Medicine and Health Sciences Commons^™

Awareness Of Dying And Conflict Resolution: Texas Asian Perspectives, Gloria Duke, Charlotte Wood, Lobsang Tenzing

Nursing Faculty Publications and Presentations

Individuals in the end-of-life (EOL) period may not be fully aware of their prognosis or know they are facing a terminal illness. As Asian beliefs and cultural tendencies intersect with Western values, health care practitioners may find their assumptions about disclosing an EOL prognosis differs from patients and their family members. Disagreements among family members regarding the disclosure of EOL to their terminally ill loved one can result in conflict--making difficult and sensitive times more burdensome. Little scientific evidence is known about first generation Asians who live in the United States (US) regarding their practices with disclosing EOL and how …

Functional Capacity Profiles In Bipolar Disorder And Schizophrenia, Ashley Sara Emami

UNLV Theses, Dissertations, Professional Papers, and Capstones

Serious mental illnesses (SMIs) often have an onset early in life and go on to produce disability and functional impairment, which require ongoing supportive services and loss of productivity. Bipolar disorder (BD) and schizophrenia (SZ) are two of the most common SMIs. BD and SZ differ in their pattern of neurocognitive performance, which suggests differences in the severity of functional impairment between the illness groups. Within these psychiatric illness groups, subgroups may also be identified using cluster analysis. Evidence points to heterogeneity in functional outcomes in BD and SZ, yet very little research has assessed for subgroups based on functional …

An Intervention To Increase Nurses’ Knowledge Of Non-Opioid Pain Management In Post-Operative Elective Knee And Hip Replacement Patients, Kristen K. Grunerud

UNLV Theses, Dissertations, Professional Papers, and Capstones

Post-operative pain control is an enduring problem in health care. The extensive use of opioids since the 1980s has contributed to the current opioid crisis in the United States. In response, healthcare providers have begun to use a more biopsychosocial model to address pain control needs of patients. There is a demonstrated gap in knowledge for nurses in this area, and recent changes to hospital accreditation standards include a requirement to demonstrate both education provisions to staff and the use of non-opioid methods to control pain. The purpose of this Doctor of Nursing Practice (DNP) project was to assess, and …

The Influence Of Cerebellar Transcranial Direct Current Stimulation On Motor Function In Parkinson’S Disease, Lidio Lima De Albuquerque

UNLV Theses, Dissertations, Professional Papers, and Capstones

Parkinson's disease (PD) is the most common movement disorder and the second most common neurodegenerative disorder. PD is characterized by dopaminergic cell loss in the substantia nigra pars compacta, which leads to a reduction in dopamine in the striatum. These physiological mechanisms lead to a number of motor impairments such as bradykinesia, rigidity, tremor, and postural instability that severely limit the ability of individuals with PD to perform many essential daily living activities. Although current pharmacological, surgical, and physical exercise treatment approaches are valuable they are either only mildly effective, expensive, or associated with a variety of side effects. Therefore, …

Sexually Transmitted Infections And The 65 And Older Population: Knowledge And Perceived Risk, Alexus Miranda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, their STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used …

Countermovement Jump Assessment For Monitoring Prolonged Fatigue In Collegiate Female Soccer Players, Jeffrey A. Wilkins

Boise State University Theses and Dissertations

Introduction: Females are 4 to 6 times more likely to sustain an anterior cruciate ligament (ACL) injury than their male counterparts during running and cutting sports, such as soccer. This sex disparity is thought to result from altered lower limb neuromuscular control that females present when fatigued at the end of practice or games. Yet, current fatigue monitoring techniques typically vary in their reliability, applicability and efficiency. Purpose: The purpose of this study is to test the feasibility of the countermovement jump (CMJ) to quickly and reliably monitor fatigue in female soccer athletes. Methods: Twenty-two (age: 19.3 ± 1.1 yrs, …

