Medicine and Health Sciences Commons^™

Identification Of Veterans Experiencing Symptoms Of Mental Illness For The First Time After Covid-19 Diagnosis, Brittania Phillips

Dissertations

There has been a general increase in psychiatric symptoms since the COVID-19 pandemic began. Literature that has been published since the start of the pandemic has indicated there is an increased risk of depression, insomnia, altered mental status, new-onset psychosis, neurocognitive syndrome, and anxiety. The military veteran population is at higher risk for psychiatric illness than the general population, and should be screened accordingly. This quality improvement project was developed in collaboration with the mental health clinic at urban medical center in the Midwest to identify new symptoms of mental illness after COVID-19 diagnosis utilizing the PDSA model and descriptive …

Implementing A Depression Screening In A Pediatric Acute Care Setting For Adolescents With Type 1 Diabetes, Kelcie Marler

Dissertations

Problem: Depression among adolescents with Diabetes Mellitus type 1 (DM 1) is three times more prevalent than adolescents without chronic disease. Diagnosis of depression has been found to negatively affect the quality-of-care management, quality of life, and results in an increase in hospital admissions with hypoglycemia or hyperglycemia events.

Methods: A depression screening, the patient health questionnaire 9 (PHQ-9), a validated screening tool for use among adolescents was implemented in this quality improvement (QI) project. It was the first cycle of a plan-do-study-act (PDSA) cycle for in a pediatric ICU. Adolescents between the ages of 12 – 18, were …

A Standardized Approach To Awakening And Breathing Trials, Maureen Awuor Abongo

Dissertations

Abstract

Problem: Mechanical ventilation with sedation, are crucial co-therapies for the critically ill. Risks of both, known as Ventilator Associated Events( VAEs), can worsen outcomes. Performing Spontaneous Awakening Trials (SATs), with Spontaneous Breathing Trials(SBTs), is a targeted evidence-based strategy in reducing VAE rates. The Intensive Care Unit (ICU) lacked a coordinated approach to operationalizing SATs with SBTs.

Methods: An observational retrospective study involving a review of VAE and patient data for corresponding months in years before, and after an improvement strategy application, and making comparisons. The multimodal strategy includes filling out checklists outlining criteria for performing a SAT with …

Evaluation Of A Dirfloortime® Program For Autism Spectrum Disorder, Jennifer L. Pipitone

Dissertations

Problem. Parents with children who have neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) experience high levels of parenting stress. The prevalence of ASD is on the rise in the United States. As a result, there has been an increase in the use of treatment modalities, in effort to better understand which modalities have the most positive impact on children and their parents. DIRFloortime® is a developmental treatment modality used to help strengthen the parent-child bond and used to decrease parental-child stress. The Autism Parenting Stress Index (APSI) measures the impact of an intervention …

Transcriptomic Analysis Of Equine Chorioallantois Reveals Immune Networks And Molecular Mechanisms Involved In Nocardioform Placentitis, Hossam El-Sheikh Ali, Shavahn C. Loux, Laura Kennedy, Kirsten E. Scoggin, Pouya Dini, Carleigh E. Fedorka, Theodore S. Kalbfleisch, Alejandro Esteller-Vico, David W. Horohov, Erdal Erol, Craig N. Carter, Jackie L. Smith, Barry A. Ball

Maxwell H. Gluck Equine Research Center Faculty Publications

Nocardioform placentitis (NP) continues to result in episodic outbreaks of abortion and preterm birth in mares and remains a poorly understood disease. The objective of this study was to characterize the transcriptome of the chorioallantois (CA) of mares with NP. The CA were collected from mares with confirmed NP based upon histopathology, microbiological culture and PCR for Amycolatopsis spp. Samples were collected from the margin of the NP lesion (NPL, n = 4) and grossly normal region (NPN, n = 4). Additionally, CA samples were collected from normal postpartum mares (Control; CRL, n = 4). Transcriptome analysis identified 2892 differentially …

Professional Education To Reduce Provider Stigma Toward Harm Reduction And Pharmacotherapy, Sandra H. Sulzer, Suzanne Prevedel, Tyson Barrett, Maren Wright Voss, Cassandra Manning, Erin Fanning Madden

Extension Research

Aims: A novel professional training was developed to reduce stigma toward harm reduction and pharmacotherapy for substance use disorders.

