Medicine and Health Sciences Commons^™

Quantifying Hypertension Indicators Through Informatics, Diana Sanchez

Doctor of Nursing Practice

The purpose of this quality improvement project was to create optimal quality indicators for hypertension measures using evidence-based practice to improve metric percentages, improving hypertension management for the practice. Implementing associated interventions for the quality measures and providing the interprofessional team with fundamental knowledge of inclusion and exclusion criteria and will empower the team with knowledge, improving patient care.

An expert panel was chosen to conduct a series of three PDSA cycles for systematic measurement until desired quality indicators were achieved, within a three-month duration. The expert panel consisted of the head physician, a physician assistant, the facility administrator and …

Optimizing Peripheral Neuropathy Management Through Vitamin B12 Screening In Adults With Type Two Diabetes Mellitus Taking Metformin, Jonathan Sidle

Doctor of Nursing Practice

Peripheral neuropathy is a significant co-morbidity for patients with diabetes and as early as 1969, metformin was linked to reductions in vitamin B12, leading to deficiency. Vitamin B12 deficiency causes increased levels of homocysteine and methylmalonyl-CoA which are toxic to the nervous system and therefore can contribute to demyelination. This quality improvement study aimed to optimize the management of peripheral neuropathy symptoms by implementing a process to identify patients with clinical or subclinical vitamin B12 deficiency and initiating replacement therapy. Adult patients presenting for a scheduled office visit with a diagnosis of type two diabetes and are taking metformin or …

Implementation Of Enhanced Recovery After Surgery (Eras) Protocol After Cystectomy: A Quality Improvement Project To Evaluate Bowel Function With Implementation Of Eras Protocol, Weruche Agube

Doctor of Nursing Practice Projects

Abstract

The purpose of this Quality Improvement project was to develop and implement an enhanced recovery after surgery (ERAS) protocol for cystectomy patients at a regional hospital in central Illinois. Specific goals included reducing patient’s length of hospital stay, reducing occurrence of postoperative ileus after surgery as well as educating the nurses involved in patient care about effective implementation the protocol. An educational presentation and knowledge assessment via testing was developed and subsequently presented to the nurses both inpatient and outpatient at the host facility. A specific protocol was crafted after discussion with stakeholders and the ERAS protocol was finalized …

Homelessness Prevention Contacts Datasheet, Juan Whitehead

Capstone Projects and Master's Theses

The Coalition of Homeless Providers, located in Seaside, California provides services for over 2,400 homeless people in Monterey County. This organization collaborates with other agencies to provide support for those who are in need of emergency, transitional, or permanent housing. Because of lack of affordable housing in the area, and the lack of available resources, many men and women, as well as families find themselves without a place to stay. Homelessness Prevention Contacts Datasheet establishes a list of rental property management companies and landlords who may be interested in some of the programs provided by the Coalition. These programs provide …

No-Cost Flu Clinics, Madyson Shands

Capstone Projects and Master's Theses

Thousands of people go each year without access to flu vaccinations. In consideration of the current pandemic, there was a need for vaccinations in order to limit the possibility of a double pandemic. The Visiting Nurses Association (VNA), Community services is a non-profit organization that provides services that range from immunization to wellness programs. The community service department strives to connect with the community and construct programs that will assess their needs. The project consists of no-cost flu clinics working with agencies within the Monterey community. Interim is a transitional housing center for adults with mental illnesses. There was a …

Spirituality As A Moderator Between Ptss And Cardiovascular Reactivity, Kriti Sharda

Honors Scholar Theses

Posttraumatic stress symptoms (PTSS) can be distressing and produce robust cardiovascular symptoms, such as increased heart rate and blood pressure, which have been implicated in higher risk of developing cardiovascular disease (CVD). Identifying factors that may reduce symptoms may suggest therapeutic strategies. One such potential factor is spirituality, given that spirituality is associated with both reducing PTSS and with preventing or improving CVD. We sampled 63 young college women who indicated being exposed to unwanted sexual contact. We asked them to write about their experience while we took heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) …

