Medicine and Health Sciences Commons^™

Utilization Of The Lempert Maneuver For Benign Paroxysmal Positional Vertigo In The Emergency Department., Vanessa Hwu, Arielle Burris, Jessica R Pavolko, Daniel Sawyer Pt, Dpt, Marna R. Greenberg Do, Mph, Facep, David B. Burmeister Do, Facep, Cpe

Department of Emergency Medicine

Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. Symptoms from BPPV lead to Emergency Department (ED) visits, and persistence of symptoms, particularly in the elderly, may impact patient disposition. We describe the techniques used in the case of a 72-year-old male with dizziness, who had symptom resolution, and was able to be safely discharged after a Lempert maneuver (barbeque (BBQ) roll) was performed in the ED setting. The patient presented to the ED with left gaze nystagmus, and otherwise normal evaluation results. Physical therapy was consulted, and their initial evaluation indicated right horizontal canalithiasis noted by fatiguing …

Oral Healthcare Education, Equity And Policy Implementation In Rural Honduran Communities, Alexander J.R. Dyke

Honors Projects

Rural Honduras encompasses many individuals with limited access to a dental professional. Many public health studies demonstrate that dental shortage areas have more dental cavities, missing teeth, and more complex restorations that need periodic treatment. Dental hygiene is undermined at home with limited access to oral health advocates, and dental education becomes more essential. Here, we report an educational consensus and perspectives of rural Honduras through a questionnaire distributed at 13 mobile dental clinics in remote villages. To assess the effectiveness of education, the World Health Organization (WHO) has deemed two important indices in assessing trends: Community Periodontal Index of …

Exploration Of The Healthcare Conditions In The Occupied Palestinian Territories, Awatef Ayesh

Honors Projects

The occupation of Palestine by Israel has had a significant impact on the Palestinian citizens' health care services. The disparities were seen in maternal, infant, and child mortality rates, life expectancy, and measures of mental wellbeing. The health disparities are due to many factors involving economic conditions, food insecurity, environmental exposures, psychological trauma and stress, and access to health services most of which are directly or indirectly linked to the Israeli military occupation of the occupied Palestinian territories (oPt). This project explores the health indicators and examine the social determinants of health in the oPt that may be responsible for …

Early Il-17a Production Helps Establish Mycobacterium Intracellulare Infection In Mice, Bock-Gie Jung, Buka Samten, Kristen Dean, Richard J. Wallace, Jr., Barbara A. Brown-Elliott, Torry Tucker, Steven Idell, Julie V. Philley, Ramakrishna Vankayalapati

School of Medicine Faculty Publications and Presentations

Nontuberculous mycobacteria (NTM) infection is common in patients with structural lung damage. To address how NTM infection is established and causes lung damage, we established an NTM mouse model by intranasal inoculation of clinical isolates of M. intracellulare. During the 39-week course of infection, the bacteria persistently grew in the lung and caused progressive granulomatous and fibrotic lung damage with mortality exceeding 50%. Lung neutrophils were significantly increased at 1 week postinfection, reduced at 2 weeks postinfection and increased again at 39 weeks postinfection. IL-17A was increased in the lungs at 1–2 weeks of infection and reduced at 3 weeks …

Variations In Antibody Response To Aspergillus Fumigatus Inhalation In Mice, Andrea Wells

Student Academic Conference

Studies have configured immunological responses to Aspergillus fumigatus in mice, leading to advanced understandings. However, the comparisons of the immune responses between juvenile (younger than 6 weeks) male and female C57BL/6J mice after A. fumigatus exposure, remains uninvestigated. In this study, we intranasally inoculated 3 week old male and female mice with Aspergillus fumigatus spores dilution of 2 106spores per 40 l. They were exposed to the allergen once a week for 8 consecutive weeks and euthanized on day 28 post the last inoculation. As compared to our last report, we increased the sample size for each group in this …

Psycho-Emotional Education For Occupational Therapists Supporting Individuals Assuming The Role Of Family-Caregiver For People With A Traumatic Brain Injury (Tbi), Laura Dawn Lippman, Caitlyn E. Baird, Natalie L. Billharz

