Medicine and Health Sciences Commons^™

Following The Growth Of Sarah's Baby: An Ipe Activity For Medical Nutrition & Diagnostic Sonography Students, Tanya M. Custer, Megan Timmerman, Cynthia M. Schmidt, Teresa L. Hartman, Harlan Sayles, Kathryn Wampler, Lea Lambing, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: Interprofessional education (IPE) involves collaborative learning among students from different professions. While acceptance of these types of activities is increasing, there are opportunities to expand the number of health care professions involved in IPE. The purpose of this study was to explore student perceptions and outcomes after participation in a Diagnostic Medical Sonography (DMS) and Medical Nutrition Education (MNE) interprofessional education activity centered around a clinical case study on fetal growth. Subjects & Methods: The IPE activity was administered to four student cohorts from academic years to 2015-2016 to 2018-2019. Participants included 66 students (n=39 DMS and n=27 MNE). …

Comparison Of Ondansetron, Dexamethasone, And Its Combination In The Prevention Of Postoperative Nausea And Vomiting, Alina Palanchuk, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Postoperative nausea and vomiting remains a common and unpleasant side effect for patients following surgery. Uncontrolled PONV can result in prolonged hospital stays, unanticipated hospital readmissions, and decreased patient satisfaction. The Apfel score identifies and counts independent risk factors for PONV; females, non-smokers, postoperative opioid use, and history of PONV or motion sickness. Rates of PONV increases as the number of risk factors increase. The primary intervention to decrease PONV is administration of prophylactic antiemetics. Research supports the use of combination antiemetic therapy for patients with a high number of risk factors. The purpose of this evidence based practice …

Ultrasound Simulation For Regional Anesthesia, Kayla Brown, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Regional anesthesia is an essential skill in the practice of Nurse Anesthesia, and future employment demands expertise. Literature supports the addition of simulation training to existing didactic and apprenticeship education to improve clinical expertise. The purpose of this project was to trial simulation training, focused on anatomical visualization with ultrasound for regional anesthesia, as a means to improve student performance and confidence.

Methods • Facility project approval and exemption determination by IRB. • Hands-On Test: Ultrasound to obtain visualization for axillary (cohort 1), interscalene (cohort 2) block on live-model. Expert CRNA observed performance to determine if image was clinically …

Intraoperative Opioid Administration Among Cancer Patients, Amanda Barrett, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cancer prevalence continues to rise. In vitro and in vivo studies have demonstrated that opioid receptor agonists may be associated with poor outcomes for cancer patients. Laboratory studies have shown that opioids cause immunosuppression; tumor cell progression, recurrence and metastasis. The surgical environment further decreases immune function, causes an inflammatory response and promotes cancer cell mobilization. Anesthesia providers are in a unique position to influence postoperative outcomes. Opioid free anesthetic delivery is a growing trend amongst anesthesia providers and is supported by the literature. The purpose of this project is to compare intraoperative opioid administration rates for patients with …

Effectiveness Of Educational Intervention On Diabetic Knowledge & Hba1c Levels On Kenyan Adults With T2dm, Sabina Jeruto Bett

Doctor of Nursing Practice Projects

Background

Type II diabetes mellitus (T2DM) is a common chronic metabolic disease affecting millions of people globally, which causes many long-term complications such as high blood pressure, chronic kidney disease, improper wound healing and loss of sight. Literature supports that most people, in general and diabetic patients specifically, in Africa, including Kenya are currently not taught about the importance of proper management of their disease. Therefore, many have difficulty following treatment plans, resulting in improper eating, poor glucose control, and diabetic complications. The limited knowledge concerning T2DM contributes to the negative impact this serious disease has on those who live …

To Extubate Or Not To Extubate: Risk Factors For Extubation Failure And Deterioration With Further Mechanical Ventilation, Jingui Xie, Guang Cheng, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Background: Extubation is a critical step in the intensive care unit (ICU). In this study, we aim to investigate the risk factors for both extubation failure and deterioration with further mechanical ventilation (MV). Methods: Data were collected from a cardiothoracic ICU in a tertiary hospital. The risk factors for extubation failure and deterioration with further MV were investigated by multivariate logistic regression. Results: A total of 676 patients were enrolled in the study. Patients with extubation failure had a longer ICU length of stay and a higher mortality rate than patients without extubation failure. An age greater than 65 years, …

Preoccupation With Failure And Adherence To Shared Baselines: Measuring High-Reliability Organizational Culture, Jason M Etchegaray, Eric J Thomas, Jochen Profit

Faculty, Staff and Student Publications

OBJECTIVE: To create, administer, and psychometrically examine a survey to measure two new organizational culture factors - preoccupation with failure and adherence to shared baselines - in healthcare settings.

