also a discussion of precision treatment involving fluorescence-guided surgery, targeted chemotherapies and immunotherapies, and personalized cancer treatment approaches. The overarching goal was to identify …

The Small Rna Complement Of Adult Schistosoma Haematobium., Andreas J Stroehlein, Neil D Young, Pasi K Korhonen, Ross S Hall, Aaron R Jex, Bonnie L Webster, David Rollinson, Paul J Brindley, Robin B Gasser

Microbiology, Immunology, and Tropical Medicine Faculty Publications

BACKGROUND: Blood flukes of the genus Schistosoma cause schistosomiasis-a neglected tropical disease (NTD) that affects more than 200 million people worldwide. Studies of schistosome genomes have improved our understanding of the molecular biology of flatworms, but most of them have focused largely on protein-coding genes. Small non-coding RNAs (sncRNAs) have been explored in selected schistosome species and are suggested to play essential roles in the post-transcriptional regulation of genes, and in modulating flatworm-host interactions. However, genome-wide small RNA data are currently lacking for key schistosomes including Schistosoma haematobium-the causative agent of urogenital schistosomiasis of humans.

METHODOLOGY: MicroRNAs (miRNAs) and other …

Amygdala Corticofugal Input Shapes Mitral Cell Responses In The Accessory Olfactory Bulb, Livio Oboti, Eleonora Russo, Tuyen Tran, Daniel Durstewitz, Joshua G. Corbin

Pediatrics Faculty Publications

Interconnections between the olfactory bulb and the amygdala are a major pathway for triggering strong behavioral responses to a variety of odorants. However, while this broad mapping has been established, the patterns of amygdala feedback connectivity and the influence on olfactory circuitry remain unknown. Here, using a combination of neuronal tracing approaches, we dissect the connectivity of a cortical amygdala [posteromedial cortical nucleus (PmCo)] feedback circuit innervating the mouse accessory olfactory bulb. Optogenetic activation of PmCo feedback mainly results in feedforward mitral cell (MC) inhibition through direct excitation of GABAergic granule cells. In addition, LED-driven activity of corticofugal afferents increases …

Using An Implementation Research Framework To Identify Potential Facilitators And Barriers Of An Intervention To Increase Hpv Vaccine Uptake, Rebecca Selove, Maya Foster, Raquel Mack, Maureen Sanderson, Pamela C. Hull

Center for Prevention Research Publications

Background:

Although the incidence of cervical cancer has been decreasing in the United States over the last decade, Hispanic and African American women have substantially higher rates than Caucasian women. The human papillomavirus (HPV) is a necessary, although insufficient, cause of cervical cancer. In the United States in 2013, only 37.6% of girls 13 to 17 years of age received the recommended 3 doses of a vaccine that is almost 100% efficacious for preventing infection with viruses that are responsible for 70% of cervical cancers. Implementation research has been underutilized in interventions for increasing vaccine uptake. The Consolidated Framework for …

Hiv/Aids: Ethiopia, Luzana Girmay

Global Issues in Public Health

AIDS is a public health problem that affects the immune system of the human body which results in people getting affected by other diseases easily. This syndrome is caused by a pathogen known as HIV (Human Immunodeficiency Virus). There are numerous means of transmissions; some of which are drug use, contact with fluids like blood, semen, rectal fluids, and breast milk but the main mode of transmission is through sexual intercourse. The symptoms of HIV/AIDS include fever, rash, and night sweats. The highest number of HIV positive people are located in Africa, which is about 23.8 million people. Of those …

Direct Medical Expenditures Associated With Alzheimer's And Related Dementias (Adrd) In A Nationally Representative Sample Of Older Adults - An Excess Cost Approach, Arijita Deb, Usha Sambamoorthi, James Douglas Thornton, Bernard Schreurs, Kim Innes

Clinical and Translational Science Institute

Objective—To estimate the excess direct annual healthcare expenditures associated with Alzheimer's and related dementias(ADRD) among community-dwelling older adults in the United States. Methods—This retrospective cross-sectional study compared the annual healthcare expenditures between elderly individuals aged 65 years and older with ADRD (n = 662) and without ADRD (n = 13,398) using data from the Medical Expenditure Panel Survey (MEPS) for the years 2007, 2009, 2011 and 2013. Adjusted total annual medical expenditures was estimated using generalized linear model with gamma distribution and log link in 2013 U.S. dollars. Adjusted inpatient, outpatient, emergency, home healthcare and prescription drug expenditures, were estimated …

Disulfiram-Based Disulfides As Narrow-Spectrum Antibacterial Agents, Jordan G. Sheppard, Keely R. Frazier, Pushkar Saralkar, Mohammad F. Hossain, Werner J. Geldenhuys, Timothy E. Long

Clinical and Translational Science Institute

Sixteen disulfides derived from disulfiram (Antabuse™) were evaluated as antibacterial agents. Derivatives with hydrocarbon chains of seven and eight carbons in length exhibited antibacterial activity against Gram-positive Staphylococcus, Streptococcus, Enterococcus, Bacillus, and Listeria spp. A comparison of the cytotoxicity and microsomal stability with disulfiram further revealed that the eight carbon chain analog was of lower toxicity to human hepatocytes and has a longer metabolic half-life. In the final analysis, this investigation concluded that the S-octylthio derivative is a more effective growth inhibitor of Gram-positive bacteria than disulfiram and exhibits more favorable cytotoxic and metabolic parameters over disulfiram.

Role Of Chronic Stress And Exercise On Microvascular Function In Metabolic Syndrome, Kayla W. Branyan, Evan R. Devallance, Kent A. Lemaster, R. Christopher Skinner, Randy Bryner, I. Mark Olfert, Eric E. Kelley, Jefferson C. Frisbee, Paul D. Chantler

Clinical and Translational Science Institute

Purpose—The present study examined the effect of unpredictable chronic mild stress (UCMS) on peripheral microvessel function in healthy and metabolic syndrome (MetS) rodents, and whether exercise training could prevent the vascular dysfunction associated with UCMS. Methods—Lean and obese (model of MetS) Zucker rats (LZR; OZR) were exposed to 8 weeks of UCMS, exercise (Ex), UCMS+Ex, or control conditions. At the end of the intervention, gracilis arterioles (GAs) were isolated and hung in a pressurized myobath to assess endotheliumdependent (EDD) and -independent (EID) dilation. Levels of nitric oxide (NO) and reactive oxygen species (ROS) were measured through DAF-FM and DHE staining, …

Reduced Cell Division Control Protein 42 Activity Compromises Hematopoiesis-Supportive Function Of Fanconi Anemia Mesenchymal Stromal Cells, Jian Xu, Xue Li, Allison Cole, Zachary Sherman, Wei Du

Clinical and Translational Science Institute

Hematopoietic stem cells (HSCs) preserve their ability to self-renew and differentiate to different lineages in the bone marrow (BM) niche, which is composed in large part by BM stromal cells. Studies have shown that altered signaling in the BM niche results in leukemia initiation or progression. Fanconi anemia (FA) is an inherited BM failure syndrome associated with extremely high risk of leukemic transformation. By employing two FA mouse models, here we have investigated the hematopoiesis-supportive function of FA BM mesenchymal stroma cells (MSCs). We found that MSCs deficient for Fanca or Fancc gene are defective in proliferation and prone to …

The Effect Of Nurse- Led Group Discussions By Race On Depressive Symptoms In Patients With Heart Failure, Ubolrat Piamjariyakul, Noreen C. Thompson, Christy Russell, Carol E. Smith

Clinical and Translational Science Institute

Background—African Americans with heart failure (HF) have the highest rates of depression among all ethnicities in the United States. Objectives—To compare the effects by race on depressive symptoms and topics discussed in the first clinic appointment after HF hospitalization. Methods—This study is a secondary analysis of data obtained from a randomized clinical trial that tested a patient group discussion of HF self-management intervention with 93 Caucasians and 77 African Americans. Results—The reduction in depressive symptoms was significantly greater among African American patients within the intervention group (F = 3.99, p = .047) than controls. There were significant differences by race …

Early Stable Sinus Rhythm Associated With Greater Success 5 Years After Surgical Ablation, Niv Ad, Sari D. Holmes

Clinical and Translational Science Institute

Background—An important challenge in surgical ablation for atrial fibrillation (AF) is the scarcity of publications on credible predictors of long-term success in procedures performed with ablation tools that produce consistently reliable transmural lesions. We examined factors associated with 1-year success and no atrial arrhythmia (AA) recurrence during 1 to 5 years after surgical ablation for AF. Methods—The study prospectively monitored 743 surgical ablation patients with complete rhythm follow-up at 12 months after the operation. No detected AA was defined as no known recurrence of AA, no cardioversions, and no catheter ablations at all available follow-up assessments. Results—Patients were a mean …

Cellphone Legislation And Self- Reported Behaviors Among Subgroups Of Adolescent U.S. Drivers., Toni M. Rudisill, Gordon Smith, Haitao Chu, Motao Zhu

Clinical and Translational Science Institute

Purpose—The relationship between cellphone use while driving legislation and self-reported adolescent driver behavior is poorly understood, especially across demographic subgroups. This study investigated the relationship between statewide cellphone legislation and cellphone use behaviors across adolescent driver subgroups, including age (16/17 vs. 18), sex, race/ethnicity (white non-Hispanic and others), and rurality (urban or rural). Methods—Data from the 2011–2014 Traffic Safety Culture Index Surveys were combined with state legislation. The outcomes were self-reported texting and handheld cellphone conversations. The exposure was the presence of a texting or handheld cellphone ban applicable to all drivers (i.e., universal) in the drivers’ state of residence. …

The Promise Of Technology- Based Services For Addiction Treatment Clients Residing In Nonurban Areas, Erin L. Winstanley, Beth Stroup-Menge, Kurt Snyder

Clinical and Translational Science Institute

No abstract provided.

Examining The Correlation Between Acute Behavioral Manifestations Of Concussion And The Underlying Pathophysiology Of Chronic Traumatic Encephalopathy: A Pilot Study, M Byrd, C E. Dixon, B Lucke-Wold

Clinical and Translational Science Institute

Concussion in athletes can contribute to early neuropsychological changes that may be indicative of future neurodegenerative disease. One of the hallmark findings of chronic traumatic encephalopathy is anxiety and impulsive behavior that often develops early in the course of the disease. The behavioral dysfunction can be grouped into a broader category referred to as cognitive disruption. The current gold standard for diagnosing chronic neurodegeneration is post-mortem evaluation of tauopathy to identify neurofibrillary tau tangles in neurons. Few studies, however, have looked at clinical correlations between acute injury and chronic neurodegeneration in terms of behavior. This lack of focus towards translational …

The Use Of Liquid Biopsy In The Fight Against Cancer, Chamaka Kalutota, Emanual Rubin, Md

Department of Pathology Honors Program Student Research Symposium

In recent years, liquid biopsy has emerged as a potential alternative/adjunct to standard tissue biopsy in the diagnosis of malignancies. Current use of this technique, which tracks distinctive molecules released from neoplastic cells including circulating tumor cells (CTCs), exosomes, circulating tumor DNA (ctDNA), cell-free DNA (cfDNA) and miRNA, has generally been limited to determining therapies in lung cancer based on detectable mutations (EFGR, EML4-ALK). However, recent studies have demonstrated the possibility for using these molecules as more efficient prognostic and diagnostic biomarkers in breast, colon, rectum, lung, liver, and pancreatic cancer. Due to the need for standardization in sampled material …

Post-Concussion Symptom Score As A Possible Predictor Of Protracted Recovery In High School Athletes, Kimberly Dawn Phillips

Graduate Theses

As concussion research shifts from diagnostic to managing return to play (RTF), many studies have sought to establish safe guidelines for recovery. Computer-based neuropsychological programs measure cognitive function performance typically affected by brain injury and include a self-report post-concussion symptoms scale. The use of the total score of a post-concussion symptoms scale as a possible predictor of protracted recovery in high school athletes following injury is still being researched. This study used stored data obtained from the Vanderbilt Sports Concussion Center involving concussed high school athletes with a post-concussion symptom score and subsequent documentation of recovery time. A one-way ANOVA …

Comparison Of Osteoporosis Knowledge, Beliefs, Attitudes, And Behavior Among College Students Of Various Racial/Ethnic Groups, Lauri Deruiter-Willems

Faculty Research and Creative Activity

Osteoporosis is known as a pediatric disease with geriatric consequences. The need forbone health, awareness of controllable risk factors and prevention of osteoporosis begins duringone’s youth (Campbell, 2012; Cannada, 2016; Evenson & Sanders, 2016; Edmonds, Turner, &Usdan, 2012; Ford et al., 2011; Gammage et al., 2009; Gammage et al., 2012). Currently, mosthealth information and health campaigns focus on older adults. To promote measurableimprovements in reducing the number of cases of osteoporosis, the focus for change needs tostart as early as teenage and young adult age. In addition to the general population trends, ratesspecifically associated with the nonwhite U.S. population are …

Tracking The Trajectory Of Resident Learning Through The Lens Of Self-Determination Theory., Susan E. Hansen Ma, Nicole L. Defenbaugh Phd, Susan S. Mathieu Md, Linda Garufi Md, Med, Julie Dostal Md

Department of Family Medicine

No abstract provided.

Mr Fiscal: Medical Residency Financial Skills Curriculum To Advance Financial Literacy, Carl Bryce Md, Rachel Carpenter Md, John Ewing Do, Roselyn Clemente-Fuente Md, Faafp, Christine Huang Do, Scott Kellner Md, Faafp, Rebecca K. Kemmet Md, Caqsm, Robert Poetta Md, Caitlyn Rerucha Md, Ashley Williams Md, Todd Zakrajsek Phd

Department of Family Medicine

No abstract provided.

2018 Dnp Graduate Project Abstracts, Uthealth Cizik School Of Nursing

Doctor of Nursing Practice Projects 2018-2023

The UTHealth Cizik School of Nursing proudly presents the DNP Project abstracts for the 2018 Class of DNP Graduates.