2022 Celebration of Scholarly Works

The purpose of this research was to identify the psycho-emotional needs of family-caregivers of individuals who sustained a traumatic brain injury (TBI), and measure if there was a change in knowledge among occupational therapists, and occupational therapy students following a two-hour seminar covering topics identified in the literature. The topics covered in the seminar included the concept of ambiguous loss, the importance of validating emotions, the caregiver grieving process, and the importance of providing caregiver resources. To measure the change in knowledge, researchers utilized primarily a quantitative research design using pre- and post-test questionnaires with Likert- scale questions. The questionnaire …

Oxygen Deprivation Masks For Training, Brittany M. Hanlon

Student Publications

Oxygen deprivation masks are being advertised towards athletes as a piece of fitness equipment that can simulate the effects of high altitude, as well as a respiratory muscle training device. Studies that investigated the claims as to whether ODMs increased VO2max and improved endurance were looked into. Experimental data did not find that the use of these masks increased VO2max, nor was there any supporting data to prove that it improved endurance. The function of ODMs as a training tool to increase respiratory muscle strength was also examined. There were contradicting results between the three different studies examined. One study …

Preventing Failure To Rescue: Implementation Of An Early Warning Score System, Caitlyn Holloway Msn Rn Ccrn-Cmc Pccn Tcrn

Doctor of Nursing Practice Projects

Background: Hospitalized patients are at inherent risk of complications and further clinical deterioration, even in the presence of advanced medical interventions and expert caregivers, with the most significant risk being failure to rescue. Early Warning Score (EWS) systems allow for earlier, more effective identification of clinical deterioration than traditional medical emergency team (MET) systems and provide an opportunity to reduce failure to rescue events and improve patient outcomes.

Objective: The purpose of this quality improvement project was to implement an EWS system that allowed bedside caregivers to improve patient outcomes through reduction of failure to rescue events and improvement of …

Mental Health First Aid (Mhfa): Implementing An Evidence-Based Practice Change Initiative In A School Setting, Kate Wachutka Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: School-aged children with unidentified mental illnesses experience poor health outcomes and increased medical costs. Successful management of this public health threat requires a collaborative community approach with a focus on enhancing adults’ mental health literacy (MHL) to improve outcomes.

Objectives: The objectives of this project were to implement an evidence-based mental health education (utilizing MHFA) and sustainment program within a school setting for staff and parents supervising children to optimize the adults' MHL over a three month period.

Methods: A pretest-posttest design was used. Participants were recruited from a school in the Western United States. Inclusion criteria consisted of: …

Implementation Of A Transitional Care Model To Decrease Readmissions For Ischemic Stroke And Tia Patients, Sarah Baskind Msn, Fnp-Bc, Cnrn, Scrn

Doctor of Nursing Practice Projects

Background: Poor continuity of care after hospitalization can increase the risk of adverse health outcomes such as unplanned readmissions for stroke and transient ischemic attack (TIA) patients. Transitional care models (TCMs) can be used to improve the coordination of care post-discharge.

Objectives: The purpose of this doctoral Quality Improvement (QI) project was to develop, implement, and evaluate a TCM for ischemic stroke/TIA patients over a 3-month period. This project had four aims: 1) to decrease the unplanned 30-day readmission rate, 2) for all eligible patients to be enrolled after discharge, 3) to have all enrolled participants receive all components, and …

Implementing Sskin Bundle For Pressure Ulcer Prevention In Long-Term Care Facility, Funmilayo Oni

Doctor of Nursing Practice Projects

Background: Pressure ulcers are a major challenge in long-term care (LTC) facilities. Adult patients in LTC setting are at risk for developing pressure ulcers due to chronic medical conditions and comorbidities. Preventing the onset of these wounds is more cost-effective than treating pressure ulcers.

AIM/Objectives: The primary objective was to decrease the number of pressure ulcers by 50% within a three-month period. Secondary objectives were to achieve 100% compliance with completion of mandatory staff education, score on the posttest questionnaire, and compliance with mandatory staff documentation as instructed by the SSKIN protocol.

Methods: This DNP Project used a pretest and …

Antibiotic Stewardship For Asymptomatic Bacteriuria In Older Adults Residing In Long-Term Care At End-Of-Life, Kimberly Madison Agpcnp-Bc

Doctor of Nursing Practice Projects

Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in older adults is challenging due to their atypical presentation. There is a critical gap in practice to adhere to clinical guidelines advising against treating ASB with antibiotics.

