Medicine and Health Sciences Commons^™

Development Of A Care Management Program Within An Urban Health Center, April M. Butler

Masters Projects

Abstract

Care management (CM) services offered in primary care settings are used to increase patient engagement in self-care and improve communication between patients and health care providers. The aim of this article is to describe the creation of an evidenced-based toolkit within an urban health center that addresses the structures, processes, and outcome measures necessary for the development of a sustainable CM program. Based on the findings from an organizational assessment and comprehensive literature synthesis, several policies, procedures, and workflow diagrams of processes within the health center were created to guide the implementation of a CM program.

Collaboration Networks Of The Implementation Science Centers For Cancer Control: A Social Network Analysis, Rebekah R Jacob, Ariella R Korn, Grace C Huang, Douglas Easterling, Daniel A Gundersen, Shoba Ramanadhan, Thuy Vu, Heather Angier, Ross C Brownson, Debra Haire-Joshu, April Y Oh, Robert Schnoll

2020-Current year OA Pubs

BACKGROUND: Multi-center research initiatives offer opportunities to develop and strengthen connections among researchers. These initiatives often have goals of increased scientific collaboration which can be examined using social network analysis.

METHODS: The National Cancer Institute (NCI)-funded Implementation Science Centers in Cancer Control (ISC

RESULTS: Of the 192 invitees, 182 network members completed the survey (95%). The most prevalent roles were faculty (60%) and research staff (24%). Almost one-quarter (23%) of members reported advanced expertise in IS, 42% intermediate, and 35% beginner. Most members were female (69%) and white (79%). One-third (33%) of collaboration ties were among members from different centers. …

Neuronal Origins Of Reduced Accuracy And Biases In Economic Choices Under Sequential Offers, Weikang Shi, Sebastien Ballesta, Camillo Padoa-Schioppa

2020-Current year OA Pubs

Economic choices are characterized by a variety of biases. Understanding their origins is a long-term goal for neuroeconomics, but progress on this front has been limited. Here, we examined choice biases observed when two goods are offered sequentially. In the experiments, rhesus monkeys chose between different juices offered simultaneously or in sequence. Choices under sequential offers were less accurate (higher variability). They were also biased in favor of the second offer (order bias) and in favor of the preferred juice (preference bias). Analysis of neuronal activity recorded in the orbitofrontal cortex revealed that these phenomena emerged at different computational stages. …

Naps: A New Approach To Decrease Patient Adverse Outcomes, Ayesha Lakhani

MSN Capstone Projects

Hospitals have been short staffed, especially during the pandemic. Due to this many staff members have been overworked causing them to become stressed, exhausted, and not alert which is resulting in adverse patient outcomes (Aiken et al., 2004). One of the solutions suggested so far is nap. Nap is a low-cost solution which can help reduce the adverse outcomes of working and help promote positive patient outcomes. This benchmark study is a guide to institute naps and will provide a detailed step-by-step instruction to anyone to ensure a successful implementation of the project.

Aiken, L. H., Hwang, W., Dines, D. …

Prioritizing Sleep In The Cardiac-Surgical Patient, Ashley North

MSN Capstone Projects

Purpose: This project aimed to improve cardiac-surgical patients’ perception of sleep using earplugs and eye masks to reduce noise and light disturbances.

Implications: Sleep is imperative in the post-operative period, and many patients suffer from a lack of sleep. Earplugs and eye masks are a simple, cost-effective tool that can reduce incidences of delirium, reduce post-operative pain, and improve quality of sleep.

Methods: The Richards-Campbell Sleep Questionnaire (RCSQ) was used to survey patients’ perception of sleep pre-intervention. Information sheets were given to the patients about the eye masks and earplugs available in the room and the benefits that could from …

Telemedicine For Rheumatology Patients In Covid-19 Pandemic: Perspectives Of Patients, Muhammad Mehmood Riaz, Saad Bin Zafar Mahmood, Noreen Nasir

Section of Internal Medicine

Telemedicine use for patients with autoimmune rheumatic conditions during the pandemic mandates better characterization. We conducted a telephonic survey on patients who consulted rheumatologists remotely to determine their attitudes toward telemedicine. The study was conducted at Aga Khan University Hospital, a tertiary care hospital in Pakistan which is a lower-middle-income country. Descriptive analyses were performed. Fifty patients visited tele-rheumatology clinic, 35 (70.0%) were female with a mean (SD) age of 47.6 (18.1) years. Majority (27, 54.0%) learned about telemedicine from hospital website and outpatient clinic desk or helpline. Lack of examination was the biggest concern with teleconsultation (18, 22.2%). Most …

