Medicine and Health Sciences Commons^™

Evidence Based Practice Implementation Of The Delirium Portion Of The Abcdef Bundle, Jessica Sumner

Graduate Theses, Dissertations, and Capstones

Background: Delirium is a common complication in the ICU setting and has serious long-term consequences. Increased mortality and long-term cognitive issues are associated with under-recognition and lack of treatment for delirium. Nursing staff must identify delirium and manage the event, in addition to providing care to other assigned patients.

Purpose: The purpose of this evidence-based project was twofold. First, the project set out to determine if implementation of the delirium portion of the ABCDEF bundle promoted delirium recognition and decreased ICU length of stay and ventilator days. Second, the project examined if the use of a structured delirium education program …

Vision In An Abundant North American Bird: The Red-Winged Blackbird, Esteban Fernández-Juricic, Patrice E. Baumhardt, Luke P. Tyrrell, Amanda Elmore, Shelagh T. Deliberto, Scott J. Werner

United States Department of Agriculture Wildlife Services: Staff Publications

Avian vision is fundamentally different from human vision; however, even within birds there are substantial between species differences in visual perception in terms of visual acuity, visual coverage, and color vision. However, there are not many species that have all these visual traits described, which can constrain our ability to study the evolution of visual systems in birds. To start addressing this gap, we characterized multiple traits of the visual system (visual coverage, visual acuity, centers of acute vision, and color vision) of the Red-winged Blackbird (Agelaius phoeniceus), one of the most abundant and studied birds in North America. We …

Comparison Of Intraoperative Outcomes Between Single-Incision Robotic Cholecystectomy And Multi-Incision Robotic Cholecystectomy., Philip Schertz, Subhasis Misra, David Livert, Joanne Mulligan, Chand Rohatgi Md

Department of Surgery

Background The aim of this study was to evaluate the differences in the key surgical factors for single-incision robotic cholecystectomy (SIRC) and multi-incision robotic cholecystectomy (MIRC). Methods A retrospective data review from August 2013 to April 2018 consisting of 104 SIRC and 105 MIRC cases was done considering factors including patient gender, age, operating time (skin incision to skin closure), robotic console time (docking to undocking), the preoperative diagnosis for surgery, any complications in surgery, length of stay (LOS), and estimated blood loss (EBL). Procedures with conversion away from original robotic cholecystectomy approach were excluded. Chi-square analysis (

"The Traps Started During My Childhood": The Role Of Substance Abuse In Women's Responses To Adverse Childhood Experiences (Aces), Breanna Boppre, Cassandra Boyer

Criminal Justice Faculty Research

The gendered pathways perspective seeks to identify the biological, psychological, and social realities that lead to women’s law-breaking behavior. Prior research in this area demonstrates the link between women’s adverse childhood experiences (ACEs) and involvement in the criminal justice system later in life. The current study fills an important gap in the literature by providing a phenomenological description of the impacts ACEs had upon 19 community supervised women’s lives. Their stories illuminate the need to consider multiple forms of ACEs, from physical and sexual abuse to the death of a loved one. Interviewees’ most prevalent response to ACEs was substance …

Systematic Review And Meta-Analysis Of The Efficacy And Safety Of Apixaban Compared To Rivaroxaban In Acute Vte In The Real World., Madan Raj Aryal, Rohit Gosain, Anthony Donato, Han Yu, Anjan Katel, Yashoda Bhandari, Rashmi Dhital, Peter A. Kouides

Reading Hospital Internal Medicine Residency

Both apixaban and rivaroxaban have been approved for use in acute venous thromboembolism (VTE). Although indirect comparison through network meta-analyses of randomized trials have been performed to compare the efficacy and safety of these agents, further comparison between these agents was lacking until recently. We sought to systematically review and carry out a meta-analysis of studies to further compare apixaban with rivaroxaban from multiple studies done in the real-world settings. Studies comparing rivaroxaban with apixaban in patients with acute VTE were identified through electronic literature searches of MEDLINE, EMBASE, Scopus, and the Cochrane library up to May 2019. Study-specific risk …

First-Time Experience In Owning A Dog Guide By Older Adults With Vision Loss, Kitsum Li, Jeffrey Kou, Yvonne Lam, Patricia Lyons, Susan Nguyen

Occupational Therapy | Faculty Scholarship

Introduction: Dog guides were found to be effective in helping adults with vision loss navigate in the community and improve overall well-being. In spite of the vast amount of literature on pet therapy and dog companionship, limited study exists on older adult with vision loss experience of owning a dog guide. The purpose of this study is to explore the facilitators and barriers of first time owning and using a dog guide as experienced by older adults with vision loss.

