Medicine and Health Sciences Commons^™

Frequency And Magnitude Of Obstacles And Helpful Behavior Items In End-Of-Life Care As Perceived By Nurses Working In Critical Access Hospitals, Shalyn C. Larsen

Theses and Dissertations

Background: Twenty percent of Americans live in rural areas where most of their healthcare is provided in Critical Access Hospitals (CAHs). It is unknown how frequently obstacle and helpful behavior items occur in End-of-Life (EOL) care in CAHs. Objectives: To determine the frequency of occurrence scores of obstacle and helpful behavior items in providing EOL care in CAHs. To also determine which obstacles and helpful behaviors have the greatest or least impact on EOL care based on the magnitude scores. Methods: A questionnaire was sent to nurses working in 39 CAHs in the United States. Nurse participants were asked to …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students In The Solomon Islands, Lepani Waqatakirewa, Manoj Sharma, Hadi Danawi, Ambrose Roots Gali

Journal of Sustainable Social Impact

Background: After alcohol, tobacco, and caffeine, areca or betel nut is the fourth most commonly abused substance in the world. The prevalence of betel nut use in the Solomon Islands is estimated at 68% in young people. Long-term use can result in detrimental health outcomes such as oral cancers and metabolic syndrome.

Methods: The purpose of this quantitative cross-sectional study was to determine whether the constructs of social cognitive theory (SCT) can predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, self-efficacy to overcome barriers, …

Prevalence Of Bullying Behaviors Among Students From A National University In The United Arab Emirates: A Cross-Sectional Study, Fatima Al-Darmaki, Haleama Al Sabbah, Dalia Haroun

All Works

This study aims to investigate bullying behaviors among college students at one of the national universities in UAE, and also to examine the psychological characteristics of those who were exposed to, or have experienced bullying. A cross-sectional study was conducted on 839 undergraduate students at one of the national universities in the UAE. Students from all colleges participated in this study and were selected by using stratified random sampling. Participants completed a bullying survey designed for the study, in addition to three psychological measures [i.e., Aggression Questionnaire, Buss and Perry, 1992; The Primary Care Anxiety and Depression, El-Rufaie et al., …

Feasibility Of Using Electronic Health Records For Cascade Monitoring And Cost Estimates In Implementation Science Studies In The Adolescent Trials Network For Hiv/Aids Interventions, Tyra Dark, Kit N. Simpson, Sitaji Gurung, Amy L. Pennar, Marshall Chew, Sylvie Naar

Publications and Research

Background:One of the most difficult areas in the fight against HIV/AIDS is reaching out to youth aged 13 to 24 years. The proportion of youth living with HIV/AIDS on antiretroviral therapy (ART) and who are virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets.

Objective:This study aimed to assess the feasibility of obtaining key clinical indicators and monitoring treatment, viral suppression, and retention components of the youth HIV treatment cascade in Adolescent Trials Network for HIV/AIDS Interventions clinics using electronic health record (EHR) downloads and to provide baseline characteristics for the study …

Individual Trophic Niche Specialization In American Beaver (Castor Canadensis), Jimmy Taylor, Robert Francis, Scott Rush, Bronson Strickland, Guiming Wang

United States Department of Agriculture Wildlife Services: Staff Publications

The American beaver (Castor canadensis) has been described as a choosy generalist at the species/population scale, yet observational studies have shown little variation in diet among individuals. We compared isotopic values of δ¹³C or δ¹⁵N taken from hair of 32 beaver, representing seven colonies in northern Alabama, USA to determine 1) if colonies of beaver show overlap in isotopic niche width as a result of the similar use of food resources and 2) if individual trophic niche specialization occurs within colonies. Total Trophic Niche Width varied across the wetland with the widest being twice …

Ptsd Is Associated With Impaired Event Processing And Memory For Everyday Events, Barbara L Pitts, Michelle L Eisenberg, Heather R Bailey, Jeffrey M Zacks