Methods: The training was delivered over three sessions to n = 147 health professionals in Utah between 2019 and 2020, including n = 40 substance use disorder treatment professionals. Pre and post-training survey measures provided evaluation information on knowledge, attitudes, and planned action regarding harm reduction and pharmacotherapy. Items were grouped into a stigma score, and multilevel modeling, regression analyses, and McNemar tests were used to quantify changes in overall stigma toward harm reduction interventions both before and after the training. …

A Systematic Review Of The Rationale For Vaccine Hesitancy Among American Parents, Jordan Luttrell-Freeman, Timothy J. Bungum, Jennifer R. Pharr

Environmental & Global Health Faculty Research

Vaccines are one of the most successful interventions in the history of public health. They are largely responsible for the near eradication of several diseases. However, some people are vaccination averse which can lead to vaccine hesitancy. Vaccine hesitant parents are those that refuse or delay getting their children vaccinated despite the availability of vaccination services. This phenomenon often occurs despite parent’s belief that vaccines are effective. The purpose of this review was to exam available literature to identify predictors of vaccine hesitancy among parents and parental rationale for vaccine hesitancy

Distilling Professional Opinion To Gauge Vulnerability Of Guam Avifauna To Brown Treesnake Predation, Robert M. Mcelderry, Eben H. Paxton, Andre V. Nguyen, Shane R. Siers

United States Department of Agriculture Wildlife Services: Staff Publications

The avifauna of Guam was devastated by the introduction of the Brown Treesnake, and the restoration of native birds would need to address the problem with eradication or suppression of BTS. With eradication of the snake unlikely in the near term, and suppression capabilities limited to specific finite areas, key information for reintroductions is how low BTS abundance will likely need to be for each bird species to be re-established based on their vulnerability to BTS predation. Here, we estimate vulnerability, which can no longer be measured directly, so biologists who are familiar with one or more of seven Guam …

Predicting Synchronized Gene Coexpression Patterns From Fibration Symmetries In Gene Regulatory Networks In Bacteria, Ian Leifer, Mishael Sánchez‑Pérez, Cecilia Ishida, Hernán A. Makse

Publications and Research

Background: Gene regulatory networks coordinate the expression of genes across physiological states and ensure a synchronized expression of genes in cellular subsystems, critical for the coherent functioning of cells. Here we address the question whether it is possible to predict gene synchronization from network structure alone. We have recently shown that synchronized gene expression can be predicted from symmetries in the gene regulatory networks described by the concept of symmetry fibrations. We showed that symmetry fibrations partition the genes into groups called fibers based on the symmetries of their ’input trees’, the set of paths in the network through which …

A Dosimetric Comparison Using Physical And Biological Objectives On Targets And Organs At Risk, Whitnee Hallford

Masters Projects

Abstract

Introduction

The purpose of the present work was to determine if the use of biological-based objectives on target volumes and critical structures in the optimizer could produce a superior plan when compared to using only physical objectives for patients with intermediate-risk prostate cancer with insertion of SpaceOAR Hydrogel.

Methods

Three planning techniques were created and compared retrospectively for 10 different radiation therapy patients using Varian Eclipse treatment planning system utilizing volumetric modulated arc therapy (VMAT) treatment planning. Each technique used different planning objectives including dose volume (DV) objectives, target generalized equivalent uniform dose (gEUD) objectives, and a combination of …

Platelet And Erythrocyte Extravasation Across Inflamed Corneal Venules Depend On Cd18, Neutrophils, And Mast Cell Degranulation, Angie De La Cruz, Aubrey Hargrave, Sri Magadi, Justin A Courson, Paul T Landry, Wanyu Zhang, Fong W Lam, Monica A Bray, C Wayne Smith, Alan R Burns, Rolando E Rumbaut

Faculty, Staff and Student Publications

Platelet extravasation during inflammation is under-appreciated. In wild-type (WT) mice, a central corneal epithelial abrasion initiates neutrophil (PMN) and platelet extravasation from peripheral limbal venules. The same injury in mice expressing low levels of the β2-integrin, CD18 (CD18hypo mice) shows reduced platelet extravasation with PMN extravasation apparently unaffected. To better define the role of CD18 on platelet extravasation, we focused on two relevant cell types expressing CD18: PMNs and mast cells. Following corneal abrasion in WT mice, we observed not only extravasated PMNs and platelets but also extravasated erythrocytes (RBCs). Ultrastructural observations of engorged limbal venules showed platelets and RBCs …

Diagnostic Accuracy Of Machine Learning Models To Identify Congenital Heart Disease: A Meta-Analysis, Zahra Hoodbhoy, Uswa Jiwani, Saima Sattar, Rehana A. Salam, Babar Hasan, Jai K. Das

