Medicine and Health Sciences Commons^™

Preventing Maternal Falls, Blair Burkhart

Master's Projects and Capstones

Patient falls are unfortunate events in healthcare that are an essential quality improvement focus during patients’ hospital stays. At Hospital X, a private institution located in the suburbs of a large city, there had been 23 maternal falls within the last three years. This increase in maternal fall rate puts this hospital’s maternity unit above the average of other hospital’s fall rates according to the National Database of Nursing Quality Indicators. This quality improvement project aimed to reduce the rate of maternal falls on postpartum units through various forms of staff education. Education included Morse Fall Scale scoring, Sara Stedy …

Change Project Using A Fall Prevention Action Program To Decrease Falls On A Behavioral Health Unit, Amy Shuptrine

Student Scholarly Projects

Practice Problem: Fall rates are increasing in the behavioral health units of the East Texas hospital. Due to the worldwide COVID-19 pandemic, the units are short-staffed, which further supports the urgent need for a targeted intervention to reduce fall risk.

PICOT: The PICOT question that guided this project was: “In adult behavioral health patients (P), what is the effect of the Edmonson Psychiatric Fall Risk Assessment Tool (I), compared with previous use of the Morse Fall Risk tool (C), on the fall rate (O), in 8 weeks (T)?”

Evidence: Falls are the most reported incidents in acute care hospitals and …

Evaluation Of The Discriminative Capacity Of Anthropometric Indicators And Their Predictive Relationship Of Diabetes In Health Workers Of The University Hospital Of Guayaquil - Ecuador, Janet Dr Gordillo-Cortaza, Franklin Encalada-Calero, Fatima V. Feraud-Ibarra, Juan C. Roque-Quezada, Rosa L. Quintana-Columbus, Jennifer A. Plaza-Plaza, Miguel A. Castro-Mattos, Cinthya I. Falquez-García, Dagmar Y. Meza-Solorzano

Revista de la Facultad de Medicina Humana

Objective: To evaluate the discriminative ability to predict diabetes with anthropometric and biochemical indicators and medical history. Methods: The sampling carried out was census and the sample consisted of 104 workers. A longitudinal study was carried out to evaluate the discriminative ability to predict diabetes with the anthropometric, biochemical, and antecedent indicators, using two models, the analysis of the ROC curves and binary logistic regression. Results: By analyzing the ROC curves, the abdominal circumference obtained greater predictive discriminative power (AUC = 0.747; p <0.001; CI: 0.624-0.870), compared to glycemia (AUC=0.749; p <0.001; CI: 0.645-0.852) and the waist-height index (AUC=0.737; p=0.001; CI: 0.638-0.836). Personal medical history is included in the logistic regression equation P(Y=1)=(1+e0,693+1,897APP)-1 to predict the risk of developing diabetes in the future. Conclusions: The abdominal circumference obtained the highest discriminative power, followed by the pathological history.

Isolated Diastolic Hypertension In The Idaco Study: An Age-Stratified Analysis Using 24-Hour Ambulatory Blood Pressure Measurements, John W. Mcevoy, Wen-Yi Yang, Lutgarde Thijs, Zhen-Yu Zhang, Jesus D. Melgarejo, José Boggia, Tine W. Hansen, Kei Asayama, Takayoshi Ohkubo, Gladys E. Maestre

School of Medicine Publications and Presentations

The prognostic implications of isolated diastolic hypertension (IDH), as defined by 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines, have not been tested using ambulatory blood pressure (BP) monitor thresholds (ie, 24-hour mean systolic BP ≥75 mm Hg). We analyzed data from 11 135 participants in the IDACO (International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes). Using 24-hour mean ambulatory BP monitor values, we performed Cox regression testing independent associations of IDH with death or cardiovascular events. Analyses were conducted in the cohort overall, as well as after age stratification (≥50 years). The median age …

Global, Regional, And National Sex-Specific Burden And Control Of The Hiv Epidemic, 1990-2019, For 204 Countries And Territories: The Global Burden Of Diseases Study 2019, Deepa Jahagirdar, Magdalene K. Walters, Amanda Novotney, Edmond D. Brewer, Tahvi D. Frank, Ismaeel Yunusa Ph.D., Et. Al.

Faculty Publications

Background The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic.

