Protective Effects Of Anandamide Against Cisplatin-Induced Peripheral Neuropathy Inrats, Çi̇ğdem Çengelli̇ Ünel, Başak Ayaz, Şule Aydin, Emel Ulupinar, Orhan Özati̇k, Bi̇lgi̇n Kaygisiz, Engi̇n Yildirim, Kevser Erol

Turkish Journal of Medical Sciences

Background/aim: Cisplatin (CIS) is an effective antineoplastic agent used in the treatment of several cancer types. Peripheral neuropathy is a major dose-limiting side-effect in CIS therapy. Cannabinoids may alleviate this painful side effect. This study investigated the analgesic effects of anandamide (AN) on CIS-induced peripheral neuropathy, in vitro effects of AN in CIS neurotoxicity, and the contribution of nitric oxide (NO) in this effect. Materials and methods: This is an experimental animal study. Primary dorsal root ganglion (DRG) cultures were prepared from oneday-old rats for in vitro investigations. DRG cells were incubated with CIS (100-300 μM), and AN (10, 50, …

Neuropeptide-S Affects Cognitive Impairment And Depression-Like Behavior On Mptpinduced Experimental Mouse Model Of Parkinson?S Disease, Ayşe Özkan, Mehmet Bülbül, Nari̇n Deri̇n, Osman Si̇nen, Güven Akçay, Hande Parlak, Mutay Aydin Aslan, Aysel Ağar

Turkish Journal of Medical Sciences

Background/aim: The present study proposes to investigate the effect of neuropeptide-S (NPS) on cognitive functions and depressionlike behavior of MPTP-induced experimental model of Parkinson's disease (PD). Materials and methods: Three-month-old C57BL/6 mice were randomly divided into three groups as; Control, Methyl-4-phenyl1,2,3,6-tetrahydropyridine (MPTP) and MPTP + NPS 0.1 nmol (received intraperitoneal injection of MPTP and intracerebroventricular injection of NPS, 0.1 nmol for seven days). The radial arm maze and pole tests were carried out, and the levels of tyrosine hydroxylase (TH) were determined using western blotting. A mass spectrometer was used to measure the levels of dopamine, glutamic acid, and glutamine. …

Trace Element & Vitamin Content Of Ankaferd Hemostat And Hepatoprotective Effect, Begüm Güneş, Nazi̇fe Yasemi̇n Ardiçoğlu Akişin, Mehmet Nejat Akar

Turkish Journal of Medical Sciences

No abstract provided.

Effects Of Home-Based Exercise Using Balance Disc With Smartphone Inclinometer Application Feedback On Sitting Balance And Activity Of Daily Living In Individual With Stroke, Pantawit Aphiphaksakul

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Sitting ability is critical for daily activities in individuals who have experienced a stroke. A combination of seated balance training on an unstable surface and real-time visual feedback via a simple mobile inclinometer application may improve trunk control in stroke survivors. Objective: This randomized controlled trial aimed to determine the effects of home-based exercise utilizing a balance disc with input from a smartphone inclinometer application on sitting balance and activities of daily living in stroke survivors. Methods: This trial enrolled 32 stroke survivors aged 30 to 75 years. Participants were randomly assigned to one of two groups: intervention or …

A Structured Approach To Skin And Soft Tissue Infections (Sstis) In An Ambulatory Setting, Benjamin Silverberg

Faculty & Staff Scholarship

The skin is the largest, and arguably, the most vulnerable organ in the human body. Scratches and scrapes, bites and puncture wounds, impetigo and erysipelas—all these disruptions can lead to pain, swelling, and/or systemic symptoms. In this article, which is based on the Infectious Diseases Society of America’s 2014 guidelines and the World Society of Emergency Surgery and Surgical Infection Society of Europe’s 2018 consensus statement, a structured approach to skin and soft tissue infections (SSTIs) is reviewed, comparing treatment for suppurative and non-suppurative infections, and then discussing specific conditions commonly seen in Primary Care and Urgent Care facilities.

