Medicine and Health Sciences Commons^™

Emergent Trends In The Chinese Counterfeit Pharmaceutical Supply Chain And Opportunities For Public-Private Reform, Mary Monk

Senior Theses

This research seeks to identify and analyze emerging trends in the Chinese counterfeit pharmaceutical trade, extending from the supply chain’s point of origin to domestic and overseas retail dispensary. To aid readability, Chapter 1 of this thesis opens with key conclusions and policy recommendations for various Chinese and U.S. stakeholders based on the shortcomings identified in Chapter 5. Chapter 2 begins with a review of international roadblocks to diagnosing the issue, such as lack of consensus on working definitions and cross-border discrepancies in pharmaceutical oversight regulation. This section also provides a general overview of existing factors driving demand for counterfeit …

Us Vs. Wales: Comparing And Improving Refugee Health Policy, Payton Ramsey

Senior Theses

Inadequate strides have been made to bolster the short and long-term health of growing numbers of refugees awaiting resettlement. The United Nations Higher Commission for Refugees (UNHCR), as well as many countries of resettlement, guarantee the right to health as signatories of the UN 1951 Refugee Convention, but in many situations refugee accessibility to healthcare and health resources is limited by time restrictions on benefits, immigration status, and/or financial circumstances.

This thesis provides a synopsis of the historical roots of current policies and legislative frameworks relating to refugee health for Wales and the US. Through the analysis of governmental policy …

Sculpting Organs: An Arts-Based Educational Activity For Anatomy Learning, Annika Gupta

Senior Theses

As an integral component of healthcare, a comprehensive understanding of anatomy is necessary for accurate clinical diagnoses and medical procedures. Beginning in undergraduate classrooms (premedical), there is a need to explore new ways of teaching and learning anatomy to train healthcare professionals. Traditional methods of attending a lecture and reading a textbook may not be the most effective method to learn about anatomical structures—or to engage learners. However, recent studies have reported promising results in the use of arts-based approaches to enhance anatomy learning. Of these, clay sculpting can provide an opportunity for students to participate in an active and …

The Psychology Of Dance Medicine: Self-Perception Of Dancers, Karina Desai

Senior Theses

Derived from sports medicine, dance medicine is a subcategory that focuses on the health and well-being of dancers on a scientific and medical level. Dancers are considered “elite” athletes and artists, which requires this specific niche of medicine to study the injuries and other health-related issues that develop as a result of dancers’ unique movement. Studies show that in addition to physical injuries, dancers are also susceptible to mental health issues. There are many factors of the dance environment, such as the instructor, peers, and mirrors, that alter the self-perception of dancers. Due to dancers being required to train in …

Systematic Review Of Factors Impacting Reading Impairment Rates In Studies Of Children With Developmental Language Disorder (Dld), Kayla Dewey

Senior Theses

This systematic review examined studies of individuals with developmental language disorder (DLD) to examine the rate of co-occurring reading impairment. We hypothesized that recruitment method, age, and the type of diagnostic reading assessment would be associated with different rates of reading impairment in individuals with DLD. We searched the database PsycINFO for peer-reviewed academic articles containing specific keywords related to DLD/SLI and Dyslexia, resulting in a total of 286 studies. These articles were then filtered to ensure that all articles analyzed in the present study only examined children below the age of 18, were a study of children with DLD/SLI, …

Combination Treatment With Cdk4/6 And Cdk8/19 Inhibitors In Er-Positive Breast Cancer, Samantha Tolentino Safa

Senior Theses

Cyclin-dependent kinases (CDK) 4 and 6 are the main drivers of proliferation in estrogen receptor (ER)-positive breast cancer cells. CDK4/6 inhibitors, such as the FDA-approved cytostatic drug, Palbociclib, induce G1 arrest and prevent cell cycle progression. Prolonged treatment with CDK4/6 inhibitors can lead to drug resistance in the clinic as well as in the lab. The mechanisms behind this resistance are varied, with preliminary evidence suggesting that it may be influenced by the senescence-associated secretory phenotype (SASP), CDK6 hyperactivation, or degradation of the retinoblastoma protein (Rb). In contrast to the cell cycle mediating CDK4/6, CDK8 and 19 are involved in …