Methods To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal …

Exploring The Environmental Factors That Shape The Experiences Of Risk For Older Adults, Bernice Chung

Undergraduate Student Research Internships Conference

When a young adult wants to go mountain climbing, rarely do people think it is “too dangerous”. The same cannot be said for older adults. Although life frequently involves risk-taking, older adults are too often positioned as ‘at risk’ and therefore, in need of protection. The problem lies in the way risk is conceptualized as an individually located phenomenon. This narrow view negates the environmental factors that exist outside the control of older adults and that shape risk in older adulthood. I wanted to address this gap, so my research explored the environmental factors that shape experiences of risk for …

Outcomes Of Covid-19 In Patients With Rheumatoid Arthritis: A Multicenter Research Network Study In The United States., Rahul Raiker, Charles Deyoung, Haig Pakhchanian, Sakir Ahmed, Chengappa Kavadichanda, Latika Gupta, Sinan Kardeş

Student Papers, Posters & Projects

OBJECTIVES: To investigate outcomes of Coronavirus Disease-2019 (COVID-19) in patients with rheumatoid arthritis (RA) as compared to the general population. Additionally, outcomes were explored among RA patients stratified by sex, race, and medications use through sub-cohort analyses.

METHODS: This comparative cohort study used a US multicenter research network (TriNetX) to extract data on all adult RA patients who were diagnosed with COVID-19, and adults without RA who were diagnosed with COVID-19 (comparative cohort) anytime from January 20, 2020 to April 11, 2021. COVID-19 outcomes were assessed within 30 days after its diagnosis. Baseline characteristics that included demographics and comorbidities were …

What Are The Most Effective Risk Factor Management Strategies For The Prevention And Control Of Hypertension?, Sherlyne Barasa

Theses and Graduate Projects

Hypertension (HTN) affects millions of people globally. With the rising burden of HTN in primary care and its associated morbidity and mortality, it is necessary to explore effective risk factor management to control and prevent it in people most at risk. This research addressed both modifiable risk factors such as obesity, smoking, alcohol, and diet as well as non- modifiable risk factors such as age, race/ethnicity, and family history. The aim of this paper was to examine the most effective risk factor management strategies to control and prevent hypertension. The studies reviewed indicate that there are various risk factor management …

Improving Suicide Risk Assessment Through Educational Program Implementation, Timothy Booth

Doctor of Nursing Practice Projects

Background: Unsustainable behavioral health education focused on comprehensive suicide risk assessment performance contributes to decreased registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients.

Purpose: To educate medical-surgical and progressive care registered nurses in assessing patients for suicide risk factors and warning signs comprehensively.

Design Method: A quasi-experimental designed quality improvement project with evidence-based suicide educational program implementation. Project results yielded a 56.7% increase in registered nurses’ perceived self-efficacy in assessing and caring for suicidal patients. Future DNP work will focus on sampling a larger population (N) to decrease opportunities for the skewness of project results …

The Relationship Between Nonalcoholic Fatty Liver Disease And Cancers, Ahmed K. Abd Elaziz Ewida, Ashraf G. Dala, El-Arab A. A. Ezz

Menoufia Medical Journal

Objectives To discuss the link age between nonalcoholic fatty hepatic disease and malignant tumors. Data sources MEDLINE databases (PubMed, Medscape, Science Direct) and every one material obtainable on the net from 1998 to 2019 were searched. Study selection The initial search included 88 articles, of that 34 met the inclusion criteria. The articles studied the linkage between nonalcoholic fatty hepatic disease and malignant tumors. Data extraction If the studies failed to fulfill the inclusion criteria, they were excluded. Study quality assessment enclosed whether or not moral approval was gained, eligibility criteria nominative, applicable controls and adequate data, and outlined assessment …

Spatial, Temporal, And Demographic Patterns In Prevalence Of Smoking Tobacco Use And Attributable Disease Burden In 204 Countries And Territories, 1990-2019: A Systematic Analysis From The Global Burden Of Disease Study 2019, Ismaeel Yunusa Ph. D., Marissa B. Reitsma, Parkes J. Kendrick, Emad Ababneh, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Et. Al.

Faculty Publications

Background

Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally.

Methods

We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health …

Association Between Appendicular Skeletal Muscle Index And Leukocyte Telomere Length In Adults: A Study From National Health And Nutrition Examination Survey (Nhanes) 1999-2002, Lingzhi Chen, Nitin Shivappa Mbbs, Mph, Ph.D., Xiuxun Dong, Jinjing Ming

Faculty Publications

Background

A higher body mass index (BMI) is associated with shorter telomeres. The loss of muscle mass with aging is associated with adverse outcomes. The appendicular skeletal muscle index (ASMI) is currently used to quantify muscle mass.

Objective

We investigated the association of the ASMI with leukocyte telomere length in adult Americans.

Methods

This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). The telomere-to-single-copy gene ratio (T/S ratio) was converted to …

Associations Between Family-Based Stress And Dietary Inflammatory Potential Among Families With Preschool-Aged Children, Valerie Hruska, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Alison M. Duncan, Jess Hines, David W. L. Ma

Faculty Publications

Chronic stress is known to influence dietary choices, and stressed families often report poorer diet quality; however, little is known about how family-based stress is linked with dietary patterns that promote inflammation. This study investigated associations between family-based stress and the inflammatory potential of the diet among preschool-aged children and their parents. Parents (n = 212 mothers, n = 146 fathers) and children (n = 130 girls, n = 123 boys; aged 18 months to 5 years) from 241 families participating in the Guelph Family Health Study were included in the analyses. Parents reported levels of parenting distress, depressive symptoms, …

Disparities In Meeting Uspstf Breast, Cervical, And Colorectal Cancer Screening Guidelines Among Women In The United States, Gabriel A. Benavidez, Anja Zgodic, Whitney Zahnd, Jan Eberth

Faculty Publications

Introduction

Many sociodemographic factors affect women’s ability to meet cancer screening guidelines. Our objective was to examine which sociodemographic characteristics were associated with women meeting US Preventive Services Task Force (USPSTF) guidelines for breast, cervical, and colorectal cancer screening.

Methods

We used 2018 Behavioral Risk Factor Surveillance System data to examine the association between sociodemographic variables, such as race/ethnicity, rurality, education, and insurance status, and self-reported cancer screening for breast, cervical, and colorectal cancer. We used multivariable log-binomial regression models to estimate adjusted prevalence ratios and 95% CIs.

Results

Overall, the proportion of women meeting USPSTF guidelines for breast, cervical, …

The Association Of Dietary Patterns With Dietary Inflammatory Index, Systemic Inflammation, And Insulin Resistance, In Apparently Healthy Individuals With Obesity, Maryam Saghafi-Asl, Susan Mirmajidi, Mohammad Asghari Jafarabadi, Farhad Vahid, Nitin Shivappa, James R. Hébert Scd, Vahideh Ebrahimzadeh Attari

Faculty Publications

Inflammation is considered a key mechanism leading to obesity. Dietary patterns and certain food items influence inflammation. Few studies have investigated the contribution of major dietary patterns to biological measures of inflammation. Therefore, the present study aimed to examine the associations of different dietary patterns with dietary inflammatory index (DII), systemic inflammation, and insulin resistance (IR) in the apparently healthy obese. In this cross-sectional study, 151 abdominally obese subjects were recruited from the Northwest of Iran. Dietary intake, demographic data, anthropometric indices, and physical activity (PA) was assessed. DII scores were calculated based on a validated 168-item food frequency questionnaire …

Assessment Of Risk Of Diabetes Mellitus By Using Indian Diabetes Risk Score Among Housekeeping Staff, Ramesh Holla

Kasturba Medical College, Mangalore Theses and Dissertations

No abstract provided.

Hospital Security. A Vision Of Multidimensional Security, Augusto Figueroa Uribe, Julia Hernández Ramírez

Revista de la Facultad de Medicina Humana

The risks during the performance of work is an inherent situation to any human activity. Hospital Safety is defined as: “the condition that guarantees that the workers, patients, visitors, infrastructure and equipment within a health care center are free of risk or danger of accidents”. The construction of the prevention culture starts from the knowledge of the risks, the safety culture is directly related to the quality of care of the service provided, which is why these terms are of special interest in health institutions. Talking about comprehensive risk management, either, involves determining all the risks that could cause considerable …