2020-Current year OA Pubs

Current theories of posttraumatic stress disorder (PTSD) propose that memory abnormalities are central to the development and persistence of symptoms. While the most notable memory disturbances in PTSD involve memory for the trauma itself, individuals often have trouble remembering aspects of everyday life. Further, people with PTSD may have difficulty segmenting ongoing activity into discrete units, which is important for our perception and later memory of the activity. The current study investigated whether PTSD diagnosis and symptom severity predicted event segmentation and memory for everyday activities. To do so, 63 people with PTSD and 64 controls with a trauma history …

Surgical Management Of Vascular Tumors And Malformations Of The Head And Neck In Adults, Rachel A. Giese, Cristina Valero, Jatin P. Shah

School of Medicine Publications

Vascular tumors and malformations present a diagnostic and therapeutic challenge to many physicians. Because these lesions are rare, few surgeons have enough experience with them other than those practicing in tertiary vascular anomaly treatment centers. Some patients may have been misdiagnosed or mistreated during childhood and present in adult age with either recurrence or with an untreated lesion. Ideally, a multidisciplinary treatment team should be involved to discuss management with the patient including specialists in surgery, interventional radiology, pathology, hematology, genetics, and dermatology. As our understanding of the pathogenesis of these lesions grows, novel therapies are being employed which may …

Disease Severity And Response To Induction Therapy In Hispanic Patients With Antineutrophilic Cytoplasmic Autoantibody-Associated Vasculitis-Related Diffuse Alveolar Hemorrhage, Christine Loftis, Emilia C. Dulgheru, Rosa White

School of Medicine Publications

Objectives We examined the response to induction therapy of Hispanic patients with antibody-associated vasculitis (AAV)-related diffuse alveolar hemorrhage (DAH). This study aimed to determine the severity of disease at presentation and the response to induction therapy in our patient population.

Methods We retrospectively reviewed the clinical data of Hispanic patients hospitalized with antineutrophil cytoplasmic antibody (ANCA) vasculitis between October 1, 2010, and December 31, 2021. We identified 98 Hispanic patients hospitalized with AAV and 19 admitted with AAV-related DAH. The Birmingham Vasculitis Activity Score (BVAS) was obtained from all patients on presentation.

Results Based on the 2012 Revised International Chapel …

A Psychopharmacology Review Of Brexpiprazole, Nicole A. Marion

Conspectus Borealis

Brexpiprazole is an antipsychotic drug often used to help treat schizophrenia and major depressive disorder. This review paper breaks down the drugs history including what it is used for, how it is used, and how it was developed. Pharmacokinetics including administration routes, steady states, and metabolism. This review also describes pharmacodynamics, focusing on drug affinity. It will also discuss pharmacological effects pulling evidence from clinical trials. Last this review will describe the toxicology and safety of brexpiprazole.

Awareness Of Racial Disparities In Healthcare: An Analysis Of Undergraduate Science Students’ Perceptions, Liz Bleyer

Honors Scholars Collaborative Projects

General and systemic racial inequalities, including slavery, mass incarceration, and health disparities, have existed throughout the history of the United States. Recent public health issues, specifically the COVID-19 pandemic, have shed light on enduring health disparities, including the disproportionate impact on black communities and other racial minorities. A crucial first step towards a more equitable healthcare system is increasing general awareness of the presence and effects of racial disparities. Previous research has quantified and described the awareness of racial disparities in healthcare practitioners, including medical students and practicing physicians, but little research has been dedicated to understanding the perspectives of …

2022-04-24_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus/stats/coronavirus-symptoms. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated twice a week on Mondays and Thursdays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, …

Cross-Sectional Survey Regarding Marijuana Use In Pregnancy, Kathleen S. Carlson

Costas T. Lambrew Research Retreat 2022

Introduction • There is a paucity of data regarding extent and patterns of marijuana use in pregnancy. • Nausea, sleep problems, anxiety are commonly reported reasons for use (Kaarid, 2021) • Marijuana use in pregnancy is associated with increased risk for neonates of preterm delivery, NICU admission, small for gestational age, and lower 1min APGAR scores (Marchand, 2022) • Knowledge of reasons and patterns of marijuana use is important to properly counsel patients, identify patients at risk for use during pregnancy and to offer alternative therapies that are safer during pregnancy.