Driving With Low Vision: Development Of Evidence Based Practice Manual For Bioptic Drivers, Emily Rose Sonni

OTD Capstone Projects

This doctoral capstone was centered around the creation of a pre-driver training manual for novice drivers with Bioptic Telescope Systems (BTS) in preparation for behind-the-wheel training. The BTS pre-driver training manual was created with OTs at Vanderbilt Eye Institute as well as various OTS/CDRS from additional universities around the country. The manual consists of several parts including: bioptic care/hygiene, steps to become a bioptic driver in TN, how to use the bioptic, pre-driver training activities, time log form and helpful resources page. We also distributed a survey to current novice drivers (without the training manual) to get an impression of …

Facemasks: Perceptions And Use In An Ed Population During Covid-19, Vidya Eswaran, Anna Marie Chang, R. Gentry Wilkerson, Kelli N. O’Laughlin, Brian Chinnock, Stephanie A. Eucker, Brigitte M. Baumann, Nancy Anaya, Daniel G. Miller, Adrianne N. Haggins, Jesus R. Torres, Erik S. Anderson, Stephen C. Lim, Martina T. Caldwell, Ali S. Raja, Robert M. Rodriguez

School of Medicine Faculty Publications

Study objective Facemask use is associated with reduced transmission of SARS-CoV-2. Most surveys assessing perceptions and practices of mask use miss the most vulnerable racial, ethnic, and socio-economic populations. These same populations have suffered disproportionate impacts from the pandemic. The purpose of this study was to assess beliefs, access, and practices of mask wearing across 15 urban emergency department (ED) populations. Methods This was a secondary analysis of a cross-sectional study of ED patients from December 2020 to March 2021 at 15 geographically diverse, safety net EDs across the US. The primary outcome was frequency of mask use outside the …

Wellness Promotion Through Leisure Activity Among Community-Dwelling Older Adults, Gabriela Morrell-Zucker

Spring 2022 Virtual OTD Capstone Symposium

The purpose of this capstone project is to analyze the outcomes of an occupation-based wellness program which aims to address the problem of a lack of wellness promotion programs for community-dwelling older adults. Through structured programming older-adults demonstrated increased participation in leisure activities contributing to positive health and wellness. As the older adult population continues to grow, there is a need to engage community-dwelling older adult populations in wellness promotion through leisure activities. For this purpose, a quantitative approach examines the outcomes of program development from older adults' perspectives through a the CHAMPS Older Adult Physical Activity Questionnaire.

Happy And Healthy: A Positive Mental Health Program For Early Elementary School-Aged Children, Haleigh Freeman, Angela L. Blackwell, Erik Pérez

Spring 2022 Virtual OTD Capstone Symposium

Approximately 17% of children from the ages six to 17 in the U.S. have a treatable mental health disorder, however, of those children, 70% have not received appropriate mental health care to address their mental health problems (MHP) (American Academy of Family Physicians, 2019; Mental Health Foundation, 2016). The severity of MHP identified within the literature points to a distinct need for mental health promotion, prevention, and intervention to address those needs (Albuquerque et al., 2020). Specifically, the need for school-based and after-school based mental health services continues growing at alarming rates (Map, 2013). However, school systems often lack provisions …

Fostering Community Participation For Youth With Intellectual And Developmental Disabilities: An Occupation-Based Program For Caregivers, Mindy Goltiao, Kristin Domville, Pam Kasyan-Howe, Lisa Schubert

Spring 2022 Virtual OTD Capstone Symposium

Caregiver expectations influence outcomes of youth with intellectual and developmental disabilities (IDD) as they seek more independence transitioning from adolescence to adulthood. The purpose of this program development capstone project is to promote realistic expectations of caregivers of youth by improving caregiver youth relationships and facilitating activities. Strategies of current and evidence-based programs that support caregivers of youth with IDD, such as Maximizing Adolescent Post-Secondary Success and TrASDition training. The American Occupational Therapy Association Vision 2025 aligns with the program as it aims to provide caregivers equal opportunity, access to care, and expands an individual’s capacity to advocate for caregivers. …

Program To Increase Occupational Therapy Inclusion In Community Mental Health Practice, Leeanne A. Bugter-Vanloon, Pam Kasyan-Howe, Kristin Domville, Lisa Schubert