Objectives: The purpose of this Quality Improvement project was to implement an antibiotic stewardship program at a hospice organization to standardize judicious use of antibiotics at the end-of-life. The outcome measures were designed to evaluate clinician knowledge, prescribing policies and practice changes, the completeness of documentation, the appropriate usage of antibiotics, and clinician antibiotic use attitudes and beliefs.

Methods: Hospice clinicians …

Structured Type 2 Diabetes Education To Improve Self-Monitoring Blood Glucose, Self-Care Management, And Diabetes Knowledge In A Multicultural Family Practice Clinic, Deedee Foster Fnp-C

Doctor of Nursing Practice Projects

Background: The family practice providers at the family medicine residency clinic (FMRC) have neither sufficient time nor continuity of care to provide diabetes education to effectively reduce A1c levels. The FMRC has 500 multicultural type 2 diabetes patients with an A1c >7% that has increased by 23.2% in the previous five months. Multiple studies have demonstrated that structured diabetes education can significantly decrease blood glucose readings, improve self-care management, and diabetes knowledge to attain optimal glycemic control.

Objectives: To implement an evidence-based practice (EBP) project in the FMRC to improve participants blood glucose readings, self-care management, and diabetes knowledge.

Methods: …

Effect Of A Web-Based Educational Intervention In Improving Depression Knowledge And Help-Seeking Behaviour In Women, Chibuzo Efuribe Rn Msn Fnp-Bc

Doctor of Nursing Practice Projects

Background: Depression is of global concern and one of the leading causes of disability in the United States. Based on a needs assessment conducted in a faith-based organization, we noticed a gap in depression knowledge, an unwillingness to seek help, and a lack of open dialogue among the women. Studies have shown that low depression literacy impedes early recognition, prevention, and willingness to seek help (Brijnath et al., 2016; Reavley et al., 2014).

Aims: This study aimed to evaluate the effects of web-based educational intervention in improving depression knowledge and help-seeking behavior among women in a faith-based organization.

Methods: Using …

Program Evaluation Of Leader Rounding In Emergency And Trauma, Allen Fasnach Msn, Rn

Doctor of Nursing Practice Projects

Background: Patient satisfaction scores are an area of priority for hospitals throughout the United States because of their association with quality outcomes for the patients (Davenport, O'Connor, Szychowski, Landry, & Hernandez, 2017). This healthcare organization implemented the practice of nurse leader rounding over the last five years with the goal of leaders rounding on 75% or greater of the units' populations without any organizational sustainment or achievement of upper decile patient satisfaction scores.

Aims: The aim of this project was to utilize the Centers for Disease Control Framework for a Program Evaluation to evaluate the redesigned leadership rounding program for …

Effectiveness Of Provider Education To Improve Screening, Diagnosis, And Management Of Postpartum Depression, Gina M. Tytula

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) effects approximately 15% of new mothers after the birth of their child which results in feelings of anger, fear and being overwhelmed. In the practice setting for this project there were low rates of PPD screening, leading to missed diagnoses and inadequate management of PPD.

Purpose: The purpose of this project was to implement and evaluate the effectiveness of an education program to increase providers’ perceived knowledge and improve screening, diagnosis and management of PPD for a multicultural patient population at an urban obstetrics practice.

Methods: This pre-post design project evaluated the effectiveness of an educational …

Evaluating Telehealth As A Means Of Communicating With Living Donors And Its Effect On Quality Of Care, Ashley Anne Hamby Rn Msn

Doctor of Nursing Practice Projects

Background: Despite the advantages of living donor kidney transplantation (LDKT), there are barriers that potential donors face that make living donation less appealing. Research supports the use of telehealth as an effective method of enhancing access to care and building efficiencies.

Aims/Objectives: To evaluate access to care, effectiveness, financial impact, and experience after implementing telehealth as a means of communicating with living donors.

Methods: Utilizing a pretest-posttest design, an analysis was performed among medically cleared donors evaluated in-person between January 1, 2019 to December 31, 2019 (Control Group; N=64) and donors evaluated via telehealth (Zoom®) between January 1, 2021 to …

Implicit Bias Training: Improving Racial/Ethnic Disparities In Maternal Care, Marilyn Mapp

Doctor of Nursing Practice Projects

Background: Racial and ethnic disparities persist in the United States leading to adverse maternal outcomes. Nationally, the maternal mortality rates in black women are two to three times higher than white women. Implementing implicit bias training, recommended by the Council on Patient Safety in Women’s Health, is a key intervention that may help to reduce these disparities.

Objectives: This quasi-experimental/mixed methods project evaluated the effectiveness of training on implicit bias to increase awareness of implicit bias among a convenience sample of registered nurses in labor and delivery and postpartum units at two community hospitals.

Methods: Quantitative data was analyzed with …

Ventilator-Associated Pneumonia Bundle Compliance: A Quality Improvement Project, Keesha L. Holmes Msn, Fnp, Ne-Bc

Doctor of Nursing Practice Projects

Background: In many hospitals, patients requiring mechanical ventilation are managed in an intensive care unit (ICU) or a unit that requires a higher level of care compared to a medical-surgical unit. Patients on mechanical ventilation are susceptible to acquiring ventilator-associated pneumonia (VAP) if precautionary measures are not taken.

Aims/Objectives: The purpose of this quality improvement project was to assess if after an identified group of critical care registered nurses (RN) participated in an education session on ventilator-associated pneumonia and ventilator-care bundle (VCB) interventions, would their knowledge be enhanced, would the RNs implement the knowledge learned into their practice, and if …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …

The Effect Of Scan And Patient Parameters On The Diagnostic Performance Of Ai For Detecting Coronary Stenosis On Coronary Ct Angiography, Rebecca Jonas, Emil Barkovich, Andrew D Choi, William F Griffin, Joanna Riess, Hugo Marques, Hyuk-Jae Chang, Jung Hyun Choi, Joon-Hyung Doh, Ae-Young Her, Bon-Kwon Koo, Chang-Wook Nam, Hyung-Bok Park, Sang-Hoon Shin, Jason Cole, Alessia Gimelli, Muhammad Akram Khan, Bin Lu, Yang Gao, Faisal Nabi, Ryo Nakazato, U Joseph Schoepf, Roel S Driessen, Michiel J Bom, Randall C Thompson, James J Jang, Michael Ridner, Chris Rowan, Erick Avelar, Philippe Généreux, Paul Knaapen, Guus A De Waard, Gianluca Pontone, Daniele Andreini, Marco Guglielmo, Mouaz H Al-Mallah, Robert S Jennings, Tami R Crabtree, James P Earls

Division of Internal Medicine Faculty Papers & Presentations

Objectives: To determine whether coronary computed tomography angiography (CCTA) scanning, scan preparation, contrast, and patient based parameters influence the diagnostic performance of an artificial intelligence (AI) based analysis software for identifying coronary lesions with ≥50% stenosis.

Background: CCTA is a noninvasive imaging modality that provides diagnostic and prognostic benefit to patients with coronary artery disease (CAD). The use of AI enabled quantitative CCTA (AI-QCT) analysis software enhances our diagnostic and prognostic ability, however, it is currently unclear whether software performance is influenced by CCTA scanning parameters.

Methods: CCTA and quantitative coronary CT (QCT) data from 303 stable patients (64 ± …

Staff Matters: Attracting Qualified Candidates, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

In the current competitive job market, dental practices face challenges in recruiting qualified staff. This Staff Matters column explores strategies to stand out and attract candidates, addressing the impact of the "great resignation" and the projected growth in dental openings. Suggestions include offering part-time positions for increased flexibility, considering evening appointments, providing additional benefits like childcare support, attending to the practice's image through positive online reviews and marketing, and building a future workforce through partnerships with educational institutions.

J Mich Dent Assoc April 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this April 2022 issue, the reader will find the following original content:

• A cover feature “Protect Your Patients and Yourself: The Complete and Honest Medical History”
• A feature article “The Foundation for Dental Care: The Patient Interview and Dental/Medical Health History”
• A 10-Minute EBD “The Preferred Analgesia for Orthodontic Tooth Movement: Acetaminophen or NSAIDs?”
• News you need: an Editorial, a "Reminder about Antitrust Law", and regular department articles, …

Novel Tool Used For Measuring Team Resilience Among Caregivers In A Hospital Setting: Resilient Team Traits Identified, Tiara Benson, Ma Fe Chase, Amanda Miles

Articles, Abstracts, and Reports

No abstract provided.

