Medicine and Health Sciences Commons^™

Emergency Department Workplace Violence Against Nurses, Adam Johnson

MSN Capstone Projects

Emergency room nurses are often thought of as the adrenaline junkies of the nursing world. Emergency nurses interact with a wide array of patients and visitors and are often the first clinician a patient may see upon arriving at an emergency department. With this wide array of patients and visitors, also comes a volatile environment with the increased risks of violence against nurses. This violence could include verbal, physical, and emotional violence from patients, visitors, and even fellow staff members. As violence increases, nursing longevity decreases and thus further increases the expense of nursing on a facility. Therefore, this has …

Cellular Proliferation Of Equine Bone Marrow- And Adipose Tissue-Derived Mesenchymal Stem Cells Decline With Increasing Donor Age, Jasmin Bagge, James N. Macleod, Lise C. Berg

Maxwell H. Gluck Equine Research Center Faculty Publications

Background: Bone marrow (BM)- and adipose tissue (AT)-derived mesenchymal stem cells (MSCs) are used increasingly for autologous cell therapy in equine practice to treat musculoskeletal and other injuries. Current recommendations often call for 10–100 million MSCs per treatment, necessitating the expansion of primary cells in culture prior to therapeutic use. Of concern, human and rodent studies have shown a decline of both MSC recovery from sampled tissue and in vitro proliferative capacity with increasing donor age. This may be problematic for applications of autologous cell-based therapies in the important equine demographic of older patients.

Objectives: To investigate the effect of …

Evaluating A Technology-Mediated Hpv Vaccination Awareness Intervention: A Controlled, Quasi-Experimental, Mixed Methods Study, Heather M. Brandt, Beth Sundstrom, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Chelsea Larsen, Melissa Stansbury, Karen Magradey, Andrea Gibson, Delia Smith West

Faculty Publications

College-aged women and men are an important catch-up population for human papillomavirus (HPV) vaccination interventions. Limited research has explored technology-mediated HPV vaccination awareness interventions aimed at college students. The purpose was to evaluate a novel, technology-mediated, social media-based intervention to promote HPV vaccination among college students. A controlled, quasi-experimental, mixed methods study examined the feasibility of a technology-based intervention among two undergraduate classes ( = 58) at a public university in the southeastern United States of America. Classes were randomized to receive one of two cancer prevention programs (i.e., HPV vaccination (intervention) or healthy weight (control)). Both programs contained eight …

The Poststroke Peripheral Immune Response Is Differentially Regulated By Leukemia Inhibitory Factor In Aged Male And Female Rodents, Stephanie M. Davis, Lisa A. Collier, Sarah J. Messmer, Keith R. Pennypacker

Neurology Faculty Publications

Background. The goal of this study was to determine whether leukemia inhibitory factor (LIF) promotes anti-inflammatory activity after stroke in a sex-dependent manner. Methods. Aged (18-month-old) Sprague-Dawley rats of both sexes underwent sham surgery or permanent middle cerebral artery occlusion (MCAO). Animals received three doses of intravenous LIF (125 μg/kg) or PBS at 6, 24, and 48 h before euthanization at 72 h. Spleen weights were measured immediately following euthanization. Western blot was used to measure protein levels of CCL8, CD11b, CXCL9, CXCL10, IL-12 p40, IL-3, and the LIF receptor (LIFR) in spleen tissue. ELISA was used …

Smoking Cessation And Shared Decision-Making Practices About Lung Cancer Screening Among Primary Care Providers, Maria A. Lopez-Olivo, Jennifer A. Minnix, James G. Fox, Shawn P. Nishi, Lisa M. Lowenstein, Kristin G. Maki, Viola B. Leal, Ya-Chen Tina Shih, Paul M. Cinciripini, Robert J. Volk

School of Medical and Biological Sciences Faculty Publications and Presentations

Objective: We describe primary care providers' current practice patterns related to smoking cessation counseling and lung cancer screening (LCS). Methods: Family, internal medicine, and pulmonary medicine providers from two medical centers were asked to complete an electronic survey to report their practice patterns. Results: Of 52 participating providers, most reported initiating three major components of a smoking cessation intervention often or very often: advise to quit (50, 96%), assess willingness to quit (47, 90%), and assist with counseling or pharmacotherapy (49, 94%). However, other components were less commonly initiated such as arranging follow-ups (only 11 providers indicated recommending them often …

Revisiting The Role Of Physicians In Assisted Living And Residential Care Settings, Sarah Dys, Lindsey Smith, Ozcan Tunalilar, Paula C. Carder

Institute on Aging Publications

As the United States population ages, a higher share of adults is likely to use long-term services and supports. This change increases physicians’ need for information about assisted living and residential care (AL/RC) settings, which provide supportive care and housing to older adults. Unlike skilled nursing facilities, states regulate AL/RC settings through varying licensure requirements enforced by state agencies, resulting in differences in the availability of medical and nursing services. Where some settings provide limited skilled nursing care, in others, residents rely on resident care coordinators, or their own physicians to oversee chronic conditions, medications, and treatments. The following narrative …

Sepsis Alert Benchmark Project, Leigh A. Normand

MSN Capstone Projects

Sepsis is steadily rising as one of the leading health concerns in our country due to the high risk of mortality and morbidity. Based on the data released by the Centers for Disease Control and Prevention (CDC), the state of Texas, in 2018, had over 4,000 mortalities due to sepsis. Texas was ranked fifth in the nation for the highest sepsis mortality rate (Stats of the States - Septicemia Mortality, 2020). Anyone can develop an infection which can lead to sepsis, severe sepsis, or septic shock. Those at highest risk are infants, immunocompromised, advanced age, and those with chronic conditions …

Managing Hypertension With Lifestyle Modifications, Ladonna D. Willis

MSN Capstone Projects

Cardiovascular disease has taken the lives of millions of Americans, specifically, African Americans who do not have access to health care, which leads to morbidity and increased mortality. This benchmark project proposes to provide cardiovascular educational packets to patients who are admitted to the hospital and have been diagnosed with hypertension.

Meaningful Recognition And The Effect On A Medical-Surgical Unit's Staff Satisfaction And Retention, Lindsey Greene

MSN Capstone Projects

The current state of the American healthcare system is riddled with challenges. Nurse administrators are faced with the formidable tasks of decreasing operating costs; improving the patient experience; delivering high-quality and safe patient care; and decreasing the mounting rates of nurse turnover. Nurse leaders must understand the complexities of their work environment, including the key drivers for nurse satisfaction and retention. In 2005, the American Association of Critical Nurses developed six standards for creating a healthy work environment. (American Association of Critical Care Nurses, 2016). An adult, medical-surgical unit at a South Texas hospital was faced with rising rates of …

Less Worthy Lives? We Must Prioritize People With Intellectual And Developmental Disabilities In Covid-19 Vaccine Allocation, Scott D. Landes, Margaret A. Turk, Katherine E. Mcdonald, Maya Sabatello

Population Health Research Brief Series

Individuals with developmental and intellectual disability should prioritized during COVID-19 vaccination allocation.

Protein Kinase D1 Regulates Metabolic Switch In Pancreatic Cancer Via Modulation Of Mtorc1, Sonam Kumari, Sheema Khan, Radhiki Sekhri, Hassan Mandil, Stephen Behrman, Murali M. Yallapu, Subhash C. Chauhan, Meena Jaggi

School of Medicine Publications

BACKGROUND: Protein kinase D1 (PKD1) is a serine–threonine kinase that regulates various functions within the cell. Herein, we report the significance of PKD1 expression in glucose metabolism resulting in pancreatic cancer (PanCa) progression and chemo-resistance.

METHODS: PKD1 expression in PanCa was investigated by using immunohistochemistry. Functional and metabolic assays were utilised to analyse the effect of PKD1 expression/knockdown on associated cellular/molecular changes.

RESULTS: PKD1 expression was detected in human pancreatic intraepithelial neoplasia lesions (MCS=12.9; P < 0.0001) and pancreatic ductal adenocarcinoma samples (MCS=15, P < 0.0001) as compared with faint or no expression in normal pancreatic tissues (MCS= 1.54; P < 0.0001). Our results determine that PKD1 enhances glucose metabolism in PanCa cells, by triggering enhanced tumorigenesis and chemo-resistance. We demonstrate that mTORC1 activation by PKD1 regulates metabolic alterations in PanCa cells. siRNA knockdown of Raptor or treatment with rapamycin inhibited PKD1-accelerated lactate production as well as glucose consumption in cells, which confirms the association of mTORC1 with PKD1-induced metabolic alterations.

CONCLUSION: This study suggests a novel role of PKD1 as a key modulator of the glucose metabolism in PanCa cells accelerating tumorigenesis …

Geographic Monitoring For Early Disease Detection (Geomedd), Andrew Curtis, Jayakrishnan Ajayakumar, Jacqueline Curtis, Sorapat Vijitakula, Justin Yax

Faculty Scholarship

Identifying emergent patterns of coronavirus disease 2019 (COVID-19) at the local level presents a geographic challenge. The need is not only to integrate multiple data streams from different sources, scales, and cadences, but to also identify meaningful spatial patterns in these data, especially in vulnerable settings where even small numbers and low rates are important to pinpoint for early intervention. This paper identifies a gap in current analytical approaches and presents a near-real time assessment of emergent disease that can be used to guide a local intervention strategy: Geographic Monitoring for Early Disease Detection (GeoMEDD). Through integration of a spatial …

Decreasing The Fall Rate On A Medical Surgical Unit With An Enhanced Fall Algorithm In The Electronic Medical Record, Natali Sokolovski

Master's Projects and Capstones

This paper summarizes the quality improvement falls prevention project on a Medical-Surgical unit with an Enhanced Fall Algorithm incorporated in the Electronic Medical Record conducted by two Clinical Nurse Leader students of the University of San Francisco.

This project addresses the patient falls events in a San Francisco-Bay Area Hospital on a Medical-Surgical unit. The aim is to decrease the rate of falls on a Medical-Surgical microsystem unit by 50% with an Enhanced Fall Algorithm incorporated into the Electronic Medical Record by June 2021. The patient population consists of general medical surgical patients where many of the patients have an …

Psychological Aspects Of Adolescent Diabetes, Dawn Ziegler

Master of Science in Nursing Final Projects

Abstract

Adolescence is a time of swift change physically, psychologically, and socially. A severe onset of diabetes and the life-long treatment required can cause significant changes for adolescents integrating this chronic illness into their identity. This study examined the current literature surrounding self-esteem in the newly diagnosed adolescent with diabetes, the quality of evidence, and the knowledge gaps addressing the social and personal challenges of advancing through life with this illness. A systematic search contained articles between 2010-2020. Key search terms included adolescents, diabetes type 1, behavioral approaches, emotional health interventions, self-esteem, self-worth, self-image, psychological, psychosocial, coping, stress, and resilience. …

Arrhythmogenic Right Ventricular Cardiomyopathy In Patients With Biallelic Jup-Associated Skin Fragility., Hassan Vahidnezhad, Leila Youssefian, Masoomeh Faghankhani, Nikoo Mozafari, Amir Hossein Saeidian, Fatemeh Niaziorimi, Fahimeh Abdollahimajd, Soheila Sotoudeh, Fateme Rajabi, Liaosadat Mirsafaei, Zahra Alizadeh Sani, Lu Liu, Alyson Guy, Sirous Zeinali, Ariana Kariminejad, Reginald T. Ho, John A Mcgrath, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

Arrhythmogenic right ventricular cardiomyopathy (ARVC), with skin manifestations, has been associated with mutations in JUP encoding plakoglobin. Genotype-phenotype correlations regarding the penetrance of cardiac involvement, and age of onset have not been well established. We examined a cohort of 362 families with skin fragility to screen for genetic mutations with next-generation sequencing-based methods. In two unrelated families, a previously unreported biallelic mutation, JUP: c.201delC; p.Ser68Alafs*92, was disclosed. The consequences of this mutation were determined by expression profiling both at tissue and ultrastructural levels, and the patients were evaluated by cardiac and cutaneous work-up. Whole-transcriptome sequencing by RNA-Seq revealed JUP as …

Difficult Turned Easy: Suggestion Renders A Challenging Visual Task Simple, Mathieu Landry, Jason Da Silva Castanheira, Jérôme Sackur, Amir Raz

Psychology Faculty Articles and Research

Suggestions can cause some individuals to miss or disregard existing visual stimuli, but can they infuse sensory input with nonexistent information? Although several prominent theories of hypnotic suggestion propose that mental imagery can change our perceptual experience, data to support this stance remain sparse. The present study addressed this lacuna, showing how suggesting the presence of physically absent, yet critical, visual information transforms an otherwise difficult task into an easy one. Here, we show how adult participants who are highly susceptible to hypnotic suggestion successfully hallucinated visual occluders on top of moving objects. Our findings support the idea that, at …

Using The Model For Improvement To Address Invasive Hemodynamic Safety Concerns In Critical Care, Selena Truban

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Abstract

The use of invasive catheters to monitor hemodynamic readings is common in the critical care setting and requires the use of specialized equipment. Variation in equipment set-up impacts operational efficiency and creates the potential for improper patient treatment based on inaccurate readings. The methodology of setting up and maintaining hemodynamic pressure lines in the critical care units lacked structural and processional measures, creating the potential for patient harm. Multimodal strategies, guided by the Model for Improvement, were used to increase the use of evidence-based methods for setting up and maintaining invasive hemodynamic lines in the critical care units. A …

Providing A Safe Space For Children Who Have Experienced Trauma, Alexis Garcia

Honors Theses

Health care professionals are continuing to learn about childhood trauma and the implications on health and development. With time, there has become a better understanding of how to determine and provide the resources needed for families and children who have experienced childhood trauma. Additionally, information about childhood trauma is slowly being understood throughout public school districts. This allows teachers to better understand children and accommodate their needs. This honors thesis will discuss childhood trauma and the development of a resource that can be used to provide elementary school-aged students with a place to go when they need assistance with regulation. …

Spare Parts Surgery For Oncologic Reconstruction To Preserve Local Advancement Flap For Decubitus Ulcer Reconstruction: A Case Report, Emily Zurbuchen, Nathan Foje, Sean Figy

Graduate Medical Education Research Journal

A 58-year-old male presented to our institution with synchronous large left thigh sarcoma and sacral decubitus ulcer requiring oncologic resection and reconstruction. Due to extensive tumor involvement, use of local flap for reconstruction was not feasible. Therefore, a spare parts free fillet flap from the disarticulated lower leg was utilized for reconstruction following oncologic resection. The benefits of this spare parts approach include no donor site morbidity, sufficient tissue padding for later use of prosthesis, and preservation of other flaps for future reconstruction of his sacral decubitus ulcer.

Multi-Digit Auto-Amputation In Setting Of Mixed Connective Tissue Disease, Kishan P. Patel, Jennifer L. Medlin, Michelene Hearth-Holmes

Graduate Medical Education Research Journal

Raynaud’s disease is a cutaneous manifestation often present in various connective tissue and vascular diseases. Depending on the age of onset and acuity of symptoms, the phenomenon can provide clinicians with some insight as to the severity of underlying disease, including the distinction between primary and secondary Raynaud’s. However, this diagnostic approach seems to have its limitations regarding efficacy and timing of treatment. Traditionally, treatment of Raynaud’s has focused on reestablishing blood perfusion to affected tissue, which has previously been achieved with vasodilatory medications and site-specific surgical intervention. In lieu of the severe sequelae of Raynaud’s in the setting of …

Nontuberculous Mycobacterium (Ntm) Infection In Aquatic Workers With Purified Protein Derivative (Ppd) And Gold Quantiferon Tests., Lavanya Ravipati, Sarah A. Howard

Graduate Medical Education Research Journal

Background: Nontuberculous mycobacteria (NTM) infections are commonly caused by Mycobacterium marinum and fortuitum with M. marinum more likely to cause skin infections. Aquatic environments are a potential source of contact with M. marinum and fortuitum. Patients with NTM infections may present with positive tuberculin purified protein derivative (PPD) and/or gold QuantiFERON tests. However, PPD cannot differentiate between NTM infection and other tuberculous infections caused by different mycobacterial strains. We present a patient a marine biologist who was asymptomatic and presented for further evaluation as she has a h/o positive PPD and gold QuantiFERON test.