Risk Factors For Mortality From Covid-19 In Hospitalized Patients: A Logistic Regression Model, Irma Luz Yupari, Lucia Bardales Aguirre, Julio Rodriguez Azabache, Jaylin Barros Sevillano, Angela Rodríguez Díaz

Revista de la Facultad de Medicina Humana

Introduction: The population is susceptible to COVID-19 and knowing the most predominant characteristics and comorbidities of those affected is essential to diminish its effects. Objective: This study analyzed the biological, social and clinical risk factors for mortality in hospitalized patients with COVID-19 in the district of Trujillo, Peru. Methods: A descriptive type of study was made, with a quantitative approach and a correlational, retrospective, cross-sectional design. Data was obtained from the Ministry of Health’s database, with a sample of 64 patients from March to May 2020. Results: 85,71% of the total deceased are male, the most predominant occupation is Retired …

Risk Perception For Developing Erectile Dysfunction Among Malaysian Men With Type 2 Diabetes Mellitus, Anuar Mohamad, Hizlinda Tohid, Saharuddin Ahmad, Seng Fah Tong, Mahadir Ahmad

Kesmas

Risk perception for developing erectile dysfunction (ED) is an appreciation of the susceptibility to having ED and its severity. This study examined this risk perception and its associated factors among 180 men with type 2 diabetes mellitus (T2DM), who claimed not to have ED. This cross sectional study was conducted at a public health clinic using a validated self-administered questionnaire, which assessed participant characteristics, perceived susceptibility to developing ED, perceived severity of ED, and knowledge on risk factors for ED. About 71.1% had an inaccurate perception of susceptibility to developing ED and their perception on its severity was moderate (median …

Hypertension Guidelines And Coronary Artery Calcification Among South Asians: Results From Masala And Mesa, Jaideep Patel, Anurag Mehta, Mahmoud Al Rifai, Michael J. Blaha, Khurram Nasir, John W. Mcevoy, Ambarish Pandey, Alka M. Kanaya, Namratha R. Kandula, Salim S. Virani

Office of the Provost

Untreated hypertension may contribute to increased atherosclerotic cardiovascular disease (ASCVD) risk in South Asians (SA). We assessed HTN prevalence among untreated adults free of baseline ASCVD from the MASALA & MESA studies. The proportion of participants who received discordant recommendations regarding antihypertensive pharmacotherapy use by the 2017-ACC/AHA and JNC7 Guidelines across CAC score categories in each race/ethnic group was calculated. Compared with untreated MESA participants (n = 3896), untreated SA (n = 445) were younger (55±8 versus 59±10 years), had higher DBP (73±10 versus 70±10 mmHg), total cholesterol (199±34 versus 196±34 mg/dL), statin use (16% versus 9%) and …

Women Have A Lower Risk Of Nonalcoholic Fatty Liver Disease But A Higher Risk Of Progression Vs Men: A Systematic Review And Meta-Analysis., Maya Balakrishnan, Parth Patel, Sydney Dunn-Valadez, Cecilia Dao, Vinshi Khan, Hiba Ali, Laith El-Serag, Ruben Hernaez, Amy Sisson, Aaron P Thrift, Yan Liu, Hashem B El-Serag, Fasiha Kanwal

Library Staff Publications

BACKGROUND & AIMS: The risk of nonalcoholic fatty liver disease (NAFLD) and its progression may differ between men and women. We conducted a systematic review and meta-analysis to determine the relationship between sex and NAFLD, nonalcoholic steatohepatitis (NASH), and advanced NAFLD fibrosis.

METHODS: Studies reporting sex-stratified NAFLD prevalence among population-based samples and either NASH or advanced fibrosis among patients with biopsy-proven NAFLD were identified from MEDLINE, EMBASE, and Cochrane databases through December 2017. We calculated pooled relative risk ratios comparing women vs men for each outcome.

RESULTS: Our final analysis comprised 54 studies. Samples sizes were 62,239 for the NAFLD …

Anterior Cruciate Ligament Injury Incidence Across Sex, Sport, And Level: A Systematic Review And Meta-Analysis, Dana Anderson

Dissertations, Master's Theses and Master's Reports

Well controlled Anterior Cruciate Ligament (ACL) injury prevention neuromuscular training reduces the risk of ACL injury by 50%, but despite the efficacy of these programs, ACL injury rates have not decreased. This lack of decrease in injury incidence may be due in part to limited knowledge on who is most at risk for sustaining an ACL injury, and there is no formal clinical tool available to estimate the personalized or group risk of ACL injury. The purpose of this study was to better understand what groups of athletes are most at risk of sustaining a primary ACL injury, as the …

Evidence For Continental-Scale Dispersal Of Antimicrobial Resistant Bacteria By Landfill-Foraging Gulls, Christina A. Ahlstrom, Mariëlle L. Van Toor, Hanna Woksepp, Jeffrey C. Chandler, John A. Reed, Andrew B. Reeves, Jonas Waldenström, Alan B. Franklin, David C. Douglas, Jonas Bonnedahl, Andrew M. Ramey

USDA Wildlife Services: Staff Publications

Anthropogenic inputs into the environment may serve as sources of antimicrobial resistant bacteria and alter the ecology and population dynamics of synanthropic wild animals by providing supplemental forage. In this study, we used a combination of phenotypic and genomic approaches to characterize antimicrobial resistant indicator bacteria, animal telemetry to describe host movement patterns, and a novel modeling approach to combine information fromthese diverse data streams to investigate the acquisition and long-distance dispersal of antimicrobial resistant bacteria by landfill-foraging gulls. Our results provide evidence that gulls acquire antimicrobial resistant bacteria from anthropogenic sources, which they may subsequently disperse across and between …

Influence Of The Inherent Safety Principles On Quantitative Risk In Process Industry: Application Of Genetic Algorithm Process Optimization (Gapo), Mehdi Jahangiri, Abolfazl Moghadasi, Mojtaba Kamalinia, Farid Sadeghianjahromi, Sean Banaee

Community & Environmental Health Faculty Publications

Inherent safety (IS) refers to a set of measures that enhance the safety level of processes and equipment, rendering additional equipment and/or add-ons. The early design phase of processes is suited best for implementation of IS strategies as some of such strategies either are impossible to be implemented at the operation phase or substantially increase costs. The purpose of this study is to present a new approach called genetic algorithm process optimization (GAPO), by which processes can be made inherently safer even at the operation phase. This study simulates the IS principle, assessing its impact on quantitative risk and the …

The Association Between Relationships With Approachable Adults At School And Non-Suicidal Self-Harm In Vermont High School Youth Identifying As Transgender: A Cross-Sectional Study, Gabe Clarke, Bidur Dahal Ms, Mallory James, Robin Katrick, Casey Rogers Dc, Abby Beerman

Master of Public Health Culminating Projects

Objectives. To explore the association between non-suicidal self-harm (also known as non-suicidal self-injury (NSSI)) in adolescents in Vermont identifying as transgender and relationships with approachable adults at school.

Methods. Responses of self-reported self-harm in adolescents identifying as transgender and the ability to confide in an approachable adult or teacher at school were obtained from the 2019 Youth Risk Behavior Survey (YRBS) (n=18,613). Analysis was conducted using a binary logistic regression at a 95% confidence interval (CI) for the odds ratio (OR) and a best selection process.

Results. Students who identify as transgender and had self-harmed in the past 12 months …

How Safe Are Children With Covid-19 From Cardiac Risks? Pediatric Risk Assesment;Insights From Echoc, Berna Şaylan Çevi̇k, Şule Arici, Zeynep Ergenç, Eda Kepenekli̇ Kadayi̇fci̇, Özge Günal, Nurhayat Yakut

Turkish Journal of Medical Sciences

Background/aim: Approximately 40 million individuals worldwide have been infected with SARS-CoV-2, the virus responsible for the novel coronavirus disease-2019 (COVID-19). Despite the current literature about the cardiac effects of COVID-19 in children, more information is required. We aimed to determine both cardiovascular and arrhythmia assessment via electrocardiographic and echocardiographic parameters. Materials and methods: We evaluated seventy children who were hospitalized with COVID-19 infections and seventy children as normal control group through laboratory findings, electrocardiography (ECG), and transthoracic echocardiography (TTE). Results: We observed significantly increased levels of Tp-Te, Tp-Te/QT, and Tp-Te/QTc compared with the control group. Twenty-five of 70 (35.7%) patients …