A Word From The Writing Team (April 2022), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Upcoming Workshop
• News from the OPWPC
• Quick Reminder

Mental Health Mobile Apps And The Need To Update Federal Regulations To Protect Users, Kewa Jiang

Michigan Technology Law Review

With greater societal emphasis on the need for better mental health services coupled with COVID-19 limits, mental health mobile applications have significantly risen in variety, availability, and accessibility. As more consumers use mental health mobile applications, more data is generated and collected by mobile application companies. However, consumers may have the false assumption that the data collected is protected under HIPAA or have an expectation of privacy protection higher than current regulations afford. This Note examines HIPAA, Health Breach Notification Rule, and section 5 of the Federal Trade Commission Act, as well as how these regulations fall short of protecting …

Targeting Squalene Epoxidase Interrupts Homologous Recombination Via The Er Stress Response And Promotes Radiotherapy Efficacy, Zhipeng Hong, Tao Liu, Lingfeng Wan, Pengyan Fa, Pankaj Kumar, Yanan Cao, Chandra Bhushan Prasad, Zhaojun Qiu, Joseph Liu, Hongbing Wang, Zaibo Li, Qi-En Wang, Peixuan Guo, Deliang Guo, Ayse S. Yilmaz, Lanchun Lu, Ioanna Papandreou, Naduparambil K. Jacob, Chunhong Yan, Qing-Bai She

Pharmacology and Nutritional Sciences Faculty Publications

Over 50% of all patients with cancer are treated with radiotherapy. However, radiotherapy is often insufficient as a monotherapy and requires a nontoxic radiosensitizer. Squalene epoxidase (SQLE) controls cholesterol biosynthesis by converting squalene to 2,3-oxidosqualene. Given that SQLE is frequently overexpressed in human cancer, this study investigated the importance of SQLE in breast cancer and non–small cell lung cancer (NSCLC), two cancers often treated with radiotherapy. SQLE-positive IHC staining was observed in 68% of breast cancer and 56% of NSCLC specimens versus 15% and 25% in normal breast and lung tissue, respectively. Importantly, SQLE expression was an independent predictor of …

Rates Of Physical Abuse Screening And Detection In Infants With Brief Resolved Unexplained Events (Brues), Angela Doswell, James Anderst, Joel Tieder, Henry T. Puls, Brue Research And Quality Improvement Network

Presentations

Background: “Apparent Life-Threatening Events” (ALTEs) have been associated with child physical abuse (CPA). In 2016, “Brief Resolved Unexplained Event” (BRUE) and the development of its clinical guidelines and risk-stratification replaced ALTE. However, it is unknown if there is a similar association between BRUEs and CPA. Hypothesis/Objectives: To determine the rate of CPA in infants presenting with a BRUE, examine differences between infants with and without CPA, and to examine rates of diagnostic testing used to detect CPA. Methods: This study was part of the BRUE Research and Quality Improvement Network, composed of 15 hospitals. Subjects were infants presenting with BRUE …

Patient Attitudes, Perceptions, Knowledge, And Beliefs Regarding Immigration Status In The Healthcare Setting, Anik Patel

Presentations

No abstract provided.

Rare Variants In Renal Developmental Genes And The Risk Of Hypertension And Ckd: A Uk Biobank Study, Benjamin Spector, Byunggil Yoo, Neil Miller, Laurel K. Willig

Posters

Background: Prior studies show chronic kidney disease (CKD) is heritable but only a few common variants have been associated with CKD and kidney dysfunction. Much of CKD heritability remains unknown and limited studies have explored the role of rare genetic variants in this missing heritability. Objectives: Identify rare genetic variants in renal developmental genes associated with hypertension and CKD. Methods: We examined the association between rare variants in 58 candidate genes from five renal developmental compartments and presence of CKD and elevated blood pressure (BP) in 49,989 individuals using whole exome sequencing and phenotypic data from the UK Biobank. Criteria …