METHOD: Direct care providers (n = 4484) from a large healthcare system in the Southern United States completed a survey as part of their annual safety culture assessment.

RESULTS: We provide evidence about the internal consistency (Cronbach's alpha ranged from .80 to .89) factor structure, concurrent validity (correlation with overall patient safety grade ranged from .60 to .67, p

CONCLUSIONS: We established evidence for internal consistency and validity of two new …

The Society Of Abdominal Radiology At 10 Years: Reflections, Status Report, And Look To The Future, Manju Ambelil, David M Saulino, Atilla Ertan, Andrew W Dupont, Mamoun Younes

Faculty, Staff and Student Publications

CONTEXT.—: Recent studies examining immunohistochemical staining of colorectal biopsies for cytomegalovirus (CMV) reported that some cases showed only occasional small positive nuclei that were called equivocal for CMV.

OBJECTIVES.—: To determine the extent and clinical significance of equivocal CMV staining in colorectal biopsies.

DESIGN.—: Two-hundred twenty-one consecutive cases of colon and rectal biopsies that were stained for CMV by immunohistochemistry were retrieved from our files and reviewed. Staining results were recorded as negative, unequivocal, or equivocal. Results were correlated with clinicopathologic data, results of polymerase chain reaction studies for CMV, and treatment history.

RESULTS.—: Fifty-two cases (24% of all tested, …

Next-Generation Paclitaxel-Nanoparticle Formulation For Pancreatic Cancer Treatment, Andrew Massey, Mohammed Sikander, Neeraj Chauhan, Sonam Kumari, Saini Setua, Advait B. Shetty, Hassan Mandil, Vivek K. Kashyap, Sheema Khan, Meena Jaggi, Murali M. Yallapu, Bilal B. Hafeez, Subhash C. Chauhan

School of Medicine Publications

Pancreatic cancer (PanCa) is a major cause of cancer-related death due to limited therapeutic options. As pancreatic tumors are highly desmoplastic, they prevent appropriate uptake of therapeutic payloads. Thus, our objective is to develop a next-generation nanoparticle system for treating PanCa. We generated a multi-layered Pluronic F127 and polyvinyl alcohol stabilized and poly-L-lysine coated paclitaxel loaded poly(lactic-co-glycolic acid) nanoparticle formulation (PPNPs). This formulation exhibited optimal size (~160 nm) and negative Zeta potential (−6.02 mV), efficient lipid raft mediated internalization, pronounced inhibition in growth and metastasis in vitro, and in chemo-naive and chemo-exposed orthotopic xenograft mouse models. Additionally, PPNPs altered nanomechanical …

Antimicrobial Sensitivity Pattern, Demographic Findings And Risk Factors Amongst Meningitis And Non-Meningitis Invasive Streptococcus Pneumoniae At Aga Khan University Hospital Clinical Laboratory, Karachi, Pakistan, Seema Irfan, Joveria Farooqi, Afia Zafar, Haresh Kumar

Department of Pathology and Laboratory Medicine

Objective: To determine the resistance rate of penicillin and ceftriaxone amongst invasive meningitis and nonmeningitis isolates of streptococcus pneumoniae. Methods: The prospective cross-sectional study was conducted from January 2011 to March 2014 at the Clinical Microbiology Laboratory of Aga Khan University, Karachi, and comprised all invasive strains of streptococcus pneumoniae. Penicillin and ceftriaxone susceptibilities were performed and interpreted based on minimum inhibitory concentration breakpoints recommended by Clinical and Laboratory Standards Institute guidelines. Data was analysed using Stata 12.
Result: There were 163 strains isolated from sterile body fluids of 109 patients. Of the total, 46(28%) samples were meningitic while 117(72%) …

Spectrum Of Neurological Disorders In Neurology Outpatients Clinics In Urban And Rural Sindh, Pakistan: A Cross Sectional Study, Safia Awan, Alam Ibrahim Siddiqi, Ahmed Asif, Naveeduddin Ahmed, Hazim Brohi, Sajad Jalban, Mohammad Wasay

Section of Neurology

Background: Neurological disorders are the most common cause of morbidity and mortality in developing countries. Available evidence on urban–rural differences on neurological diseases is scare in such countries. Our study objective was to determine the prevalence of neurological diseases in urban and rural tertiary care hospitals of Sindh, Pakistan.