The Effects Of The Use Of Medical Interpreters Amongst The Latina Population In The Context Of Sexual And Reproductive Health, Carson Collins

Senior Theses

The Latino population in the United States is large and consistently growing. These individuals, due to cultural and systemic factors, are at greater risk for a variety of health problems, especially in the context of sexual and reproductive health. Many of these patients may not speak English as their first language and thus need to access interpretative services to receive care. This study sought to examine whether medical facilities using certified medical interpreters and requiring cultural competency training for their staff could reduce the cultural and communication barriers LEP Latinas experience when receiving sexual and reproductive health care services. An …

Research Participation Of Minor Adolescents In Foster Care, Jenny Francis, Jane Andresen, Heidi Kloster, Jill Mcleigh, Alexis Guzman, Susan Rosenthal

Health Status, Outcomes, and Literacy and Healthcare Utilization

In this study we evaluated published studies about foster care to: (1) determine the types of data used; (2) describe the degree to which a sexual/reproductive health topic was addressed; and (3) describe the consent process.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Self-Efficacy Of Professionalism: Online Modules To Improve Implementation On Level Ii Fieldwork, Leigh Leonard, Otd, Ms, Otr/L

Department of Occupational Therapy Faculty Papers

Professionalism is a fundamental component of occupational therapy. The American Occupational Therapy Association (AOTA) has many official documents that reference professionalism including the Occupational Therapy Code of Ethics, Standards for Continuing Competence, Standards of Practice for Occupational Therapy, and the Occupational Therapy Practice Framework: Domain and Process, 4th ed. There are high professional expectations of occupational therapy students, however, the definition of professional behaviors varies among fieldwork educators, faculty, and occupational therapy students. The literature revealed four themes of professionalism that were consistent across all stakeholders. Online education has increasingly become the norm for many programs and there is strong …

Jefferson Digital Commons Quarterly Report: January-March 2021, Kelsey Duinkerken, Msi, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• Articles
• Dissertations
• Grand Rounds and Lectures
• JCPH Capstone Presentations
• Journals and Newsletters
• Know Diabetes by Heart Meetings
• Library Resources
• MPH COVID-19 Infographics
• Posters
• Scholarly Inquiry Graphics
• The Big in Big Data Symposium
• What People are Saying About the Jefferson Digital Commons

Support For Me Key Takeaways Of The Care Integration Assessment, Rachel M. Gallo Mph, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma, Mark Richards Bs, Tyler Egeland Ba, Olivia Dooley Mpa

Substance Use Research & Evaluation

In 2019, Maine’s Department of Health & Human Services received a $2.1 million grant from the Centers for Medicare and Medicaid Services (CMS) SUPPORT Act, establishing the SUPPORT for ME initiative within the Office of MaineCare Services. The primary goal of this planning grant is to increase MaineCare providers’ capacity to deliver Substance Use Disorder (SUD) treatment and recovery services for Medicaid beneficiaries. One key component of this project is an assessment to collect information from Maine organizations to help MaineCare better understand levels of care integrations within organizations and across several dimensions of care (“Care Integration Assessment”). This condensed …

An Assessment Of Communication Between Speech-Language Pathologists And Intervention Specialists In Schools, Sarah Painter

Honors Projects

The American Speech-Language Hearing Association states that Speech-Language Pathologists (SLPs) should collaborate with other professionals, including Intervention Specialists (ISs). In recent decades, there has been a shift from pull-out therapy, where students are removed from the classroom for services, to push-in therapy, which takes place within the classroom. This shift has resulted in greater overlap in SLP-IS caseloads. However, there is little known about the collaborative practices of these professionals. This study aimed to close the gap by using surveys to address two main research questions.