Liver Cancer-Specific Serine Protease Inhibitor Kazal Is A Potentially Novel Biomarker For The Early Detection Of Hepatocellular Carcinoma, Felix Lu, Pir Ahmad Shah, Abhishek Rao, Cynthia Gifford-Hollingsworth, Anne Chen, Gary Trey, Mina Soryal, Arslan Talat, Aysha Aslam, Bilal Nasir, Saad Choudhry, Rizwan Ishtiaq, Hanna Sanoff, Lanla F Conteh, Anne Noonan, Ke-Qin Hu, Carl Schmidt, Janssen Research & Development, Jesse M. Civan, Gary Xiao, Daryl T-Y Lau, Xuanyong Lu

Division of Gastroenterology and Hepatology Faculty Papers

Introduction: Liver cancer-secreted serine protease inhibitor Kazal (LC-SPIK) is a protein that is specifically elevated in cases of hepatocellular carcinoma (HCC). We assessed the performance of LC-SPIK in detecting HCC, including its early stages, in patients with cirrhosis, hepatitis B virus (HBV), and hepatitis C virus (HCV).

Methods: We enrolled 488 patients, including 164 HCC patients (81 early HCC) and 324 controls in a blinded, prospective, case-control study. Serum LC-SPIK levels were determined by an enzyme-linked immunosorbent assay-based assay. The performance of serum LC-SPIK and α-fetoprotein (AFP), including area under the curve (AUC), sensitivity, and specificity, are compared. The performance …

Voluntary Hypoventilation At Low Lung Volume (Vhl) During Strength And Conditioning Training Increases Anaerobic Performance: A Pilot Study, Zachary Taylor Hundley

Masters Theses

To determine whether a VHL protocol implemented into an already existing strength and conditioning program could improve anaerobic conditioning more efficiently within the military population. Six active duty males completed a seven-week training cycle with VHL protocols implemented on each training day (2-4 days/week). Before (Pre) and after (Post) protocol implementation, the participants performed a multi-stage 20-m shuttle run test (MSRT). After incorporating VHL, participants significantly improved their MRST scores by an average of 50.3%. Additionally, Body Oxygen Level Test (BOLT) scores were improved across the duration of the study. This study showed employing VHL can improve anaerobic performance in …

External Stoma Diversion: A Palliative Measure For Peristomal Wound Healing In Resource-Limited Settings, Rachel W. Davis, Youmna A. Sherif, Catherine Anne Morrison

Faculty Publications

The provision of intestinal stoma care is challenging in austere settings due to limitations in surgical and wound care access as well as the high cost and sparsity of ostomy supplies. As a result, many surgical patients suffer from ostomy-related complications such as peristomal wounds and are unable to find relief for these complications from standard treatments and measures. This article describes the external stoma diversion, a cost-effective palliative surgical procedure that assists in the healing of peristomal wounds in resource-limited settings.

Vopo Leverages Cellular Heterogeneity For Predictive Modeling Of Single-Cell Data, Natalie Stanley, Ina A. Stelzer, Amy S. Tsai, Ramin Fallahzadeh, Edward A. Ganio, Martin Becker, Thanaphong Phongpreecha, Huda Nassar, Sajjad Ghaemi, Ivana Maric, Anthony Culos, Alan L. Chang, Maria Xenochristou, Xiaoyuan Han, Camilo Espinosa, Kristen Rumer, Laura Peterson, Franck Verdonk, Dyani Gaudilliere, Eileen Tsai, Dorien Feyaerts, Jakob Einhaus, Kazuo Ando, Ronald J. Wong, Gerlinde Obermoser, Gary M. Shaw, David K. Stevenson, Martin S. Angst, Brice Gaudilliere

All Dugoni School of Dentistry Faculty Articles

High-throughput single-cell analysis technologies produce an abundance of data that is critical for profiling the heterogeneity of cellular systems. We introduce VoPo (https://github.com/stanleyn/VoPo), a machine learning algorithm for predictive modeling and comprehensive visualization of the heterogeneity captured in large single-cell datasets. In three mass cytometry datasets, with the largest measuring hundreds of millions of cells over hundreds of samples, VoPo defines phenotypically and functionally homogeneous cell populations. VoPo further outperforms state-of-the-art machine learning algorithms in classification tasks, and identified immune-correlates of clinically-relevant parameters.

