Medicine and Health Sciences Commons^™

Utilizing A Video-Based Intervention To Improve Medicine Adherence And Retention Of Hiv Care In A Hiv Clinic., Robert Currie

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

Memphis, Tennessee has higher rates of black men who have sex with men living with human immunodeficiency (BMSMLWH) compared to state and national levels. ART has been shown to be effective in keeping people living with HIV virally suppressed and unable to transmit HIV through sex. However, BMSMLWH are disproportionately affected by HIV than other races in Memphis, Tennesee. The proposed program relies on evidence-based data that demonstrates the effectiveness of video-based intervention in improving medication adherence and HIV retention of care. Taking Care of Me is a video-based intervention that promotes HIV treatment initiation, ART adherence, and retention in …

Changing Selection And Epistasis On Drivers Over Tumorigenesis In Primary And Metastatic Prostate Cancer, Alexander Yang

Yale Medicine Thesis Digital Library

Background: Many attempts have been made to characterize and describe the driver genes and mutations responsible for prostate cancer tumorigenesis. We have quantified the cancer effect size—a direct measurement of the survival advantage a mutation confers—for 2699 primary and metastatic prostate tumor samples. Our measure of cancer effect treats tumorigenesis as an evolutionary process, subject to positive and negative selective pressures. We have applied this metric in a stage-specific manner to elucidate which mutations are selected for as prostate cancer develops.Methods: We analyzed 2699 prostate cancer tumor exomes, genomes, and panel sequences (1648 primary tumors and 1051 metastatic samples). The …

Did The Political Climate Exacerbate The Pandemic In The U.S.?, Brittany T. Morin, Joanna Gyory, Anthony F. Morin

Master's Theses and Capstones

The global pandemic that began in the United States in early 2020 continues to be a topic of controversy. The added aspect of affect polarization in the country’s political realm may have exacerbated the effects of COVID-19. In their published article in Nature Human Behaviour, Gollwitzer et. al. found that it was possible to link voting partisanship, physical distancing, and COVID-19 outcomes showing that a county’s partisanship might be used to predict the degree to which that county would socially distance and then, therefore, the rate of cases and fatalities in that error on a lagged timescale. This researcher attempted …

Addressing Barriers To Colorectal Cancer Screening In A Federally Qualified Health Center: A Quality Improvement Project, Tania Centra

DNP Scholarly Projects

Abstract

Background: Colorectal cancer (CRC) is a leading cause of death from cancer in the United States, despite the availability of several high-quality screening options. Multiple barriers to CRC screening have been identified, including cost (non-insured), younger age, racial or ethnic minority, recent immigration to the U.S. (non-English speaking), fear or distrust of the healthcare system and rural residence. Addressing health equity within underserved populations requires improved access to CRC screenings per evidence-based guidelines.

Local Problem: The mean CRC screening rate for the designated Federally Qualified Health Center (FQHC) was 33.7% for the 5 months preceding this quality improvement (QI) …

Implementation Of Telehealth Clinical Nurse Leader Interventions To Reduce Rehospitalizations In Rural Home Health Patients, Briana White

DNP Scholarly Projects

Reimbursement for home-based care is moving towards a value-based purchasing (VBP) model. This change brings a renewed sense of urgency to focus efforts in care delivery to sustain positive outcomes such as reducing rehospitalizations. The Clinical Nurse Leader role has been instrumental in hospital settings in improving patient outcomes, and evidence points toward the potential success of implementation of this role in the rural microsystem setting. This quality improvement project implemented a remote telehealth intervention led by Clinical Nurse Leaders, to decrease rehospitalizations of Medicare patients assessed as at-risk for 30-day rehospitalization. The DMAIC QI model was used to ensure …

Increasing Awareness Of Personal Harm Reduction Interventions In The Clinical Setting: A Quality Improvement Project, Shawn Theberge

DNP Scholarly Projects

Abstract

The ever-rising concern for safety in the healthcare setting has become increasingly prevalent and levels of hostility and violence more publicly visible. Over the last decade both patients and clinicians have been targeted in healthcare facilities at record levels. These incidents have created an environment of not only risk but increased anxiety and feelings of uncertainty for most clinical personnel. The study will initially measure clinician’s viewpoint of the clinical setting that they work in; and over the span of the project, track and evaluate the effects of the interventions on clinicians’ overall feelings and perceptions. The expected outcome …

Increasing Rates Of Urine Albumin Creatinine Ratio Ordering By Providers In Diabetics In Adult Primary Care: A Quality Improvement Initiative, James Ehrlich

DNP Scholarly Projects

Background: The rising incidence of diabetes within the United States and worldwide has led to increased diabetes related morbidity and mortality. As the leading cause of end stage renal disease (ESRD), more attention needs to be placed on increasing rates of diabetic nephropathy screening. The vast majority of diabetics are treated in primary care, positioning primary care as a center focus for diabetes related screening and treatment.