Implementation Of An Individualized Onboarding And Training For Nurse Managers, Marcelo Castro

DNP Scholarly Projects

Abstract

BACKGROUND: The onboarding and training of nurse managers varies drastically in healthcare institutions across the US, even within the same organization. Though evidence-based studies have demonstrated that the onboarding and training process are related to employee engagement, retention, and to the achievement of positive departmental and institutional goals and outcomes, most healthcare organizations do not invest in providing an effective onboarding and training based on evidence models and frameworks. This project was conducted at a 345-bed tertiary teaching medical center in the Boston area to determine the need for instituting an effective evidence-based onboarding and training process for nurse …

Use Of A Simplified Protocol For The Prevention Of Postoperative Nausea And Vomiting In Adult Ambulatory Surgical Patients, Roger Horne

DNP Scholarly Projects

Postoperative nausea and vomiting (PONV) remains a common complication affecting surgical patients after receiving anesthesia. Prevention of PONV is important in an ambulatory surgical setting where patient access to rescue treatment is limited after discharge. A quality improvement (QI) project introduced a simplified PONV prevention strategy to decrease the incidence of PONV at a Veterans Health Administration ambulatory surgery center. A retrospective chart audit of all facility surgical patients receiving anesthesia care (n = 94), excluding ophthalmology patients, was conducted prior to COVID-19 restrictions to establish baseline PONV incidence. An evidence-based, simplified PONV prevention protocol was developed and implemented. …

Impact Of A Comprehensive Clinician Educational Program On Health Literacy And Patient Satisfaction, Jennifer Yokopenic

DNP Scholarly Projects

BACKGROUND: The Institute of Medicine has defined health literacy as “the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”. Health literacy is a significant social determinant of overall health and can be particularly challenging in the critical care environment. According to the U.S. Department of Health and Human Services, only 12% of adults have proficient health literacy, 53% have intermediate health literacy, 21% have basic health literacy ability, and 14% have below basic health literacy (AHQR.gov, 2008).

METHODS: A pre- and post-intervention survey of satisfaction with clinician communication and assessment of …

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project. …

Using A Psychopharmacology Education Program To Increase Primary Care Provider Comfort With Treating Basic Psychiatric Disorders, Latesha Reed

DNP Scholarly Projects

BACKGROUND: Almost 1 in 5 people have been diagnosed with a mental health illness but the supply of psychiatric providers does not meet patient’s needs. Multiple reasons contribute to this shortage and nurse practitioners are part of the solution. Even with nurse practitioners specializing in psychiatric mental health there is still a shortage. Primary care is where most patients first present their mental health issues.

METHODS: Literature review informed the development of the educational intervention presented to the primary care providers using a digital, asynchronous learning format. A gap analysis of organizational needs and weaknesses was used to determine the …

A Patient-Facing Dashboard To Promote Shingrix™ Vaccination In A Continuing Care Retirement Community: A Quality Improvement Project, Emily S. Stewart

DNP Scholarly Projects

BACKGROUND: Shingles is considered one of the most significant vaccine-preventable diseases of older adults based on its morbidity and public health burden, which increase drastically with age. Adult vaccine awareness and promotion programs are undervalued in the U.S.; in particular, educational programs targeting older adults are needed. Older adults have increasing rates of adoption of health information technology (HIT) to seek guidance and support for their medical needs. Leveraging HIT in the form of clinical dashboards is an option for providing reliable, safe and cost-effective vaccine education to older adults at high risk of vaccine-preventable disease.

METHODS: The specific aims …

Addressing Medical Mistrust In In-Patient Psychiatric African American (Aa) Patients, Eselle Molua

DNP Scholarly Projects

Abstract

Background: Medical Mistrust (MM) is associated with patient dissatisfaction, treatment nonadherence, and poor health outcomes. In the United States, MM is prevalent in African American patients in In-Patient Psychiatric settings. Caregiver training and education on MM and cultural sensitivity can help identify mistrust and provide strategies to increase trust and reduce mistrust.