1) What is the focus, modality, and frequency of collaboration between SLPs and ISs? …

Navigating The Community With A Disability: How Ability App Can Help And Why Ots Should Get Involved, Hailey Scandin

OTD Capstone Projects

Ability App was invented and founded by Alex Knoll, an incredible teenager with a passion for helping provide resources for individuals with disabilities. The app strives to serve people with disabilities, their families, and caregivers by providing a road-map of accessible public spaces and business locations around the world while raising awareness about the importance of accessibility and inclusion. The project goal was to network the app to different occupational therapy programs in order to help expand the number of locations that are available for Ability App users. Occupational therapists can use Ability App to advocate for individuals with disabilities, …

Tranexamic Acid To Reduce Head Injury Death In People With Traumatic Brain Injury: The Crash-3 International Rct, Ian Roberts, Haleema Shakur-Still, Amy Aeron-Thoma, Danielle Beaumont, Antonio Belli, Amy Brenner, Madeleine Cargill, Rizwana Chaudhri, Nicolas Douglas, Rashid Jooma

Section of Neurosurgery

Background: Tranexamic acid safely reduces mortality in traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury and can cause brain herniation and death. We assessed the effects of tranexamic acid in traumatic brain injury patients.
Objective: To assess the effects of tranexamic acid on death, disability and vascular occlusive events in traumatic brain injury patients. We also assessed cost-effectiveness.
Design: Randomised trial and economic evaluation. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers and those assessing outcomes were masked to allocation. …

Sars-Cov-2 Infects Human Engineered Heart Tissues And Models Covid-19 Myocarditis., Adam L Bailey, Oleksandr Dmytrenko, Lina Greenberg, Andrea L Bredemeyer, Pan Ma, Jing Liu, Vinay Penna, Emma S Winkler, Sanja Sviben, Erin Brooks, Ajith P Nair, Kent A Heck, Aniket S Rali, Leo Simpson, Mehrdad Saririan, Dan Hobohm, W Tom Stump, James A Fitzpatrick, Xuping Xie, Xianwen Zhang, Pei-Yong Shi, J Travis Hinson, Weng-Tein Gi, Constanze Schmidt, Florian Leuschner, Chieh-Yu Lin, Michael S Diamond, Michael J Greenberg, Kory J Lavine

Faculty Research 2021

There is ongoing debate as to whether cardiac complications of coronavirus disease-2019 (COVID-19) result from myocardial viral infection or are secondary to systemic inflammation and/or thrombosis. We provide evidence that cardiomyocytes are infected in patients with COVID-19 myocarditis and are susceptible to severe acute respiratory syndrome coronavirus 2. We establish an engineered heart tissue model of COVID-19 myocardial pathology, define mechanisms of viral pathogenesis, and demonstrate that cardiomyocyte severe acute respiratory syndrome coronavirus 2 infection results in contractile deficits, cytokine production, sarcomere disassembly, and cell death. These findings implicate direct infection of cardiomyocytes in the pathogenesis of COVID-19 myocardial pathology …

A Clinical Review Of Robotic Navigation In Total Knee Arthroplasty: Historical Systems To Modern Design., Ahmed Siddiqi, Timothy Horan, Robert M Molloy, Michael R Bloomfield, Preetesh D Patel, Nicolas S Piuzzi

Orthopedic Surgery Resident Research

Robotic-assisted total knee arthroplasty (RA-TKA) has shown improved reproducibility and precision in mechanical alignment restoration, with improvement in early functional outcomes and 90-day episode of care cost savings compared to conventional TKA in some studies. However, its value is still to be determined.Current studies of RA-TKA systems are limited by short-term follow-up and significant heterogeneity of the available systems.In today's paradigm shift towards an increased emphasis on quality of care while curtailing costs, providing value-based care is the primary goal for healthcare systems and clinicians. As robotic technology continues to develop, longer-term studies evaluating implant survivorship and complications will determine …

Alumni Journal - Volume 92, Number 1, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | From the Editor
4 | From the President
6 | From the Dean

News
7 | This and That
10 | School of Medicine News
12 | Students - Spencer J. Freed ('22)
14 | Alumni News
16 | AIMS Report
18 | Department Reports: Ophthalmology and Medicine

APC 2021
23 | APC 2021 in Review

Features
34 | COVID-19 Vaccination
36 | Oral Roberts to Loma Linda
39 | Yearning for Healing
41 | Alumni Spotlight
42 | Historical Snapshot

In Memoriam
45 | Featured Obituary - Clifton D. Reeves ('60)
46 | Alumni Remembered

Against Personal Ventilator Reallocation, Joel Michael Reynolds, Laura Guidry-Grimes, Katie Savin

All Faculty Scholarship

The COVID-19 (Coronavirus disease of 2019) pandemic has led to intense conversations about ventilator allocation and reallocation during a crisis standard of care. Multiple voices in the media and multiple state guidelines mention reallocation as a possibility. Drawing upon a range of neuroscientific, phenomenological, ethical, and sociopolitical considerations, the authors argue that taking away someone's personal ventilator is a direct assault on their bodily and social integrity. They conclude that personal ventilators should not be part of reallocation pools and that triage protocols should be immediately clarified to explicitly state that personal ventilators will be protected in all cases.

Erratum: Against Personal Ventilator Reallocation-Addendum (Cambridge Quarterly Of Healthcare Ethics : Cq : The International Journal Of Healthcare Ethics Committees (2021) 30 2 (272-284)), Joel Michael Reynolds, Laura Guidry-Grimes, Katie Savin

All Faculty Scholarship

No abstract provided.

An Art Therapist's Use Of Art Making As Self Care In Pediatric Medicine, Emily Hargraves

LMU Theses and Dissertations

This heuristic research project examines my personal use of art making as a form of self-care while interning in a pediatric hospital. The review of the literature investigates the concept of self-care and the use of art making as a therapeutic outlet for working art therapists, for professionals in the healthcare field, and for art therapy students working specifically in hospital settings. The literature suggests that self-care is a necessary process, that self-care is not just for the physical self, but also for one’s mental health. The literature also indicates that art therapists have found that art making as a …

Patients On Non-Icu Floors Accessibility To Complex Monitoring Devices Compared To Standard Monitors On The Ability To Provide Critical Monitoring When Necessary, Ashton Seifert

Spring Showcase for Research and Creative Inquiry

Cardiac arrest that occurs in hospitals carries a mortality rate of 80%, even though there are numerous advances in health care (Yousaf et al., 2018). Typically, these life-threatening cardiac arrests can be preceded by changes in the client's status, specifically in the vital signs (Yousaf et al., 2018). While in the ICU mortality rates are increased and all patients are monitored on a monitor that can read Arterial line pressures, continuous pulses, and monitoring of oxygen saturation. Patients on the non-ICU floor receive monitoring using standard devices. These devices only monitor vital signs periodically and do not provide continuous monitoring …

Evidence Based Research Project: Racial Disparities In Healthcare, Annie Elliott, Bridget Canderelli, Miranda Mozingo, Elizabeth Powers

Spring Showcase for Research and Creative Inquiry

Many studies completed in the United States have proven that there is a national problem surrounding our country regarding racial disparities in health care. The issue of racial disparities directly impact patient care negatively, and statistics prove that people of color actually have a higher mortality rate. There are a variety of reasons that this issue is happening in our country, beginning with our education system, and even unconscious biases among healthcare professionals. Research has shown that many healthcare professionals believe, and are taught, the misbelief that People of Color feel less pain or that they may be drug addicts …

Health Disparities In Low Income Areas, Kerry Williams Williams, Angelika Gomez, Anaya Jennings, Isabella Kohama-Flores

Spring Showcase for Research and Creative Inquiry

The goal of our presentation is to discuss the healthcare disadvantages within lower income areas within the Unites States. It has been found that dependent upon the area in which an individual lives, their access to various forms of healthcare can be scarce and practically non-beneficial to them. Throughout our presentation, we hope to not only bring awareness to this unfortunate issue but also focus and incorporate ways in which healthcare professionals, such as nurses, can take initiative and help to give the community the healthcare needed to survive and maintain.