Department of Paediatrics and Child Health

Background: With the dearth of trained care providers to diagnose congenital heart disease (CHD) and a surge in machine learning (ML) models, this review aims to estimate the diagnostic accuracy of such models for detecting CHD.
Methods: A comprehensive literature search in the PubMed, CINAHL, Wiley Cochrane Library, and Web of Science databases was performed. Studies that reported the diagnostic ability of ML for the detection of CHD compared to the reference standard were included. Risk of bias assessment was performed using Quality Assessment for Diagnostic Accuracy Studies-2 tool. The sensitivity and specificity results from the studies were used to …

Prevalence And Incidence Of Possible Vascular Dementia Among Mexican Older Adults: Analysis Of The Mexican Health And Aging Study, Sara G. Yeverino-Castro, Silvia Mejia-Arango, Alberto José Mimenza-Alvarado, Carlos Cantú-Brito, José A. Avila-Funes, Sara G. Aguilar-Navarro

School of Medicine Publications

Introduction: Vascular dementia is the second most common cause of dementia. Physical disability and cognitive impairment due to stroke are conditions that considerably affect quality of life. We estimated the prevalence and incidence of possible vascular dementia (PVD) in older adults using data from the Mexican Health and Aging Study (MHAS 2012 and 2015 waves).

Methods: The MHAS is a representative longitudinal cohort study of Mexican adults aged ≥50 years. Data from 14, 893 participants from the 2012 cohort and 14,154 from the 2015 cohort were analyzed to estimate the prevalence and incidence of PVD. Self-respondents with history of stroke …

Using Debriefing For Meaningful Learning With Screen-Based Simulation, Kristina Dreifuerst, Cynthia S. Bradley, Brandon K. Johnson

College of Nursing Faculty Research and Publications

Background

COVID-19 has led to increased use of screen-based simulation. However, the importance of including a robust debriefing as a component of these simulations is often neglected.

Problem

Failing to include debriefing with screen-based simulation could negatively impact student learning outcomes.

Approach

Debriefing, including recollection, discussion to reveal understanding, feedback and reflection, is a process of helping learners make sense of learned content and knowledge as it is applied to the patient care experience. Debriefing for Meaningful Learning (DML) is an evidence-based method derived from theory, which can be easily incorporated into screen-based simulation to augment the clinical learning experience. …

Is Atrial Fibrillation A Risk Factor For Worse Outcomes In Severe Covid-19 Patients: A Single Center Retrospective Cohort, Abdulkarim Abdulrahman, Tajammul Hussain, Safraz Nawaz, Shereen Alshaikh, Abdulrahman Almadani, Fawaz Bardooli

Journal of the Saudi Heart Association

Introduction: New onset atrial fibrillation leads to worse outcomes in patients with sepsis. The association between new onset atrial fibrillation (AF) in COVID19 patients with COVID19 outcomes are lacking. This study aims to determine whether new onset atrial fibrillation in COVID19 patients admitted in the ICU is a risk factor for death or requirement of mechanical ventilation (MV) Methods: This is a retrospective study conducted in a cohort of COVID-19 patients admitted to Bahrain’s COVID-19 Field Hospital (BDF-FICU) between April 2020 to November 2020. Data were extracted from the electronic medical records. The patients who developed new onset AF during …

A Framework For Accessing Patient Big Data: Ant View Of A South African Health Facility, Sibulela Mgudlwa, Tiko Iyamu

The African Journal of Information Systems

This study was undertaken to develop a framework that can be used to guide analysis when translating and transforming big data into a more purposeful resource for healthcare service delivery in South Africa. It is intended to assist in addressing some of the challenges encountered by healthcare facilities. Qualitative data were collected, with a focus on the types of interactions that happen between actors when accessing and using patients’ big data for healthcare services. Actor-network theory (ANT) was applied as a lens in the analysis of the data, to examine the relationships between actors when accessing and using big data …

Organizational Mission Impact On Achieving Competitive Advantage In Jordanian Pharmaceutical Sector, Yaser Adwan, Ruba Al-Hamshari

Jerash for Research and Studies Journal مجلة جرش للبحوث والدراسات

The current study examined the impact of organizational mission's components, quality, research and development (R & D), customer satisfaction, and technology, on achieving a competitive advantage as measured by sales volume, market share, and net financial profit. Five public Jordanian pharmaceutical companies in Amman city were randomly selected from a population of eighteen pharmaceutical industrial companies. Out of two-hundred and fifty surveyed, one hundred and sixty-eight respondents were received with a rate of 67% responses. Different statistical procedures were conducted including analysis of variance and stepwise regression, among others. The results suggested that there was a statistically positive significant impact …

The Impact Of Switching Rrom Traditional To Digital Education On The Teacher In Light Of The Corona Pandemic - Covid 19, Majdaleen M. Alqaoud, Lina Badr

Jerash for Research and Studies Journal مجلة جرش للبحوث والدراسات

The study aimed to identify the impact of switching from traditional education to digital education concerning the corona pandemic-covid19.