Local problem: Low rates of diabetic nephropathy screening were noted at an academic medical center affiliated primary care clinic. A quality improvement initiative was elicited to increase the number of urine microalbumin creatine …

Implementation Of Oncology Standardized Scheduling Bundle Impacting Staff Productivity And Patient Satisfaction, Carolyn Brausch

DNP Scholarly Projects

BACKGROUND: Patients having timelyaccess to healthcare services is the entryway to quality of care and patient safety. Timely access is essential in cancer treatment and often requires complex scheduling requiring multiple, highly coordinated, time sensitive appointments. To facilitate optimal clinical care, timely appointment scheduling must be patient-centered. With the heavy scheduling workload growing at the the Cancer Network at Froedtert & the Medical College of Wisconsin and recognition of timely scheduling as a quality indicator, the need to examine the workflow and improve the process became apparent.

METHODS: The goal of the quality improvement project was to provide patients with …

Chronic Low Back Pain In Veterans And The Role Of Yoga: An Overview Of Randomized Controlled Trials, Suresh Kumar Thanneeru, Roshan Chanchlani, Pramod K. Sharma, Sudarsan Agarwal, Nalla Srinivas, M Sukumar, Amit Agrawal

Manipal Journal of Medical Sciences

Introduction One of the most debilitating diseases in elderly is the chronic low back pain (cLBP) which is most often nonspecific and involves using unrelenting medication and physical therapy. Yoga practice has been explored to treat this condition and was shown good results. This systematic review was done to emphasis the role of Yoga in management of cLBP. Objectives To evaluate the effectiveness of Yoga in pain relief and improvement in disability for veterans suffering from cLBP. Methods A systematic search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane to identify studies on usage of Yoga in the treatment of …

“Om” Chanting And Its Impact On Selected Neuropsychological Functions: A Literature Overview, Suresh Kumar Thanneeru, Roshan F. Sutar, Vijendra Singh, Anuradha Kushwah, Saikat Das, Mahendra Atlani, Madhukar Mittal, Amit Agrawal

Manipal Journal of Medical Sciences

The "OM" mantra is one of the most sacred symbols in Indian culture, and Om chanting holds emotional, spiritual, and religious significance. The domain and spectrum of the impact of "Om" chanting include delta and theta brainwaves on EEG, overall EEG activity, asthma symptom control, quality of life, brain hemodynamics, and physiological and psychological effects of "Om" chanting and singing. It also plays a role in the management of major depressive disorder (MDD). "OM" listening or chanting activates the frontal lobe and supramarginal gyrus, promoting calmness, enhancing thinking processes, and improving memory. In the present review, we selectively examine articles …

Privacy Paradox: The Impact A Health Crisis Has On Individual Views Regarding Privacy And Data Collection, Jessica B. Walsh

Honors Theses and Capstones

No abstract provided.

Knowledge Gaps: Addressing The Need For Palliative Care Education For University Nursing Students, Odin Todd Bickford

Honors Theses and Capstones

This study aimed to analyze undergraduate nursing students’ primary palliative care knowledge to determine if there is a need for further palliative care education in undergraduate, pre-licensure curriculums. To make this determination, this study utilized the Undergraduate Nursing Palliative Care Knowledge Survey (UNPCKS), created by Dr. Andra Davis and Dr. Megan Lippe, a 27-question survey that addresses the 6 domains of holistic palliative care; i) holistic, patient-centered care (Whole person care), ii) collaborative (Interprofessional), iii) understanding of primary palliative care as a resource and how to support patients/families (Advocacy and Knowledge of Primary Palliative Care), iv) the importance of understanding …

Perinatal Patient Education On Substance Use Risk Factors In The Age Of The Opioid Crisis, Rebecca Ane Leary, Alyssa O'Brien

Honors Theses and Capstones

From 2014 to 2016, NH ranked first for fentanyl and all opioid-related overdose deaths per capita in the United States (Moore et al., 2021). In 2016 the New Hampshire Department of Health and Human Services (NH DHHS) found that there are many repercussions of this opioid crisis including overdose deaths, child and elder abuse, and newborns experiencing withdrawal. In utero substance exposure places a child at a higher risk for developmental, behavioral, and physical health concerns. To address this gap, a secondary data analysis using NH Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2013 to 2020 was conducted. PRAMS …