Purpose: The aim of this project was to implement an educational tool to improve caregiver awareness about knowledge of MM. By doing so, it was the goal to enhance cultural sensitivity skills and patient-centeredness in the African American population at the adult psychiatric unit in Northwest …

A Case Of Antipsychotic-Induced Hypothermia, Joseph Michael Ahearn Iii

Department of Psychiatry

No abstract provided.

Covid Mitigation Strategies And Safety Perceptions Among Workers During Spring 2020 Shutdown, William Mciver

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

A novel coronavirus pandemic radically shifted the working environment of the population in the United States in the spring of 2020. Studies have examined the difference between healthcare workers and the general population, but there exists a gap when looking at mitigation strategies between healthcare workers and other workers that continued working outside the home. This study surveyed workers and asked about employment status, employment field, COVID safety precautions taken in the workplace, and feelings of safety. This study examined that and found statistically significant differences in the mitigation strategies used by healthcare workplaces and all other non-healthcare workplaces. This …

Educational Intervention To Change Knowledge And Attitudes Regarding Sexual Behaviors To Reduce Rates Of Sexually Transmitted Infections Among University Of Kentucky’S Sorority Life Students., Julianna Maita

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Sexually transmitted infections disproportionally affect young adults. Within this age group, women are at an increased risk for contracting and STI and face more severe long-term adverse consequences than men. College aged individuals are at an increased risk for contracting an STI due to risky sexual behaviors such as unprotected sex with multiple partners. College students involved in Greek Life have been found to engage in risker sexual behaviors than non-Greek life students. These individuals perceive themselves to be at a higher risk for contracting an STI and have an increased number of unprotected sexual encounters under the influence of …

Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs), such as abuse, neglect, and dysfunction in a child’s home are considered a public health crisis due to their correlation to health disparities and psychosocial problems in adulthood such as substance use, relationships, education, and maintaining employment. However, some individuals are resilient and demonstrate the ability to adapt and function well despite experiencing adverse events. To better understand resilience when ACEs are present, I conducted a basic qualitative research study to explore the lived experiences of individuals in Tennessee with elevated ACE and resilience scores. A purposeful sample of 12 participants who scored high on ratings …

Strategic Management Of Digital Contact Tracing Technologies: Covid-19 And Singapore, Yaya Sirimongkarakorn

Engineering and Technology Management Student Projects

The emergence of the COVID-19 virus and global health pandemic has sparked a rapid need for new digital solutions. Singapore took a strategic lead by paving the path towards innovating digital contact tracing (DCT) technologies to contain the spread of the virus. The nation’s expedited response and model for DCT has shown to be one that many countries can take example from, regardless of experiencing hurdles in gaining sufficient user uptake initially. The concerns surrounding data security and privacy has fueled the movement for DCT technologies. With the vast majority of the population being involved, many aspects need to be …

Implementation Of Community Health Worker Education Toolkit To Promote Compliance In Managed Care Organization, Lamonica Johnson

DNP Scholarly Projects

Community health workers provide case management and care coordination services to high-risk members enrolled in Louisiana Department of Health’s Medicaid program. Centers for Medicare and Medicaid Services require states entering contracts with managed care organizations to conduct external quality reviews by an independent External Quality Review Organization. Healthcare Effectiveness Data and Information Set are quality metrics managed by the National Committee for Quality Assurance. These metrics are reported annually and required by Louisiana Department of Health. Community health workers are required to demonstrate quality accreditation and meet state specific requirement compliance through documentation. The aim of this project was to …

Improving Employee Engagement On An Inpatient Unit: A Quality Improvement Project, Holly Mccormack

DNP Scholarly Projects

BACKGROUND: Engaged employees are paramount to the success of an organization. They are more invested in their organization and the unit on which they work. This investment in the organization results in higher patient satisfaction and safety, less staff turnover, and improved quality. According to the literature, generational differences may be necessary to consider when improving employee engagement. To successfully lead a multigenerational workforce, nurse leaders should consider these differences and incorporate them into their strategic plan for employee engagement.