Factors Affecting Esophageal Tissue Radiation Response, Latisha T. Pryor

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation-induced esophageal cancer can be a deadly and unfortunate secondary outcome of radiotherapy or chronic occupational exposure to radiation. Although the esophagus is known to be a radiosensitive organ, it is under studied and further information regarding how dose and radiation quality impact its sensitivity may provide strategies to prevent esophageal cancer. The purpose of this thesis was to understand factors that play a role in the tissue’s radiosensitivity that may relate to its cancer risk. In this study, we used two esophageal 3D models, as well as both human and mouse cells, to define radiation quality and dose dependent …

Memory And Stereotypes For Lesbian/Gay Characters, Amber Rose Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Stereotype-consistency bias refers to the idea that people tend to remember stereotypical information about others better than non-stereotypical information (Fyock & Stangor, 1994). Limited research has examined how people may use stereotype-consistency bias when recalling information about LGBT characters in narratives (Bellezza & Bower, 1981; Clark & Woll, 1981; McGann & Goodwin, 2007; Snyder & Uranowitz, 1978). This line of research suggests that, instead of genuinely remembering stereotypical information better, participants tended to guess stereotypical answers to questions they do not know. In contrast to those studies, the experiment I conducted for this thesis suggests that heterosexual young adults tend …

Avoiding Covid-19 Complications With Diabetic Patients Could Be Achieved By Multi-Dose Bacillus Calmette–Guérin Vaccine: A Case Study Of Beta Cells Regeneration, Bassam M. Ayoub, Eman Ramadan, Nermeen Ashoush, Mariam M. Tadros, Moataz S. Hendy, Mohamed M. Elmazar, Shaker A. Mousa

Pharmacy

Diabetes mellitus (DM) is one of the major risk factors for COVID-19 complications as it is one of the chronic immune-compromising conditions especially if patients have uncontrolled diabetes, poor HbA1c and/or irregular blood glucose levels. Diabetic patients' mortality rates with COVID-19 are higher than those of cardiovascular or cancer patients. Recently, Bacillus Calmette-Guérin (BCG) vaccine has shown successful results in reversing diabetes in both rats and clinical trials based on different mechanisms from aerobic glycolysis to beta cells regeneration. BCG is a multi-face vaccine that has been used extensively in protection from tuberculosis (TB) and leprosy and has been repositioned …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Postoperative Length Of Stay Following Enhanced Recovery After Surgery Protocol Implementation For Scheduled Cesarean Deliveries, Hannah Zimmerman, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cesarean delivery is the most common major surgery worldwide. 1 In 2018, 1.2 million cesarean deliveries occurred in the United States, accounting for nearly 32% of all deliveries.2 Research has shown ERAS benefits include decreased length of stay, improved pain control, and improved patient satisfaction.2,3 Despite its use in numerous surgical specialties, ERAS implementation within obstetrics has been slow.2 The ERAS Society released a three-part guideline specific to cesarean deliveries in 2018 and 2019,4,5,6 yet few studies have assessed the impact of ERAS on cesarean postoperative outcomes.2 An improved perioperative course would be particularly beneficial for mothers undergoing cesarean …

Prophylactic Phenylephrine Infusion To Mitigate Intraoperative Hypotension After Spinal Anesthesia Among Orthopedic Patients, David Nelson, Braden Hemingway, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background

Intraoperative Hypotension (IOH) is common after spinal anesthesia (SA) and is associated with an increased risk of end organ damage.1 2 3 The treatment regimen for IOH after SA varies in the orthopedic population. However, the current research literature suggests that a prophylactic infusion of phenylephrine significantly reduces the number of episodes and duration of hypotension.1 This EBP project aims to report the proportion of patients receiving prophylactic phenylephrine infusions and the incidence of hypotension following SA among orthopedic surgery patients at Providence Sacred Heart Medical Center (PSHMC) in Spokane, WA.

Methods

• A retrospective, observational EBP project was …

Barriers Inhibiting Detection And Management Of Postpartum Hemorrhage By Providers In Madagascar, Breakthrough Research, Usaid's Health Evaluation And Applied Research Development

Reproductive Health

Breakthrough RESEARCH partner ideas42 conducted research in June 2019 in peri-urban and rural areas of Vohipeno and Manakara districts of Madagascar's Vatovavy-Fitovinany region to identify health care providers' challenges for detecting and managing complications during childbirth including postpartum hemorrhage and identify optimal solutions. This brief summarizes the results of a behavioral diagnosis that reveals “Facility-based providers do not consistently follow best practices for the detection and management of complications during childbirth.” Low perception of risk of postpartum hemorrhage, limited review of compliance with best practices, consequences of current practices, and resource scarcity can negatively affect provider decision-making and clinical practice.

Obstacles Limitant La Détection Et La Prise En Charge De L’Hpp Par Les Prestataires De Soins De Santé À Madagascar, Breakthrough Research

Reproductive Health

Breakthrough RESEARCH partner ideas42 conducted research in June 2019 in peri-urban and rural areas of Vohipeno and Manakara districts of Madagascar's Vatovavy-Fitovinany region to identify health care providers' challenges for detecting and managing complications during childbirth including postpartum hemorrhage and identify optimal solutions. This brief summarizes the results of a behavioral diagnosis that reveals “Facility-based providers do not consistently follow best practices for the detection and management of complications during childbirth.” Low perception of risk of postpartum hemorrhage, limited review of compliance with best practices, consequences of current practices, and resource scarcity can negatively affect provider decision-making and clinical practice.

J Mich Dent Assoc August 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on "Antibiotic Guidelines for Dentistry: Who, When, What, Why, and How to Prescribe”.
• A feature, “Collaboration Is the Wave of the Future: Hospital-Based General Practice Residency”.
• “Taking Advantage of Secondary and Tertiary Evidence”, a feature in the JMDA’s series on evidence-based dentistry.
• “Statistics Tutorial Part III: Interpretation of Forest Plots from Meta …

Reducing Urinary Retention In Post-Operative Cesearean Patients, Celine Podlesney Bsn, Rn, Elizabeth Gurzynski Bsn, Rn, Savannah Miles Bsn, Rn, Gianni Wright Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Managing Stress In The Workplace, Ashley Gannon Rn, Caelee Sorto Rn, Ashley Stutz Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Ready, Set, Act!, Kevin Gustafson Adn, Rn, Elissa Meyers Adn, Rn, Jennifer Stoves Adn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Pain Assessment Documentation, Elizabeth Bill Rn, Bsn, Lauren Bostick Rn, Adn, Yasmin Orlowski Rn, Bsn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Evaluating The Quality Of Information Found In The Most Common Health Websites In Google Using Discern And Craap, Ivan A. Portillo, Scott Yosuke Johnson, Catherine V. Johnson

Library Presentations, Posters, and Audiovisual Materials

Objectives: Google search results can have an outsized impact on the health information that consumers find and trust. The researchers analyzed the health-related websites that show up most frequently on the first page of Google search results. After determining the websites that appear most frequently, the authors would evaluate the quality of the health information on these websites using the DISCERN instrument and the CRAAP test.

Methods: To replicate a common health information search, a list of search terms was gathered from the most frequently searched health-related topics on Google Trends. Each term would then be searched on Google and …

Consensus Guidelines For Management Of Hyperammonaemia In Paediatric Patients Receiving Continuous Kidney Replacement Therapy., Rupesh Raina, Jirair K. Bedoyan, Uta Lichter-Konecki, Philippe Jouvet, Stefano Picca, Nicholas Ah Mew, Marcel C. Machado, Ronith Chakraborty, Meghana Vemuganti, Manpreet K. Grewal, Timothy Bunchman, Sidharth Kumar Sethi, Vinod Krishnappa, Mignon Mcculloch, Khalid Alhasan, Arvind Bagga, Rajit K. Basu, Franz Schaefer, Guido Filler, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