Methods: This was a cross sectional study conducted in selected urban and rural region of tertiary care hospitals of Sindh, Pakistan. The outpatients medical records of adults (18 years and above) was obtained from January 1st, 2014 to December 31st, 2014.

Results: A total of 10,786 outpatients visit were recorded in …

Patient-Centered Design Grounded In User And Clinical Realities Towards Valid Digital Health, Victor P. Cornet, Carly Daley, Davide Bolchini, Tammy Toscos Phd, Michael Mirro Md, Richard J. Holden

Health Services and Informatics Research

Valid design of patient-centered digital health or health information technology (IT) systems is based on a thorough and accurate understanding of both “user reality” and “clinical reality.” Type 1 Design Error (User-Reality Error) occurs when designers do not accommodate user characteristics, tasks, context of use, needs, or preferences. Type 2 Design Error (Clinical-Reality Error) occurs when designers do not accommodate the clinical reality, including biomedical knowledge, clinical workflows, and organizational requirements. Both types of errors can invalidate the design, leading to products being rejected by patient end-users or their healthcare delivery systems, product non-use or inappropriate use, and risk of …

Visualization Of Cardiac Implantable Electronic Device Data For Older Adults Using Participatory Design., Ryan Ahmed, Tammy Toscos Phd, Romisa Rohani Ghahari, Richard J Holden, Elizabeth Martin, Shauna Wagner, Carly Daley, Amanda Coupe, Michael Mirro Md

Health Services and Informatics Research

Patients with heart failure (HF) are commonly implanted with cardiac resynchronization therapy (CRT) devices as part of their treatment. Presently, they cannot directly access the remote monitoring (RM) data generated from these devices, representing a missed opportunity for increased knowledge and engagement in care. However, electronic health data sharing can create information overload issues for both clinicians and patients, and some older patients may not be comfortable using the technology (i.e., computers and smartphones) necessary to access this data. To mitigate these problems, patients can be directly involved in the creation of data visualization tailored to their preferences and needs, …

Selection Biases In Technology-Based Intervention Research: Patients' Technology Use Relates To Both Demographic And Health-Related Inequities., Tammy Toscos Phd, Michelle Drouin, Jessica Pater, Mindy Flanagan, Rachel Pfafman, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

OBJECTIVE: Researchers conduct studies with selection biases, which may limit generalizability and outcomes of intervention research. In this methodological reflection, we examined demographic and health characteristics of implantable cardioverter defibrillator patients who were excluded from an informatics intervention due to lack of access to a computer and/or the internet.

MATERIALS AND METHODS: Using information gathered from surveys and electronic health records, we compared the intervention group to excluded patients on demographic factors, computer skills, patient activation, and medical history.

RESULTS: Excluded patients were older, less educated, less engaged and activated in their health, and had worse health (ie, more medical …

Animal Assisted Therapy And Support Animals, What Mental Health Professionals Know And Understand, Alexandro H. Velez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Animal-assisted therapy can greatly benefit mental health professionals with clients in and out of the school settings in many ways. It is believed mental health professionals are successfully implementing Animal Assisted Therapy, even though some are not. Mental health professionals who are not using Animal Assisted Therapy are not doing so as the result of various variables, such as lack of information, knowledge, training, certification and policies, which prevents them from using Animals Assisted Therapy with clients and the community. It is also believed some mental health professionals are using animals as part of therapeutic interventions without proper training. The …

Sex Effects On Ankle Biomechanics During Sports-Relevant Tasks And Peroneal Muscle Parameters, Wyatt D. Ihmels

Boise State University Theses and Dissertations

Introduction: Ankle sprains from excessive inversion are the most frequent sports- related injury. Common ankle prophylactics are designed to prevent injury by limiting excessive ankle inversion, yet may restrict other ankle motions leading to repeated re-injury. Females are twice as likely as males to suffer an ankle sprain, however, it is unknown if a sex dimorphism in ankle biomechanics exists when wearing ankle prophylactics, and whether differences in the peroneal musculature exist between sexes. Purpose: To quantify the ability of ankle prophylactics (Ankle Roll Guard (ARG), Brace, Control, and Tape) to prevent excessive ankle inversion during a sudden inversion event, …

Validity Of The Polar M430 Among Females Of Varying Fitness Levels, Body Fat Percentage, And Reported Physical Activity, Kevin Earl Miller