The study utilized the descriptive and analytical approaches. A self-administered questionnaire was used to collect data from study's sample, the questionnaire included (20) paragraphs distributed into four dimensions (the teacher dimension, the student dimension, the curriculum dimension and the technical dimension). A stratified random sample of (345) teachers in private schools in Medina was chosen to represent the study community.

The results of the study found that all tested dimensions in this scale were highly rated, with the relative weight of …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Proactive Text Messaging For Public Health Surveillance During The Covid-19 Pandemic, Daria Kester

Dissertations

Problem

The Department of Public Health (DPH) of a suburban Midwestern county considers surveillance and control of COVID-19 to be sub-optimal, resulting in part from difficulties with completing case and contact interviews.

Methods

To increase the success rate of case investigation, proactive messaging using short message media (SMS) alerts is used in a quality improvement initiative based on the PDSA framework. Participants are sent text message alerts prior to receiving a call from a DPH case investigator. Results are recorded in a statewide database.

Results

Individuals who received text messages prior to receiving a case investigation interview phone call were …

A Telehealth Palliative Care Objective Structured Clinical Examination, Lindsey Q. Mcintyre

Dissertations

Problem: Palliative care is a service focused on symptom management and improved quality of life for persons with serious or chronic illnesses and is widely underutilized. Although advanced practice registered nurses (APRNs) possess a unique skillset to contribute to palliative care, there is minimal reporting on palliative care training for this professional group. The purpose of this clinical scholarship project was to implement the End-of-Life Nursing Education Consortium (ELNEC) online training program for APRN students in the BSN-DNP program and evaluate its effect on student performance during a telehealth objective structured clinical examination (OSCE).

Methods: An observational, descriptive …

Attitudes Toward Sars-Cov-2 In Frontline Healthcare Workers And First Responders, Michelle Tiffany Arrington

Dissertations

Problem: To date, little evidence exists to understand attitudes of SARS-CoV-2 in frontline healthcare workers (HCW) and first responders (FR), related to best practices in mitigating virus spread. The purpose of this project was to assess attitudes toward COVID-19 in young adults, ages 18-44 years old, who are frontline workers related to their adherence to PPE guidelines, social distancing, hand hygiene, community exposures, and vaccinations.

Methods: A descriptive survey design using five-point Likert scale questions and 26 open-ended questions and was implemented one-year after onset of the pandemic. A purposive sample working in a large, urban, Midwest metropolitan area was …

Mental Health Effects Of The Covid-19 Pandemic On Older Adults, Elizabeth Kerr

Dissertations

Problem: Significant psychological effects such as anxiety, depression, stress, and loneliness are shown to affect the older adult population, aged 65 years and older. The social isolation and disconnectedness related to the COVID-19 pandemic potentially worsens anxious and depressive feelings, increasing the risk for adverse outcomes in the high-risk older adult population. This project aimed to identify older adults at risk for acute, situational mental health issues associated with the pandemic.

Methods: A descriptive study design was used. Telephone interviews were conducted to explore effects of the COVID-19 pandemic on mental health responses in older adults. A convenience sample …

Youth Sports In A Pandemic Age, Robert Bohnert

Dissertations

Abstract

Problem: Youth sporting events is a public health concern as infected youth with coronavirus disease 2019 may unknowingly spread the virus, as many show little to no symptoms (Zimmerman & Nigel, 2020). This project aimed to identify level of adherence to posted Youth Sports Guidelines, which were designed to mitigate the spread of virus at youth sporting events.

Methods: An observational descriptive design was utilized. Two observers tallied guideline violations by participants and spectators at six high-contact (basketball) and six low-contact (swimming) public high school youth sporting events.

Results: A total of 726 youth sport participants and 139 …

Pattern Of Use Of Electronic Health Record (Ehr) Among The Chronically Ill: A Health Information National Trend Survey (Hints) Analysis, Rose Calixte, Sumaiya Islam, Zainab Toteh Osakwe, Argelis Rivera, Marlene Camacho-Rivera

Publications and Research

Effective patient–provider communication is a cornerstone of patient-centered care. Patient portals provide an effective method for secure communication between patients or their proxies and their health care providers. With greater acceptability of patient portals in private practices, patients have a unique opportunity to manage their health care needs. However, studies have shown that less than 50% of patients reported accessing the electronic health record (EHR) in a 12-month period. We used HINTS 5 cycle 1 and cycle 2 to assess disparities among US residents 18 and older with any chronic condition regarding the use of EHR for secure direct messaging …

Management Of Maternal Depression: Qualitative Exploration Of Perceptions Of Healthcare Professionals From A Public Tertiary Care Hospital, Karachi, Pakistan, Makkiya Jawed, Nousheen Pradhan, Rozina Mistry, Amirah Nazir, Sualeha Shekhani, Tazeen Saeed Ali

Community Health Sciences

The lack of implementation and routine screening of management techniques at tertiary care hospitals leads to an increased burden of maternal depression. The consequences are borne emotionally, physically, and mentally by the mother, the child, the overall family, and society. Hence, it is vital to contextualize this mental disorder to design and implement effective healthcare interventions. The study is aimed to assess the knowledge and practices of healthcare professionals, in a tertiary care setting, who deal with depressive symptoms amongst mothers. It gauges whether a psychological screening criterion is being implemented by the clinical staff during prenatal and postnatal visits …

Assessing Participant Feedback To Dental Screenings Provided By Dental Hygiene Students And Follow-Up Dental Hygiene Care In New York City, Susan H. Davide, Margarita Rivera

Publications and Research

Objectives: The purpose of this study was to validate the association between dental screenings and follow-up care to support the level of awareness of dental hygiene services available in the community by increasing access to care and determine patients’ knowledge of dental insurance status. Methods: A first-time dental screening was conducted, and complimentary care was provided for those who followed through with dental hygiene care at the clinic. Survey questionnaires were administered to participants following screening and clinic care. Results: Ten participants of the 50 screened received care at the clinic. Less than half of those screened (41 %) had …

Diagnostic Accuracy And Agreement Between Four Phenotypic Carbapenemase Detection Tests Among Enterobacterales, Fizza Farooqui, Seema Irfan, Sidra Laiq

Department of Pathology and Laboratory Medicine

Introduction: Carbapenem-resistant Enterobacterales (CREs) are becoming increasingly popular as a cause of hospital-acquired infections that are difficult to treat and are frequently reported as causes of outbreaks in various hospitals. Conventional culturing techniques take at least 2 days to report a case as carbapenem resistant, and it is therefore important to detect such resistance mechanisms as early as possible.
Methods: This study aimed to compare the diagnostic performance of Carba NP, modified Hodge test (MHT), ethylenediaminetetraacetic acid (EDTA) disk synergy test (DST), and the modified carbapenem inactivation method (mCIM). This study was done at Microbiology Laboratory, Aga Khan University Hospital, …

Identification Of Human Kinin-Forming Enzyme Inhibitors From Medicinal Herbs, Hassan Madkhali, Amer Tarawneh, Zulfiqar Ali, Hoang V. Le, Stephen J. Cutler Ph.D.

Faculty Publications

The goal of this study was to assess the pharmacological effects of black tea (Camellia sinensis var. assamica) water extract on human kinin-forming enzymes in vitro. Tea is a highly consumed beverage in the world. Factor XII (FXII, Hageman factor)-independent- and -dependent activation of prekallikrein to kallikrein leads to the liberation of bradykinin (BK) from high-molecular-weight kininogen (HK). The excessive BK production causes vascular endothelial and nonvascular smooth muscle cell permeability, leading to angioedema. The prevalence of angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema appears to be through BK. Both histamine and BK are potent inflammatory mediators. However, the treatments for histamine-mediated …

Relation Between A Systematic Analysis Of Spelling And Orthographic And Phonological Awareness Skills In First Grade Children, Victoria Henbest

Victoria S. Henbest Publications

As an initial step in determining whether a spelling error analysis might be useful in measuring children's linguistic knowledge, the relation between the frequency of types of scores from a spelling error analysis and children's performance on measures of phonological and orthographic pattern awareness was examined.The spellings of first-grade children with typical spoken language skills were scored using the Spelling Sensitivity System (Masterson & Apel, 2010a); words were parsed into elements based on phonemes and then assigned a score based on the linguistic skills represented in the spelling. The children also completed more traditional measures of phonological and orthographic knowledge: …