Methods: Data were gathered among seven participants using open-ended semi-structured telephone interviews. Participants were asked to describe their experiences related …

Mental Illness Stigma, Devine Lewis

WRIT: Journal of First-Year Writing

Mental illness stigma is a national issue prevalent due to common misconceptions of mental illness presented in media and entertainment outlets. The stigmatization of mental illness causes the increase of mental patients refusing to seek treatment, it prohibits the advancement of psychological science, and causes discrimination and prejudice towards the mental health community. Solutions to this issue include prioritizing awareness and advocacy for this issue as well as educating the general public with relevant and correct information/representations relevant to the mental health community. The increase of social interaction with mental health patients decreases the stigmatization of mental illness as does …

The Place Of Arbs In Heart Failure Therapy: Is Aldosterone Suppression The Key?, Uma Markan, Samhitha Pasupuleti, Celina M. Pollard, Arianna Perez Bhs Student, Beatrix Aukszi, Anastasios Lymperopoulos

Chemistry and Physics Faculty Articles

Since the launch of the first orally available angiotensin II (AngII) type 1 receptor (AT₁R) blocker (ARB) losartan (Cozaar) in the late 1990s, the class of ARBs (or ‘sartans’, short for Angiotensin-RecepTor-ANtagonistS) quickly expanded to include candesartan, eprosartan, irbesartan, valsartan, telmisartan, and olmesartan. All ARBs have high affinity for the AT₁ receptor, expressed in various tissues, including smooth muscle cells, heart, kidney, and brain. Since activation of AT₁R, the target of these drugs, leads, among other effects, to vascular smooth muscle cell growth, proliferation and contraction, activation of fibroblasts, cardiac hypertrophy, aldosterone secretion from the …

Introduction To Biomedical Ethics, Katherine Mendis

Open Educational Resources

This course introduces students to issues in the field of biomedical ethics, the theoretical tools bioethicists use to analyze them, and methodology for resolving clinical ethical dilemmas.

What's Happening: August 12, 2019, Maine Medical Center

What's Happening

No abstract provided.

Creating A Culture Of Courage: A Behavioral Health Study Of Resilience And Response To Traumatic Events For Firefighters, Brett Ellis

CUP Ed.D. Dissertations

Firefighters experience a variety of challenging situations and traumatic events while performing necessary job duties as public servants, which can create behavioral health concerns and even suicide ideation. The purpose of this study is to recognize how individual resilience relates to lived experiences for firefighters who may need next-level behavioral healthcare, which in turn, will identify higher “at risk” firefighters with suicide ideation who need increased mental and emotional care outside of peer interventions. The fundamental question centers on what role does individual resilience, as well as formal and informal resources of behavioral health support, play in mitigating the impact …

The Effects Of Aging On Sleep Parameters In A Healthy, Melatonin-Competent Mouse Model, Jiffin K. Paulose, Chanung Wang, Bruce F. O'Hara, Vincent M. Cassone

Biology Faculty Publications

Background: Sleep disturbances are common maladies associated with human age. Sleep duration is decreased, sleep fragmentation is increased, and the timing of sleep onset and sleep offset is earlier. These disturbances have been associated with several neurodegenerative diseases. Mouse models for human sleep disturbances can be powerful due to the accessibility to neuroscientific and genetic approaches, but these are hampered by the fact that most mouse models employed in sleep research have spontaneous mutations in the biosynthetic pathway(s) regulating the rhythmic production of the pineal hormone melatonin, which has been implicated in human sleep.

Purpose and method: The present study …

Wellness For One, Healthy Community For All: Improving A Multidimensional University Wellness Programlth, Shea Gaier

Master's Projects and Capstones

Background: Evidence suggests that college students are often unaware of the seven

dimensions of wellness (Social, emotional, environmental, financial, physical, intellectual, and spiritual). According to interviews, most students think of physical wellness only when it comes to wellness. Besides the dimensions of wellness, students have shown to gain substantial benefits from increasing their knowledge of school resources regarding personal health.

Methods: This was a quality improvement project for the Wellness Matters Program that encompassed a Plan, Do, Study, Act cycle. The goal was to improve the program by adding a comprehensive educational workshop and optimizing the one-on-one sessions. Pilot tests …

Safety Attitudes In Hospital Emergency Departments: A Systematic Review, Naif Alzahrani, Russell Jones, Amir Rizwan, Mohamed E. Abdel-Latif

Research outputs 2014 to 2021

PURPOSE: The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs).

DESIGN/METHODOLOGY/APPROACH: An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs.

FINDINGS: Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of …

Week Of August 12, 2019, New York Medical College

InTouch

• NYMC Receives NYS Grant to Expand BioInc@NYMC Facility and Center for Disaster Medicine
• GSBMS Welcomes New Cadre of Students
• New Faculty Member Brings Groundbreaking Diabetes Research Program to NYMC

Amorphous Solid Dispersion Formation Via Solvent Granulation – A Case Study With Ritonavir And Lopinavir, Niraj S. Tirasi, Sonal Bhujbal, Qi Tony Zhou, Lynne Taylor

Department of Industrial and Physical Pharmacy Faculty Publications

Herein, we evaluate the potential of using a simple solvent granulation process to prepare a binary drug amorphous solid dispersion (ASD) containing two anti-HIV drugs, ritonavir and lopinavir. The drugs were granulated onto a mixture of lactose and microcrystalline cellulose, followed by drying to remove the solvent. The resultant granules were characterized and each drug was found to be X-ray amorphous. No crystallization was observed following storage for 1 month under accelerated stability conditions (40 °C and 75% relative humidity). The dissolution behavior of the compacted granules was compared with the marketed formulation. The dissolution rate of ritonavir was found …

An Attenuated Zika Virus Encoding Non-Glycosylated Envelope (E) And Non-Structural Protein 1 (Ns1) Confers Complete Protection Against Lethal Challenge In A Mouse Model, Arun S. Annamalai, Aryamav Pattnaik, Bikash R. Sahoo, Zack P. Guinn, Brianna L. Bullard, Eric A. Weaver, David J. Steffen, Sathish Kumar Natarajan, Thomas M. Petro, Asit K. Pattnaik

School of Veterinary and Biomedical Sciences: Faculty Publications

Zika virus (ZIKV), a mosquito-transmitted flavivirus, emerged in the last decade causing serious human diseases, including congenital microcephaly in newborns and Guillain-Barré syndrome in adults. Although many vaccine platforms are at various stages of development, no licensed vaccines are currently available. Previously, we described a mutant MR766 ZIKV (m2MR) bearing an E protein mutation (N154A) that prevented its glycosylation, resulting in attenuation and defective neuroinvasion. To further attenuate m2MR for its potential use as a live viral vaccine, we incorporated additional mutations into m2MR by substituting the asparagine residues in the glycosylation sites (N130 and N207) of NS1 with alanine …

Dietary Inflammatory Index And Non-Communicable Disease Risk: A Narrative Review, Catherine M. Phillips, Ling-Wei Chen, Barbara Heude, Jonathan Y. Bernard, Nicholas C. Harvey, Liesbeth Duijts, Sara M. Mensink-Bout, Kinga Polanska, Giulia Mancano, Matthew Suderman, Nitin Shivappa, James R. Hébert

Faculty Publications

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII^®), a literature-derived …

Factor-H Partners With Latin American Organizations To Aid Destitute Huntington's Disease Families, Seeks To Expand Support, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Medical School Watercooler Newsletter - August 11, 2019, Lindsey Lyle

Watercooler Newsletter

This is the August 11, 2019 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

New pathologist focuses research on AL amyloidosis

USA researcher to study socioeconomic stress, impact on breast cancer risk for African Americans

USA medical student awarded first place at 117th NMA Annual Convention and Scientific Assembly

A seamless transition: from fellow to faculty

Petty selected to participate in national pediatrics teaching program

Evaluation Of Rapid Syphilis Testing Using The Syphilis Health Check In Florida, 2015–2016, Jennifer Richards, James Matthias, Charlotte Baker, Craig Wilson, Thomas A. Peterman, C Perry Brown, Matthew T. Dutton, Yussif Dokurugu

Florida Public Health Review

The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) …

Increased Dietary Inflammatory Index Is Associated With Schizophrenia: Results Of A Case-Control Study From Bahrain, Haitham Jahrami, Mo'ez Al-Islam Faris, Hadeel Ali Ghazzawi, Zahra Saif, Layla Habib, Nitin Shivappa, James R. Hebert

Faculty Publications

Background: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII (R)), and schizophrenia. Methods: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed based …

Increased Dietary Inflammatory Index Is Associated With Schizophrenia: Results Of A Case–Control Study From Bahrain, Haitham Jahrami, Moez Al-Islam Faris, Hadeel Ghazzawi, Zahra Saif, Layla Habib, Nitin Shivappa, James R. Hébert

Faculty Publications

Background: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII^®), and schizophrenia. Methods: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed …

Mental Health Jail Diversion: A Therapeutic Approach To Offending In Twenty-First Century America, Ryan J. Parent

Criminology Student Work

This analysis is concerned with understanding the facets of criminal justice diversion programs that successfully improve the mental wellbeing of participants and, as a subsequent effect, reduce offending amongst the mentally ill populous in the United States. An inquiry of pre-program and post-program data from both adult and juvenile mental health specific programs reveals that participation amongst both groups shows a meaningful reduction in new/repeat offending in comparison to non-participants. The data shows that the expansion of law enforcement Crisis Intervention Team’s (CIT’s) has a compounding effect to the positive results. A review of these programs in Australia indicates that …

Emergency Department Nursing Psychological Care (Early Crisis Intervention) For Adult Victims Of Violent Crime: A Quantitative Study, Barbara Conn

Electronic Theses and Dissertations

Recognition of the significance of early interventions and the importance of addressing psychological trauma for the victim of violence is of utmost importance for quality of life and the victim’s future. The serious impact of psychological trauma on victims of violent crime supports further study to determine whether Emergency Department (ED) nurses assess this trauma and initiate early interventions and referral for ongoing psychological care. Nursing care, assessment and early intervention with victims of violent crime was the focus of this dissertation study.

A quantitative study, with a non-experimental, descriptive design employed retrospective chart reviews to determine whether ED nurses …

Cultural Aspects Of End Of Life Advance Care Planning For African Americans: An Ethnonursing Study, John Collins

Electronic Theses and Dissertations

Introduction: Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are impacted by demographic variables, cultural distinctives related to patient autonomy, mistrust of the healthcare system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. End of Life (EOL) advance care planning (ACP) promotes patient and family centered care. The purpose of this study was to identify culturally based meanings, expressions, and traditions of EOL ACP and decision making among African Americans, to better understand and provide culturally congruent nursing …

Design And Synthesis Of Pyrimidine Based Heterocycles As Potential Anti-Cancer Agents With Combination Chemotherapeutic Potential Or Targeted One Carbon Metabolism Inhibition And Anti-Opportunistic Agents, Arpit Doshi

Electronic Theses and Dissertations

This dissertation describes the design, synthesis and biological evaluation of monocyclic, bicyclic and tricyclic pyrimidine-based heterocycles as a) single agents with combination chemotherapy potential having dual antiangiogenic effects and cytotoxic effects or b) one-carbon metabolism inhibitors for targeted tumor therapy; or c) selective Pneumocystis jirovecii (pj) dihydrofolate reductase (pjDHFR) inhibitors for pneumocystis pneumonia (PCP) infection.

The work in this dissertation is centered on identifying structural features that are necessary for inhibition of tubulin polymerization or thymidylate synthase as well as for inhibition of one or more of the receptor tyrosine kinases (RTKs)- vascular endothelial growth factor receptor-2 (VEGFR2), epidermal growth …

Carer Information Needs Following A Family Member's Right Hemisphere Stroke, Christyn Davidson

Electronic Theses and Dissertations

Background: Previous studies have explored information needs for carers of persons with aphasia; however, there is minimal research on information needs of carers with right hemisphere disorder (RHD). RHD describes cognitive and communication impairments a person experiences following a right hemisphere stroke or brain injury. Carers have an important role in rehabilitation and the long-term quality of life of a person with RHD. This study explores the information needs for carers following a family member’s right hemisphere stroke throughout different periods of recovery.

Methods/Procedures: Participants completed online surveys and a semi-structured phone interview. Analysis of the interviews revealed four major …

A Quantitative Study Of Drug Recrystallization In Drug-In-Adhesive Transdermal Patches Using Vibrational Spectroscopy, Yi Li

Electronic Theses and Dissertations

Drug-in-adhesive (DIA) transdermal patches are an important type of transdermal drug delivery system (TDDS). The drugs used in the DIA system are frequently present in metastable forms, such as amorphous solids or supercooled liquids. These drug states are thermodynamically unstable and tend to undergo recrystallization. Recrystallization of the active pharmaceutical ingredient can adversely affect the efficacy of transdermal products. This dissertation demonstrates a systematic approach to quantify the crystalline content of the API in DIA systems. This approach uses a novel method of preparing calibration standards and a spectroscopic method to reliably predict crystalline content in DIA patches. Spectroscopic tools, …

Humeral Retroversion, Range Of Motion, And Strength Adaptations In Tennis Players, Daniel Hannah

Electronic Theses and Dissertations

Purpose: This study aimed to develop an understanding of humeral retroversion (HRV) asymmetries in tennis players and its impact on physical and performance characteristics of the shoulder.Participants: Healthy tennis players were categorized into 3 groups: younger juniors (n=11, age=14.5±0.5 years), older juniors (n=12, age=17.1±0.9 years), and collegiate (n=16, age=19.6±1.2 years). Methods: HRV, internal rotation (IR), and external rotation (ER), total arc of motion (TAM), HRV-corrected IR (HRVcIR), and HRV-corrected ER (HRVcER) were measured and calculated bilaterally using a digital inclinometer and ultrasonography. Bilateral differences (Δ) were calculated (dominant minus nondominant) for HRV and ROM variables. Isometric ER:IR strength ratios …