Spring 2022 Virtual OTD Capstone Symposium

Occupational therapists are qualified mental health providers, however, inadequate numbers of practitioners work in the community to treat individuals with mental health conditions. A program to advocate for the profession of occupational therapy in community-based mental health was created to increase capacity for occupational therapy practitioners in this setting. A two-hour virtual workshop was implemented to educate participants on occupational therapy's role, the barriers that limit occupational therapy inclusion, and methods to increase occupational therapy inclusion. Results indicate the virtual workshop was effective at increasing an individuals knowledge on the roles, limitations, and opportunities for occupational therapy practitioners in community …

Sexuality Based Content In An Entry- Level Occupational Therapy Curriculum: A Content Analysis, Victoria E. Ontiberos, Steven M. Gerardi, Elizabeth Deluca

Spring 2022 Virtual OTD Capstone Symposium

Sexuality is multifaceted and is developed across the lifespan. Researchers report little advancement, consistency, and knowledge regarding incorporation of sexuality into occupational therapy (OT) curricula, which supports the need for research. The purpose of this capstone project was two-fold: a) to conduct a content analysis of an entry-level OT curriculum to identify content gaps regarding addressing sexuality in practice; and b) to develop sexuality-based educational materials as a resource for the faculty for potential inclusion in future courses. The Model of Human Occupation (MOHO) is an evidenced-based model that was used in this project, in conjunction with notional sexuality educational …

Role Of Extracellular Vesicles In Glia-Neuron Intercellular Communication, Shahzad Ahmad, Rohit K Srivastava, Pratibha Singh, Ulhas P. Naik, Amit K Srivastava

Department of Medicine Faculty Papers

Cross talk between glia and neurons is crucial for a variety of biological functions, ranging from nervous system development, axonal conduction, synaptic transmission, neural circuit maturation, to homeostasis maintenance. Extracellular vesicles (EVs), which were initially described as cellular debris and were devoid of biological function, are now recognized as key components in cell-cell communication and play a critical role in glia-neuron communication. EVs transport the proteins, lipids, and nucleic acid cargo in intercellular communication, which alters target cells structurally and functionally. A better understanding of the roles of EVs in glia-neuron communication, both in physiological and pathological conditions, can aid …

Vulvovaginal Candidiasis: A Review Of The Evidence For The 2021 Centers For Disease Control And Prevention Of Sexually Transmitted Infections Treatment Guidelines., Paul Nyirjesy, Carolyn Brookhart, Gweneth Lazenby, Jane Schwebke, Jack D Sobel

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Vulvovaginal candidiasis (VVC) is a common cause of vulvovaginal itching and discharge. This article discusses the latest CDC STI Treatment Guidelines for VVC.

METHODS: A literature search of relevant topics was performed, and a team of experts was convened to discuss (1) diagnosis/testing modalities; treatment of (2) uncomplicated VVC , (3) complicated VVC, and (4) VVC caused by non-albicans yeast; (5) alternative treatment regimens; (6) susceptibility testing of yeast; Special Populations: (7) pregnancy and (8) HIV and VVC.

RESULTS: Yeast culture remains the gold standard for diagnoses. Newer molecular assays have been developed for the diagnosis of VVC and …

Daratumumab Plus Lenalidomide/Bortezomib/Dexamethasone In Black Patients With Transplant-Eligible Newly Diagnosed Multiple Myeloma In Griffin., Ajay K Nooka, Jonathan L Kaufman, Cesar Rodriguez, Andrzej Jakubowiak, Yvonne Efebera, Brandi Reeves, Tanya Wildes, Sarah A Holstein, Larry D Anderson, Ashraf Badros, Leyla Shune, Ajai Chari, Huiling Pei, Annelore Cortoos, Sharmila Patel, J Blake Bartlett, Jessica Vermeulen, Thomas S Lin, Paul G Richardson, Peter Voorhees

Oncology Articles

No abstract provided.

Sleep Deprivation And Delirium Development In The Icu, Cynthia Howell Msn Fnp-Bc, Stacy Murillo Msn Fnp-Bc, Amy Wilson Msn Fnp-Bc, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Delirium is an acute syndrome characterized by disturbances in cognition occurring in critically ill patients, particularly those over 65 in the intensive care unit (ICU). Numerous risk factors are associated with delirium development, with sleep being a modifiable factor. This review explores existing literature regarding the relationship between sleep deprivation and delirium development while evaluating the effectiveness of a sleep promotion protocol to decrease the incident of delirium in those ICU patients 65 years or older.