The Phenomenon Of Integration Of Religious Practices As An Auxiliary Tool In Contemporary Medicine: Ukrainian Hospital Chapels In Modern Times, Mariia Ovchar, Yalovyk Anton, Igor Koreshchuk

Occasional Papers on Religion in Eastern Europe

The relevance of the research topic is ensured by the wide integration of such religious practices as an aid in contemporary medicine. The article describes the activities of more than 15 currently operating famous hospital chapels. The histories behind the foundation of each of them are analyzed, and the facts of public participation and the leadership of hospitals in the establishment of chapels at medical institutions are given. Special attention is paid to the characteristics of the psychological support component as an auxiliary factor along with the main course of treatment. For clarity of the descriptive part, the study presents …

Presynaptic Plasticity In A Mammalian Synapse Involves Actin Remodeling And Vesicle Recruitment, Shobana Subramanian

Yale Medicine Thesis Digital Library

Short term synaptic plasticity is required for working memory and executive functions, which become impaired in neurodegenerative diseases such as dementia. A form of short-term plasticity that can be induced by repeated stimulation of neurons is called post-tetanic potentiation (PTP). One way in which PTP occurs is through an increase in the number of vesicles at the active zone, the specialized region of the presynaptic terminal where synaptic transmission occurs. The calyx of Held is a large, rapidly firing synapse located in the auditory brainstem that is involved in sound localization. We have previously shown that the dense layer of …

International Physical Therapists Consensus On Clinical Descriptors For Diagnosing Rotator Cuff Related Shoulder Pain: A Delphi Study., Néstor Requejo-Salinas, Jeremy Lewis, Lori A Michener, Roy La Touche, Rubén Fernández-Matías, Juan Tercero-Lucas, Paula Rezende Camargo, Marcus Bateman, Filip Struyf, Jean-Sébastien Roy, Anju Jaggi, Timothy Uhl, Leanne Bisset, Craig A Wassinger, Robert Donatelli, Melina Nevoeiro Haik, Enrique Lluch-Girbés

Physical Therapy Faculty Publications

BACKGROUND: There is a lack of standardized criteria for diagnosing rotator cuff related shoulder pain (RCRSP).

OBJECTIVE: To identify the most relevant clinical descriptors for diagnosing RCRSP.

METHODS: A Delphi study was conducted through use of an international physical therapists expert panel. A 3-round Delphi survey involving an international panel of physical therapists experts with extensive clinical, teaching, and research experience was conducted. A search query was performed in Web of Science, along with a manual search, to find the experts. The first round was composed of items obtained from a previous pilot Delphi study along with new items proposed …

Efficacy Of Power Training To Improve Physical Function In Individuals Diagnosed With Frailty And Chronic Disease: A Meta-Analysis, Alexander B. Sklivas, Lauren E. Robinson, Timothy L. Uhl, Esther E. Dupont-Versteegden, Kirby P. Mayer

Physical Therapy Faculty Publications

Muscle power training with emphasis on high-velocity of concentric movement improves physical functionality in healthy older adults, and, maybe superior to traditional exercise programs. Power training may also be advantageous for patients with acute and chronic illnesses, as well as frail individuals. To determine the efficacy of power training compared with traditional resistance training on physical function outcomes in individuals diagnosed with frailty, acute illness or chronic disease. PubMed (MEDLINE), CINAHL, PEDro, Web of Science, and Google Scholar. (1) at least one study group receives muscle power training of randomized controlled trial (RCT) (2) study participants diagnosed as prefrail, frail …

Bending The Elbow During Shoulder Flexion Facilitates Greater Scapular Upward Rotation And A More Favorable Scapular Muscle Activation Pattern, Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, Zvi Kozol

Physical Therapy Faculty Publications

Context: Decreased scapular upward rotation (UR) and diminished activation of the serratus anterior (SA) and lower trapezius (LT) are often observed among patients with subacromial impingement syndrome. Maintaining the elbow fully flexed during shoulder flexion may limit glenohumeral motion due to passive insufficiency of the triceps brachii and therefore facilitate greater scapular UR and increased scapular muscle activation. Objectives: To compare scapular UR, SA, upper trapezius (UT), middle trapezius, and LT activation levels between shoulder flexion with the elbow extended (Flexion-EE) to shoulder flexion with the elbow fully flexed (Flexion-EF). This study hypothesized that Flexion-EF would result in …

