Medicine and Health Sciences Commons^™

Evaluating Awareness Of Horticulture Therapy In The Omaha Area, Hannah Shepley

Theses/Capstones/Creative Projects

Horticulture therapy, where gardens, landscapes, and other plant materials are used to increase overall wellness or reach defined therapeutic goals, has a body of research which supports its effectiveness. To assess potential clients' knowledge and interest in utilizing horticulture therapy, a survey was conducted. UNO college students were asked for their input for these questions. Furthermore, businesses that were potential horticulture therapy providers were contacted and asked six questions regarding any current or future horticulture therapy programs offered at their facilities. Afterwards, the University of Nebraska-Lincoln Extension office of Douglas-Sarpy County was contacted and asked about any involvement in horticulture …

Clopidogrel Versus Newer P2y12 Antagonists For Percutaneous Coronary Intervention In Patients With Out-Of-Hospital Cardiac Arrest Managed With Therapeutic Hypothermia: A Meta-Analysis, Ayman Elbadawi, Islam Y. Elgendy, Ahmed H. Mohamed, Kirolos Barssoum, Erfan Alotaki, Gbolahan O. Ogunbayo, Khaled M. Ziada

Internal Medicine Faculty Publications

Introduction: The impact of therapeutic hypothermia (TH) on outcomes of percutaneous coronary intervention (PCI) and the optimal antiplatelet treatment remains debatable.

Methods: Electronic databases were searched for randomized trials and observational studies to evaluate the available clinical evidence comparing the use of clopidogrel versus newer P2Y12 antagonists in cases of TH after PCI. The primary outcome was in-hospital definite stent thrombosis while the secondary outcomes were in-hospital mortality and major bleeding. Fixed-effects risk ratios (RRs) were estimated using Mantel–Haenszel method.

Results: The final analysis included five studies with a total of 290 patients. There was no difference in the incidence …

Removal Of Carbamazepine From Drinking Water, Thomas Krumpolc, Juan Rodriguez, Jordan Alex Gadberry, Zach Wiese, Paola Marrero-Rivera, Adam Johnson

Chemical Engineering Undergraduate Honors Theses

Due to the increasing prevalence of prescription medication over the past few decades, pharmaceuticals have accumulated in various water sources. This has become a public health concern because many pharmaceuticals have limited research on the effects of chronic low-level exposure. According to the World’s Health Organization (WHO), traces of pharmaceuticals products have been reported in different water sources such as surface waters, wastewater, groundwater, and drinking water.^[1] One pharmaceutical of interest that has been detected in water sources is carbamazepine. Carbamazepine (CBZ) is a common pharmaceutical prescribed for the treatment of seizure disorders, neuropathic pain, and various psychological disorders. …

Dental Practice Success Special Issue: Dental Office Design (December 2018), American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

Safety, Stephen M. Vantassel, Brenda K. Osthus

Wildlife Damage Management Technical Series

Wildlife damage management (WDM) is an exciting field with many opportunities to provide solutions to the complex issues involved in human-wildlife interactions. In addition, WDM wildlife control operators (WCO) face a variety of threats to their physical well-being. Injuries can result from misused (Figure 1), faulty, or poorly maintained equipment, inexperience, mishandled wildlife, harsh weather, and dangerous situations, such as electrical lines. The goals of this publication are to: * Develop an awareness of safety issues and adopt a mindset of “Safety First”, * Review the major safety threats that WCOs face, * Provide basic information for WCOs to protect …

Early Identification Of Depression In Patients With Pediatric Epilepsy, Erin Fecske, Paul Glasier, Lines Vargas Collado, Elizabeth Rende

Posters

Describes the use of the Neurological Disorders Depression Inventory-Epilepsy-Youth (NDDI-E-Y) in adolescent patients in a comprehensive epilepsy center to identify patients who need referral for mental health care.

Investigating Affective Pathways For The Influence Of Justification On Self-Control, Morgan Hill

Graduate Theses and Dissertations

People struggle with temptation in their everyday lives. Research often attributes failures in self-regulation to overwhelming and uncontrollable impulses. However, research also supports the idea that cognitive factors (e.g., justification) can license tempting behavior and allow individuals to behave in ways that run counter to their long-term goals. In addition, it is likely that affect plays a role in justification-based self-control failure. The current set of three studies investigated the role of affect in justification-based self-control failure. Study 1 tested the prediction that recall of past successes would result in increased positive affect. Study 2 assessed whether justification results in …

Analysis Of Current Practices For Measuring Endotracheal Cuff Pressures, Myisha Jessie Dixon

Doctoral Projects

The current practice for the measurement of endotracheal tube (ETT) cuff pressure intraoperatively is subjective, potentially leading to negative consequences for patients. The purpose of this best practice project was to examine and synthesize the current evidence-based literature on measuring ETT cuff pressure and developed a policy recommendation for measuring ETT cuff pressure in the intraoperative setting by anesthesia providers. The ACE star model of knowledge transformation guided this best practice project. An extensive literature review was performed to evaluate and synthesize the current evidence-based research that can be used to develop the policy on measuring endotracheal tube cuff pressure. …

A Support Program For College Students With Autism Spectrum Disorder: The Functioning Of Participants Versus Non-Participants And The Role Of Program-Sponsored Mentoring, Ayla Raven Mapes

Graduate Theses and Dissertations

Increasingly more students with autism spectrum disorder (ASD) are attending college. In response, many colleges are now offering these students the extra support of an Autism Support Program (ASP), many of which include a mentoring component. This study is one of only a handful of attempts to examine these programs empirically. Using a small sample of college students who identified as having ASD, I compared participants and non-participants of a university ASP. An online survey was used to assess demographic characteristics and pre-college academic performance, as well as students’ functioning across the following domains: social, adaptive, academic, emotional, and having …

Seven Decades Of Vitamin D Research In Pakistan : Too Little, Too Much Or Just Right!, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

No abstract provided.

Haemoglobin: An Amenable Outcome Factor Of Acute Ischemic Stroke After Thrombolysis, Saumya H. Mittal, Rakshith Kc, Misri Zk, Shivanand Pai

Manipal Journal of Medical Sciences

Objective: To study the role of haemoglobin in outcome of thrombolysis after stroke. Material and method: Our observational study was conducted over five years at KMC Hospital, Mangalore from July 2011 to July 2016. All patients above the age of 18 years presenting to the hospital within 4.5 hours of onset of stroke were included into the study. The patients’ stroke severity was calculated by National Institute of Health Stroke Scale (NIHSS) score, while the outcome was measured by Modified Rankin Scale (mRS) score. The patients were divided into good outcome, poor outcome and expired group of patients depending on …

Genetic Variants Of The 11 Beta-Hydroxysteroid Dehydrogenase Type 1 Gene Influence Metabolic Syndrome, Nayana Devang, Kapaettu Satyamoorthy, Padmalatha S. Rai, Nandini M, Prabha Adhikari Dr

Manipal Journal of Medical Sciences

Background: Metabolic syndrome (metS) is the prominent public issue around the globe which contributes to several diseases, including type 2 diabetes, obesity, and insulin resistance (IR). At a recent time, IR due to cortisol excess has been implicated as part of metS etiology. The 11 beta- hydroxysteroid dehydrogenase type 1 (HSD11B1) gene that encodes 11 beta- hydroxysteroid dehydrogenase (11β-HSD1) enzyme has a pivotal role in maintaining serum cortisol level against IR. The aim of this study was to detect the frequency of HSD11B1 gene polymorphisms and their association with metS among the South Indian cohort. Methods: Our study included 613 …

A Review On Contact Lens Related Microbial Keratitis In Asian Countries, T Thevi, S C Reddy

Manipal Journal of Medical Sciences

Bacterial or fungal keratitis/corneal ulcer is the most dangerous complication which occurs when patients do not follow good hygiene practices in handling the contact lenses. When the ulcer heals, it results in corneal opacity and loss of vision. A review of the literature on keratitis/corneal ulcer in patients wearing contact lenses from different countries in Asia was performed in Pubmed, Google scholar and Science direct search engines. In patients of infectious keratitis/corneal ulcer, contact lens wear was reported as a risk factor in 0.4% to 69.4% in Asian countries. Soft lenses and those made of polymethylmethacrylate accounted for most ulcers. …

Floxed-Cassette Allelic Exchange Mutagenesis Enables Markerless Gene Deletion In Chlamydia Trachomatis And Can Reverse Cassette-Induced Polar Effects, Gabrielle Keb, Robert Hayman, Kenneth A. Fields

Microbiology, Immunology, and Molecular Genetics Faculty Publications

As obligate intracellular bacteria, Chlamydia spp. have evolved numerous, likely intricate, mechanisms to create and maintain a privileged intracellular niche. Recent progress in elucidating and characterizing these processes has been bolstered by the development of techniques enabling basic genetic tractability. Florescence-reported allelic exchange mutagenesis (FRAEM) couples chromosomal gene deletion with the insertion of a selection cassette encoding antibiotic resistance and green fluorescent protein (GFP). Similar to other bacteria, many chlamydial genes exist within polycistronic operons, raising the possibility of polar effects mediated by insertion cassettes. Indeed, FRAEM-mediated deletion of Chlamydia trachomatis tmeA negatively impacts the expression of tmeB. We …

Knowledge And Awareness Of Std Risk Perception Of Msm In Philadelphia, Timothy Chou, Nancy Brisbon, Md

Phase 1

There has been a rise in incidence of sexually transmitted diseases (STDs), in particularly in men who have sex with men (MSM). MSM were 106x as likely to have primary or secondary syphilis as compared to men who exclusively had sex with women (MSW). MSM account for large portion of antimicrobial resistant gonorrhea diagnoses and saw a 151% increase in incidence while compared to a 31.7% increase in MSW. This study examines what MSM in Philadelphia know about transmission methods and outcomes of syphilis and gonorrhea to better understand MSM risk perception of these diseases. A multiple-choice test was distributed …

Clinician Perspectives On Factors Affecting Shared Decision Making About Lung Cancer Screening, Mohammad Abubaker-Sharif, Melissa Dicarlo, Mph, Ms, Ronald E. Myers, Phd, Dsw

Phase 1

Background/Objective. In 2015, the Centers for Medicare and Medicaid Services (CMS) announced coverage for annual lung cancer screening (LCS) with low dose computed tomography (LDCT) for individuals who are 55 to 77 years of age, have > 30 pack years of smoking history, and undergo shared decision making (SDM) prior to screening. Most referrals for LCS are initiated in primary care. Currently, little is known about how primary care physicians view SDM and barriers in practice to SDM about LCS. This study aimed to gather information to help fill these knowledge gaps.

Methods. I worked with senior leadership in …

Knowledge, Attitudes, And Beliefs About Sexual Health And Behavior In Huye, Rwanda, Sara Charles, Lianna Drobatz, Ryan Dorey

Phase 1

Introduction: Pregnancy and its associated complication is the leading cause of death for women aged 15-19 worldwide. Teenage pregnancy is correlated with increased health complications, death, poverty, and societal stigma. Pregnancy in Rwanda has been documented at rates of 7% among teen women.

Objective: The objectives of this research study include assessing the attitudes, knowledge, and beliefs of adolescents in the Huye District of Rwanda regarding sexual health and behavior. We hypothesize that gaps in sexual health knowledge may exist and that differing beliefs among male and female adolescents affect adolescent sexual decision making, and, therefore, teenage pregnancy prevalence.

Methods: …

Impact Of Physical Activity On Stress Levels And Methadone Maintenance Treatment Outcomes, Praneeja Matta, Robert Sterling, Phd

Phase 1

Introduction: While the opioid epidemic has continued to intensify over the last decade, unfortunately the likelihood of achieving stable long-term abstinence using methadone maintenance treatment (MMT) remains as low as 60 percent. Perceived stress has been identified as a factor predictive of premature termination and relapse, making stress reduction an important area of study in MMT. However, little research is available on the effects of active stress-coping mechanisms on MMT outcomes.

Objective: To address this gap, the current study was conducted to examine the impact of physical activity on stress reduction and treatment outcomes.

Methods: This was a retrospective cohort …

Peer Assessments May Predict Objective Long-Term Academic Performance, Noah Christian, Yousif Hanna, John Spandorfer, Md

Phase 1

Introduction: A common challenge in medical education is to create a curriculum that both teaches the required material but still delivers a personable physician. In this data study, 673 Sidney Kimmel Medical College (SKMC) students were given a required survey to judge their group members on personal attributes ranging from preparedness to affability. These scores were used to aid students and hopefully prevent unfortunate habits from settling. We hypothesize that peer assessments will predict academic performance.

Methods: A five-question, Likert scale, peer assessment was given to each first-year medical student at SKMC. The electronic survey was given twice during the …

Medication Assisted Treatment For Opioid Use Disorder In The Primary Care Setting In Philadelphia: A Retrospective Review, Denis Ostick, Lara Weinstein, Md, Mph

Phase 1

Introduction:

The opioid crisis continues to be a growing public health concern across the United States. Americans struggling with Opioid Use Disorder (OUD) can seek different resources to help curtail their addiction. These include abstinence -based programs such as Narcotics Anonymous and Specialty treatment facilities including methadone and suboxone clinics. It has been shown that increased availability of drugs to treat opioid use addiction, such as methadone and buprenorphine, is linked to a lower likelihood of relapse and fatal overdoses. Therefore, medication assisted treatment (MAT) is a valuable asset because it combines behavioral therapy and medications to treat opioid use …

Screening, Brief Intervention, And Referral To Treatment (Sbirt) For Substance Use Disorders In Title X Facilities: Assessing Barriers, Change Of Provider Behavior, And Patient Outcomes, Christian Iversen, Ms, Holly Ireland, Lcsw-C, Dickie Lynn Gronseth, Mph

Phase 1

Introduction: Substance use disorders, specifically opioids, are an increasing problem in the US. Screening, brief intervention, and referral to treatment (SBIRT) is a method to identify and treat patients at risk, or currently using illicit substances. Integrating SBIRT into Title X facilities, which provide reproductive healthcare to lower income populations, may allow identification and treatment of individuals that do not seek healthcare elsewhere. Objective: We aim to assess the efficacy of a longitudinal training program in Title X facilities. The program provides a structured approach to implementing new protocols, including an educational session on SBIRT and motivational interviewing (MI).

Methods: …

Advocating For Support For Families Of Pregnant And Parenting Women Impacted By The Opioid Crisis In Pennsylvania, Caitlin Weiss, Rosemarie Halt, Rph, Mph

Phase 1

Introduction:

The perinatal period is a key opportunity for intervention for families impacted by opioid use disorder (OUD). However, in 2016 only 7.6% of treatment facilities in PA offered childcare for parents receiving treatment and only 2.8% of residential facilities offered beds for clients’ children.

Objective:

The purpose of this project was to understand the magnitude of the opioid crisis as it affects pregnant women and their children in PA as well as what avenues exist to advocate for policy changes to better support their recovery.

Methods:

1. A policy brief was prepared for the Maternity Care Coalition (MCC) using …

Quality Improvement For The Jeffmd Clinical Experience Program, Chloe Virgil, Emily Romano, Sara Goldstein, Msw, Lsw, Rhea E. Powell, Md, Mph

Phase 1

Introduction: The JeffMD curriculum at Sidney Kimmel Medical College, which completed its inaugural year in the spring of 2018, aims to prepare future physicians to “thrive in the landscape of modern healthcare.” The curriculum is based upon the knowledge that human health exists interdependently with all aspects of life, including but not limited to social, health care system, behavioral, and biological factors. The JeffMD Clinical Experience Program (CE) is a mandatory, experiential, value-added component of the curriculum. Through the CE course, which spans the 21-month preclinical period, students work with a Community Health Worker to screen patients for social …

A Longitudinal Assessment Of Change In Blood Pressure Among Participants In The Heart Smarts Program, Kathryn Haskins, Susana Suzrez, Rickie Brawer, Phd, Mph, Sandra Sherman, Edd, Michelle Abel, Msph, James Plumb, Md, Mph

Phase 1

Many low-income areas of the United States are considered food deserts because people living in those communities have limited access to fresh fruits and vegetables (FFV); lack of FFV is tied to numerous health issues, including cardiovascular disease and obesity. The Heart Smarts Program (HSP) provides increased access to FFV in food deserts, as well as providing participants with nutrition education courses and health screenings, including blood pressure. The purpose of this study is to examine HSP participants who have been with the program for differing lengths of time in order to determine if length of participation has an impact …

Medical Respite Care Services For Homeless Patients Discharged From Thomas Jefferson University Hospital: A Needs Based Assessment, Taylor Treacy, Lara Weinstein, Md

Phase 1

Introduction: Medical respite programs have been proposed as a temporary solution to address the increased hospital readmission rates and lack of appropriate discharge options that exist for homeless patients.

Objective: This study examines the 90-day readmission rate and discharge locations of patients experiencing homelessness.

Methods: We conducted a retrospective chart review of homeless patients discharged from Thomas Jefferson University Hospital (TJUH) between April 30^th 2017 to April 30^th 2018. Homelessness was identified as any patient with 1 of the following locations listed for residency: 833 Chestnut Street, Broad Street Ministry, St. John’s Hospice, shelter as address, no address …

Health Needs Of Philadelphia’S Latinos Through Photovoice, Martin Hehir, Rickie Brawer, Phd, Mph, Mches, Caleb Dafilou

Phase 1

Introduction: The Patient Protection and Affordable Care Act requires non-profit hospitals to complete a Community Health Needs Assessment (CHNA) every three years that provides insight into the health and social needs of the community served and develop a plan to address priority needs. Community engagement and collaborative participation are essential to the process. For the 2019 CHNA, Thomas Jefferson University Hospitals is conducting a more in-depth assessment of the Philadelphia Latino community in North Philadelphia in order to better understand the specific issues faced by this population.

Objective: To conduct a CHNA in North Philadelphia’s Latino community that identifies priority …

Patient Perceptions And Expectations About Postoperative Analgesia, Carrie Mok, Nirmal Shah, Do, Stephen F. Goldberg, Md, Amir C. Dayan, Md, Marc Torjman, Phd, Jaime L. Baratta, Md

Phase 1

Introduction

Opioid overdose deaths have nearly quadrupled since 1999. Nearly 2 out of 3 persons being prescribed medications are prescribed an opioid. Physicians may be prescribing opioids for more than what is required for postoperative pain control, leading to increased risk for opioid abuse and addiction. Patient perceptions of perioperative pain medications are poorly understood.

Objective

This survey aims to understand patient expectations of perioperative analgesics.

Methods

Following IRB approval, patients 18 years of age or older, were given a 13-question survey prior to their surgery at Thomas Jefferson University Hospital, to evaluate the perception of pain medications, medication efficacy, …

A Comparison Of Screening, Prevention, And Management For Hepatitis B Patients Between The Us And Chinese Healthcare Systems, Thomas Chen, James D. Plumb, Md

Phase 1

Introduction: Hepatitis B (HBV) is a complex disease entity with potentially serious outcomes, including developing hepatocellular carcinoma (HCC). HBV is estimated to be responsible for about 50-80% of HCC cases worldwide, and 75-95% of HCC cases in HBV endemic regions.¹ HBV and HCC are great concerns especially in East Asian countries like China. In China, HCC ranks as the 2^nd most common cancer and 2^nd in cancer mortality, both behind only lung cancer.¹ China is considered an endemic HBV region, with about 100-150 million people infected. In comparison, only an estimated 550,000-2 million people are chronically …

Opioid-Prescribing Practices For Post-Operative Patients In Otolaryngology: A Multiphasic Quality Improvement Project In A Single Large Institution, Zachary Gandee, Sophia Dang, Alexander N. Duffy, Jonathan C. Li, Tanvi Rana, Brittany Gunville, Tingting Zhan, Elizabeth Cottrill, Md, David Cognetti, Md

Phase 1

Objectives:

In otolaryngology, postoperative pain management lacks evidence-based guidelines. We investigated opioid prescription and consumption for common procedures to develop prescribing guidelines at our institution.

Study Design:

Prospective, survey study.

Methods:

Patients who underwent surgery between July and September were given surveys upon discharge and at first follow-up visit. We assessed opioid usage and pain using the visual analog scale and opioid consumption throughout the postoperative period. Opioid prescriptions were converted to a standardized unit of 5 mg Oxycodone pills for reporting. Four procedures (transoral robotic surgery resection [TORS], sialendoscopy, parathyroidectomy/thyroidectomy, and parotidectomy) were selected for isolated analysis.

Results: …

The Impact Of Mental Health On Cancer Preventative Screenings, Chelsea Edirisuriya, Amy Leader, Phd

Phase 1

Among the mental health population of the United States, overall preventative health services, such as cancer screening rates, are remarkably low. Additionally, there is a significant 30% higher mortality rate due to cancer in psychiatric patients. This project established if there are disparities in cancer screening rates between the general population and the mental health population of Southeastern Pennsylvania. The project analyzed and compared the differences in cancer screenings for colorectal, breast, and cervical cancer among those currently diagnosed with a mental condition and the general population. Through p-value and Pearson chi-square statistical analysis of the Community Health Data Base …