Hyperammonaemia in children can lead to grave consequences in the form of cerebral oedema, severe neurological impairment and even death. In infants and children, common causes of hyperammonaemia include urea cycle disorders or organic acidaemias. Few studies have assessed the role of extracorporeal therapies in the management of hyperammonaemia in neonates and children. Moreover, consensus guidelines are lacking for the use of non-kidney replacement therapy (NKRT) and kidney replacement therapies (KRTs, including peritoneal dialysis, continuous KRT, haemodialysis and hybrid therapy) to manage hyperammonaemia in neonates and children. Prompt treatment with KRT and/or NKRT, the choice of which depends on the …

Capturing Functional Epigenomes For Insight Into Metabolic Diseases., Fiona Allum, Elin Grundberg

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Metabolic diseases such as obesity are known to be driven by both environmental and genetic factors. Although genome-wide association studies of common variants and their impact on complex traits have provided some biological insight into disease etiology, identified genetic variants have been found to contribute only a small proportion to disease heritability, and to map mainly to non-coding regions of the genome. To link variants to function, association studies of cellular traits, such as epigenetic marks, in disease-relevant tissues are commonly applied.

SCOPE OF THE REVIEW: We review large-scale efforts to generate genome-wide maps of coordinated epigenetic marks and …

Dual X-Ray Absorptiometry Has Limited Utility In Detecting Bone Pathology In Children With Hypophosphatasia: A Pooled Post Hoc Analysis Of Asfotase Alfa Clinical Trial Data., Jill H. Simmons, Eric T. Rush, Anna Petryk, Shanggen Zhou, Gabriel Á. Martos-Moreno

Manuscripts, Articles, Book Chapters and Other Papers

Asfotase alfa is an enzyme replacement therapy approved for treatment of patients with pediatric-onset hypophosphatasia (HPP), a rare, inherited, systemic disease causing impaired skeletal mineralization, short stature, and reduced physical function in children. The role of dual X-ray absorptiometry (DXA) in the assessment of children with HPP has been insufficiently explored. This post hoc analysis included pooled DXA data from 2 open-label, multicenter studies in 19 children with HPP. The study population was aged ≥5 to≤6.6 years at enrollment (male: 79%; median age at enrollment: 10.4 y [range: 5.9-16.7]; treatment duration: 6.3 y [range: 0.1-6.6]. Baseline height Z-scores indicated short …

De Novo Variants Of Nr4a2 Are Associated With Neurodevelopmental Disorder And Epilepsy., Sakshi Singh, Aditi Gupta, Michael Zech, Ashley N. Sigafoos, Karl J. Clark, Yasemin Dincer, Matias Wagner, Jennifer B. Humberson, Sarah Green, Koen Van Gassen, Tracy Brandt, Rhonda E. Schnur, Francisca Millan, Yue Si, Volker Mall, Juliane Winkelmann, Ralitza H. Gavrilova, Eric W. Klee, Kendra Engleman, Nicole P. Safina, Rachel Slaugh, Emily M. Bryant, Wen-Hann Tan, Jorge Granadillo, Sunita N. Misra, G Bradley Schaefer, Shelley Towner, Eva H. Brilstra, Bobby P C Koeleman

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: This study characterizes the clinical and genetic features of nine unrelated patients with de novo variants in the NR4A2 gene.

METHODS: Variants were identified and de novo origins were confirmed through trio exome sequencing in all but one patient. Targeted RNA sequencing was performed for one variant to confirm its splicing effect. Independent discoveries were shared through GeneMatcher.

RESULTS: Missense and loss-of-function variants in NR4A2 were identified in patients from eight unrelated families. One patient carried a larger deletion including adjacent genes. The cases presented with developmental delay, hypotonia (six cases), and epilepsy (six cases). De novo status was …

Combinatorial Pharmacogenomic Algorithm Is Predictive Of Citalopram And Escitalopram Metabolism In Patients With Major Depressive Disorder, Richard C. Shelton, Charles R. Conway, Et Al.