Boise State University Theses and Dissertations

Introduction: The Polar M430 is a heart rate monitor that uses a non-exercise prediction method to predict one’s V̇O_2max. Research has revealed that this method will overestimate predicted V̇O_2max among females. Studies have investigated the validity of this method, however, these studies have not taken into account how physical activity (PA) levels, body fat percentage, or measured V̇O_2max could affect the prediction value. Purpose: The purpose of this study was to investigate the validity of the Polar M430 in predicting V̇O_2max amongst females of varying PA levels, body fat percentages, and fitness levels. Methods: Forty-eight …

Microbial Colonization Of Pneumatic Tourniquets In The Orthopedic Operating Room, Syed Hamza Mufarrih, Nada Qaisar Qureshi, Rizwan Haroon Rashid, Bilal Ahmed, Seema Irfan, Akbar Jaleel Zubair, Shahryar Noordin

Section of Orthopaedic Surgery

Background: The rate of surgical site infections following orthopedic procedures is approximately 2% globally. Potential sources of contamination in the operating room include pneumatic tourniquets, blood pressure cuffs, and stethoscopes, among others. Our study aims to investigate microbial colonization on reusable pneumatic tourniquets stored and used in the orthopedic department of our institution and evaluate the efficacy of the cleaning protocols employed. Methods: Over a course of two weeks, 26 samples were obtained. A total of 14 pneumatic tourniquets were sampled preoperatively on Monday morning following the weekly cleaning protocol of soaking the tourniquets in sodium hypochlorite for 30 minutes …

The Relationship Between Frequency Of Yoga And Meditation On Ptsd Symptoms In Individuals Who Have Experienced Intimate Partner Violence, Kimberly Polignani

Dissertations

Intimate partner violence (IPV) has become a growing phenomenon in the United States,

affecting nearly 13% of the population. The adverse mental health outcomes from people who experience IPV are prevalent and more than half have a diagnosis of posttraumatic stress disorder (PTSD). Therefore, therapeutic techniques for PTSD appear to be feasible for IPV survivors and their mental health issues. Complementary and alternative medicine has become a widely accepted approach for PTSD. Being two complementary and alternative medicine techniques, yoga and meditation are effective forms of therapy in many diagnoses, including PTSD. This study utilized a not-for-profit organization called the …

The Underlying Psychophysiology Of Pedophilic Disorder And The Implications For Treatment Approaches, Tonise Florexil

Dissertations

Sexual crimes are a persistent and significant social dilemma that continues to plague our society (Lee, Jackson, Pattison, & Ward,2002). Past research has made considerable advancements in terms of the types of interventions that clinicians can utilize when they work with individuals who have a history of child sexual offenses. However, current literature lacks an understanding of the risk factors that influence the development of Pedophilic Disorder. A history of sexual trauma also affects families. The children of traumatized individuals have more adjustment difficulties than their counterparts who did not have a parent(s) with a sexual trauma history. This clinical …

Improving Internal Reliability Of A Trauma-Informed Care Program Evaluation Instrument, Ashley A. Raposo-Hadley

Capstone Experience: Master of Public Health

The project has analyzed the recent changes to the trauma-informed care (TIC) curriculum evaluation instrument by assessing the changes in Cronbach’s Alpha scores and effect significance. Data was collected from pre-training and post-training surveys completed at the time of delivery of the TIC curriculum training. Participants included hospital staff and medical or nursing students at Nebraska Medicine, University of Nebraska Medicine Center, and Health Creighton University Medical Center. The three research questions are (1) Did the item edits change item subgroupings? (2) Did the item edits increase instrument reliability? (3) Did the item edits impact statistical significance? 3 subscales, working …

Access To Care And Melanoma Incidence And Mortality In Nebraska, Natalia Trinidad

Capstone Experience: Master of Public Health

The purpose of this study is to determine incidence and mortality of melanoma across all counties in Nebraska in the context of access to primary care providers and dermatologists. Crude and age-adjusted incidence rates of melanoma from 2001-2016 by county were calculated for the following year intervals: 2001-2005, 2006-2010, 2011-2016. Variables for melanoma cases were obtained from the Nebraska Cancer Registry and included the case’s zip code at diagnosis, race, ethnicity, sex, age at diagnosis, year, cancer site, vital status, stage of disease, and the ICD-O code for the cancer type. Crude and age-adjusted mortality rates were calculated for the …

The Good, The Bad, And The Ugly Behavior, Michal Lavi

Cardozo Law Review

Shaming is usually referred to as the publication of perceived anti-social or illegal behavior of an individual in order to condemn or humiliate him. It has some virtues: it makes it harder for people to get away with wrongful behavior, and it promotes justice. It also promotes freedom of expression and enables efficient deterrence. By spreading information on the behavior of individuals, shaming encourages one to maintain his reputation and facilitates beneficial transactions. Finally, it helps the public to avoid inefficient services.

Yet shaming raises many problems. Anyone can shame another based on individual, as opposed to universal, values, thus …

Antibiotic Drug Discovery Targeting Bacterial Metabolism, Miranda J. Wallace

Theses and Dissertations (ETD)

Over the last century, the use of antibiotics has enabled many advances in modern medicine, making life as we know it possible. In recent years, however, emerging bacterial resistance to virtually all major antibiotic classes has resulted in a worldwide increase in morbidity, mortality, and financial burden associated with drug resistant infections. The antimicrobial resistance crisis presents an urgent need for new antimicrobials with distinct mechanisms of action from existing drugs. The current pharmaceutical pipeline of new antibiotics is limited due to three obstacles: a lack of understanding of resistance mechanisms, a dearth of novel mechanisms of action among new …

Investigation Of Riluzole’S Synaptic Protection Mechanism Through Hsf1-Bdnf Axis, Yi Zhang

Theses and Dissertations (ETD)

The FDA-approved amyotrophic lateral sclerosis (ALS) drug Riluzole has great potential in treating Alzheimer’s disease (AD) based on promising animal data as well as its known action on modulating synaptic transmission. However, its detailed mechanism of action is not fully understood. Here, we proposed work aiming to address this aspect via focus- ing on the Heat Shock Factor 1 (HSF1)-dependent mechanisms. We found that Riluzole could increase HSF1 and BDNF (Brain-Derived Neurotrophic Factor) expression both at transcriptional and translational levels. CA1 (Cornu Ammonia, the first region in the hip- pocampal circuit), is its main target. We also demonstrated a protective …

Investigation Of Narrow Spectrum Targets In Antibacterial Drug Discovery, Jesse Jones

Theses and Dissertations (ETD)

Background: Significant concerns are associated with the use of broad-spectrum antibacterial agents, including collateral eradication of beneficial bacteria from the human microbiome, the onset of antibacterial-associated infections, and continued emergence of antibacterial drug resistance. As such, a critical need for novel and selective antibacterial targets exists. The investigation of two such targets, each pertaining to the highly concerning infections caused by streptococcal species and Clostridioides difficile, are presented herein. Bacterial topoisomerase I represents a potentially promising narrow-spectrum target as studies have arisen demonstrating its essentiality in bacterial species lacking the only other type IA topoisomerase (topoisomerase III). Additionally, recent studies …

Fear Learning And The Olfactory Bulb: Neural Correlates Of Behavioral Fear Generalization, Jordan Marie Ross

Theses and Dissertations (ETD)

The exploration of how learning alters neural coding to guide behaviors remains fundamental to neuroscience. At the most basic level, the ability for organisms to flexibly adapt to changing environments and situations is paramount to biological success and often manifests in behavioral responses controlled by neural activity. For example, organisms must modify their behavior to defensive responses in the face of biological threat. Neural circuitry is involved in coordinating an initial defensive behavioral response but must undergo reorganization in order to reliably employ defensive responses in subsequent encounters based on a cue that signals imminent danger. One such form of …

Children Shouldn't Play With Dead Things, Sarah Adcock

Graduate School of Art Theses

I view my creative process as alchemy, the transformation of materials through experimentation. I use wax as a material that transcends its historical use as a sculptural process for casting and instead, use it for its transmutable qualities to inform content. Because of its plasticity and duality as fragile and resilient, wax is symbolically submissive and assertive. By applying heat, wax can be molded and formed into new shapes. Once it cools, wax reverts back to its natural state; solid and impermeable. I use objects to explore desires of origin and life. Transitional objects, the first “me not me” possession …

Knowledge Of Women Of Childbearing Age Regarding Preconception Counseling, Allison Britt, Shelby Jackson, Jessica Mcgee, Jenna Pugh

MSN Research Projects

The purpose of the current research study was to assess the knowledge of women of childbearing age regarding key components of preconception counseling and look at relationships between demographics and knowledge of preconception health care.

Compliance Of Primary Care Providers With Knee Osteoarthritis Guidelines, Komalben Desai, Catherine Elridge, Ashley Barber, Melissa Floyd

MSN Research Projects

The purpose of this study was to determine the compliance of primary care providers with AAOS guidelines of knee osteoarthritis (OA) and identify the most commonly used management options chosen by primary care providers for knee osteoarthritis.