Method A literature review of peer-reviewed studies from PubMed and additional search engines was completed. Articles reviewed were published within the last five …

Evaluation Of Antibody Response Against G4 And G1 Eurasian Avian-Like H1n1 Strains With Ha Vaccination In Swine., Callie Jo Olson

Honors Thesis

We are investigating the use of the Huber laboratory H1N1 influenza broad-antibody response vaccine product candidates HA-111 and HA-113 against emerging swine H1N1 virus variants G1 and G4 that are circulating in China. The question is, what would happen in the event that the G1 and/or G4 viruses were to jump from swine to humans and become transmissible between humans? As a subtype of influenza A viruses, H1N1 viruses have pandemic potential due to their ability to infect a variety of hosts other than humans and acquire new gene segments from those other reservoirs. Broad-coverage influenza vaccines are of great …

Neurofibromatosis Type 1 Has A Wide Spectrum Of Growth Hormone Excess, Fady Hannah-Shmouni, Giampaolo Trivellin, Pablo Beckers, Lefkothea P Karaviti, Maya Lodish, Christina Tatsi, Adekunle M Adesina, Fotini Adamidou, Gesthimani Mintziori, Jami L Josefson, Martha Quezado, Constantine A Stratakis

Faculty, Staff and Students Publications

Overgrowth due to growth hormone (GH) excess affects approximately 10% of patients with neurofibromatosis type 1 (NF1) and optic pathway glioma (OPG). Our aim is to describe the clinical, biochemical, pathological, and genetic features of GH excess in a retrospective case series of 10 children and adults with NF1 referred to a tertiary care clinical research center. Six children (median age = 4 years, range of 3−5 years), one 14-year-old adolescent, and three adults (median age = 42 years, range of 29−52 years) were diagnosed with NF1 and GH excess. GH excess was confirmed by the failure to suppress GH …

Targeting Non-Coding Rnas To Overcome Cancer Therapy Resistance, Baoqing Chen, Mihnea P Dragomir, Chen Yang, Qiaoqiao Li, David Horst, George A Calin

Faculty, Staff and Student Publications

It is now well known that non-coding RNAs (ncRNAs), rather than protein-coding transcripts, are the preponderant RNA transcripts. NcRNAs, particularly microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), are widely appreciated as pervasive regulators of multiple cancer hallmarks such as proliferation, apoptosis, invasion, metastasis, and genomic instability. Despite recent discoveries in cancer therapy, resistance to chemotherapy, radiotherapy, targeted therapy, and immunotherapy continue to be a major setback. Recent studies have shown that ncRNAs also play a major role in resistance to different cancer therapies by rewiring essential signaling pathways. In this review, we present the intricate mechanisms through …

Closing The Loop: Automatically Identifying Abnormal Imaging Results In Scanned Documents, Akshat Kumar, Heath Goodrum, Ashley Kim, Carly Stender, Kirk Roberts, Elmer V Bernstam

Faculty, Staff and Student Publications

OBJECTIVES: Scanned documents (SDs), while common in electronic health records and potentially rich in clinically relevant information, rarely fit well with clinician workflow. Here, we identify scanned imaging reports requiring follow-up with high recall and practically useful precision.

MATERIALS AND METHODS: We focused on identifying imaging findings for 3 common causes of malpractice claims: (1) potentially malignant breast (mammography) and (2) lung (chest computed tomography [CT]) lesions and (3) long-bone fracture (X-ray) reports. We train our ClinicalBERT-based pipeline on existing typed/dictated reports classified manually or using ICD-10 codes, evaluate using a test set of manually classified SDs, and compare against …

College Of Public Heath News, Georgia Southern University

College of Public Health: News & Publications

• The Office of Advising Selects 2021-22 Outstanding Advisors
• Georgia Southern Recognizes Exemplary Donors at 2022 Gratitude Gala

Robotic Table And Serious Games For Integrative Rehabilitation In The Early Poststroke Phase: Two Case Reports, Grigore Burdea, Nam Kim, Kevin Polistico, Ashwin Kadaru, Namrata Grampurohit, Jasdeep Hundal, Simcha Pollack

Department of Occupational Therapy Faculty Papers

Background: BrightArm Compact is a new rehabilitation system for the upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with cognitively challenging serious games.

Objective: The aim of this study is to design and test a robotic rehabilitation table-based virtual rehabilitation system for functional impact of the integrative training in the early poststroke phase.