Vascular Access Teams And Their Success In The Acute Care Setting, Amanda King

Spring Showcase for Research and Creative Inquiry

Peripheral intravenous catheters (PIV) are frequently used in acute care settings for short-term delivery of intravenous (IV) medications and fluids (Marsh et al., 2018). While this is a common practice in the hospital, the insertion of these PIVs can be quite difficult. According to Marsh et al. (2018), multiple insertion attempts are common, and post-insertion failures from complications such as occlusion are as high as 69%, triggering the insertion of subsequent catheters. This research analyzed the use of a vascular access team, commonly known as an IV team, to improve PIV outcomes in the acute care setting. These vascular access …

2021-04-01_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2021-04-01_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 …

2021-04-01_Michiganoverview_Misc, Michigan Department Of Health & Human Services

Michigan COVID-19 MIS-C Data

The MIS-C Data page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_104661---,00.html.

This report is created by the Michigan Department of Health & Human Services from data self-reported by health care providers and local health departments. Data is updated on the first and third Thursdays of the month.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition in children and adolescents under 21 years of age where multiple organ systems become inflamed or dysfunctional which occurs in association with illness. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, …

Kujdesi Dhe Menaxhimi I Të Sëmurëve Me Hipertension Dhe Ushqyeshmëria E Tyre, Artan Loshaj

Theses and Dissertations

Hyrje: Tensioni i lartë i gjakut (hipertensioni arterial) është një nga shkaktarët e sëmundshmërisë dhe vdekshmërisë së parakohshme që mund të parandalohet.

Hipertensioni është një faktor i rëndësishëm i rrezikut për insultet cerebrovaskulare, iskemitë tranzitore, infarktin e miokardit, insuficiencën e zemrës, sëmundjet kronike të veshkave, dëmtimit kongnitiv dhe vdekjeve të parakohshme. Hipertensioni i patrajtuar, zakonisht shoqërohet me një rritje progresive të tensionit arterial. Rëndësi të veqantë në trajtim ka edhe ushqyeshmëria e këtyre pacienteve si p.sh: ndryshimi i stilit të jetës, kufizimi i kripës, reduktimi i peshës, ndërprerja e duhanit etj.

Qëllimi i studimit ishte marrja e informatave lidhur me …

“Infeksionet Intrahospitalore Postoperative Të Plagëve Kirurgjike. Kujdesi Infermieror Në Parandalimin Dhe Mjekimin E Tyre”, Sara Berisha

Theses and Dissertations

Hyrje: Infeksionet spitalore të indeve te buta dhe kryesisht ato të plagëve operatore përbëjnë një nga komponentët kryesore të infeksioneve spitalore, ato zënë 30% të të gjithë infeksioneve spitalore dhe janë përgjegjës për vonesat në konvaleshencën e të sëmurëve kirurgjikal për rritjen e ditë qëndrimit spitalor dhe influencojnë ndjeshëm morbiditetin dhe mortalitetin postoperator.

Qëllimi i punimit: Qëllim i punimit është edhe analizimi i të dhënave statistikore për numrin e pacientëve me plagë të ndryshme trajtuar në repartin e Kirurgjisë në Spitalin e Përgjithshëm të Prizrenit nga muaji Janar deri në muajin Qershor të vitit 2020.

Metodologjia: Punimi është i llojit …

Kujdesi Infermieror Dhe Menaxhimi I Dhimbjes Tek Pacientët, Adhurim Sallahu

Theses and Dissertations

Ky punim është bërë me qëllim studimi, studimi lidhur me dhimbjen që mbizotëron çdo lloj dhe çdo sistem të trupit të njeriut.

Dhimbja na motivon ne qe te tërhiqemi nga situata qe mund te na shkaktojnë dëmtime, te mbrojmë pjesët e dëmtuara te trupit derisa ato te shërohen, dhe gjithashtu te shmangim situata te tilla ne te ardhmen. Kjo tregohet nga stimulimi i receptorëve ne sistemin nervor periferik ose nga dëmtimi dhe keqfunksionimi i sistemit nervor qendror dhe periferik.

Dhimbjet me te shumta shërohen me shpejtësi dhe saktësi ne te njëjtën kohe kur nxitja e dhimbjes është larguar dhe trupi …