METHODS: A pilot survey was conducted on a medical-surgical unit to assess a perceived lack of engagement. Subsequently, work engagement …

The Lived Experiences Of African American Nurses In South Carolina Emergency Rooms, Debra A. Dixon

Walden Dissertations and Doctoral Studies

The underrepresentation of African American (AA) nurses in South Carolina (SC) emergency rooms (ERs) may affect quality patient care for AAs and all other patients in culturally diverse populations. This qualitative interpretive (hermeneutic) phenomenological study explored the lived experiences of AA nurses in several SC ERs concerning quality patient care in culturally diverse populations. Herzberg's two-factor theory and Maslow's hierarchy of needs theory framed the study. The research question investigated the lived experiences of AA ER nurses in SC ERs concerning quality patient care in culturally diverse populations. Interpretive phenomenology was used to gain insight from a sample of 17 …

Diabetes Management And Self-Perception Of Health Among Adults In The United States, Moses Ajoku

Walden Dissertations and Doctoral Studies

The burden and complications of diabetes have been a public health concern and societal challenge for decades, and the rate of prevalence is projected to increase in the future. The study aims to examine the association between blood glucose monitoring, glycated hemoglobin test, and self-perceived health status among diabetic adults in the United States. Guided by the chronic care model, the study used data from the 2019 Behavioral Risk Factor Surveillance System to investigate diabetes management practices among diabetic adults in the United States. Quantitative and cross-sectional methods were used to assess the associations between diabetes management practices and self-perceived …

Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink

Walden Dissertations and Doctoral Studies

AbstractThe influenza virus is one of the most commonly occurring respiratory viral infections in the world. The outer capsule of the virus contains 18H proteins and 11N proteins, which allows the virus to reform in over 100 different strands and outperform the vaccine. Despite efforts to improve access to care and reduce vaccine inequities; the Center for Disease Control and Prevention estimates 9-45 million documented influenza-related illnesses, 140,000 to 810,000 hospitalization, and 64,000 deaths yearly. The purpose of this study is to investigate whether food insecurity, access to care and other social determinants of health such as age, race, and …

Repair Of Vesicouterine Fistula By Not Using Traditional O' Connor Method, Lubna Razzak, Raheela Mohsin Rizvi

Department of Obstetrics & Gynaecology

A 25-year-old female patient visited our clinic with complaint of cyclic haematuria. She had previous two Caesarean Sections at a secondary care hospital. Her complete urinalysis showed abundant red blood cells. Through computed tomography a fistula tract between the posterior wall of the bladder and the anterior wall of the lower uterine segment was diagnosed. The Cystoscopy revealed a fistulous opening with a diameter of nearly 1.5 cm localized between the bladder and uterine cavity. Fistulae was repaired by abdominal approach without transection of bladder. Surgery was performed by mobilization of bladder and wide anterior uterine dissection. A 2cm defect …

Reflections On The Bgj Anti-Racism Seminar, Michelle Billies

Publications and Research

In this Letter to the Editor, Billies (2021) responds to critical and supportive opinion pieces in the British Gestalt Journal (BGJ) following their plenary presentation at BGJ’s 2018 annual seminar (see Asherson Bartram, 2019; O’Malley, 2019). As author of the companion article "How/ Can Gestalt Therapy Promote Liberation from Anti-Black Racism?” (Billies, 2021), Billies, who identifies as white, discusses the intent at the seminar to support white people to increase accountability and reduce harm in dialogue with people of color, while supporting the work and needs of people of color on their terms from a Gestalt perspective. Describing a fishbowl …

Same-Day Referral Of Patients With Elevated Preoperative Blood Pressure To Primary Care Providers, Shaunte Butler

Yale Medicine Thesis Digital Library

SAME-DAY REFERRAL OF PATIENTS WITH ELEVATED PREOPERATIVE BLOOD PRESSURE TO PRIMARY CARE PROVIDERSShaunte Butler, Natalie Holt, Feng Dai, Catherine Quick, Jeffrey D. Kravetz, Albert Perrino Jr., Robert B. Schonberger. Department of Anesthesiology, Yale University, School of Medicine, New Haven, CT.

Although recent studies show that elevated blood pressures as measured during the preoperative evaluation are often predictive of true hypertension, it is not yet known what interventions during the preoperative evaluation may result in modifications of longitudinal blood pressure trajectories. We herein report the results of a quality improvement project at a preoperative evaluation clinic that aimed to improve hypertension …

Associations Between Cardiac Manifestations Of Noonan Syndrome And Adverse Pregnancy Outcomes, Christopher Chow-Parmer

Yale Medicine Thesis Digital Library

ASSOCIATIONS BETWEEN CARDIAC MANIFESTATIONS OF NOONAN SYNDROME AND ADVERSE PREGNANCY OUTCOMESChristopher Chow, Katherine Campbell, and Robert Elder Yale University School of Medicine, New Haven, CT The goal of this study was to characterize a population of woman with Noonan syndrome who had been pregnant in order to determine the safety and feasibility of pregnancy. We performed a retrospective chart review of patients evaluated at Yale-New Haven Hospital from 2012-2020 with a diagnosis of Noonan syndrome and pregnancy. We identified 5 women with Noonan syndrome who had a total of 10 pregnancies. In terms of maternal cardiac disease, 3/5 patients had …

Preauthorizations In Orthopaedic Surgery: An Analysis Of A Single Institution’S Spine Center, Kareem Jamal Kebaish

Yale Medicine Thesis Digital Library

Introduction

Preauthorizations are frequently required by commercial insurers before patients can undergo magnetic resonance imaging (MRI) of the spine. In addition to the administrative burden, such processes can lead to delays in care. The current study assessed the rates and eventual disposition of preauthorizations required prior to spine MRIs ordered from an academic spine center.

Methods

Patients from a single academic institution’s spine center who were covered by commercial insurance and referred for a spine MRI between January 2013 and December 2019 were included in the analysis. The requirement for preauthorization and eventual disposition of each of these studies was …

Temporal And Geographic Trends Analysis Of American Academy Of Ophthalmology Political Action Committee (Ophthpac), Jun Hui Lee

Yale Medicine Thesis Digital Library

The purpose of study was to examine the trends in both the incoming donations from American Academy of Ophthalmology members and outgoing political contributions to U.S. House of Representative candidates by OPHTHPAC. This retrospective, observational analysis included all of OPHTHPAC’s large donations and campaign contributions between 1989 and 2018. Data on U.S. congress members were combined with the financial records to tabulate the results of campaigns that received OPHTHPAC contribution. Ordinary linear regression was used to assess temporal trends in the amount and number of financial transactions as well as the election results and political characteristics of candidates. The donations …

Somatic Gja4 Mutation In Vascular Malformations Reveals A Novel Pathway For Vascular Neoplasia, Nelson C. Ugwu

Yale Medicine Thesis Digital Library

The term “cavernous hemangioma” has been used to describe vascular anomalies with histology featuring dilated vascular spaces, vessel walls consisting mainly of fibrous stromal bands lined by a single layer of flattened endothelial cells, and a variably irregular outer rim of interrupted smooth muscle cells. Hepatic hemangiomas (HH) and cutaneous venous malformations (cVM) share this histologic pattern, and we examined lesions in both tissues to identify genetic drivers. Paired WES of lesional tissue and normal liver in HH subjects revealed a recurrent GJA4 c.121G>T, p.Gly41Cys somatic mutation in four of five unrelated cases, and targeted sequencing in paired tissue …

Challenges During Colonoscopy In Women With A Prior Hysterectomy, Lubna Kamani, Nazish Butt, Hanisha Khemani

Section of Gastroenterology

No abstract provided.