Methods: A new robotic rehabilitation table, controllers, and adaptive games were developed. The 2 participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity function (primary outcome), depression, and cognition were administered before and after …

Lenalidomide Induced Secondary Acute Lymphoblastic Leukemia In A Multiple Myeloma Patient: A Case-Report, Saqib Raza Khan, Muhammad Tariq, Sidra Malik Fayyaz, Salman Muhammad Soomar, Munira Moosajee

Section of Haematology/Oncology

Lenalidomide mechanism of action has been shown to modulate the different components of the immune system. A 68-year-old lady presented to us with severe backache and was then diagnosed with MM. Lenalidomide started as per protocol along with dexamethasone. Later, she presented with complaints of generalized weakness and her workup showed significant blast cells with Pan-B-cell markers consistent with secondary B-ALL. The reported incidence of secondary Acute Lymphocytic Leukemia is 2.3%. The development of more aggressive neoplasm in a patient with prior malignancy dictates a poor outcome and hence such patients should be enrolled in a clinical trial whenever available

Comparing An Evidence-Based Screening Tool To Standard Substance Abuse Screening Questions In Identifying Pregnant Women At Risk For Substance Abuse, Nicole Y. Romero

Doctor of Nursing Practice Scholarly Projects

The purpose of the study project was to compare a nonspecific substance screening questionnaire with a well validated, evidence-based substance screening tool designed specifically for the pregnant population Evidence has shown use of an evidence-based screening tool improves maternal and fetal outcomes and reduces the risk of missed cases, stereotyping, and stigma. This study project utilized the social learning theory model, which defines human behavior as a reciprocal, continuous interaction among cognitive, behavioral, and environmental determinants. A pilot observational study project was conducted within a focal organization in a specified women’s health clinic over a 12-week period comparing their currently …

Fumarate-Based Polymers: Oligo(Poly(Ethylene Glycol) Fumarate) And Poly(Butylene Fumarate) For Tissue Engineering Heart Valve And Bone Tissue, Christian T. Denny

Biomedical Engineering ETDs

Tissue engineering is an emerging field that came from the fields of medicine, materials science, and engineering. The foundation of tissue engineering uses a paradigm that incorporates cells, biomaterials, and exogenous factors to create living tissues for medical, pharmaceutical, and research purposes. Within the last 100 years, biomaterials have been developed to solve many medical and research problems. As biomaterials have developed throughout the years new materials have been developed to have specific properties appropriate for medical applications. Fumarate is a naturally derived molecule in the body and has been found useful for developing polyesters that can be crosslinked into …

Applying Requisite Imagination To Safeguard Electronic Health Record Transitions, Dean F Sittig, Priti Lakhani, Hardeep Singh

Faculty, Staff and Student Publications

Over the next decade, many health care organizations (HCOs) will transition from one electronic health record (EHR) to another; some forced by hospital acquisition and others by choice in search of better EHRs. Herein, we apply principles of Requisite Imagination, or the ability to imagine key aspects of the future one is planning, to offer 6 recommendations on how to proactively safeguard these transitions. First, HCOs should implement a proactive leadership structure that values communication. Second, HCOs should implement proactive risk assessment and testing processes. Third, HCOs should anticipate and reduce unwarranted variation in their EHR and clinical processes. Fourth, …

Effect Of Different Diet Methods On Body Composition And Insulin, Leptin, And Ghrelin Levels In Overweight Women, Begum Sarica, Gulbin Rudarli Nalcakan, Ece Onur

Baltic Journal of Health and Physical Activity

Introduction. This study aims to compare the effects of similar calorie-restricted intermittent overnight fasting diet (OFD) and frequent-meal diet (FMD) on body composition and insulin, leptin, and ghrelin levels in overweight women. Materials and Methods: While the FMD was administered as six mealtimes, the OFD was administered as five mealtimes and at least 12 hours overnight fasting for four weeks. Some parameters regarding the metabolic rate and fat metabo-lism (glucose, insulin, HOMA-IR, leptin, ghrelin levels), body composition, resting metabolic rate, and physical activity level were measured before and after the diet. Results: There was no sig-nificant difference in the resting …

Adaptive Coping For Covid-Related Stress, Sandra Maloy

Undergraduate Research Conference

The restrictions placed on society by the COVID- 19 pandemic for the purpose of limiting spread of the disease appear to have produced a different set of potential chronic health issues. Through lockdown and social distancing measures the general public lost access to key elements of daily life. The literature and qualitative interview data primarily support a negative association between participation in spiritual and physical activity and COVID-19 related stress. These findings are not surprising based on previous research investigating coping and other chronic stressors.

Returning What Was Lost: Reengaging And Reconnecting Students Through Community Engagement, Mackenzie Pendarvis, Danyelle Richardson

Undergraduate Research Conference

Humanistic geographers have referred to the theory of sense of place as a personal connection with place, built up over both years of residence and involvement in the community (Hay, 1988). Community engagement activities such as the SFA Stone Fort Museum’s “Esperanza’s Night Out” provided a venue for the students to belong to a place after the pandemic. Students were able to reconnect and reengage through a collaborative event with the university and the local community.