Ozanimod To Treat Relapsing Forms Of Multiple Sclerosis: A Comprehensive Review Of Disease, Drug Efficacy And Side Effects, Grace Lassiter, Carlie Melancon, Tyler Rooney, Anne Marie Murat, Jessica S. Kaye, Adam M. Kaye, Rachel J. Kaye, Elyse M. Cornett, Alan David Kaye, Rutvij J. Shah, Omar Viswanath, Ivan Urits

School of Pharmacy Faculty Articles

Multiple sclerosis (MS) is a prevalent and debilitating neurologic condition characterized by widespread neurodegeneration and the formation of focal demyelinating plaques in the central nervous system. Current therapeutic options are complex and attempt to manage acute relapse, modify disease, and manage symptoms. Such therapies often prove insufficient alone and highlight the need for more targeted MS treatments with reduced systemic side effect profiles. Ozanimod is a novel S1P (sphingosine-1-phosphate) receptor modulator used for the treatment of clinically isolated syndrome, relapsing–remitting, and secondary progressive forms of multiple sclerosis. It selectively modulates S1P1 and S1P5 receptors to prevent autoreactive lymphocytes from entering …

Move For A Healthy Mind: A Program Of Peer-Led Physical Activity For Adolescents With Depression And Anxiety, Emily Edwards

Master's Projects and Capstones

The following discusses adolescent depression and anxiety and the utilization of physical activity as an intervention or coping mechanism. Adolescents have been experiencing increased rates of anxiety or depression diagnoses over the past roughly two decades. Adolescence is, physiologically, a formative period in the developmental stage from childhood to adulthood. Current barriers to achieving optimal mental health among the adolescent population include the stigmatization of mental health issues, lack of education, socioeconomic status and healthcare access. Further, physical activity has been studied and identified to be an effective treatment for individuals experiencing depression and anxiety. In an effort to treat …

Association Study: Apoe Alleles Association With Neurodegenerative Disorders In The Hispanic Population, Kimberly Moreno

Theses and Dissertations

The purpose of this study was to assess the impact of phenotypic variables and Apolipoprotein E (APOE) alleles and its effect on cognitive statues. APOE is a gene found vastly in the Hispanic community, speculated to be linked to neurodegenerative disorders such as Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI). Compared demographic, clinical, and genetic features among Hispanics who were diagnosed with Alzheimer's Disease, Mild Cognitive Impairment, and psychiatric disorders (e.g., anxiety and depression) in the efforts to assess the role of APOE. In past research, APOE has been considered a pathological hallmark for neurological diseases.

Past research has …

College Students' And Educators' Attitudes Toward Offenders With Mental Illness, Sulema Perales

Theses and Dissertations

The purpose of the present study was to examine college students’ and college educators’ attitudes toward offenders with mental illness (MI). A non-experimental, exploratory research design was used to measure the following variables: demographics characteristics, academic major/teaching discipline, and personal relationships with offenders. Correlational and regression analyses and a one-way analysis of variance were used to analyze the data for 349 college students and 35 college educator participants. The results of the study showed there was a significant relationship between college students’ attitudes toward offenders with MI and students’ academic major. The results also showed significant relationships between college students’ …

Bivariate Markov Chain Model Of Irritable Bowel Syndrome (Ibs) Subtypes And Abdominal Pain, Ricardo Reyna Jr.