Social Determinants Of Care In The Mmc Cardiology Fellow’S Clinic, Bhavini Prajapati, Laura Onderko, Darcy Chandler, Sanjeev Francis

Costas T. Lambrew Research Retreat 2022

Introduction • Social determinants of health are upstream risk factors for cardiovascular disease. • Patients seen in the Cardiology Fellow’s Clinic at MMC are a diverse group that are burdened by many socioeconomic issues. • Addressing these disparities has the potential to prevent the development of other comorbidities known to increase the risk of a cardiovascular event. • The aim of this project was to identify the prevalence of these factors in the cardiology fellow’s clinic

Development Of A Codebook For A Prospective Mixed Methods Study Focusing On Experiences Of Mindfulness Intervention In Patients Undergoing Colorectal Surgery, Laura Nicolais, Rebecca Brown, Julie Fitzgibbons, Rachel Farrington

Costas T. Lambrew Research Retreat 2022

Mindfulness is a state of being present with one's thoughts without judgment • Relaxation is a technique to help achieve a state of rest (i.e., physical relaxation) and inner calm (i.e., mental relaxation). • Prior research has shown the many benefits of mindfulness and relaxation practice including improved psychological well-being, stress relief, reduced pain perception, improved sleep, relief of headaches, vomiting; all of which could prove beneficial in the postoperative phase.1 • Measuring the mental and emotional response to a mindfulness intervention in a quantitative manner can be challenging and therefore, a qualitative approach is justified.

Central Line Associated Blood Stream Infection (Clabsi) Prevention Through Designated-Nurse Peripherally Inserted Central Catheter (Picc) Line Dressing Change, Belinder Atabongafac

MSN Capstone Projects

The goal of this review is to show ways in which a nurse can have influence in the patient’s life by caring for their PICC line. The rate of hospital-acquired infections is related to the care that patients get while admitted in the hospital. All hospital acquired infections can and should be prevented. This is also true for central line associated blood stream infections (CLABSI). The care provided to a patient with a PICC line, including how their line is taken care of, decides if the line gets infected, and if the patients get an infection. When patients get a …

Comparing The Effectiveness Of Perioperative Ketorolac To Opioids: A Scoping Review, Kruze T. Vanderford Bsn, Ccrn, Srna, Abbie E. Walter Bsn, Ccrn, Srna, Anastasiya V. Woodard Bsn, Ccrn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Abstract Purpose/Background Opioids are commonly administered in the perioperative period to manage surgical pain. However, the ongoing opioid epidemic in the United States makes it necessary to evaluate other modalities of pain management that do not cause respiratory depression, nausea, vomiting and addiction. Ketorolac is a nonsteroidal anti-inflammatory drug that can manage pain safely and effectively. This scoping review examines the available literature on the effectiveness and feasibility of using ketorolac to minimize perioperative opioid use.

Methods A comprehensive literature review was performed between October 2020 and September 2021 utilizing five scholarly databases: GoogleScholar ™, PubMed, Ovid, Cochrane Library, and …

Development And Preclinical Investigation Of Physically Cross-Linked And Ph-Sensitive Polymeric Gels As Potential Vaginal Contraceptives, Ankit K. Rochani, Vivek Agrahari, Neelima Chandra, Onkar N Singh, Timothy J Mccormick, Gustavo F Doncel, Meredith R Clark, Gagan Kaushal

Department of Pharmacology and Experimental Therapeutics Faculty Papers

This study explored the development of cross-linked gels to potentially provide a physical barrier to vaginal sperm transport for contraception. Two types of gels were formulated, a physically cross-linked iota-carrageenan (Ci) phenylboronic acid functionalized hydroxylpropylmethyacrylate copolymer (PBA)-based (Ci-PBA) gel, designed to block vaginal sperm transport. The second gel was pH-shifting cross-linked Ci-polyvinyl alcohol-boric acid (Ci-PVA-BA) gel, designed to modulate its properties in forming a viscoelastic, weakly cross-linked transient network (due to Ci gelling properties) on vaginal application (at acidic pH of ~3.5-4.5) to a more elastic, densely cross-linked (due to borate-diol cross-linking) gel network at basic pH of 7-8 of …

The Impact Of The Covid-19 Pandemic On Care Delivery And Quality Of Life In Lung Cancer Surgery, Dede K. Teteh, Jovani Barajas, Betty Ferrell, Ziaoke Zhou, Loretta Erhunmwunsee, Dan J. Raz, Jae Y. Kim, Virginia Sun

Health Sciences and Kinesiology Faculty Articles

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) pandemic and associated restrictions have altered the delivery of surgical care. The purpose of this study was to explore the impact of COVID-19 on care delivery and quality of life (QOL) from the perspectives of lung cancer surgery patients, family caregivers (FCGs), and thoracic surgery teams.

Methods

Patients/FCGs enrolled in a randomized trial of a self-management intervention for lung cancer surgery preparation/recovery were invited to participate in this qualitative study. Patients/FCGs data were collected separately 1-month postdischarge. Interviews were also conducted with thoracic surgery team members. Content analysis approaches were …

Undocumented Students And Mental Health, Flor Reyes

Nonprofit and NGO Studies Student Projects

Deferred Action for Childhood Arrivals also known as DACA was first implemented in 2012 after many failed attempts to legalize the millions of undocumented people in this country. DACA was an executive order of former President Obama. This program provides temporary relief from deportation and a work permit that allows those under this program to legally work in the United States. DACA has allow many undocumented people who arrived to this country at a young age in the hopes of leading a somewhat normal life. Some of those who are protected by this program have gone to college, built their …

A Novel Nonparametric Test For Heterogeneity Detection And Assessment Of Fluid Removal Among Crrt Patients In Icu, Shaowli Kabir

Theses and Dissertations--Epidemiology and Biostatistics

Over the past decade acute kidney injury (AKI) has been occurring among 20%-50% of patients admitted to the intensive care unit (ICU) in United States. Continuous renal replacement therapy (CRRT) has become a popular treatment method among these critically ill patients. But there are multiple complications in implementing this treatment, including discrepancies in practiced and prescribed fluid removal, possibly related to the heterogeneity among these patients. With mixture modeling there have been several techniques in detecting heterogeneity with their specific limitations. In this dissertation a novel nonparametric ‘d test’ will be used to detect heterogeneity among CRRT patients in ICU. …

Heat And Sun Related Medical Concerns In Australian Led Outdoor Activities: A Three-Year Prospective Study, Lauren V. Fortington, Natassia Goode, Caroline F. Finch, Paul M. Salmon

Research outputs 2022 to 2026

Active participation in the outdoors is beneficial for health and wellbeing. However, the impact of extreme weather, particularly heat, on safe participation is causing concern for organisations who lead these activities. Local mitigation strategies and acute management of heat- and sun-related illness (HSRI) are generally well understood by researchers and medical practitioners, however, cases continue to occur so further understanding of why this happens is required. This study aimed to identify the number, nature and contributory factors of HSRI in Australian led outdoor activities in order to seek opportunities for their prevention. This study presents a descriptive analysis of contributory …

Asthma Education With Asthma Action Plan, Lois K. Sanders

MSN Capstone Projects

MSN capstone project in which pediatric asthma patients were given audio visits for the purpose of formulating asthma action plans.

Effectiveness Of Perioperative Ketamine Vs. Opioid Analgesia On Extubation Time And Total Perioperative Opioid Requirement, Robert H. Gray Srna, Sarah S. Hardesty Srna, Heidi E. Higginbotham Srna, Charles A. Hoyt Ii, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Purpose/Background Opioid analgesics are a primary source of pain control in the perioperative patient. However, all opioids decrease ventilatory drive secondary to mu2 receptor agonism in the brainstem. Ventilatory depression delays extubation after mechanical ventilation in post-operative patients, thus increasing the risk of complications such as ventilator-associated pneumonia and barotrauma. Non-opioid analgesics such as ketamine have been considered for use in order to reduce this risk. Ketamine is a noncompetitive N-methyl-D-aspartate receptor-antagonizing sedative that bears analgesic properties while preserving respiratory drive. Research suggests that ketamine provides effective perioperative pain control and decreases postoperative extubation time when given alone or with …

Downward Spiral, Meghan Hickey

Akesis

There are still moments when I find myself folding inwards: sinking, spiraling, struggling. I become attacked by my own intrusive thoughts. I’ve been my own monster all along.

It took me a long time to understand that progress is never linear. And I bring that idea into my PT practice. I want my patients to understand that set backs, both mental and physical, can occur throughout the healing journey. I often tell my patients expressing anxieties and concerns to observe the way they speak to themselves. Our self talk is influenced by our subconscious mind, and it reveals our thoughts, …

Deeply Rooted, Maryam Nahidian

Akesis

I captured this photo on my first solo hike, a very memorable moment for me. I was tired and questioning why I was putting myself in this position. No one would know if I turned back, but I would. Right at that moment, I stopped looking down at my feet and looked up at this scene. “Oh wow,” I said. The trees, strong and tall, but that was not what captured my attention. It was the roots. Exposed, intricate, and vulnerable and I realized at that moment that this scene portrayed me. The journey has been an uphill climb that …

Assessing Onu Students Perspective On Sexual Health, Dakota L. Roberts

ONU Student Research Colloquium

Background: It is important for college students to understand sexual health to prevent sexually transmitted infections, help to plan future pregnancies, and support overall well-being. The American College Health Association (ACHA) has released guidelines titled “Best Practices for Sexual Health Promotion and Clinical Care in College Health Settings” as guidance for universities and services to provide. However, it is not known what students at Ohio Northern University know about sexual health and whether they are aware of or desire helpful/useful sources on campus to improve knowledge and ensure the best outcomes.

Methods: A 10-question survey was developed and designed based …

Pharmacists Provision Of Non-Dispensing Services In Health Professional Shortage Areas, Haley L. Kessinger, Emily R. Landis

ONU Student Research Colloquium

Background: Individuals living in primary care health professional shortage areas (PCHPSAs) experience health inequities. Community pharmacists are healthcare professionals with an opportunity to provide care to underserved populations. The objective of this study was to compare non-dispensing services provided by Ohio community pharmacists in PCHPSAs and non-PCHSPAs.

Methods: An electronic, IRB-approved 19-item survey was sent to all community pharmacists practicing in full PCHPSA counties and a random sample practicing in non-PCHPSA counties in Ohio (n=324). Questions assessed current provision of non-dispensing services as well as interest and barriers regarding such services.

Results: Seventy-three usable responses were received (23% response rate). …

Checklist Based Vap Bundle, Molly Van Gorp

ONU Student Research Colloquium

Problem: Ventilator Associated Pneumonia (VAP) is the leading cause of death of all hospital acquired infections. VAP bundles have been researched and utilized throughout hospitals. However, there is a gap that exists between physical practice and knowledge.

Purpose: This proposed study aims to implement a checklist based VAP Bundle into the ICU to increase nurse adherence to bundle and thereby decrease rates of VAP.

Methods: This project is a three phase quasi-experimental research design taking place in an ICU. The first phase is a retrospective data collection over five months. The second phase will take place over two months. This …

Quality Improvement Initiative To Improve Door To Needle Time In Acute Stroke Patients, Lauren N. Trace

ONU Student Research Colloquium

Problem: A stroke is when a blockage occurs in the blood vessels to the brain or when a blood vessel bursts in the brain, creating a lack of oxygen supply to keep the brain functioning effectively. The earlier a stroke patient is treated, the better the outcomes will be. Door to needle time is the time difference between when the patient arrives to the time treatment is given.

Purpose: The purpose of this project is to determine if implementing a one call notification system can decrease door-to-needle (DTN) time.

Methods: A quasi-experimental approach will be used for this study. Five …

Ensuring Safety During Behavioral Health Emergencies In Emergency Rooms, Allison Logue

ONU Student Research Colloquium

Problem: Psychiatric patient emergencies and behavioral outbursts are increasingly present in nonmental health units. With the associated increase in complexity and acuity of mental health emergency room visits, there is an associated increase in risk that they will become agitated, posing a risk to themselves and others. The yelling, manipulating, physical outbursts, and verbal or physical threats that can be associated with this patient population increases the risk of injury for staff and patients.

Purpose: The purpose of this project is to determine if the implementation of a behavioral health/aggressive patient bundle will decrease the number of staff injuries by …