Methods: Patient informed consent was …

Costs Associated With Recurrent Epistaxis In A Patient With A Ventricular Assist Device, Eric T. Rohe, Evan M. Ryan, Jayme R. Dowdall, Dwight T. Jones

Graduate Medical Education Research Journal

Mucosal bleeding is a well-known complication of having a ventricular assist device and commonly presents with epistaxis. Although the frequency of epistaxis as a complication in patients with a ventricular assist device has been documented in the literature, to our knowledge the cost of this complication has not been reported. This case report examines the financial burden of ventricular assist device-associated epistaxis in a single patient from September 2018 to December 2019 using ICD 10 diagnostic codes. The patient was found to have accumulated $138,020 in costs over 38 encounters. This case report not only highlights the recurrent nature and …

A Case Of Carcinoid Heart Disease And Echocardiographic Findings, Brandon Alex, Jeffrey Songster, Helenmari L. Merritt, Rebecca A. Aron

Graduate Medical Education Research Journal

Abstract: Carcinoid heart disease occurs in approximately 50% of patients with carcinoid syndrome. Right heart involvement resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis is most common. We report a case of tricuspid heart disease resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis.

Neurolytic Celiac Plexus Blockade In Patients With Upper Intraabdominal Malignancies: An Evidence-Based Narrative Review, Kevin Wong, Apollo A. Stack, Madhuri Are

Graduate Medical Education Research Journal

Background: Cancer-related abdominal pain is a common symptom associated with upper intra-abdominal carcinoma, especially in patients with advanced disease and it has posed a significant therapeutic challenge to medical practitioners. Typically, cancer pain can be managed by following the World Health Organization 3-step analgesic ladder. However, analgesic use of opioids, the mainstay treatment for moderate-to-severe cancer-related pain, may be ineffective in a subset of cancer patients. Escalation of dosage may be limited by opioid-induced side effects. The aim of this study was to review the literature addressing the effect of neurolytic celiac plexus block (NCPB) on the palliation of pain …

Internet Transparency Of Local Men’S Health Clinics In Nebraska, Jinfeng Jiang, Jordan Stegman, Christopher M. Deibert

Graduate Medical Education Research Journal

An overview of Men’s Health Clinics offering Testosterone Therapy in a Midwest State.

Introduction/ Background – Since 2001, there has been a 300% increase in the use of Testosterone therapy. However, there remains limited published data on the demographics of facilities and providers that advertise this service. This study aims to look at such demographics of advertised Men’s health clinics in Nebraska.

Methods/ Materials – An internet search was conducted with the phrases “Nebraska Male health clinics, Nebraska Low T/testosterone, Nebraska Hormone Replacement Therapy”. All clinics that were found offering Testosterone therapy with Men’s health in their mission statement were …

Personal Finance Skills Among Health Professionals: Piloting A Student-Led Finance Curriculum And A Review Of The Current Landscape, Jeremy Payne, Stephen Haller, Laura E. Flores, Jared Baxter, Walker Payton, Kari Nelson

Graduate Medical Education Research Journal

Introduction

Despite high costs of education, extended lengths of training, and rapidly increasing student debt, personal finance is an often-overlooked topic within professional school curricula. Due to the combination of high debt burden and poor financial literacy, professional students report low confidence and high stress regarding their personal finances. While some medical schools have begun to integrate financial education into their formal training, others provide little to no resources to combat this growing issue.

Methods

To address this gap and provide financial education opportunities, the Financial Development Club (FDC) was founded by students at the University of Nebraska Medical Center. …

Customized Blister Packaging For Patients Living With Hiv: Assessment Of Patient Attitudes And Satisfaction, Holly Groteluschen, Harlan Sayles, Rebecca Osborn, Joshua P. Havens, Sara Bares, Jasmine R. Marcelin

Graduate Medical Education Research Journal

Adherence to antiretroviral medication results in reduced HIV transmission and improved health outcomes, yet challenges with medication adherence remain. A Collaborative Care Program was developed with a community pharmacy integrating a multi-dose adherence packaging service. We surveyed program participants to assess their satisfaction with this program and found an overall positive sentiment toward the program, that the program helped with reducing missed doses, and all patients would recommend the program to others.

The Uncharted Waters Of Graduate Medical Education During A Pandemic, Chandrakanth Are

Graduate Medical Education Research Journal

No abstract provided.

Prd-2 Directly Regulates Casein Kinase I And Counteracts Nonsense-Mediated Decay In The Neurospora Circadian Clock., Christina M Kelliher, Randy Lambreghts, Qijun Xiang, Christopher L. Baker, Jennifer J Loros, Jay C Dunlap

Faculty Research 2020

No abstract provided.

2020-12-09_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …