Medicine and Health Sciences Commons^™

Sickle Cell Disease: Development Of An Acute Pain Management Program In A Hematology/Oncology Practice, Elizabeth Pohl

Doctoral Projects

Background: Patients with sickle cell disease experience can experience acute episodes of severe pain that require prompt pain medication. Treating uncomplicated, acute sickle cell disease pain in the emergency department setting has been shown to be costly and lead to higher rates of hospitalization than similar care in a dedicated outpatient setting.

Objectives: The aim of this article is to outline the program development efforts undertaken to apply current literature findings and evidence-based practice guidelines to create a program development toolkit and business plan for a sickle cell disease acute pain management program in an outpatient hematology practice.

Methods: A …

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Evaluation Of A Chewing Gum Protocol For Postoperative Spinal Patients, Lauren E. Vachon

Doctoral Projects

Aims and objectives: The purpose of this project was to evaluate if the implementation of a chewing gum protocol improved bowel motility, decreased ileus rate, length of stay, bowel and pain medication use, and hospital costs in post-surgical spinal patients in a suburban hospital.

Background: Postoperative bowel dysfunction is a major source of health problems, including abdominal pain, ileus, increased length of stay, pain medication use, and healthcare costs.

Design: Retrospective cohort study with a focus on program evaluation of the previously implemented chewing gum protocol. An audit of the electronic health record compared outcomes in patients five months before …

Evaluating The Impact Of Nurse Server Standardization On Patient Safety, Megan L. Priebe

Doctoral Projects

Aim: The aims of nurse server (supplies at bedside) standardization program evaluation were to: (1) examine supply costs; (2) identify staff efficiency; (3) evaluate patient safety; (4) identify staff satisfaction and acceptance.

Background: A healthcare facility in the Midwest implemented standardization of the nurse server. Standardization was done to improve patient safety and staff efficiency

Methods: The literature provided metrics for evaluating standardized nurse servers to determine the impact on patient safety. Specific measures used in this quality improvement project were: census data, costs analysis, supply room observations, semi-structured interviews, and data from the VOICE reporting system (system for adverse …

Enhancing Medication Adherence Behaviors Among Ambulatory Pediatric Hematology & Oncology Patients: A Quality Improvement Project, Desiree Palmer

Doctoral Projects

Introduction: Researchers have found that pediatric patients with acute lymphoblastic leukemia and adolescent patients with sickle cell disease struggle to adhere to medication treatment requirements. Because of this trend, there is a clear need to address medication adherence. The purpose of this quality improvement project was to enhance medication adherence behaviors among pediatric hematology and oncology patients and their families within an ambulatory hematology and oncology clinic.

Methods: The project included a systematic literature review to identify evidence-based interventions, an organizational assessment, and a three-phase multifaceted quality improvement process. To increase patients bringing medications to appointments, 32 medication transportation bags …

A Program Evaluation To Assess Readiness For The National Committee For Quality Assurance’S Patient Centered Medical Home Model Application, Alida M. Semrinec

Doctoral Projects

The Patient Centered Medical Home Model is associated with enhanced patient experience and quality improvement outcomes. The Model has the capacity to guide primary care practices to enhance quality, provide more comprehensive, patient centered care, and increase practice revenue. An urban, nurse managed community health center that has recently implemented the nurse care manager role (a Model requirement) desires to apply for recognition. A program evaluation was conducted to assess current practice, policies, and procedures in place at a Community Health Center through the lens of the National Committee for Quality Assurance’s forty Patient Centered Medical Home Model core competencies. …

Utilization Of Home Blood Pressure Monitoring In Adult Patients With Hypertension, Justin R. Crow

Doctoral Projects

Hypertension is one of the most prevalent conditions in the United States, affecting roughly 45% of adults in the country (Centers for Disease Control and Prevention [CDC], 2020). The CDC (2020) reports that only an estimated 24% of patients have controlled blood pressure, which is defined as blood pressure less than 130/80 mm Hg. In 2017, the American Heart Association (AHA) and American College of Cardiology (ACC) released a comprehensive set of guidelines that aimed to assist providers with hypertension management. The Measure Accurately, Act Rapidly, and Partner with Patients (MAP) protocol was formulated as an evidence-based strategy to improve …

Apolipoprotein E And Development Of Alzheimer’S Disease In Hispanic Populations: A Scoping Review, Amy Nguyen, Stacey Moeller

Undergraduate Research Symposium Posters

Alzheimer’s disease (AD) disproportionately affects Hispanic individuals, who face about 1.5- fold more risk for AD than non-Hispanic whites (NHW). Few studies examine AD biomarkers by ethnoracial group, even for the well-established susceptibility locus of apolipoprotein E (APOE). This study reviews current literature on the association between APOE and incidence of AD in Hispanic populations. A scoping review was conducted to identify publications with Hispanic study samples that examined prevalence of APOE’s three alleles (e2, e3, e4) and the risk of disease conferred by each. Two researchers combined search results from PubMed, Scopus, and APA PsycInfo databases, deleted duplicates, and …

Cone Beam Computed Tomography Versus Intraoral Digital Radiography In Detection And Measurements Of Simulated Periodontal Bone Defects Diagnostic Accuracy Study, Marwa Ezz, Hossam Kandil

Dentistry

Detection and accurate assessmentof periodontal disease is important to determine the tooth prognosis and treatment. Radiographic assessment provides information about the pattern and extent of the alveolar bone loss. Digital radiography has ability to enhance images and make direct measurements. CBCT provides unique 3D images used for diagnosis and treatment plans, but its use in periodontology not well-reviewed as there is few number of studies searched about the role of CBCT in periodontology. We compare digital radiography with CBCTin the detection and measurements of different bone defects. Dry jaws with simulated bone defects were imaged by CBCT and Digital radiography …

Histological And Ultrastructural Study Of Silver Nanoparticles Toxicity And The Possible Protective Effect Of Vitamin C On Submandibular Salivary Glands Of Albino Rats, Mohamed Shamel, Mahmoud Ankily

Dentistry

Introduction: Despite silver nanoparticles (AgNPs) beneficial effect in many fields, it has been shown that AgNPs can induce toxic effects. Cytotoxic effect of AgNPs is related to the increased release of reactive oxygen species (ROS) which may lead to cell death. Natural antioxidant scavengers like vitamin C have the capacity to bind and neutralize ROS thus having a vital role in cellular defense against oxidative stress. Objective: The objective of the current study was to assess the cytotoxic impact of AgNPs on the submandibular salivary glands of Albino rats and to reveal the potential antioxidant influence of vitamin C to …

04-06-2021 Hsc Committee Agenda - Revised, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Project C.O.P.E Sexual Health Intervention On Sexual Negotiations Skills Among Black And Hispanic Adolescents In An Under-Resourced Northeastern Urban Community, Irene N. Cantu

Individual, Family, and Community Education ETDs

Decades of sexual health interventions have focused on the disparities youth of color face; however, inequalities in health outcomes and resources remain. This study evaluated Project C.O.P.E. (Communities Organizing for Prevention and Empowerment), a sexual health intervention in an under-resourced northeastern urban community. The goal of the study was to determine if the intervention, personal domains (ethnic identity and family support), or sexual health domains (Viral Hepatitis [VH] knowledge and human immunodeficiency virus [HIV] knowledge) had an impact on sexual negotiation skills in Black and Hispanic adolescent participants (n =510; M_age =16.78 ± 1.14). Between group analyses found significant …

Effect Of Using Smartphone Before Bedtime And Sleep Quality Of Middle-Adulthood Officers At Chulalongkorn University, Bhakkhaphorn Booranasuntikul, Naowarat Kanchanakhan

Chulalongkorn Medical Journal

Background: Nowadays, smartphone has become part of everyday life of the people and tend to be more active continuously. However, it causes many adverse effects, both physically and mentally including potentially resulting in poor sleep quality. Objective: The aim of this study was to investigate the effect of using smartphone before bedtime and sleep quality among the middle-adulthood university officers at Chulalongkorn University. Methods: This cross-sectional descriptive study was conducted among middle-adulthood officers at Chulalongkorn University, aged between 45 - 64 years from 5 faculties within the university. The data were collected by using self-reported questionnaires including general characteristics and …

Unusual Position Of Appendix In A Complicated Group Of Children With Acute Appendicitis Causing Midline With Additional Right Lower Quadrant Incision: A Report Of 2 Cases, Vichack Chakrapan Na Ayudhya, Kobkool Chakrapan Na Ayudhya, Paiboon Sookpotarom

Chulalongkorn Medical Journal

We reported two cases of acute appendicitis in a complicated group of pediatric patients in which the appendix also located at extraordinary sites. A child aged 5 years old experienced abdominal tenderness with the greatest point at lower abdomen. Another child aged 13 years old suffered from symptoms of abdominal pain. Due to the very young age and presence of full bladder in the former and the underlying cerebral palsy with spasticity in nature in the latter case, finally the diagnosis of appendicitis was established with a great concern. Open appendectomies through Lanz incision were performed in both cases. Since …

Anxiety Of Students With Visual Impairment In School For Visually Impaired Students In Thailand, Penphitcha Leksaranyaphong, Siriluck Suppapitiporn

Chulalongkorn Medical Journal

Background: Anxiety is a prominent cause of mental health issues in students. Studies on this in the visual impairment are limited and none has been conducted in Thailand. The researcher finds that mental health in visually impaired students is significant and the study should be conducted so the data can be used as a tool to plan prevention and help visually impaired students in the future. Objectives: To study anxiety and related factors in visually impaired students. Methods: A cross-sectional descriptive study was conducted in 77 visually impaired students by having them take 2 questionnaires in Braille; basic personal information …

Effects Of Customized Foot Orthoses On Lower Limbs Kinematics In Adults With Highly Pronated Foot, Pimwadee Permsombat, Praneet Pensri

Chulalongkorn Medical Journal

Background: Previous studies have assumed that pronated foot may cause mechanical deviations of the lower limbs. Foot orthoses have been used for management to elevate the arch of the foot and alter the kinematic variables during walking. Objective: The purpose of this study was to examine changes in lower limb kinematic variables during the subphases of the gait stance of individuals with highly pronated foot after wearing customized foot orthoses (CFO). Methods: Thirteen adults (five women and eight men, average age 23.3  3.0 years) with asymptomatic highly pronated foot were included in the study. Participants with Foot Posture Index …

Effects Of Fenoterol/Ipratropium Bromide On Fev1 And Hyperinflation In Thai Copd Patients, Kamon Kawkitinarong, Anan Ananpipatkul, Nareerat Sae-Eao, Thanin Asawawichienchinda, Worawan Sirichana

Chulalongkorn Medical Journal

Background: Patients with chronic obstructive pulmonary disease (COPD) usually suffer from breathlessness caused by chronic progressive worsening of airway obstruction and lung hyperinflation. Objective: This study aimed to evaluate the effects of fenoterol hydrobromide and ipratropium bromide combination on lung function parameters in Thai COPD patients. We also compared the effects from two commercially available products; Aerobidol® metered-dose inhaler (MDI) and Berodual® inhaler. Methods: A double-blind, randomized cross-over study was conducted in 31 COPD patients from outpatient service, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. To compare the responses of both inhalers on lung volume parameters, patients were randomized to be …

Exploring The Efficacy Of The Helen B. Landgarten Art Therapy Clinic’S Transition To Telehealth During Covid-19, Brittany Benjamin Amante, Alejandra Hernandez, Emily Lin, Amanda D. Martin, Chao Zhao

LMU Theses and Dissertations

This research qualitatively explores the impacts of the Helen B. Landgarten Art therapy Clinic’s transition to art therapy telehealth services during the COVID-19 pandemic. The purpose of this research was to explore the efficacy of interventions and the clinical themes that emerged as a result of telehealth art therapy services delivered to marginalized communities through the Helen B. Landgarten Art Therapy Clinic. Data that was collected includes anonymous surveys from administrators, teachers, and caregivers of those receiving services and facilitators of services, semi-structured interviews with administrators, teachers, and caregivers of those receiving services, as well as a focus group with …

The Effects Of Sleep Deprivation On Work Performance Amongst Night Shift Nurses, Hannah Pham

Nursing | Student Research Posters

The aim of this study is to identify sleep hygiene and coping mechanisms utilized by night shift nurses and to determine its association in relieving sleep deprivation.

We Are People First, Mary I. Fisher

Physical Therapy Faculty Publications

No abstract provided.

Genetic Mechanisms Of Transcriptional Regulation In Childhood Acute Lymphoblastic Leukemia, Xujie Zhao

Theses and Dissertations (ETD)

Introduction. Advances in genomic profiling and sequencing studies have identified germline and somatic variations that are associated with childhood ALL, improving our understanding of the genetic basis of childhood acute lymphoblastic leukemia (ALL). Recent genome-wide association studies (GWAS) have identified germline genetic variations of ARID5B and, more recently, IGF2BP1 that are associated with susceptibility to ALL. Genome-wide sequencing studies also discovered a new ALL subtype characterized of ZNF384-mediated chromosomal translocations, providing new insights into genetic heterogeneity in childhood ALL. However, the underlying mechanism by which these genetic variants contribute to the transcriptional regulatory circuitries of ALL is still poorly understood. …

Modeling Covid-19 Infection Rates Using Sir And Arima Models, Janelle Domantay, Ilya Pivavaruk, Victor Taksheyev

Undergraduate Research Symposium Posters

With the onset of the COVID-19 pandemic, it has become of increasing interest to both monitor and predict the growth of its infection rates. In order to analyze the accuracy of epidemiological prediction, we consider two different models for prediction, the Susceptible Infected and Removed (SIR), and Autoregressive Integrated Moving Average (ARIMA) models. Using a dataset of Clark County COVID-19 infections, we create various ARIMA and SIR models that attempt to predict the progression of COVID-19 infections whilst comparing these predictions to the dataset. We observed that the ARIMA model performed more accurately overall, having a much lower Root Mean …

Huntington's Disease: A Timeline, Brian Kerlin, Brandon Polimeni, Michaelangelo Ortega

Undergraduate Research Symposium Posters

The purpose of this investigation is to examine the discovery, treatment, social impact, and current research for Huntington’s disease (HD) to provide a foundation to analyze future research towards a cure. Huntington’s disease was first comprehensively described in 1872 by George Huntington. HD is an autosomal-dominant, neurodegenerative disorder that affects approximately 2.7 per 100,000. Individuals with HD present with involuntary muscle movement, cognitive decline, and personality alterations arising at a mean age of 35 years. Symptoms are subtle at first, but as the disease progresses over 15-20 years, the individual’s ability to talk diminishes and their mental abilities decline into …

The Aftermath Of Sexual Assault: Creating The “Am More Than My Experience” Workbook, Isabella Chung

Undergraduate Research Symposium Podium Presentations

The following thesis includes a literature review of the immediate and long-term effects of sexual assault on victims in regard to their physical, mental, and emotional health and romantic relationships, followed by a proposed workbook for sexual assault victims/survivors. Being that typical responses immediately after an assault are fear, disbelief, and activation of the sympathetic nervous system, it is to no surprise that long term issues of depression, anxiety, and Posttraumatic Stress Disorder (PTSD) often arise as well. Thus, a workbook was created with the intention of educating readers about sexual assault and helping victims/survivors to heal from the trauma …

Collaboration Therapy: Telehealth Principles And Case Studies, Elliot Cole, Phd, Larry M. Starr, Phd

School of Continuing and Professional Studies Faculty Papers

While conventional in-clinic Traumatic Brain Injury (TBI) rehabilitation serves the needs of the vast majority of patients many of whom go on to resume their lives a significant percentage of patients continue to have enduring cognitive disabilities despite long-term and skilled therapy. However, these patients can rapidly achieve gains which typically continue to increase toward substantial self-sufficiency when engaged in Collaboration Therapy (CT). CT is directed toward patient populations appropriate for a telehealth service who meet the following criteria: 1) patients have plateaued in conventional in-clinic therapy; 2) in-patients are too distant from an appropriate outpatient facility; and 3) individuals …

Impact Of Body Mass Index On Covid-19-Related In-Hospital Outcomes And Mortality., Waqas Ullah, Sohaib Roomi, Nayab Nadeem, Rehan Saeed, Shafaq Tariq, Moataz Ellithi, Shujaul Haq, Ahmad Arslan, John Madara, Margot Boigon, Donald C. Haas, David L. Fischman

Abington Jefferson Health Papers

Background: Given the high prevalence of obesity around the globe, patients with coronavirus disease 2019 (COVID-19) are at an increased risk of devastating complications.

Methods: A retrospective cohort study was performed to determine the association of basal metabolic index (body mass index (BMI)) with the need for invasive mechanical ventilation (IMV), dialysis, upgrade to an intensive care unit (ICU) and mortality. Independent t-test and multivariate logistic regression analysis were performed to calculate mean differences and adjusted odds ratios (aORs) with its 95% confidence interval (CI), respectively.

Results: A total of 176 consecutive patients with confirmed COVID-19 diagnosis were included. …

The Role Of Awake Fiberoptic Intubation In The Difficult Airway, Robert Montague

Nurse Anesthesia MSNA Student Capstones

Awake fiberoptic intubation (AFOI) is a specialized technique used by anesthesia providers to decrease the risk of airway management during tracheal intubation of a predicted difficult airway. The rate of AFOI has decreased, and the advent of the video laryngoscope may be a contributing factor. However, there is still a need for AFOI. This case study reviews the relevance of, current indications for, and best practices for performing AFOI. Is AFOI still relevant in current anesthesia practice when managing airway difficulties such as limited mouth opening, obstructive sleep apnea, limited neck extension, head and neck pathology, morbid obesity, and progressive …

The Evaluation Of The Brøset Violence Checklist (Bvc) And Interventions To Reduce Patient Violence Incidents Occurring In The Emergency Department, Grace D. Yoon, Dnp, Rn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Patient violence in healthcare is an issue across many departments, but many staff members in the emergency department (ED) are directly affected by violent incidents.

Objectives: Three primary purposes determined the success of this Quality Improvement (QI) project: 1) to evaluate the effectiveness of utilizing the Brøset Violence Checklist (BVC) and implementing appropriate interventions to reduce the number of physical assault occurrences against healthcare providers in the ED; 2) to assess if there was an increase in reporting patient violence incidents; and 3) to assess for any improvements in perceived safety in the ED among the nurses.

Methods: Adult …

Implementation Of Capnography Monitoring To Improve Outcomes Among Intensive Care Unit Patients On Patient-Controlled Analgesia Or Opioids, Leslie Smith, Msn, Bmtcn, Aocns, Aprn-Cns

Doctor of Nursing Practice Projects

Background: Patient-controlled analgesia (PCA) administration of opioids is associated with risk for respiratory depression. Capnography is a non-invasive way to identify early respiratory depression and prevent adverse patient events.

Purpose: This project evaluated the effectiveness of capnography versus standard monitoring in reducing adverse events among patients admitted to an intensive care unit (ICU) who were prescribed PCA opioids and evaluated patients at high-risk for respiratory depression according to age, gender, diagnosis, co-morbidities, and type of opioid prescribed.

Methods: This project used a pre- and post-intervention design to compare differences in the number of adverse events among 20 adult patients …

A Quality Improvement Initiative To Engage Older Adults In The Discharge Process Using The Ideal Discharge Protocol, Ava D. Williams, Msn, Crnp Fnp-Bc

Doctor of Nursing Practice Projects

Background: Readmissions are costly and adversely affect patient outcomes. Readmissions significantly impact older adults’ ability to manage post-discharge. Older adults are more likely to have challenges with understanding newly prescribed medications after discharge and therefore are less compliant with medications. Older adults are also less likely to follow-up with their primary care physician after discharge. Engaging patients and families in a collaborative discharge process is a key foundational element needed to improve patient outcomes and reduce avoidable readmission rates.

Purpose: This quality improvement initiative engaged patients and families in an evidence-based discharge protocol to reduce avoidable readmission over three months. …