2020-Current year OA Pubs

Pharmacogenomic tests used to guide clinical treatment for major depressive disorder (MDD) must be thoroughly validated. One important assessment of validity is the ability to predict medication blood levels, which reflect altered metabolism. Historically, the metabolic impact of individual genes has been evaluated; however, we now know that multiple genes are often involved in medication metabolism. Here, we evaluated the ability of individual pharmacokinetic genes (CYP2C19, CYP2D6, CYP3A4) and a combinatorial pharmacogenomic test (GeneSight Psychotropic®; weighted assessment of all three genes) to predict citalopram/escitalopram blood levels in patients with MDD. Patients from the Genomics Used to Improve DEpression Decisions (GUIDED) …

The Efficacy Of Lenvatinib Plus Everolimus In Patients With Metastatic Renal Cell Carcinoma Exhibiting Primary Resistance To Front-Line Targeted Therapy Or Immunotherapy, Lana Hamieh, Rachel L Beck, Valerie H Le, James J Hsieh

2020-Current year OA Pubs

BACKGROUND: Patients with primary refractory metastatic renal cell carcinoma (mRCC) have a dismal prognosis and poor response to subsequent treatments. While there are several approved second-line therapies, it remains critical to choose the most effective treatment regimen.

PATIENTS AND METHODS: We identified 7 patients with clear cell mRCC who had primary resistance to vascular endothelial growth factor (VEGF)-targeted tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitor (ICI) combination therapy. The patients were treated with lenvatinib (a multitargeted TKI) plus everolimus (a mammalian target of rapamycin inhibitor). Among these 7 patients, 2 had prior TKI therapy, 3 had prior ICI therapy, …

De Novo Variants Of Nr4a2 Are Associated With Neurodevelopmental Disorder And Epilepsy, Sakshi Singh, Rachel Slaugh, Jorge Granadillo, Et Al.

2020-Current year OA Pubs

PURPOSE: This study characterizes the clinical and genetic features of nine unrelated patients with de novo variants in the NR4A2 gene.

METHODS: Variants were identified and de novo origins were confirmed through trio exome sequencing in all but one patient. Targeted RNA sequencing was performed for one variant to confirm its splicing effect. Independent discoveries were shared through GeneMatcher.

RESULTS: Missense and loss-of-function variants in NR4A2 were identified in patients from eight unrelated families. One patient carried a larger deletion including adjacent genes. The cases presented with developmental delay, hypotonia (six cases), and epilepsy (six cases). De novo status was …

Hello, I’M Fat: Finding Myself In A Hulu Original, Mac Clark

Student Works

My first relationship happened when I was 18. We matched on Tinder and spent the following month doing everything people in relationships do, just without the label. This casual mindset was not my choice, and neither was the constant feeling of disappointment. I yearned to be respected; I knew it wasn’t right for him to sleep through our dates nor return my texts for days at a time. I wanted a real relationship, one where I wouldn’t have to beg for clarity, but as a fat, young woman, I believed this lesser form of relationship was my only option, so …

A Three Article Study Examining Sexual And Gender Minority Competency Of Health Service Providers, Corrine N. Wilsey

Health Services Research Dissertations

Sexual and gender minority (SGM) individuals endure a number of health disparities, such as higher rates of violence, mental health conditions, and more medical conditions. These disparities are exacerbated by the fact that SGM individuals face issues such as accessing health insurance, social support programs, and health service providers who are knowledgeable about SGM health issues. Certain health service provider governing organizations (i.e., the American Psychological Association, the Association of American Medical Colleges, and the Gay and Lesbian Medical Association) have recognized the need for guidelines regarding SGM care in recent years and published guidelines for health service providers regarding …

Himmelfarb Library Liaison Letter - August 2020, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Library Liaison Letters

No abstract provided.