Theses and Dissertations

Researchers use stochastic models like continuous-time Markov chains (CTMC) to model progression of morbidities of public health impact, like HIV and Hepatitis C. Most of the research in that area is done for a single disease. In this research, we use a bivariate continuous-time Markov chain (CTMC) to model progression of co-morbidities. In particular, we use a bivariate CTMC to model the joint progression of Irritable Bowel Syndrome (IBS) and abdominal pain. Symptoms of IBS are known to change throughout the duration of the disorder. Hence, patients are normally asked to make a journal of the stool type, symptoms, and …

Pre-Transplant Marital Status And Hematopoietic Cell Transplantation Outcomes., J Tay, S Beattie, C Bredeson, R Brazauskas, N He, Ibrahim A. Ahmed, M Aljurf, M Askar, Y Atsuta, S Badawy, A Barata, A M Beitinjaneh, N S Bhatt, D Buchbinder, J Cerny, S Ciurea, A D'Souza, J Dalal, N Farhadfar, C O Freytes, S Ganguly, U Gergis, S Gerull, H M Lazarus, T Hahn, S Hong, Y Inamoto, N Khera, T Kindwall-Keller, R T Kamble, J M Knight, Y N Koleva, A Kumar, J Kwok, H S Murthy, R F Olsson, M Angel Diaz-Perez, D Rizzieri, S Seo, S Chhabra, H Schoemans, H C Schouten, A Steinberg, K M Sullivan, J Szer, D Szwajcer, M L Ulrickson, L F Verdonck, B Wirk, W A Wood, J A Yared, W Saber

Manuscripts, Articles, Book Chapters and Other Papers

Background: Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting.

Methods: We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct.

Results: We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, …

Inflammatory Myopathies: Update On Diagnosis, Pathogenesis And Therapies, And Covid-19-Related Implications., Marinos C. Dalakas

Department of Neurology Faculty Papers

The inflammatory myopathies constitute a heterogeneous group of acquired myopathies that have in common the presence of endomysial inflammation. Based on steadily evolved clinical, histological and immunopathological features and some autoantibody associations, these disorders can now be classified in five characteristic subsets: Dermatomyositis (DM) Polymyositis (PM), Necrotizing Autoimmune Myositis (NAM), Anti-synthetase syndrome-overlap myositis (Anti-SS-OM), and Inclusion-Body-Myositis (IBM). Each inflammatory myopathy subset has distinct immunopathogenesis, prognosis and response to immunotherapies, necessitating the need to correctly identify each subtype from the outset to avoid disease mimics and proceed to early therapy initiation. The review presents the main clinicopathologic characteristics of each subset …

Towards Pragmatic Adaptations: Orthopedic Surgery Amidst The Coronavirus Disease 2019 Pandemic, Maryam Ehtesham, Talal Almas, Muhammad Ali Niaz, Absam Akbar

Medical College Documents

No abstract provided.

Identification Of Micrornas Related To Type 2 Diabetic Osteopath, Mouza Mohammed Saeed Alfashti Alaleeli

Theses

T2DM is linked to an increase in the fracture rate as compared to the non-diabetic population even with normal or raised Bone Mineral Density (BMD). Previous studies have addressed the question of how T2DM induces osteoporosis; the exact underlying mechanism is still elusive. Bones undergo continuous remodelling throughout life. Bone remodelling implicates the coupling of osteoclastic bone resorption and osteoblastic bone formation. This process is controlled by numerous genetic, hormonal, and neurogenic mechanisms. Osteoporosis is a result of bone loss that occurs by uncoupled remodelling. The existing evidence indicates that short non-coding RNAs known as microRNAs (miRNAs), are the key …

Pelvic Inflammatory Disease Treated With Homoeopathic Medicine Calcarea Carbonica: A Case Report, Swati Pandey, Raj Pandit

Indian Journal of Research in Homoeopathy

Introduction: Pelvic Inflammatory Disease (PID) is a polymicrobial infection of the upper genital tract characterised clinically by triad of symptoms and signs: pelvic pain, cervical motion with adnexal tenderness and fever. Conventional treatment is with broad-spectrum antibiotics. The alternative medicine, especially Homoeopathy, is the second choice of therapy as per the WHO. Case reports of PID in the medical literature are scant. We aim to report a case treated with homoeopathic constitutional medicine in a woman suffering from PID. Case Summary: A 29-year-old female presented with the symptoms of white discharge per vagina, constant dull pain in the lower abdomen, …

Systems Genetics And Systems Biology Analysis Of Paraquat Effects In Bxd Recombinant Inbred Mice, Carolina Del Valle Torres Rojas

Theses and Dissertations (ETD)

Paraquat (PQ) is a chemical herbicide that is used in many countries including the United States. It is also highly acutely toxic to humans and has been used as a means of suicide. As PQ is applied mainly in agricultural settings, it moves to soil and well water. Chronic low dose exposure via drinking water may have adverse effects on humans, including increased risk for sporadic Parkinson’s disease (sPD). The etiology of sPD is unclear and the most accepted hypothesis states it is the result of the interaction between environmental factors and genetic susceptibility. Increasing evidence led us to infer …

Early Diagnosis Of Alzheimer’S Disease In The Primary Care Setting, Raymond R. Romano

Theses and Dissertations (ETD)

The burden of Alzheimer’s disease (AD) affects not just the individual but also families, providers, and society. Early recognition and diagnosis of AD may reduce cost by reducing interaction with the health care system, earlier initiation of treatment, and prolonging time to long- term care. Primary care providers, the first contact for diagnosis of patients with AD, are not fulfilling the potential of early diagnosis for a variety of reasons. Biomarkers of AD emerge on average 15 to 20 years before clinical diagnosis, yet currently established biomarkers are not easily available in the primary care setting. A growing body of …

Rabbit As A Reservoir Of Multidrug-Resistant Acinetobacter Baumanniiexpressing The Ade Multidrug Efflux Pumps, Sirawit Pagdepanichkit, Rungtip Chuanchuen

The Thai Journal of Veterinary Medicine

Acinetobacter baumanniihas emerged as a nosocomial pathogen and considered as a major cause of hospital acquired infections. While A. baumanniiin humans have been extensively studied in various situations, the study of A. baumanniiin companion animals is still limited. The aim of this study was to examine the presence and antimicrobial resistance profile of A. baumanniiisolates from companion rabbits. A total of 17 nasal swab from rabbit carcasses were obtained. A. baumanniiwas detected in 23.53% (4/17) of the samples and all the isolates exhibited resistance to chloramphenicol, erythromycin, spectinomycin and trimethoprim. Fifty percent of the isolates (2/4) were multidrug resistance (MDR) …

Chronic Effects Of Methylphenidate On Neuronal Viability And Plasticity, Hannah Oakes

Electronic Theses and Dissertations

Methylphenidate (MPH) is the most commonly prescribed drug to treat Attention Deficit Hyperactivity Disorder (ADHD). ADHD is now considered a life-long disorder; therefore, patients take MPH from adolescence into adulthood, highlighting the need for research studying chronic MPH use. MPH increases dopamine and norepinephrine within the synaptic cleft; therefore, chronic use of MPH may lead to changes within important dopaminergic pathways. One pathway, the mesolimbic pathway, includes the hippocampus, an area where adult neurogenesis occurs. We investigated the effects of chronic low and high doses of MPH on neurogenesis and examined levels of a few key proteins linked to cell …

Collectivism, Individualism, And Interprofessional Education: A Comparison Of Faculty Across Five Academic Health Sciences Colleges, S. Alicia Williams

Electronic Theses and Dissertations

Collaborative practice among interprofessional groups of health care providers is essential to the provision of safe and effective medical care. However, health professions training programs have not traditionally prepared students for interprofessional practice. One challenge in transforming health professions education programs has been a limited number of faculty prepared to teach students in an interprofessional learning environment. Thus, faculty development programs aimed at preparing faculty to provide interprofessional learning experiences across disciplines are increasingly important. Unfortunately, best practice in training faculty for interprofessional education programs is not well-defined.

Interprofessional education faculty development programs should aim to train faculty to model …

Undergraduate Nursing Students’ Learning Style Preferences And Preferred Faculty Teaching Methods Compared To The Actual Methods Used By Faculty, Linda Simpson

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the generational differences of undergraduate nursing students’ learning style preferences and their preferred faculty teaching methods to the teaching methods used most often by nursing faculty in the classroom.

Background. Nursing educators are responsible for creating learning environments that are effective for students that are in different generations and nursing educational pathways. Each generational cohort brings a collective set of characteristics, expectations, and preferences to the classroom, challenging educators to balance the generational learning styles of all students with respectable, evidence-based, pedagogical approaches. This study was one of the …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Bullous Hemorrhagic Sweet Syndrome With Cryptococcoid Neutrophils In Patients Positive For Antineutrophil Cytoplasmic Antibody Without Primary Vasculitis., Alex Sherban, Collin Fuller, Mansha Sethi, Eleni Mcgeehin, Dawn Hirokawa, Courtney Guerrieri, Jason B. Lee, Md, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Consensus Parameter: Research Methodologies To Evaluate Neurodevelopmental Effects Of Pubertal Suppression In Transgender Youth., Diane Chen, John F Strang, Victoria D Kolbuck, Stephen M Rosenthal, Kim Wallen, Deborah P Waber, Laurence Steinberg, Cheryl L Sisk, Judith Ross, Tomas Paus, Sven C Mueller, Margaret M Mccarthy, Paul E Micevych, Carol L Martin, Baudewijntje P C Kreukels, Lauren Kenworthy, Megan M Herting, Agneta Herlitz, Ira R J Hebold Haraldsen, Ronald Dahl, Eveline A Crone, Gordon J Chelune, Sarah M Burke, Sheri A Berenbaum, Adriene M Beltz, Julie Bakker, Lise Eliot, Eric Vilain, Gregory L Wallace, Eric E Nelson, Robert Garofalo

Department of Pediatrics Faculty Papers

Purpose: Pubertal suppression is standard of care for early pubertal transgender youth to prevent the development of undesired and distressing secondary sex characteristics incongruent with gender identity. Preliminary evidence suggests pubertal suppression improves mental health functioning. Given the widespread changes in brain and cognition that occur during puberty, a critical question is whether this treatment impacts neurodevelopment.

Methods: A Delphi consensus procedure engaged 24 international experts in neurodevelopment, gender development, puberty/adolescence, neuroendocrinology, and statistics/psychometrics to identify priority research methodologies to address the empirical question: is pubertal suppression treatment associated with real-world neurocognitive sequelae? Recommended study approaches reaching 80% consensus were …

Loss To Follow Up Of Pregnant Women With Hiv And Infant Hiv Outcomes In The Prevention Of Maternal To Child Transmission Of Hiv Programme In Two High-Burden Provinces In Papua New Guinea: A Retrospective Clinical Audit, Angela Kelly-Hanku, Claire Elizabeth Nightingale, Minh Duc Pham, Agnes Mek, Primrose Homiehombo, Mary Bagita, Justine Nankinga, Andrew Vallely, Lisa Vallely, Stanley Luchters

Population Health, East Africa

Introduction Despite early adoption of the WHO guidelines to deliver lifelong antiretroviral (ARV) regimen to pregnant women on HIV diagnosis, the HIV prevention of mother to child transmission programme in Papua New Guinea remains suboptimal. An unacceptable number of babies are infected with HIV and mothers not retained in treatment. This study aimed to describe the characteristics of this programme and to investigate the factors associated with programme performance outcomes.

Methods We conducted a retrospective analysis of clinical records of HIV-positive pregnant women at two hospitals providing prevention of mother to child transmission services. All women enrolled in the prevention …