Delivery Room St Segment Analysis To Predict Short Term Outcomes In Near-Term And Term Newborns, Jorgen Linde, Anne Lee Solevag, Joar Eilevstjonn, Ladislaus Blacy, Hussein Kidanto, Hege Ersadal, Claus Klingenberg

Obstetrics and Gynaecology, East Africa

Background: ST-segment changes to the fetal electrocardiogram (ECG) may indicate fetal acidosis. No large-scale characterization of ECG morphology immediately after birth has been performed, but ECG is used for heart rate (HR) assessment. We aimed to investigate ECG morphology immediately after birth in asphyxiated infants, using one-lead dry-electrode ECG developed for HR measurement.

Methods: Observational study in Tanzania, between 2013–2018. Near-term and term infants that received bag-mask ventilation (BMV), and healthy controls, were monitored with one-lead dry-electrode ECG with a non-diagnostic bandwidth. ECGs were classified as normal, with ST-elevations or other ST-segment abnormalities including a biphasic ST-segment. We analyzed ECG …

Structural Violence & Small Victories: Political Epidemiology Of Hiv Among Msm In Nigeria, 2000-2010, Debbie A. Dada

Harvey M. Applebaum ’59 Award

No abstract provided.

Ret Signaling Pathway And Ret Inhibitors In Human Cancer, Angelina T Regua, Mariana Najjar, Hui-Wen Lo

Faculty, Staff and Student Publications

Rearranged during transfection (RET) receptor tyrosine kinase was first identified over thirty years ago as a novel transforming gene. Since its discovery and subsequent pathway characterization, RET alterations have been identified in numerous cancer types and are most prevalent in thyroid carcinomas and non-small cell lung cancer (NSCLC). In other tumor types such as breast cancer and salivary gland carcinomas, RET alterations can be found at lower frequencies. Aberrant RET activity is associated with poor prognosis of thyroid and lung carcinoma patients, and is strongly correlated with increased risk of distant metastases. RET aberrations encompass a variety of genomic or …

The Impact Of Nutrition And Gastrointestinal Symptoms On Health-Related Quality Of Life In Survivorship After Oesophageal Cancer Surgery, Sarah Bennett, Conor F. Murphy, Michelle Fanning, John V. Reynolds, Suzanne Doyle, Claire L. Donohoe

Articles

Summary

Background and Aims Oesophagectomy is the primary curative treatment for oesophageal cancer but is associated with considerable postoperative morbidity and mortality. To better understand the aetiology of impaired health-related quality of life (HRQL) in oesophageal cancer survivors (OCS), this study sought to determine the longitudinal changes in nutritional status, nutrition-impact symptoms (NIS), and HRQL in this cohort, and to determine which variables have the greatest impact on postoperative HRQL decline.

Methods Data, derived from St. James' Hospital, Dublin, included patients who underwent oesophagectomy from October 2017 to May 2019 and attended clinic preoperatively and 6 months postoperatively. A subset …

Potential Interactions Between Metal-Based Phenanthroline Drugs And The Unfolded Protein Response Endoplasmic Reticulum Stress Pathway, Tadhg O'Leary, Pauraic Mccarron, Michael Devereux, Steve Meaney

Articles

The unfolded protein response has recently been implicated as a mechanism by which 1,10-phenanthrolinecontaining coordination compounds trigger cell death. We explored the interaction of two such compounds —one containing copper and one containing manganese—with endoplasmic reticulum (ER) stress. Pretreatment with anisomycin significantly enhanced the cytotoxic activity of both metal-based compounds in A2780, but only the copper-based compound in A549 cells. The effects of pretreatment with tunicamycin were dependent on the nature of the metal center in the compounds. In A2780 cells, the cytotoxic action of the copper compound was reduced by tunicamycin only at high concentration. In contrast, in A549 …

Efficacy Of Plasma Activated Saline In A Co‑Culture Infection Control Model, Evanthia Tsoukou, Paula Bourke, Daniela Boehm

Articles

Plasma activated liquids have demonstrated antimicrobial effects and receive increasing attention due to the potential to strengthen the armoury of novel approaches against antibiotic resistant bacteria. However, the antibacterial activity and cytotoxic effects of these solutions need to be understood and balanced before exposure to humans. In this study, the antibacterial effects of plasma activated saline (PAS) were tested against Gram negative and positive bacteria, and HaCaT keratinocytes were used for cytotoxicity studies. For the first time, a co-culture model between these bacteria and eukaryotic cells under the influence of PAS has been described. Exposure of saline to plasma resulted …

Dat3m: A Data Tracker For Multi-Faceted Management Of Multi-Site Clinical Research Data Submission, Curation, Master Inventorying, And Sharing, Shiqiang Tao, Licong Cui, Wei-Chun Chou, Samden Lhatoo, Guo-Qiang Zhang

Faculty, Staff and Student Publications

Managing research data is an important and challenging aspect of clinical studies, especially for multi-site collaboratives. To address this challenge, we designed, developed and deployed a multi-faceted, multi-level interactive data tracker (DaT3M) for multi-site clinical research data submission, curation, master inventorying, and sharing. Components of DaT3M include data overview, data portal, data status panel, data query engine, and data downloader. DaT3M managed clinical research data for the Center for SUDEP Research (CSR). The CSR instance of DaT3M includes 2,743 subjects from seven data contributing institutions, 7 data modalities and 10,678 data components: 3,398 Epilepsy Monitoring Unit reports, 3,440 electroencephalography recordings, …

Deep Graph Convolutional Network For Us Birth Data Harmonization, Lishan Yu, Hamisu M Salihu, Deepa Dongarwar, Luyao Chen, Xiaoqian Jiang

Faculty, Staff and Student Publications

In this paper, we developed a feasible and efficient deep-learning-based framework to combine the United States (US) natality data for the last five decades, with changing variables and factors, into a consistent database. We constructed a graph based on the property and elements of databases, including variables, and conducted a graph convolutional network (GCN) to learn the embeddings of variables on the constructed graph, where the learned embeddings implied the similarity of variables. Specifically, we devised a loss function with a slack margin and a banlist mechanism (for a random walk) to learn the desired structure (two nodes sharing more …

Apaview: A Web-Based Platform For Alternative Polyadenylation Analyses In Hematological Cancers, Xi Hu, Jialin Song, Jacqueline Chyr, Jinping Wan, Xiaoyan Wang, Jianqiang Du, Junbo Duan, Huqin Zhang, Xiaobo Zhou, Xiaoming Wu

Faculty, Staff and Student Publications

Background: Hematologic malignancies, such as acute promyelocytic leukemia (APL) and acute myeloid leukemia (AML), are cancers that start in blood-forming tissues and can affect the blood, bone marrow, and lymph nodes. They are often caused by genetic and molecular alterations such as mutations and gene expression changes. Alternative polyadenylation (APA) is a post-transcriptional process that regulates gene expression, and dysregulation of APA contributes to hematological malignancies. RNA-sequencing-based bioinformatic methods can identify APA sites and quantify APA usages as molecular indexes to study APA roles in disease development, diagnosis, and treatment. Unfortunately, APA data pre-processing, analysis, and visualization are time-consuming, inconsistent, …

Hyperbranched Poly(Β-Amino Ester)S (Hpaes) Structure Optimisation For Enhanced Gene Delivery: Non-Ideal Termination Elimination, Yinghao Li, Zhonglei He, Jing Lyu, Xianqing Wang, Bei Qiu, Irene Lara-Saez, Jing Zhang, Ming Zeng, Qian Xu, Sigen Sigen A., James Curtin, Wenxin Wang

Articles

Growing at an impressive pace, gene therapy has emerged as a prospective segment in the biotechnology field and presents a bright outlook, given the increasing investments in R&D and the mounting incidence of genetic disorders [1]. Amid the COVID-19 crisis, the global market for gene therapy, estimated at 1.2 billion dollars in the year 2022, is projected to reach a revised size of 2.7 billion dollars by 2026, according to the Cision PR Newswire. However, the lack of efficient gene delivery vectors still hinders the large-scale manufacturing of gene therapy agents. Viral vectors, such as the adeno-associated virus, lentivirus, retrovirus, …

Polymeric Nanovaccine Delivery System For Influenza Vaccine, Chaitanya K. Valiveti

Electronic Theses and Dissertations

Vaccines are the most efficient and cost-effective method for preventing illnesses caused by infectious pathogens. Even though the great success of vaccines over decades, the development of safe and robust vaccines is still essential for emerging new pathogens, re-evolving old pathogens, and improving the insufficient protection given by existing vaccines. One of the most critical strategies for developing effective new vaccines is selecting and using a suitable adjuvant or immune stimulant. Immunologic adjuvants are essential for improving vaccine potency by enhancing the immune response of vaccine antigens. The amount of antigen could be spared with improved potency, especially during mass …

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …